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Patient care apps serve a purpose, but need to be closely monitored

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Besides concerns on data privacy, aren’t such digital initiatives vulnerable to conflict of interests, and merely another reinforcement of the ‘pharma company-doctor nexus’? 

According to a recent EY report, Life Sciences 4.0: transforming health care in India, 47 per cent of top pharma companies in India now use digital means to dispense medical information for doctors while 33 per cent reach out to patients via ‘virtual caregiving’ initiatives spanning health tips and disease information.

US-based Abbott was the latest to launch an app in this category, a:care. India is an important market for Abbott Pharma, contributing 23 per cent of global sales, reason enough to debut the app in this lead market. Philippines, Vietnam, and Mexico are reportedly next in the pipeline, while the app also mentions Brazil and Russia. Diabetes, thyroid and osteoarthritis are the focus disease areas as of now, with more therapies to be added later this year.

India has a huge disease burden in these areas, but are these apps as benign as they seem? Besides concerns on data privacy, aren’t such digital initiatives vulnerable to conflict of interests, and merely another reinforcement of the ‘pharma company-doctor nexus’? Jawed Zia, Head of Abbott’s pharma business in India emphasised that no Abbott brands would be promoted on the app, while the content will be neutral and non-commercial. He says 2000 doctors across the country are already on the app , and the plan is to sign up a million patients in the next five years.

Signing up doctors on the app will be the responsibility of the Abbott’s sales force. These doctors receive codes from the company, which they pass on to their patients to enroll on the app. The decision to enroll is left up to patients, as is the choice to allow their doctor to review and track their health data. Anyone can download the app from the Android Play Store and access content related to the selected disease areas.

On concerns related to data privacy, the company clarified that all data is collected with consent from users and follows all applicable privacy laws. Abbott does not have access to identifiable patient data. Data entered by patients online is collected in a health record system and is used to provide services and information to users, such as pill reminders for patients or medical adherence charts for doctors.
Such apps do serve a need. Today’s impatient patient is bombarded with (mis)information, from
Dr Google, Professor Wikipedia and an ever increasing slew of digital health start ups, even before s/he enters a doctor’s clinic for a consultation. In India, relatives and neighbours too pitch in with advice, further confusing the patient. In fact, Dr Manoj Chaddha, Consultant Endocrinologist, Hinduja Hospital, Mumbai & Immediate Past President – Endocrine Society of India, one of the doctors associated with a:care and present at the launch, has been part of putting together similar platforms for the past three years. He believes that by providing scientifically validated information and access to advice from qualified experts throughout their continuum of care, a:care will help combat misinformation and debunk myths. This would enable physicians to have high-quality engagement with patients, which can drive better outcomes.

Another doctor present at the launch, Dr Ram Chaddha, Consultant Spine Surgeon, Lilavati Hospital, Mumbai & Past President, Association of Spine Surgeons of India, pointed out that while an appointment or surgery is just an event, treatment is a process. Therefore such a system helps doctors remain connected to their patient beyond the clinic, helping in long-term management of chronic diseases that need continuous monitoring.

Besides increasing brand recall for Abbott Pharma to an increasing circle of patients, the app also deepens the company’s connect with doctors through a:care academy, through an offline three-year continuing medical education (CME) programme. Zia reveals that they plan to expand the information service to pharmacists as well.

The app uses gamification to engage patients, with a points-based rewards programme, in which they earn points through various activities, such as taking quizzes or marking that they took their medicine. They can later use these points to get discounts when buying medicine, diagnostics or health related services from partners on the app. Abbott has already tied up with e pharmacy 1mg and plans to tie up with more e pharmacies. A company executive mentioned that the rewards system ensures that patients need to use the app for at least a couple of months, before they accumulate enough redeemable points.
This is to ensure positive health outcomes of patient adherence start to kick in before the financial rewards do.

The company plans to launch a native app, interactive and regional content, a multilingual platform and personalised health coach. These services overlap with existing well established doc-patient apps like Practo, Just Doc, Lybrate, etc. Thus a:care will compete with such brands for mind share (and by extension, market share) of doctors, patients and pharmacists. We’ll have to wait and watch to see how Abbott, as well as other pharma companies with similar digital outreach plans, manage to allay concerns regarding data privacy and conflict of interest.

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