HCS Confidential
BEHAVIOR SCIENCE EXPERIENCE DESIGN PROVEN RESULTS
+ =
B O S T O N | L O N D O N | S A N F R A N C I S C O
HCS ConfidentialHCS Confidential
We Design, Develop and Deploy comprehensive
support PROGRAMS for HCPs and Patients. Our
p...
HCS ConfidentialHCS Confidential
3
about.
Locations & Experience
• Asthma
• Back problems
• Chronic Kidney Disease
• COPD
...
HCS ConfidentialHCS Confidential
process.
The HCS System
Revenue
 Awareness
 Initiation
 Adherence
 Retention
Events
T...
HCS ConfidentialHCS Confidential
Map
5
Knowledge of
stakeholder
experience from
understand phase
Priorities
of brand
team
...
HCS ConfidentialHCS Confidential
Rules based customized solution
6
Treatment
initiation
HCP prescribes
Product X
NurseCall...
HCS ConfidentialHCS Confidential
7
Return on Investment
DIABETES RARE KIDNEY
DISORDER
ORAL
ONCOLYTIC
• Reduced 6 month att...
HCS ConfidentialHCS Confidential
8
Our Clients Include…
HCS ConfidentialHCS Confidential
Clinical Health
Psychologists
Experience
Designers
Software
Platform
Multi-Channel
Delive...
HCS ConfidentialHCS Confidential
10
solution.
This is Human Care Systems
We design, develop, and deploy service & support ...
HCS Confidential
B O S T O N | L O N D O N | S A N F R A N C I S C O
HCS Confidential
11
How We Work
HCS Confidential
v v
Approach
Define Current
Experience Map
Map Ideal
Experience
Build & Deliver
Solution
• All stakeholde...
HCS ConfidentialHCS Confidential
HCS Solution Framework
13
Events Barriers Triggers
• Logistic
• Social
• Physical and Cog...
HCS Confidential
HCS Confidential
HCS Confidential
Design All Touchpoints vs. Events & Barriers
Event Focused Barrier Focused
Time Based
• Mailing, e-mail, ...
HCS Confidential
Creating a Whole Experience
Goal: Design and deploy integrated individual touchpoints to deliver a
coordi...
HCS Confidential
Solution Architecture
18
Tools & Support
HCS Confidential
B O S T O N | L O N D O N | S A N F R A N C I S C O
HCS Confidential
results.
Case Study: Biologic Adhere...
HCS ConfidentialHCS Confidential
Key Barriers / Unmet needs Surrounding Taking Treatment:
• Injecting with Disability
• Ed...
HCS ConfidentialHCS Confidential
Ongoing treatment1st injectionCan I afford it?Pre-RxPatient
Journey
Tactics
HCP
DTP
Enrol...
HCS ConfidentialHCS Confidential
The Nurse Coach provides human, personalized
support to patients.
• Leads them through th...
HCS ConfidentialHCS Confidential
Print Materials
Nurse coach mails patients
targeted print materials that
supplement their...
HCS ConfidentialHCS Confidential
Interactive Web Portal provides a private
space for patients to overcome their barriers a...
HCS ConfidentialHCS Confidential
Tear SheetsPocket Guide
HCP Skills Training
• Virtual/Print Tool training
• Listening lik...
HCS ConfidentialHCS Confidential
Schedule calls
Assess
readiness
Initial
injection
support
Trouble-
shooting
follow up
Ove...
HCS Confidential
B O S T O N | L O N D O N | S A N F R A N C I S C O
HCS Confidential
results.
Case Study: Insulin Pump an...
HCS ConfidentialHCS Confidential
Decide to
Pursue Pump
• Reimbursemen
t
• Psychosocial
issues
Order and
Shipment
• Big box...
HCS ConfidentialHCS Confidential
29
results.
Case Study (Insulin Pump and CGM Adherence):
Touchpoints
Pre Start Post Start...
HCS ConfidentialHCS Confidential
30
results.
Case Study (Insulin Pump and CGM Adherence):
Solution: Multichannel Support
HCS Confidential
B O S T O N | L O N D O N | S A N F R A N C I S C O
HCS Confidential
31
HCS ConfidentialHCS Confidential
Decide to pursue
pump
Pump and training
materials arrive
Receive training
and start pump ...
HCS Confidential
BEHAVIOR SCIENCE EXPERIENCE DESIGN PROVEN RESULTS
+ =
B O S T O N | L O N D O N | S A N F R A N C I S C O
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Human Care Systems Overview

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Human Care Systems provides comprehensive patient and HCP support programs for biopharm and medtech companies and provider and payer organizations in the rare disease market. We help organizations reach patient and HCP initiation, adherence and retention goals by integrating a proprietary intelligent stakeholder algorithm. The result is Real World Outcomes: optimized patient quality of life, HCP brand preference and brand ROI

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  • Automated
  • Automated
  • In developing our solutions, we want to consider events, barriers, and triggers when it comes to developing patient support programs. There are key milestones or events that every patient goes through in their patient journey. These will be unique to the disease process that we are thinking about, but here are some example events. We take these events and align them with barriers that patient encounter along their journey. We also consider triggers that arise along the way that may foreshadow non adherence or discontinuation. It is to these 3 areas that we target the intervention.Two other areas that are also important to consider in the framework are the level of support infrastructure, so how And how complex is the administration. We know that the more complex, the poorer adherence will be.
  • Lkey insights Support was very reactive. It relied on patient to contact physician or client to ask questions. In many cases, the patient would not know there was a problem.Onboarding was not a seamless or effective experience.Tools to drive monitoring of patients and feedback loop were not being utilized.Onboarding was one size fits all and did not account for psychosocial factors that would affect Patient adherence and persistence.
  • In alignment with pump foundations. Keep in mind all other PORT campaigns still taking place (welcome letter, email, 7 day pump tip sheet, 30 day pump tip sheet.
  • Human Care Systems Overview

    1. 1. HCS Confidential BEHAVIOR SCIENCE EXPERIENCE DESIGN PROVEN RESULTS + = B O S T O N | L O N D O N | S A N F R A N C I S C O
    2. 2. HCS ConfidentialHCS Confidential We Design, Develop and Deploy comprehensive support PROGRAMS for HCPs and Patients. Our programs are based in BEHAVIORAL SCIENCE and… Add More VALUE To Product  Impact clinician decision making  De-risk the product  Impact patient self-management, adherence and QoL  Improve real world outcomes 2 solution. This is Human Care Systems deliver. change behaviors. monitor & measure. engage. personalize.
    3. 3. HCS ConfidentialHCS Confidential 3 about. Locations & Experience • Asthma • Back problems • Chronic Kidney Disease • COPD • Diabetes (T1 and T2) • Heart Failure • Hemophilia (A & B) • Hepatitis (B & C) • HIV • Kidney Transplant • Mood disorders • Multiple Sclerosis • Lupus • Oncology (CML, CLL, MBC, MCL NSCLC, RCC & others) • Osteoporosis • Nephrotic Syndrome • Pain • Pneumonia • Pulmonary Hypertension • Rheumatology • Stroke SAN FRANCISCO BOSTON LONDON FRANKFURT (Opening 2014) TOKYO (via partnership) SINGAPORE (Opening 2014) SÃO PAOLO (via partnership)
    4. 4. HCS ConfidentialHCS Confidential process. The HCS System Revenue  Awareness  Initiation  Adherence  Retention Events Time and Trigger identifiable inflection points relevant to clinicians and patients Barriers Learn, Gain Insight, Take Action to impact clinician and patient decisions and behaviors TargetsInputs Results We use an analytical system to design, deliver and measure high impact service and support to clinicians and patients. Behavioral Science Application of literature and experience on effective learning, decision-making and behavior change. Experience Design Integrated customer experiences across channels (print, web, mobile, salesforce, phone, etc.) Outcomes  Quality of Life,  Health Outcomes  Health Economics 4
    5. 5. HCS ConfidentialHCS Confidential Map 5 Knowledge of stakeholder experience from understand phase Priorities of brand team Proposed rules-based customized solutions to address barriers and gaps to fulfill brands objectives and provide a comprehensive patient, provider, and payor solutions Identified barriers and gaps extrapolated from the synthesized information in the understand phase Utilizing the training in psych evaluation, research, and analysis and with the principles of social, cognitive, and behavior theories of human behavior as well as the transtheoretical model, biopsycho-socio- environmental theory, health belief model, and theory of planned behavior, the experience map is created in an iterative fashion.
    6. 6. HCS ConfidentialHCS Confidential Rules based customized solution 6 Treatment initiation HCP prescribes Product X NurseCalls Email or Mail Text Reminders 1 2 3 4 5 6 7 8ProductX Applicatio ns Patient self-assessment R x Barrier topics delivered in a multi-channel program based on patient endorsement and a pre-determined barrier ranking (developed from learning in the understand and map phases) Treatment initiation HCP prescribes Product X NurseCalls Email or Mail Text Reminders 1 2 3 4 5 6 7 8ProductX Applicatio ns Patient self-assessment R x Barrier Assessment Patient Identified Barriers
    7. 7. HCS ConfidentialHCS Confidential 7 Return on Investment DIABETES RARE KIDNEY DISORDER ORAL ONCOLYTIC • Reduced 6 month attrition rate from 22% to 5% • Improved Market Share by 2 points • Improved adherence by 8 additional infusion sets per year • Improved 6 month A1C by 24% • 15 point Net Promoter Score Improvement • Initiation rates have increased from 70% to 85% after implementation of this program • Discontinuation rates have dropped from 40% to 15%. • 90% of eligible countries have implemented program • Measured adherence improvements have ranged from 10%-38% across countries
    8. 8. HCS ConfidentialHCS Confidential 8 Our Clients Include…
    9. 9. HCS ConfidentialHCS Confidential Clinical Health Psychologists Experience Designers Software Platform Multi-Channel Delivery Field Clinicians • Trained in Clinical Psychology with subspecialty in Health Psychology • Health Psychology is the application of behavioral science to medical health management • Information Architects and User Experience Experts (IA/UX) • Print and interactive designers • Software architects and developers • Salesforce.com administrators • Nurse phone coaches • Web • Mobile • Text • Email • Mail house • Trained and Certified • Provide in person training (i.e. home infusions, product management, etc.) Management: • Business unit and geographic leadership • Company leadership • Guide Medical Regulation Review about. Team Expertise 9
    10. 10. HCS ConfidentialHCS Confidential 10 solution. This is Human Care Systems We design, develop, and deploy service & support solutions to modify behavior and drive higher rates of adherence, improved health outcomes, and increased patient and HCP satisfaction. The HCS system is based on the following pillars: Behavioral science. HCS’ team of health psychologists use behavioral science to deliver programming to change adherence, patient/clinician communications, and other self-managing and self-monitoring behaviors. o Deep and actionable understanding of patient pain points based on existing knowledge and research + systematic literature review + ethnographic research. o Most effective programming to change behaviors:  High impact education to support learning.  Cognitive behavioral exercises to change relationships between thoughts, feelings and actions.  Motivational interviewing techniques to build self-efficacy and motivation. Personalized, high-impact experiences. HCS’ technology platform personalizes program content and timing to individual patient’s events and barriers as well as evolving over time as patient progresses through therapy. o The HCS platform combines a personalization rules engine + CRM database + interfaces to deliver personalized and integrated programs through multiple channels. o Multichannel solutions, that feel to the patient like a coherent and personalized experience, are the most effective way to reach and impact patient behaviors. Change, measure and communicate outcomes. HCS’ measurement, analysis and publishing support capabilities ensure that the results of the support program are best captured and communicated. o Measured impact on Trx (brand choice + initiation + adherence). o Real world outcomes. o Studies and publishing.
    11. 11. HCS Confidential B O S T O N | L O N D O N | S A N F R A N C I S C O HCS Confidential 11 How We Work
    12. 12. HCS Confidential v v Approach Define Current Experience Map Map Ideal Experience Build & Deliver Solution • All stakeholders • Existing research and knowledge • Patient and Clinician & Patient Ethnography • Literature review • Netnography • Mine data sets • Barriers & Events • Specific to the needs of each stakeholder • Personalized experiences for each patient • Integrated and coherent across multiple channels • Customize experience for each population and indication • Deliver integrated support across multiple channels • Change patient and clinician behaviors 1 2 3 12
    13. 13. HCS ConfidentialHCS Confidential HCS Solution Framework 13 Events Barriers Triggers • Logistic • Social • Physical and Cognitive • Emotional • Attitudinal/Cultural • Side effects • Provider • Health Literacy • Regimen requirements • Financial Key milestones that occur along a timeline such as: • Symptom Onset • Diagnosis • Decision to Treat • Onset of Side Effects • Symptom Improvement • Treatment Fatigue Things that happen that may foreshadow non adherence or discontinuation: • Severity of side effects • Financial event • Health or Personal Crisis • Missed or Delayed Refill • Patient Feels Lack of Progress • Patient Feels They Are Doing Better 1 32 54 • To HCP about their patients • To reps about enrollment • To patients about adherence • To the client and HCS about the program 6 Level of Support Infrastructure Complexity of Treatment Feedback
    14. 14. HCS Confidential
    15. 15. HCS Confidential
    16. 16. HCS Confidential Design All Touchpoints vs. Events & Barriers Event Focused Barrier Focused Time Based • Mailing, e-mail, SMS, Phone calls at time based inflection points. • E.g. educate on week 4 test results. Trigger Based • Use passive data collection techniques, questionnaires, and HCP inputs to trigger communications. • E.g. congratulations phone call when glucose targets reached on connected meter. Learn • Bite-sized, personally relevant education tailored to learning style. Gain Insight • Cognitive-behavioral exercises to help people understand and take control of thoughts, feelings and actions. Take Actions • Guided experiences to build and sustain motivation, self- confidence and resilience. Get Feedback • Help patients & HCPs monitor progress towards goals. Help patients gain insight from remote monitored data when available. 16
    17. 17. HCS Confidential Creating a Whole Experience Goal: Design and deploy integrated individual touchpoints to deliver a coordinated, high-value experience to all treatment stakeholders Comprehensive, differentiated solution Cohesive and High-Impact Experience for Patient, Clinician, Caregiver, Office Staff 17 Individual Brand Tactics
    18. 18. HCS Confidential Solution Architecture 18 Tools & Support
    19. 19. HCS Confidential B O S T O N | L O N D O N | S A N F R A N C I S C O HCS Confidential results. Case Study: Biologic Adherence for Rare Kidney Condition 19
    20. 20. HCS ConfidentialHCS Confidential Key Barriers / Unmet needs Surrounding Taking Treatment: • Injecting with Disability • Education on Condition • Building Treatment Routines • Financial Concerns • Side Effects • Disability and Emotional Concerns results. Case Study (Biologic Adherence for Rare Kidney Condition): Challenge & Situation Challenge: • Low initiation and completion rates during the 6 month course of therapy: 70% • Discontinuation Rate: 40% • Overcome treatment barriers in a rare kidney condition including injection fears, confusion, questioning value of treatment, side effects, and psycho-social concerns. Ongoing treatment1st injectionCan I afford it?Pre-RxEvents Barriers • Poor health from primary diagnoses • Lack of knowledge • Cost • Why me? • Lack of urgency • Side effects • Confused about process • Difficult regimen • Side effects • Needle anxiety • Cost • Side effects • Treatment fatigue • Uncertain of benefits vs. costs 20
    21. 21. HCS ConfidentialHCS Confidential Ongoing treatment1st injectionCan I afford it?Pre-RxPatient Journey Tactics HCP DTP Enrollment brochure Nurse line PSK ASAP ASAP Topic-specific mailings: initiation and adherence support Printed materials Electronic Phone LogisticsKey: Interactive website: initiation and adherence support Schedule calls Assess readiness Initial injection support Trouble- shooting follow up. Overcoming barriers to adherence Building a support network Planning to complete treatment Lifelong health management habits Messaging 21 results. Case Study (Biologic Adherence for Rare Kidney Condition): Touchpoints
    22. 22. HCS ConfidentialHCS Confidential The Nurse Coach provides human, personalized support to patients. • Leads them through the Barrier Assessment, a survey tool that identifies key obstacles to initiating and continuing Acthar • Provides tailored support and guided steps to help each patient overcome his/her barriers • Monitors the progress of each patient and provides appropriate help: – information/resources – emotional support 22 results. Case Study (Biologic Adherence for Rare Kidney Condition): Solution: Customized Nurse Phone Interactions
    23. 23. HCS ConfidentialHCS Confidential Print Materials Nurse coach mails patients targeted print materials that supplement their discussions by providing additional information for patients to refer to in between coaching calls. Print materials: • Focus on specific barriers • Offer practical advice • Invite engagement 23 results. Case Study (Biologic Adherence for Rare Kidney Condition): Solution: Customized Print Materials
    24. 24. HCS ConfidentialHCS Confidential Interactive Web Portal provides a private space for patients to overcome their barriers at their leisure. Features: • Educational information about the kidneys and proteinuria • Interactive activities that help patients cope with taking and living with Acthar • Guided tools that help patients develop specific plans for staying adherent 24 results. Case Study (Biologic Adherence for Rare Kidney Condition): Solution: Digital Support
    25. 25. HCS ConfidentialHCS Confidential Tear SheetsPocket Guide HCP Skills Training • Virtual/Print Tool training • Listening like a detective • Identifying nonadherence • Giving effective direction • Responding to emotional patients • Motivational interviewing 25 results. Case Study (Biologic Adherence for Rare Kidney Condition): Solution: HCP Training & Tools
    26. 26. HCS ConfidentialHCS Confidential Schedule calls Assess readiness Initial injection support Trouble- shooting follow up Overcoming barriers to adherence Assess final status & discuss next steps Building a support network Planning to complete treatment Lifelong health management habits RESULTS: 10:1 Return on Investment Initiation rates have increased from 70% to 85% after implementation of this program Discontinuation rates have dropped from 40% to 15%. 100% of patients enrolled in program are injecting on schedule. 26 results. Case Study (Biologic Adherence for Rare Kidney Condition): Output and Results
    27. 27. HCS Confidential B O S T O N | L O N D O N | S A N F R A N C I S C O HCS Confidential results. Case Study: Insulin Pump and CGM Adherence 27
    28. 28. HCS ConfidentialHCS Confidential Decide to Pursue Pump • Reimbursemen t • Psychosocial issues Order and Shipment • Big box of supplies can be overwhelming Training • Lack of knowledge • Information Overload • Hypoglycemic events, adjusting to wearing pump Start Pump • Carb counting • Insulin rare adjustments Infusion Set Change • Difficulty with supply orders or Billing • Fragmented support See Progress • Think no longer need treatment Pump Problem • Frustration Achieve Goal • To feel healthy, have better focus, more energy (through better glycemic control) • More freedom in their schedule (eating, sleeping) • Fewer hypos • Prevent complications Events Barriers results. Case Study (Insulin Pump and CGM Adherence): Challenge & Insights Challenge: • Pump users experience many barriers, particularly in the first 90 days. • 22% of pump users quit within 6 months/ 65% CGM • Poor adherence Key Needs based off of Insights: • Less fragmentation • Small actionable bits of information • More connection to patient’s purpose for using pump • Proactive support 28
    29. 29. HCS ConfidentialHCS Confidential 29 results. Case Study (Insulin Pump and CGM Adherence): Touchpoints Pre Start Post Start Field Clinician Phone Coach Ship Orientation Call (N) +7D +30D In Person Training +24H +3D +6D +14D +30D +60D +90D +120D +180D CareLink Data HL Calls Assessments Advanced Classes Available Pre Training Call (N) Attrition Risk Score CareLink Review Transition of Care Document MONITOR CELEBRATE Monitoring Software StartRight Patient Support Program
    30. 30. HCS ConfidentialHCS Confidential 30 results. Case Study (Insulin Pump and CGM Adherence): Solution: Multichannel Support
    31. 31. HCS Confidential B O S T O N | L O N D O N | S A N F R A N C I S C O HCS Confidential 31
    32. 32. HCS ConfidentialHCS Confidential Decide to pursue pump Pump and training materials arrive Receive training and start pump 1st infusion set change Adjustment period INSULIN PUMP RESULTS  Reduced 6 month attrition rate for insulin pump from 22% to 5%  Improved Market Share by 2 ppts  Improved adherence by 8 additional infusion sets per year  Improved 6 month A1C by 24%  15 point Net Promoter Score Improvement CGM RESULTS  Reduced 6 month attrition rate for insulin pump from 61% to 23%  Improved adherence by 20 additional sensors per year results. Case Study (Insulin Pump and CGM Adherence): Output and Results 32
    33. 33. HCS Confidential BEHAVIOR SCIENCE EXPERIENCE DESIGN PROVEN RESULTS + = B O S T O N | L O N D O N | S A N F R A N C I S C O
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