Ernst & Young’s annual exercise in high-level thinking about healthcare trends, the Progressions report, has two interesting changes: the scope of the report has gone from the biopharma industry to life sciences overall; and the conceptual focus is what E&Y calls “the third place”: the patients themselves, and not the doctor’s office or the hospital. The concept is also borrowed from Starbucks, which has promoted its cafés as the “third place” (besides home and work) where social interactions occur. In a healthcare context, E&Y suggests that the third place is wherever the patient happens to be—at home, in transit, or at a healthcare setting; the idea is to provide the resources patients want (such as information delivered electronically, as well as medicine or services) when they are concerned with their well-being.

In identifying the patient as the focal point, E&Y is encompassing longstanding trends like patient-centered outcomes and the healthcare consumer as a force in the marketplace. But it also highlights the trend toward healthy behaviors—diet and exercise programs, smoking cessation, better medication adherence—that are becoming the stick, rather than the carrot, in how health insurance and employer benefits are structured. The third place concept also builds on E&Y’s previous Progressions reports, which have defined a “Pharma 3.0” theme, in which the biopharma industry realigned around outcomes, patient outreach and new business models in drug development that bring the payer into the picture.

What will drive Third Wave life sciences businesses? E&Y sees three noteworthy examples:

• Next-generation social media, which combine today’s fast-evolving social media channels with online intelligence to identify patterns and trends
• “Gamification” of patient healthcare involvement—picking up on the value of game-playing as a motivator and incentive for consumers to be engaged in their healthcare activities
• The “medicalization” of consumer devices, and the “consumerization” of medical devices—highlighting the increasing trend of using devices like smartphones as a healthcare connectivity component, or medical devices in the home that monitor and communicate health status to caregivers.

One of the flies in the ointment of this patient-empowered, hyperconnected future is the reluctance of many consumers to engage with life sciences businesses about their health status—the heavily built walls around patient privacy. But Patrick Flochel, E&Y life sciences leader, EMEA, says that the biopharma industry already has a model to follow—the close collaboration between manufacturer and patients that occurs in rare disease development, where patients have a hand not just in demonstrating outcomes of a product’s use, but also in how rare diseases are researched, and a drug for them developed. “Change will come from consumers themselves wanting to engage with life sciences companies, rather than a regulatory change,” he says.

Commercialization
The third place is a high-concept notion that is not straightforward to put into practice. But E&Y suggests that there are at least five unifying themes when thinking about commercial transformations to accommodate it:
• Providing products and services in nontraditional settings
• Building new business models that create lifelong relationships with customers and improve outcomes
• Organizing around patient populations
• Customer segmentation
• Behavioral economics levers.

Already, healthcare is adjusting to new business environments, such as retail clinics at drugstores, or telehealth accessed in the patient’s home. Particularly for chronic care, there is already movement toward relationships between patients and life sciences companies; getting more refined expression of this leads to the concepts of delivering healthcare to patients in the segments (newly diagnosed, acute care, maintenance, etc.) in the disease state they occupy. Behavioral economics shows up in the “gamification” theme, with potential value for medication adherence.

E&Y also puts in a plug for Treato, a new venture from First Life Research, Ltd. (Yehud, Israel), which is deep-mining social media sites to develop patient feedback from therapies, adverse events, off-label use, and other medication-specific or general-health themes. “Technology platforms such as Treato are leveraging the “wisdom of crowds” to provide more meaningful real-time data on patient experiences with medical interventions,” writes Itzik Lichtenfeld, PhD, cofounder of the company. The concept can be thought of as outcomes research on steroids—by providing real-world data, very quickly, on patient well-being. The company plans to generate revenue by partnering with healthcare vendors, including pharma companies.


The Progressions report is available at http://www.ey.com/GL/en/Industries/Life-Sciences/Progressions-2012---Health-care-everywhere---Overview