Improving Clinical Trial Patient Retention Using Cognizant s HealthActivate Patient Engagement Solution HealthActivate
Life Sciences companies are under increasing pressure to reduce clinical trial costs, even as less than 50 percent of trials complete on time or on budget. Patients drop out, or fail to follow trial instructions, such as when to take medication, how to document what they re eating and what kinds of activity they re doing. And patients often report they feel forgotten once trials commence, with little communication with the investigator or the staff. Understanding why patients participate in trials, and providing the ongoing communications with them are crucial to patient engagement and, by extension, successful trials. Cognizant: Helping Your Organization Increase Patient Engagement and Reduce Trial Costs Life Sciences firms are under increasing internal and external pressures to improve research and development efficiency especially around clinical trials. The growing use of specialty drugs and personalized medicine has made completing trials more difficult due to smaller patient populations. Patient retention is one of the largest determinants of whether a trial is completed on time or on budget. In addition to smaller trial sample sizes, trial subjects are often confused by complex protocols and can develop trial fatigue, especially in long, complex trials. Patients often complain of feeling out of touch with their investigators once the trial begins. At Cognizant, we enable your organization to engage clinical trial patients with powerful, proven capabilities that understand patient trial motivations, personalize communications with them for richer understanding, and provide ongoing communications tools, including mobile, web and sensor-based technologies to keep patients motivated and on track. Empower Clinical Trial Patients with Cognizant s Powerful HealthActivate Patient Engagement Platform Patient engagement is ultimately about understanding and influencing patient motivations and behaviors so they adhere to trial protocols. The Cognizant HealthActivate Patient Engagement Product that brings together three critical concepts for successful patient engagement: 1. Bring Your Own Healthcare Device (BYOhD). The BYOhD lets investigators, sponsors and patients decide which devices and sensors they ll use to collect and integrate trial data from multiple sources. These sources can include a wide variety of healthcare consumer and patient self-monitoring devices, from wireless glucometers, BP monitors, and spirometers to wearable fitness trackers. Our BYOhD capability then creates an integrated, longitudinal patient record that is analyzed and turned into actionable insights that can further stimulate engagement. 2. Behavior modification techniques. The point of patient engagement in trials is to encourage adherence with trial regimens and reduce (or eliminate) patient drop-outs. Cognizant s HealthActivate platform? provides personalized, targeted patient education and services that: a. Encourage and support the right trial-related behaviors regarding medication, activity and nutrition regimens b. Assist the patient in understanding the trial, their condition, their medications and their trial obligations such as responding to surveys and reporting Adverse Events c. Send reminders and notifications regarding medication dosing and appointments d. Use gamification techniques to make trial participation fun and encourage positive behaviors e.g., dosing on time, reading educational materials, keeping appointments 2 KEEP CHALLENGING September 2014
3. Personalized health coaching. Cognizant HealthActivate provides patients with real-time virtual coaching through their mobile devices or laptops. It notifies them about new educational material, reminds them of appointments, and periodically surveys patients to encourage them towards the right trial behaviors. We couple this with optional, live health care coaches who can offer effective and timely support with appropriately tailored interventions. As we know, one size doesn t fit all patients, so Cognizant HealthActivate dynamically adjusts your messaging and engagement mechanisms as circumstances and data warrant. Underpinning all of these capabilities are powerful analytics capabilities that are collecting and evaluating patient data and then using those descriptive and predictive evaluations to select the right engagement mechanisms for the patient as the trial progresses. 1.0 Personal Instrumentation (BYOhD) 2.0 Behavior Changing Techniques Social collaboration/using Game Design/analytics to target the right intervention 3.0 Virtual & Real health coaches Improved health outcomes, lower cost, better experience Figure 1: Cognizant s Patient Engagement Platform is based on interweaving three critical components, each of which is necessary to create and sustain effective engagement with clinical trial patients Cognizant HealthActivate: A Modular Approach to Match Your Needs Cognizant HealthActivate is comprised of plug-and-play modules that help you customize a clinical trial patient engagement program that best matches your business objectives and strategy. Cloudbased delivery options ensure fast and economical implementation. Figure 2: Cognizant s Patient Engagement Platform Plug & Play modules COGNIZANT S HEALTHACTIVATE PATIENT ENGAGEMENT SOLUTION 3
Our Patient Engagement Platform modules include: Patient Education Medication Adherence Overcome the barrier that only 12% of patients are health literate by delivering the consumable information in the right medium at the right time and provide incentives to motivate users Consumable Right Medium Right Time Intrinsic Incentives 2 minute videos Mobile articles Quizzes Tips & Challenges Leverage patient archetypes to deliver information via the right channel Smartphone Web Portal SMS Email Phone Customer-centric access and ability to pause, rewind or repeat on your terms 24/7 portal access Evening and weekend clinical support Intrinsic incentives Points, badges and levels for actions Leader board Team challenges Recognitions Extrinsic Incentives Team lunch Starbucks card Free Fitbit or scale Increase medication adherence rates with alerts, recognitions, passive collection and reporting Alerts Recognitions Passive Collection Reporting Rule based triggers and events Push education on impact of non-adherence Call pharmacist Notify health coach Acknowledge adherence and allow users to notify peers Badges Adherence challenges Share badges with friends Collect injections via Bluetooth or proxy biometric data Auto-injector Blood glucometer BP monitor Pulse Oximeter Send actionable information to: Nurse Health coach Care giver Virtual Coach Increase self-awareness by providing immediate feedback for alerts, acknowledging the accomplishments of milestones and provide educational topics most relevant to your health status. Alerts Milestones Educational Topics Biometric data is outside the normal range Medication non-adherence will trigger requests to call a pharmacist or advice nurse Congratulations for earning badges, passing quizzes and completing challenges Group recognitions about the leaders for team based challenges Recognitions when new levels are reached Challenge the user daily to take tips, quizzes or watch videos Share educational tips to increase awareness about symptoms or risks based on user profile Social & Gamification Engage users with their peers by voting on videos and content, providing team and individual based challenges, and sharing milestones and results with their friends Team/Individual Challenges Voting or like Content Sharing Milestones Teams compete based on department, location or position. Teammates can motivate others towards a common goal. Individuals can invite others to join challenges Users can rate videos and other educational content Surveys used to assess effectiveness and understand motivations by archetype When milestones are reached, users can share them with their friends, care givers or community Health coaches also view milestones and can add personalized, motivational messages 4 KEEP CHALLENGING October 2014
Reporting & Analytics Member feedback lets users view results and track progress over time. Health coach reporting will target at risk patients and Administrative reporting shows program progress and activity over time. Member Feedback Health Coach Reporting Administrative Reporting View trending on my biometric and medication adherence data Share quiz results in real time Use points, rankings badges and levels to compare progress to peers Real-time feedback on at-risk and compliant patients Trending to track patient progress over time Group comparisons to show progress vs other health coaches Assess utilization and activity reporting View outcomes and correlate results with activity Assess resource utilization to increase the efficiency of your local nurses/health coaches Bring Your Own health Device (BYOhD) Cognizant HealthActivate strongly supports trials in which patients are required to use one or more medical devices, wireless wearable devices and in-home monitoring devices. This BYOhD capability gives the trial sponsor and investigator additional flexibility and encourages patient trial participation. Device connects Device integration Other Features Wireless and USB Glucometers BP monitors Spirometers Weight scales Pulse Oximeters Commercial Fitness and Wellness devices from multiple manufacturers Intelligent integration hub for 40+ devices; 100+ by EOY 2014 Device and OS agnostic 3rd party applications and data streams Multiple fitness and wellness portals e.g., exercise and nutrition Integrated longitudinal patient record from all data sources Fully HIPAA and PHI compliant Supports de-identified data and Safe Harbor standards Metered open API Out of box user app & portal with social features Sponsor and Investigator Support Cognizant HealthActivate includes sponsor and investigator portals that give you a deeper understanding of individual patient progress, including dosing compliance, educational materials access, visit scheduling and compliance and patient survey results across different trials and in different geographies. Learn More Cognizant can help you engage with the patients you recruit for your trials to reduce your trial costs and get to real-world outcomes faster. For more information contact inquiry@cognizant.com, HealthActivate@cognizant.com or visit www.cognizant.com. COGNIZANT S HEALTHACTIVATE PATIENT ENGAGEMENT SOLUTION 5
About Cognizant Cognizant (NASDAQ: CTSH) is a leading provider of information technology, consulting, and business process outsourcing services, dedicated to helping the world s leading companies build stronger businesses. Headquartered in Teaneck, New Jersey (U.S.), Cognizant combines a passion for client satisfaction, technology innovation, deep industry and business process expertise, and a global, collaborative workforce that embodies the future of work. With over 75 development and delivery centers worldwide and approximately 187,400 employees as of June 30, 2014, Cognizant is a member of the NASDAQ-100, the S&P 500, the Forbes Global 2000, and the Fortune 500 and is ranked among the top performing and fastest growing companies in the world. Visit us online at www.cognizant.com or follow us on Twitter: Cognizant. World Headquarters 500 Frank W. Burr Blvd. Teaneck, NJ 07666 USA Phone: +1 201 801 0233 Fax: +1 201 801 0243 Toll Free: +1 888 937 3277 inquiry@cognizant.com European Headquarters 1 Kingdom Street Paddington Central London W2 6BD Phone: +44 (0) 207 297 7600 Fax: +44 (0) 207 121 0102 infouk@cognizant.com India Operations Headquarters #5/535, Old Mahabalipuram Road Okkiyam Pettai, Thoraipakkam Chennai, 600 096 India Phone: +91 (0) 44 4209 6000 Fax: +91 (0) 44 4209 6060 inquiryindia@cognizant.com Copyright 2014, Cognizant. All rights reserved. No part of this document may be reproduced, stored in a retrieval system, transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the express written permission from Cognizant. The information contained herein is subject to change without notice. All other trademarks mentioned herein are the property of their respective owners.