Example Reflection – Visualization tool    Challenge & Selection      Patient adherence to medications is by far lower than ideal. Data from USA

estimate that approximately half of all medical prescriptions are not followed  appropriately by the patients, leading to increase in hospital admissions, costs, and  deaths related to the non-adherent behavior. The issue of patient non-adherence brings  concerns to the entire healthcare system, and therefore the solution should include all  stakeholders.       Design thinking could be a starter point for this complex question, and the

visualization tool could facilitate the communication among different players towards  improving patient engagement into the treatments through innovative solutions. The  visualization tool, by using visual elements, brings a common language for people  with different skills and could be applied from the very beginning of the “what is”  stage, helping with the “what if” purposes.     Application      A big pharmaceutical company was concerned about a new released product.

It was a new class of antiplatelet drug, indicated for patients with coronary heart  disease. The drug efficacy has been proved in a clinical trial and the approved doses  was one pill taken twice a day, on a daily basis, for at least one year. The drug seemed  to be much better than the current therapy, however, real world data indicated patient  adherence concerns. According to some preliminary real world information, the rate  of patient adherence to this drug was lower than expected. Apparently, many patients  were not following the right posology and moreover, part of them interrupted the  treatment abruptly.       Our consulting firm was contacted to help the pharmaceutical company to

understand what was going on. We suggested a design thinking approach, and applied  the visualization tool. We invited a selected group composed by fifteen  representatives of the pharmaceutical company from different areas (mainly  marketing, supply chain, and medical affairs) and also five assistant physicians that  usually prescribed this type of medication. It was an one day meeting divided into two  periods, the first one in the morning aimed to discuss the “what is” issues, and the  second, in the afternoon, in which we discussed the “what if” aspects.      We started the day presenting data regarding low patient adherence to the

drug, which was defined as the problem we would like to solve. Then, we introduced  to the audience some key elements of design thinking and after that, we divided the  participants in five groups, each one composed by representatives of the  pharmaceutical with different skills together with one assistant physician. We started  the activity by asking each group to use the visualization tool in order to draw the  patient journey across the treatment. Each group was stimulated to design through  images the journey of the patient from diagnosis to the treatment considering the  entire care cycle and including the use of the drug we were interested in. Additionally,  we asked each group to identify pain points and opportunities during the cycle that  could be associated with the low rate of medication adherence. After one hour of

discussion and design, each group produced a big picture of the care cycle, with many  pain points. Then, each group presented the big picture and the results of their  discussion to the audience, and finally, based on each visual presentation, all  participants came up with common and relevant pain points that could make a  difference in the rate of patient adherence.       Insight & Approach      The visualization tool allowed the identification of many opportunities during

the process of care that could be associated with lack of medication adherence.    For instance one group drew the figure of a patient taking the medication twice a day  (which is the right posology) and the group discussed that taking twice increased the  chance of sometimes forgetting to take the pill as compared to other similar  medication that is taken once a day. Another interesting picture showed a patient  going to the drugstore to buy the pills, and the group discussed that perhaps one  patient on a busy day or having a tight schedule could not have time to buy the  medication on that day, interrupting the treatment till the next day. Many other  situations came up during the discussion and certainly going deeper through these  elements could generate alternatives that ultimately would result in innovation and  better compliance with the treatment.       The next time we would apply the visualization tool we should invite other

players from the healthcare system that could have different point of views from those  we had in our session. We realized that the broader is the expertise of the audience,  more ideas are generated.


Example Reflection – Visualization tool Challenge & Selection Patient adherence to medications is by far lower than ideal . Data from USA estimate that approximately half of all medical prescriptions are not followed appropriately by the patients , leading to increase in hospital admissions , costs , and deaths related to the non - adherent behavior . The issue of patient non - adherence brings concerns to the entire healthcare system , and therefore the solution should include all stakeholders . Design thinking could be a starter point for this complex question , and the visualization tool could facilitate the communication among different players towards improving patient engagement into the treatments through innovative solutions . The visualization tool , by using visual elements , brings a common language for people with different skills and could be applied from the very beginning of the “ what is ” stage , helping with the “ what if ” purposes . Application A big pharmaceutical company was concerned about a new released product . It was a new class of antiplatelet drug , indicated for patients with coronary heart disease . The drug efficacy has been proved in a clinical trial and the approved doses was one pill taken twice a day , on a daily basis , for at least one year . The drug seemed to be much better than the current therapy , however , real world data indicated patient adherence concerns . According to some preliminary real world information , the rate of patient adherence to this drug was lower than expected . Apparently , many patients were not following the right posology and moreover , part of them interrupted the treatment abruptly . Our consulting firm was contacted to help the pharmaceutical company to understand what was going on . We suggested a design thinking approach , and applied the visualization tool . We invited a selected group composed by fifteen representatives of the pharmaceutical company from different areas ( mainly marketing , supply chain , and medical affairs ) and also five assistant physicians that usually prescribed this type of medication . It was an one day meeting divided into two periods , the first one in the morning aimed to discuss the “ what is ” issues , and the second , in the afternoon , in which we discussed the “ what if ” aspects . We started the day presenting data regarding low patient adherence to the drug , which was defined as the problem we would like to solve . Then , we introduced to the audience some key elements of design thinking and after that , we divided the participants in five groups , each one composed by representatives of the pharmaceutical with different skills together with one assistant physician . We started the activity by asking each group to use the visualization tool in order to draw the patient journey across the treatment . Each group was stimulated to design through images the journey of the patient from diagnosis to the treatment considering the entire care cycle and including the use of the drug we were interested in . Additionally , we asked each group to identify pain points and opportunities during the cycle that could be associated with the low rate of medication adherence . After one hour of discussion and design , each group produced a big picture of the care cycle , with many pain points . Then , each group presented the big picture and the results of their discussion to the audience , and finally , based on each visual presentation , all participants came up with common and relevant pain points that could make a difference in the rate of patient adherence . Insight & Approach The visualization tool allowed the identification of many opportunities during the process of care that could be associated with lack of medication adherence . For instance one group drew the figure of a patient taking the medication twice a day ( which is the right posology ) and the group discussed that taking twice increased the chance of sometimes forgetting to take the pill as compared to other similar medication that is taken once a day . Another interesting picture showed a patient going to the drugstore to buy the pills , and the group discussed that perhaps one patient on a busy day or having a tight schedule could not have time to buy the medication on that day , interrupting the treatment till the next day . Many other situations came up during the discussion and certainly going deeper through these elements could generate alternatives that ultimately would result in innovation and better compliance with the treatment . The next time we would apply the visualization tool we should invite other players from the healthcare system that could have different point of views from those we had in our session . We realized that the broader is the expertise of the audience , more ideas are generated .