Welby×AZ “Medication and Self-Management App” for cancer patients

Innovation Infusion Japan, i2.JP is a healthcare innovation engine that aims to realize a "patient-centric" business model. The Japanese subsidiary of global pharma AstraZeneca launched this open community in November last year with the belief that "there must be much more we can do beyond drug discovery”. Over 100 companies and organizations who share the vision participate in the community and the count continues to increase (as of August 2021).

TOMORUBA started feature articles titled "Challenges to Healthcare Innovation" to follow i2.JP initiatives. Through the voices of the founding members and partners of i2.JP, we will consider and deep dive into the future of healthcare at its best.

In this second article, we introduce a case study of co-creation between AstraZeneca and Welby, which formed a strategic partnership agreement. Welby aims to implement PHR (Personal Health Record*1) in society. It has a track record with as many as 30 joint projects including ones with pharmaceutical companies.

In June 2020, the two firms jointly released an app to support patients taking the anticancer drug developed and deployed by AstraZeneca and help them self-manage their medication status. In this interview, we asked the representatives of each company about the background and vision behind the development of the app, the co-creation process, the future outlook, as well as the current situation and issues surrounding PHR.

Transformation in patients and HCP through ‘Medication and Self-Management App’

——It's been about a year since the app was released. What kind of feedback have you received from patients?

Suehiro：We conducted interviews with patients/app users and identified four key points. First, adding and reviewing data is easier on a smartphone. Conventional paper-based booklets are inconvenient in many ways such that it takes more time to enter information, needs storage space to keep used booklets, which may go missing during storage. However, with a smartphone, entering and reviewing data can be done easily any time. Many users shared positive feedback about using their smartphones.

The second is a peace of mind that the patients can get with the self-care contents. Patients are generally well informed about the side effects of our anticancer drug at the care facility, yet they still have some concerns. This app has contents that help the patients learn deeply how to cope should side effects occur. They said that this has given them a sense of assurance.

The third point is better communication between HCP and patients. This app has a feature that allows user to take and save a picture of symptoms. Let’s say, a female patient wants to share her symptoms with her doctor who is a male. She would hesitate to physically expose the area affected in the examination room. In that case, the patient can take a picture beforehand and simply present it to communicate her current conditions. In this way, the app seems to help in terms of communication as well.

The fourth point is support for routine medical examination. In some areas, there is a lack of HCP manpower. Informing patients on treatments and guiding them on self-care may be of secondary importance in communication. Some people suggested that this app is a useful tool to support patient care in place of HCP.

——I see. What are your thoughts on the future development of ‘Medication and Self-Management App’?

Suehiro：Ultimately, as a treatment outcome, we hope to contribute to patients in a way that maximizes survival and time to disease progression. Since our anticancer drug is a tablet, even if it is prescribed at a hospital for the first time, it is often prescribed at a dispensing pharmacy for the second and subsequent times. Therefore, for the purpose of information sharing, we would like to expand our reach to cover pharmacists at dispensing pharmacies and construct database of patient adherence and adverse events.

Also, many of the patients on the anticancer drug for which this app is intended are 75 years old or older, and some of them are not positive about using this app. However, in many cases family members are engaged in supporting patient care. In fact, for about half of age 75+ users of this app, the direct user is not the patient but family members. I would like to add improvements with that in mind.

——I would also like to ask about the future development of Welby as a company.

Iokawa：First of all, we hope to empower patients with this app to have better communication with doctors. Using the accumulated data, we would like to visualize patients' pain points and leakage points and develop this into a better service. Hopefully, we can develop a system that feeds our findings to doctors.

Beyond that, we are aiming to interface with electronic health records and other services, which may streamline HCP work and improve their productivity. We believe that the key to our success lies in our ability to create products that make patients happy and lift burdens on HCP.

——What is AstraZeneca's vision for PHR?

Takashima：With the recent rise of telemedicine offering the ease of data sharing between patients and HCP, people will start to expect better and more connected healthcare services. I believe that PHR can bridge the gap. So, we would like to work with Welby in oncology and beyond.

Also, while making the most of patient-enabled data including one captured with sensor devices, we would like to step up our efforts to empower patients so they can share lab results and health exam data during a consultation with a doctor. In addition to PHR, we would like to consider interface with EHR (Electronic Health Record) and EMR (Electronic Medical Record).

i2.JP, a healthcare innovation engine aims to achieve patient centricity

——Finally, please tell us about the benefits of participating in i2.JP and give a message to those who are considering membership.

Iokawa：There are benefits to joining i2.JP: We can advertise our strengths and share our vision. What we can do on our own is limited. Through i2.JP, we can communicate our assets while considering various partnering options. In the future, by combining our PHR technology with assets offered by i2.JP members, we hope to create an opportunity to provide better services for both companies and ultimately better services for patients.

——What are the characteristics of AstraZeneca as a co-creation partner?

Iokawa：What stands out at me is the spirit of challenge. The first company to implement our PHR service was AstraZeneca. At the time, PHR and in-hospital apps were obscure concepts for the most part. However, AstraZeneca was excited about our concept and was willing to take on the challenge. That was a major turning point for our business. We are thankful for the strategic partnership as our desire has been to collaborate cross-functionally across the board, instead of limiting it to one project.

——Suehiro-san and Takashima-san, please give us a message for companies that are considering participating in i2.JP.

Suehiro：We see an increase in types and sources of information that we can utilize, such as patient data and electronic health records. These information are putting spotlights on various patient needs. When trying to meet these needs, it has become increasingly difficult to solve them internally. I see i2.JP as a place to go in such circumstances.

The pharmaceutical industry is heavily regulated, but I think there are many areas that are changing. This is the first time for me to be involved in the ambitious project with a motive to transform the entire healthcare system. Through this project, I feel inspired and educated. We are looking forward to future developments and hope that many companies and organizations will join i2.JP.

Takashima：We are working to build patient-centric communication and promote support for treatment and side effect management. If you have a technology or solution that leads to patient’s wellbeing, we would like to work with you. Some companies may think they are completely unrelated to what we do at first, but please contact us if you are interested, because various ideas may develop by having direct dialogues.

Postscript

i2.JP embarks on building an ecosystem to transform the entire industry toward realization of patient centricity. As referred to in the interview, the efforts to "transform the entire healthcare system" is likely unprecedented in Japan. i2.JP launched in November last year is now attracting close to 100 members. We will continue to follow the progress of i2.JP to see how it leads to healthcare reform.

Also, i2.JP is recruiting partners. Medical and research institutions are welcome, but it also encourages digital startups and others to participate, even if their link to healthcare industry appears weak at first. There is no obligation or fee associated with the membership. Interested parties should contact from the inquiry form below.
(Editor: Kogo Sanada, Writer: Wakako Hayashi, Photographer: Yuji Yamazaki)