Why are you interested in behaviour science?
I started off thinking that I just wanted to work in healthcare – helping people be healthier. My initial training was as an exercise physiologist, so I was helping people to become more physically healthy, which prevents many diseases. But I found it wasn’t sufficient to just inform people, as there are a lot of obstacles in people’s lives preventing them from doing exercise. To be more effective in my work, I had to delve into the world of behavioural strategies and therapies, and think of interventions to help individuals accomplish their goals. I had further training and got a formal education in behaviour science.
How is Johnson & Johnson using behavioural science to improve outcomes for patients?
The team I work with is a centre of excellence that serves all of Johnson & Johnson, so we have products in our consumer business which we’re working on to help patients with pain management. We help consumers think about using pain medication, but we also help manage the prevention of that pain. We’re working in oral healthcare as well, trying to teach the habit of floss, brush and rinse as opposed to just brush, so tacking an extra behaviour onto an existing habit. In our medical devices space we’re also helping patients better prepare for surgery. In the pharma business we’ve been looking at how we can help patients undergoing treatment for cancer, such as helping to maintain energy levels.
Do you see the application of digital technologies fostering a closer relationship between pharma and patients and, if so, how?
Yes, such as through use of companion tools that are also linked to what someone is trying to accomplish as an individual, not just as a patient. For example, with cardiovascular disease or diabetes, while medication does its part there’s a lot more the patient can do to help manage their disease. Managing stress is one factor, so we try and help patients look at how they can manage their stress. Just things that will ultimately have an effect on what happens with that disease state. We’ve been hearing a lot about other digital healthcare technologies that enable the patient’s healthcare team or family to be more involved.
Is the collection of real-world evidence becoming increasingly important for pharma in today’s climate?
Yes, and I think it has been for a long time. We’ve got this traditional method of running statistical clinical trials and we’ve put a lot of controls in place that help with statistical analysis. You have to have similar types of patients with similar backgrounds and try to make it as homogenous as possible so that you can actually measure an effect. That’s great in terms of seeing whether the drug actually works or not, but then when you have to take it out into the real world and you don’t have any of those controls in place, and you have to test the effects on people out ‘in the wild’ as they call it – it looks very different to the controlled setting. So, it’s proving that if you do it this way, it works in the real world. You don’t get that information through clinical trials, you get that through data from people living their lives day-to-day.
What’s the most exciting development in behaviour science right now?
First it’s the fact that we’re sort of blending sciences. The behaviour science field is moving into expertise areas in data science, so it’s really this new knowledge that we’re gaining and a new skill set that we’re gaining on how we think about machine learning and AI. Also, we now have different tools that we didn’t have before. So, it’s really changing the skill set of the behaviour scientists, helping us to move into technology systems and data. That’s really exciting for all of us who are working in the industry right now, because it just changes how we operate. It changes the entire landscape.
What does your day-to-day work involve?
I’m a senior leader at the largest healthcare company in the world, so I do a lot of work around collaborating and connecting across the organisation. I spend a lot of time meeting with colleagues and discussing how we can work and solve problems together. But, that’s just most of the role that I play within the organisation; I call it J&J work. Then I have my team of about 20 scientists who have backgrounds in behaviour science and data science, and evaluating digital health technology. I spend a lot of time with my team and on the projects that they’re involved in. We’re probably involved in 20 different projects at any one time, across all of Johnson & Johnson, so there’s a lot of moving parts. They’re all at various stages too, so it’s just about management of those stages.
What is the most exciting aspect, and what do you find a key frustration?
It’s the unknown. We’re at a time in the industry right now where we’re learning really rapidly and we need to ensure that we’re putting processes in place to get the right feedback back in. I call it a ‘rapid learning’ time, as we try to figure out all this real-world data and how to put it back into a model that may soon no longer suit our needs, a model that’s been in place for years. It’s a big challenge but it’s also pretty exciting. If you have been doing this for a long time it’s probably a bit more nerve-wracking, but people just entering the industry are absolutely excited about it.
Your experience in global health senior management roles spans more than 20 years, what have you seen change over this time?
Definitely the huge technology change. It’s not even just the back-end technology infrastructure and AI, ten years ago we didn’t even have a way to reach a lot of the people that we’re trying to influence. So, the advent of having a new way to connect with patients – we think of it as an ‘intervention delivery vehicle’ – has just expanded dramatically. We can now reach people that are very difficult to get to, whether they’re in rural locations or they’re in countries that are less developed; most people have either a smartphone or we can even use text messaging as a mode of communication. For example, it parts of Africa we have a programme that’s called ‘MAMA’ which gives rural women access to prenatal care and teaches them how to take care of themselves so they have a healthy baby delivery. It’s all delivered through a text programme on their phone. So, it’s enabled us to reach people that we couldn’t reach before.
