Wanted: Better Compliance Packaging
Compliance packaging has a job to doï¿½meeting the needs of both the patient and the practitioner.
Alcan Packaging has embarked recently on a mission to develop insights into innovation opportunities with customers across the value chain. At Showcase 2006, organized by the Healthcare Compliance Packaging Council and sponsored by Honeywell and Pharmaceutical & Medical Packaging News, Alcan Packaging conducted an informal workshop to illustrate one of the key elements of its value innovation process.
Photo courtesy Alcan Packaging
Value innovation is the delivery of exceptional value to the most important customers in the value chain. Companies that are value innovators redefine problems and frame them in terms of performance criteria that matter to customers.
Customers have any number of purposes, or “jobs” to do, and they “hire” products to get those jobs done. For example, a customer might need the job of compliance to be handled. However, defining compliance is difficult, because it has different meanings for different customers in the value chain. For a patient taking the drug, it means one set of needs; but for a physician or a pharmaceutical company conducting clinical trials, the needs are different. An insurance company will have yet another set of needs.
The job that the product does should be the fundamental unit of analysis when exploring the value chain, talking to customers, and innovating products and services. Studying the job reveals the often conflicting demands that different customers place on the product. Resolving these conflicts in an innovative way requires a deep, qualitative understanding of the whole value chain.
WHO IS THE CUSTOMER?
Identifying the customer means determining whose needs are most important in the value chain. These needs may vary with circumstance. Taking the time to understand the needs of multiple customers in the value chain can open up the opportunity for products and services in new market areas.
In packaging, manufacturers tend to think of products in terms of features, such as child resistance or senior friendliness. But the way in which manufacturers think of packaging and how people interpret their experiences with pharmaceuticals and their packaging have very little in common. To understand the human-centered aspects of package interaction, Alcan engaged leading design firm IDEO (Palo Alto, CA) as part of its reinvention initiative. To illustrate this disconnect in the context of compliance, Alcan asked showcase participants to write down an example of a time when they were not compliant with a medication. We then categorized these notes into larger groups (see Table I).
Table I. Reasons for noncompliance with a medication, grouped into four main categories, from the audience at the Showcase 2006 organized by the Healthcare Compliance Packaging Council and sponsored by Honeywell and Pharmaceutical & Medical Packaging News.
(click image to enlarge)
The results provide some direct consumer feedback. The most interesting observation is that participants, even though they were from the packaging industry, expressed that their compliance was centered much more on emotional needs than specific features. In the spirit of innovation, these responses can be used to inspire new people-centered packaging opportunities. They can be categorized as follows:
• “I didn’t believe it would work.” This category involves trusting the doctor and the diagnosis—and how such trust breaks down. Patients are uncomfortable if they can’t see, feel, or measure the impact of the change. Many of the conditions for which compliance packaging is important involve longterm therapies that are often without measurable change. How might packaging be hired to increase confidence in the therapy?
• “I forgot.” This group covers a variety of use situations, and many have to do with travel. In this case, the circumstance of use (travel) imposes additional needs on the job the packaging is hired to do. Forgetting can be more than accidental—especially if it concerns something people have some doubts or misgivings about. This category also includes running out of the product, being pressed for time, and forgetting whether the dose had been taken already. Defining the job of compliance means that drug packaging has to be designed to work in a range of contexts, where forgetfulness, for any reason, could be increasingly likely.
• “It was not easy enough.” Inconvenience and confusion are common themes under ease of use. The package often does not do the job of educating consumers about the dose, timing, and regimen. This is clearly a job that packaging can be hired to do, and one where it should excel. How might packaging communicate more clearly what patients want and need to know?
• “I didn’t like it.” This category contains many purely emotional responses that include reactions to issues such as container size, drug cost, dislike of side effects, and generally negative attitudes toward drugs. How can packaging set expectations in order to alleviate negative experiences that lead to distrust in the drug and drugs in general? Packaging must also set emotional expectations and manage people’s experiences throughout treatment.
WHAT DOES THIS MEAN?
If the people who took part in this exercise represent the most important customers in the value chain, then industry has some work to do. Compliance is a complicated issue, and the results of this quick exercise show that there are many contributing factors. Some relate to packaging features, others involve emotions. They may stem from a lack of empathy for emotional and informational needs.
This quick survey was focused on medications in general, and it serves to prove a general point. It illustrates the need for a human-centered approach to innovation in packaging. It is not specific enough solely to inform the design of any particular package. Rather, it serves to point out issues that need to be understood better through research. Doing field research on any type of treatment or disease (e.g., diabetes, asthma, depression) will reveal much more detailed feedback on specific issues relating to compliance in specific contexts. Research methods and processes need to be geared to understanding people’s experiences as they go through the journey of treatment. These qualitative methods (and the people that conduct the work) need to be sensitive enough to reveal and understand emotional conflicts and distress as well as uncover plain usability issues that disrupt compliance.
The first step for Alcan was to set up a process for supporting innovation within the company and researching the needs of the different customers in the value chain.
The next steps in Alcan’s reinvention process are to apply the lessons learned from this survey to packaging. We have to understand what jobs need to be done to satisfy customers’ needs and how to complete these jobs. Of course, some of these jobs may seem too much for packaging alone to achieve—but innovation cannot be achieved without daring to look ahead and think big.
We also have to look ordinary people in the eye. These people make up a diverse group with unique needs—patients who are dealing with life challenges and trying to get better, practitioners diagnosing and treating patients, professionals distributing products, and companies crafting new molecules and shipping and tracking them. Studying their needs will lead us toward innovation.