Adherence has long been one of the most baffling problems in healthcare for Franklin, who arrived in the field from the world of direct marketing in the 1990s. "I came to this from loyalty programs for banks and supermarkets, where we were trying to get people to change their behavior by writing emails with interesting headlines and lively copy," he recalls. It worked, a little. The game didn't change, however, until Franklin began consulting with a health psychologist—his group now works with 25 of them—on behavioral medicine. "We started to be able not just to predict who wouldn't adhere to their medications, but also to understand why," he says.
Franklin has learned that the reasons vary wildly. "People may resist corticosteroids because they think their testicles will shrink, for example, or reject a medication for chronic asthma because they believe their condition is episodic," he continues. "The cause of nonadherence is different for each of us, as well as for each drug." Atlantis thus built its business around behavior rather than information alone. The results? "We've got published clinical papers now, looking at such conditions as diabetes and hypertension, that show adherence gains of 20% or 30%. We believe it's because we are addressing the why in patient adherence and doing it in a way that is personal and meaningful." —Sarah Mahoney