Insights Patient Engagement - What History Teaches Us About Pharma’s...

Patient Engagement – What History Teaches Us About Pharma’s Future Evolution

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The pharmaceutical industry continues to grow by leaps and bounds. Advancements are happening on a weekly basis. But every time we take two steps forward, we end up taking one very important step back. It might not seem obvious in the short term, but if we look at our history, pharma has moved further and further away from patients since its beginning.

Since the dawn of the trade, pharma’s mission has been to improve health outcomes for patients. For many of us, it’s the ultimate measure of success, more so than any bottom line in a ledger book. But as time progressed, we were relegated mostly to a process in the background, charged primarily with developing and manufacturing drugs. That “firewall” has taken us away from our roots: the one-on-one interactions with our patients. We’ve become a cog in the machinery rather than a trusted partner in the patient’s health journey.

Figure 1: Pharma is behind the firewall of partners

This article outlines what needs to be done to bring the pharma industry and its patients back together. It will reveal how we can engage with patients better and deliver the experiences they expect.

Patient Engagement: A Far Cry

Across many patient surveys, pharma has consistently ranked poorly in terms of engagement and patient experience across all touchpoints and channels. Most patients don’t even remember the pharma company involved in their treatment journey. For years, our industry has agreed that engagement with the patient is essential, whether we called it “patient engagement,” “patient-centricity,” or something else. And to their credit, many companies have tried, but they find themselves with mostly siloed approaches. The holistic patient experience seems something too far out of reach. The answer is to look back to our history, which can teach us about engaging with our most important customers.

The original pharmacists in the apothecaries of Baghdad weren’t hidden in a room mixing concoctions. They were with their patients. They were holding their hands. They were observing what needed to be done and learning as they did it. Even with limited tools and understanding by our standards, they knew that being physically present, one-on-one with the patient, was a key ingredient to improving their patient’s health.

Figure 2: A depiction of one of the first apothecaries in Baghdad

Fast forward a few centuries. As we entered industrialization, and chemists found compounds that could solve the biggest ailments plaguing mankind, a race for mass production started. With it came a rush— intentionally or not—for the most profit. That simple evolution led to a heartbreaking unintentional flaw: our purpose to serve patients became secondary. Sure, medical innovations helped double global life expectancy in the past century.1 But they also pushed us further behind the firewall of partners, including hospitals and providers, government institutions, payers, pharmacies, and distributors. With every step in our evolution, we’ve fallen behind, and our partners have taken the front-row seat in terms of patient access and patient engagement. We are so far removed that many in the industry do not understand what patients expect from us.

Patient Journey and Siloed “Omni” Engagement

So far, we’ve identified the problem: we need to restore those one-on-one, direct interactions with the patients. We are approaching this today by employing an Omni engagement strategy, talking with the patients across several points in their journey. But we’re failing since we are not doing it cohesively.

Each function within pharma is trying to engage with the patient in a siloed process. For example, the commercial role of pharma mainly just involves access to therapies, education, and patient support. Each company function may have a patient profile, but it’s only that function’s view. They don’t venture or think outside of their limited box.

On the other hand, patient needs and behaviors have evolved rapidly, and so have their expectations. They want more from pharma, and contrary to all negative sentiments around the industry, patients are happy and willing to work directly with us if we deliver on their expectations.

Figure 3: What does the patient expect from pharma?

Patients demand personalized care and experiences. They want access to care and are heavily focused on prevention and early diagnoses. They want ongoing education and seamless coordination of care. They expect self-managed health options with the ability to change therapies automatically when they make lifestyle changes. They want us to respect their preferences and privacy, along with emotional support and physical comfort. And, most importantly, they expect therapies developed for them based on their biology. The question is – what do we need to do to be ready to meet these patient expectations?

Broadening Our View of the Patient Journey

Think back to those apothecary days. Knowledge was a trickle. Today, health data is more akin to a fire hose. And the data is much more expansive in the pre-diagnosis and post-treatment phases. However, our definition of the patient journey only looks at the timeframe when an individual gets sick. On the other hand, patients want us to add value beyond when they are sick, including before diagnosis and

after they are treated. Nevertheless, we are doing very little to get access to that pre-diagnosis and post-treatment data, and we need it to get closer to our patients.

Key Building Blocks for the Patient-first Approach

Rebuilding our one-on-one connections with the patients to deliver those expectations requires a reset. We need to rebuild the foundation, and we need building blocks. After we’ve reset and cleared the site (i.e., knowing what you need to give the patient), we can begin. That starts with the foundation. There are four building blocks, and digital technology and infrastructure is the foundational layer as it is the key enabler of these building blocks.

Figure 4: Key building blocks for a patient-first approach.

Building Block One: Organizational Design and Culture

The first building block is organizational design and culture. At this stage, we must examine how our companies are arranged and model them so that every aspect is working towards the same goal: a patient-first culture. That will innately help us understand the patients’ needs across the value chain. A proper design with the patient’s well-being at the center will lead to greater efficiency and better decision-making.

Pharma companies have an organizational design that includes Discovery, Clinical, Manufacturing and Supply Chain, Regulatory, Commercial, Market Access, and other functions. Where is the function focused on patients? Sure, companies have a range of “patient engagement professionals,” but they are all in silos with very focused mandates. We see Chief Patient Officers at many pharma companies, but the role is contained under specific functions, mostly within Discovery and Clinical. There is no one person responsible for patient experience across the pharma value chain.

This is one of the key aspects of getting back to proper patient engagement: pharma needs to empower its Chief Patient Officers so that they can ensure the best patient experience across every touchpoint.

That doesn’t just mean fostering a culture. Talk is good, but action is a must. Instead, these Chief Patient Officers need to operationalize a culture of “patient empathy” across their organization. Processes and systems need to be implemented to measure these roles with metrics like “Net Patient Score.” That will gauge how we are progressing in terms of patient engagement across those touchpoints.

Building Block Two: Patient Engagement Strategy

Once your organizational design and culture are in place, you’re off to the races with building your patient engagement strategy. At this stage, we must put the company in a mindset of co-creation with the patient instead of one-way drug development and outreach. We must be able to capture and activate data across the patient journey and touchpoints. Only then, we can leverage patient insights across the value chain from R&D to Sales.

Figure 5: Key elements of pharma patient engagement strategy

The strategy must enable partnerships within the healthcare ecosystem to break down “the firewall.” We must know patients at all phases of their health cycle. We must interact with them not just when they’re sick but when they’re healthy and when they’re not patients in an exam room. When we understand our patients in this manner, we will help them immensely with preventative and personalized care. We will be able to provide them with a holistic experience and empower them. That adds remarkable value to their lives while, in turn, providing us with constantly refreshed data, which again, in turn, leads us to improve our offerings and better care for all.

Building Block Three: Partnerships to Drive Patient Engagement

We must work closely, both internally and externally, with other players in the healthcare space. Collaboration with other stakeholders in the healthcare ecosystem will help enable access to patients

and their data. These partnerships will enable us to establish a true mapping of the patient journey and their needs to provide them with personalized care and experiences.

But these partnerships must start at home. Pharma’s internal silos must be broken so an accurate mapping of the patient journey and their needs can be established. Accordingly, the experience can be orchestrated at every touchpoint.

Building Block Four: Enable Access to Data

Once we have the above building blocks in place, they can enable access to data across the holistic patient journey from pre-clinical to commercial and beyond, including patient lifestyle data. The “lifestyle data” aspect is critical. Traditionally, pharma has never considered accessing patient data outside of drug development and sales. As new players like tech and retail rapidly get a hold of lifestyle information, they have access to real-time health data that can be a gold mine for pharma as the industry tries to develop personalized therapies for complex and rare diseases. The good news is that there are already many partnerships forming in this space in an effort to get access to this data.

Proximity Matters

One key element of patient engagement is proximity. Even where we see some aspects of building blocks being put in place and access to data enabled for Omni patient engagement, the focus is only on indirect and digitally enabled access to patients. Creating a digital patient profile versus actually getting in front of them can provide a very different understanding of the customer. Doing so enhances our ability to deliver experience, but there is minimal conversation about restoring physical proximity to patients. This can be explained visually; consider the “patient engagement flywheel” below.

Figure 6: Pharma companies can assess maturity using the patient engagement flywheel

This flywheel can help us assess where we are in our patient engagement maturity so we can focus on the right initiatives based on our stage. A flywheel is a better representation than a ladder, because our industry is rapidly evolving, and patient needs and expectations are evolving even faster. We must keep innovating to keep the patient engagement momentum going. Even when we get to a breakthrough point, any slowdown and we risk going back.

Most pharma companies are in the “start” phase on this flywheel, though some have entered the “build” phase. But as you can see, they don’t truly get to the breakthrough moment until they can get direct access to patients and serve their needs one-on-one.

Conclusion: Operationalize Patient Empathy

At the highest level, we must operationalize patient empathy across the pharma business. As mentioned earlier, this involves elevating and empowering Chief Patient Officers. It requires patient proximity by eliminating the firewall so we can co-create with them. And we need to democratize patient insights with investments in digital capability and data so we understand their personalized needs. Finally, we must implement systems and processes to measure our patient engagement efforts with key performance indicators like “net patient score.”

The question we must answer is this – do we have the vision, investments, partnerships, and leadership to go directly to the patients? In doing so, we will get back to the same way we started as an industry when we were serving the patients one-on-one.

Reference:

1. Roser M, Ortiz-Ospina E, Ritchie H. Life expectancy [Internet]. Oxford: Our World in Data. 2013 [revised 2019 Oct; cited 25 Oct 2022]. Available from: https://ourworldindata.org/life- expectancy

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Jassi Chadha is a pioneer in Data Analytics and Decision Support software. He is one of the most successful entrepreneurs in this
space, a highly regarded data scientist, and an influential thought leader in the rapidly evolving field of artificial intelligence. He currently serves as President & CEO of Axtria Inc. Since its founding in 2010, Axtria has become one of the most prominent global players in the industry, with customers in over 120 countries. Jassi and his companies have received numerous product and technology awards and have been featured in some of the most aspirational lists, including INC 500, Deloitte FAST 50, EY Entrepreneur of the Year, NJBIZ FAST 50, SmartCEO Future 50, and Red Herring

Avatar
Jassi Chadha
Jassi Chadha is a pioneer in Data Analytics and Decision Support software. He is one of the most successful entrepreneurs in this space, a highly regarded data scientist, and an influential thought leader in the rapidly evolving field of artificial intelligence. He currently serves as President & CEO of Axtria Inc. Since its founding in 2010, Axtria has become one of the most prominent global players in the industry, with customers in over 120 countries. Jassi and his companies have received numerous product and technology awards and have been featured in some of the most aspirational lists, including INC 500, Deloitte FAST 50, EY Entrepreneur of the Year, NJBIZ FAST 50, SmartCEO Future 50, and Red Herring
Avatar
Jassi Chadha
Jassi Chadha is a pioneer in Data Analytics and Decision Support software. He is one of the most successful entrepreneurs in this space, a highly regarded data scientist, and an influential thought leader in the rapidly evolving field of artificial intelligence. He currently serves as President & CEO of Axtria Inc. Since its founding in 2010, Axtria has become one of the most prominent global players in the industry, with customers in over 120 countries. Jassi and his companies have received numerous product and technology awards and have been featured in some of the most aspirational lists, including INC 500, Deloitte FAST 50, EY Entrepreneur of the Year, NJBIZ FAST 50, SmartCEO Future 50, and Red Herring
Avatar
Jassi Chadha
Jassi Chadha is a pioneer in Data Analytics and Decision Support software. He is one of the most successful entrepreneurs in this space, a highly regarded data scientist, and an influential thought leader in the rapidly evolving field of artificial intelligence. He currently serves as President & CEO of Axtria Inc. Since its founding in 2010, Axtria has become one of the most prominent global players in the industry, with customers in over 120 countries. Jassi and his companies have received numerous product and technology awards and have been featured in some of the most aspirational lists, including INC 500, Deloitte FAST 50, EY Entrepreneur of the Year, NJBIZ FAST 50, SmartCEO Future 50, and Red Herring
Avatar
Jassi Chadha
Jassi Chadha is a pioneer in Data Analytics and Decision Support software. He is one of the most successful entrepreneurs in this space, a highly regarded data scientist, and an influential thought leader in the rapidly evolving field of artificial intelligence. He currently serves as President & CEO of Axtria Inc. Since its founding in 2010, Axtria has become one of the most prominent global players in the industry, with customers in over 120 countries. Jassi and his companies have received numerous product and technology awards and have been featured in some of the most aspirational lists, including INC 500, Deloitte FAST 50, EY Entrepreneur of the Year, NJBIZ FAST 50, SmartCEO Future 50, and Red Herring

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