Bringing it Back to the PatientLeveraging the Use of Data and Technology for Innovative Insights Leading to Patient Engagement and Influence

Amy Smalarz, PhD

President, Founder of Strategic Market Insight

28 February 2014

People First, Patients Second

Traditionally, research has emphasized the development of either pharmaceuticals to treat diseases or care management programs to tell people how to deal with their diseases.

I believe we are taking the wrong approach.

Instead of focusing on the disease, we need to focus on the patient as a person with a disease.

This would result in a shift from the frame of “a disease within a patient” to “a patient with a disease.”

The “personal” influence on Outcomes

What is the impact of a person’s

situation on their clinical outcomes?

Analogous Goals Everyone is talking about patient engagement, improving adherence,

quality measures, etc. because we have similar goals of positively impacting patients’ lives while improving quality and decreasing healthcare costs.

Where we were

Where we areWhere we need to go

What data are currently used?

Randomly controlled clinical trials

Specified patient population

Clinical data and some patient-reported outcomes

Retrospective analyses

Administrative claims data

Clinical and laboratory data

Observational studies

Sometimes random, sometimes convenient samples of patients

Clinical data and some patient-reported outcomes

What’s missing?

Patient characteristics, beyond their demographic and clinical characteristics

Who are patients, as people?

What are their lifestyles and/or living circumstances?

Why is this important?

Unless we understand patients as people, we cannot work with them, engage them and influence them to improve their health and wellness.

Example:

Not all diabetics are the same. Two 50-year old women come to the doctor’s office are both diagnosed with Type II Diabetes Mellitus. One of them works 2 jobs and has 2 children in college; the other woman volunteers and does not have any children. Their lifestyle and living circumstances may affect their:

Time for exercise

Financial means to eat the “right” foods

Renting vs. owning a home/condo

Location – urban, suburban

All of these areas influence the person’s level of engagement and we only know if we ASK.

Partnerships: The Cornerstone of Success

Developing and Supporting Partnerships

Development of partnerships requires relationships; relationships require trust; and trust requires respect

By acknowledging the person’s circumstances, they are more likely to be honest with their provider

Go beyond “Shared-Decision Making”

Trust is developed/earned, which can lead to a Partnership between the person and clinician

But…Neither side is guided nor prepared to engage the other, acknowledging each other’s expertise, perspective or needs.

Cultural Challenges for Providers

Development of partnerships requires relationships; relationships require trust; and trust requires respect

Providers’ professional training does not embed the essential attitudes or communication skills and neither side is guided nor prepared to engage the other, acknowledging each other’s expertise, perspective or needs.

Physicians are trained to believe it is important to have the answer and are socialized to be in charge and desire to act as autonomous decision-makers in the care of their patients (Godolphin, 2009; AMA, 2008).

Providers need to be supported and encouraged to relinquish their role as the single, paternalistic authority and be trained to become more effective partners in care with their patients and to allow patients more of an opportunity to participate in the treatment and care decisions.

People/Patient Challenges

Patients have been ‘trained’ to present a problem or issue and then let the ‘expert’ (i.e. provider) work it out and provide one or multiple options or solutions.

We know that people want to be involved in decision making and want to participate, whether it be through representation or via full/total individual participation.

Studies have demonstrated that people who participate in decision making have higher level of productivity and satisfaction (Bridges, 2007).

However, in order for partnerships to become engrained in how we conduct ourselves and the way of business, a culture shift is needed toward development of partnerships to replace the common denominator of 2 one-way conversations that transpire today.

Where can we get these data?Surveys currently collecting descriptive details of people in the United States

Family and household composition

Income

Interests, hobbies

Ailments

Buying, purchasing data

Who they trust for healthcare information

Combining what is thought of as traditionally marketing communication data, this primary research and large database can be used toward advanced analytic methodologies

Screening tools can be developed for people to answer on-line or while they are in the waiting room – and their answers can inform clinicians and providers on the person’s potential level of engagement and influence

Data collected via provider notes

Not just information that a person switched medication but WHY they switched

What side effects are “regular” patients experiencing?

Where can we go from here?If we are serious about patient engagement, we need to take the necessary steps to define, measure and report it.

First, clearly define what we mean by patient engagement

That may differ by stakeholder, i.e., patients, providers, insurance companies, pharmaceutical companies

“Triangulate” definitions of patient engagement to be inclusive

Once it’s defined, we can then take steps to identify the data needed to measure it

What will we measure?

What data will be collected?

How will data be collected?

How will the data be analyzed?

How will the data be used?

Who will be held accountable for what?

Bringing it back to the patient…. We all have limited time and resources….and we don’t want to waste

either

People want to be healthy and well

We all want better patient adherence, which can lead to improved outcomes and health and wellness

But, first, we need to understand patients as people; there isn’t a “one size fits all” solution

Better information leads to better data, which leads to better decision making, which leads to better outcomes, which leads to better health and wellness

OR OR

Engage providers of patient care and inform them of not only the scientific and medical advances currently available but about the advances the scientific community is making in the way of using and interpreting patient data that is currently available

The more we know about patients, the better we can include and engage them which will enable them to make better health care decisions

As patients’ health care decisions improve, the better their interaction with the healthcare system will be which can result in less and/or wiser health care decisions - which may result in wiser medical spend

Go beyond reporting clinical outcomes and explore the PERSON with the disease, not just the disease and clinical characteristics of people presenting with the disease

Inform health care policy by equipping health care providers and payers with better information about who their patients and/or members are and the methods they are using to make their healthcare decisions

Amy Smalarz, PhDStrategic Market Insightwww.strategicmarketinsightllc.com

1.978.429.8744 (office)

1.877.958.8334 (toll-free)

amysmalarz@strategicmarketinsightllc.com

Thank you!