Transcript Bringing it Back to the Patient

Bringing it Back to the
Patient
Leveraging 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 are
Where we were
Where 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 decisionmakers 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
Thank you!
Amy Smalarz, PhD
Strategic Market Insight
www.strategicmarketinsightllc.com
1.978.429.8744 (office)
1.877.958.8334 (toll-free)
[email protected]