|15th September 2015
Traditionally, we look at the environment of the patient with the patient in the centre of a circle of healthcare professionals, carers, institutions or clinics, and sometimes services. This illustration is only useful to demonstrate the people, services and institutions that patients typically interact with along their treatment journey. What the vast majority of these ‘infographics’ don’t convey is the convoluted interactions, and the patient and stakeholder requirements throughout the journey.
This simplistic view is the tip of the iceberg: what is needed is a much clearer picture, albeit a much more complicated one, in order to understand where services, tools, and applications can support and transform the patients’ journey to facilitate better outcomes.
This problem with the generally accepted patient-centricity diagram is that when patients are sitting in the middle of a circle of a multitude of choices, with no clear structure or support for decision making, it is a frustrating and potentially emotional situation. The need to effectively utilise or manage all of the services or choices on offer is difficult, if not impossible.
‘Patient centricity’ doesn’t mean ‘sticking the patient in the middle of a lot of offerings’ and then giving them the freedom to navigate or choose what is right for them.
What it should mean is providing services that address the patient’s needs, capabilities, context, and desired outcome to provide a clear pathway through the system and facilitate a partnership between the patient and an extended healthcare system.
A patient’s interaction with an extended healthcare system can be complicated, and many patients and their carers find it difficult to make sense of it all. At Blue Latitude, we know from our research with patients that they want to be more confident partners in the decisions that are made concerning their care. In order to facilitate ‘patient centricity’, where patients have a role in the decisions that affect their treatment, the ‘system’ must first address the needs of the patient and carer in order to support health literacy and decision making, and also provide a flow through the system that is more easily navigable.
Patients want to be treated as individuals – the system very often treats them as a condition.
Patients want better outcomes, as do healthcare professionals and pharma. Ensuring the best possible outcomes requires a partnership; where pharma provide the drugs, HCPs are the experts on conditions and treatments, but patients are the key to ensuring that those treatments have the best chance of working. Often this requires involvement and behaviour change on the patient’s part, and making the right decisions for them throughout their treatment journey and beyond. By first understanding the flow through the system that would support each patient and facilitate the desired outcome, processes and systems can be created and made available to help patients know what to do.
A partnership between patients and physicians (and other healthcare professionals) is the clear way to bring patient centricity to the fore.
A system with services and tools that provide what patients require to understand their condition and treatment options, the actions they can take to support their desired outcome, and the confidence to engage with their healthcare professionals is how to ensure that patient can truly be brought to the centre of their treatment.
Pharma has traditionally aimed to provide services and tools that help HCPs understand their products and their effective and safe use. More recently, pharma has been playing a role in providing services and tools ‘beyond the pill’ to support patients through their treatment and work towards better outcomes. Most recently at Blue Latitude, we have created a website for cardiac patients and their carers. The aim of the site is to provide information on the condition and the array of treatments available in a way that is understandable by those without medical training, yet still contain the detail required. The goal of the site is to provide information that gives patients confidence to talk to their doctors. Another example is the patient service that we are currently pilot testing. Our research showed that for oncology patients, emotional and psychological support is often not provided through the system, resulting in disengaged patients. The service helps patients to identify issues that they may not have been able to recognise and also provides a link to where they can get more information and support.
Pharma may also have a very big role to play in providing services that can lead to better outcomes.
For example, tools or apps that support adherence to treatments and show better outcomes for patients through real world use can demonstrate better value for the cost, and may provide an edge when both drug commissioners and physicians are making decisions.
Technologies, such as wearable devices, are terrific for measuring, counting, and tracking people’s clinical data and their activities. What the vast majority of devices are not good at is providing the data in a way that is actionable by the wearer with the intention of encouraging and maintaining good behaviour change.
Just counting is not good enough. Providing content that explains the implications of the data and which actions to take, coupled with content that encourages and maintains the action or behaviour change is essential.
Another way that technology is making a big difference to patients is the use of telemedicine. Management and treatment of chronic conditions or long term illness via technology in the home has benefits for all concerned. The patient can have more frequent contact with their healthcare practitioner via remote sessions with shorter and less stressful interactions. The healthcare practitioner is able to more frequently monitor their patients, but with less time needed and potentially at a reduced cost of care.
Remote monitoring can reduce the likelihood of admission to hospital, ensure that treatments are working as intended, and circumvent the occurrence of small problems before they become serious and require hospital admission or emergency care.
Done properly, remote monitoring can also provide a greater level of comfort for recovering or chronically ill patients and can lead to better outcomes for the patient and less reliance on the wider healthcare system.
The patient is provided with the comfort that their condition is being monitored, the doctor can have data that gives a bigger picture of the patient’s progress – not just what is happening on the days they see them and the healthcare system can reduce the number of hospital admittances and emergency care.
Pharma and healthcare providers must look from the outside in and stop viewing the patient from their own internal bias. They must understand the barriers and stumbling blocks that patients face, as well as their requirements to support behaviour changes for better outcomes. The saying, “to know someone you must walk a mile in their shoes” sums up what is required to be able to deliver true patient centricity.
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