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Building the Partnership Muscle: The Key to Delivering Successful Patient Experience Solutions
Mark Violi | 01.23.25
Originally published in Med Ad News December 2024
THE BUSINESS RATIONALE: WHY PATIENT EXPERIENCE MATTERS TO PHARMA
For clinical trials
Imagine a scenario where patients feel like superheroes when joining a clinical trial. They understand what to expect before signing up. Their needs around transport and the inability to sit for long hours are addressed up front. Documents are completed before arrival, and they are offered healthy snacks and engaging materials during treatment. Trial milestones are celebrated, and at the end of the trial, there is a celebration to honor participants.
In this scenario, trial recruitment is faster and easier, and drop-offs are significantly reduced, easing the pressure on biopharma teams to hit targets. Recruitment times are shortened, which would bring valuable new treatments to patients sooner.
Today, this scenario might seem out of reach for many biopharma companies in the absence of tight partnerships with CROs, investigators, and clinical trial site staff.
“Clinical trial patients should be celebrated,” says Paul Landerville, U.S. early asset lead, Boehringer Ingelheim. “They are taking a chance on a potential new treatment, but not all trials end well for patients – not everyone gets the new treatment. I see them as explorers, and the industry calls them subjects. If we could improve their trial experience, remove the burdens, create some fanfare when they are halfway through the trial, [or] have a special day for them at the end of the trial. It would help them feel more valued.”
For patient support
In another scenario, imagine patients staying on treatment longer despite adverse events, gaining a sense of control living with their disease, and achieving improved health outcomes.
Patients enroll in a disease management program offering care team support, a patient mentor, and messaging delivered from within the EHR system tailored to their experience, which include setting expectations up front about potentially burdensome side effects. A user-friendly digital solution tracks their disease journey, with milestones patients celebrate with family, peers, and care team.
This scenario might also seem out of reach for many biopharma companies, and uncommon for most patients today, but it is achievable through careful collaboration with digital health providers, physicians or hospital systems, and patient advocacy groups.
“We have research to show that patient motivation is similar to a battery,” says Natalie Bloomfield, a global patient engagement leader. “After diagnosis, patients may be running on empty, as the process of diagnosis and treatment initiation can be exhausting and traumatic. It takes multiple milestones to recharge their battery, to see treatment progress, feel informed so they can understand their disease and treatment, and transition from their ‘old normal’ to a ‘new normal.’ Patients need solutions that create connections, enable sharing experiences with similar patients, and practical, personally relevant support – all of these things are necessary, they aren’t ‘nice to haves.’ But executing these solutions in isolation is the challenge.”
BARRIERS: SYSTEMIC ISSUES THAT HINDER SOLUTION DEVELOPMENT
Clinical trials
Many pharmaceutical companies outsource clinical trials to CROs who are focused on efficiency rather than patient experience. As a consequence, inadequate attention is paid to each step of the journey that patients (and the clinical trial site staff) experience, leading to suboptimal trial enrollment and completion rates and a longer-term reduction in the pool of willing trial participants.
If patients don’t know what to expect, and if the pharmaceutical sponsor together with the CRO and site staff do not understand patient expectations throughout the trial experience, the trial experience will not meet patient expectations.
Patient support programs (PSPs)
Pharma-sponsored PSPs often fall short due to high costs, limited scalability, perceived compliance risks, and difficulty measuring impact. Many PSPs end up as basic messaging programs, missing the mark on delivering meaningful value to patients, or too complex to use, or redundant with other solutions available in the market. Physicians and nurses may also see them as intrusive rather than complementary tools for better patient management.
Meanwhile, hospitals and group practices often don’t have the resources, time, or incentives to manage each patient optimally with customized patient engagement solutions. And, advocacy groups don’t see PSP implementation as directly in their purview.
“A key problem with pharma-sponsored patient support programs is that every time we try to create a great patient experience, to build peer-to-peer support, there is a lot of hesitation in terms of compliance risk,” Bloomfield says. “And then we go with the safest option, which doesn’t work. Meanwhile, the ideal solution cannot be delivered in a vacuum; it requires the close cooperation of multiple players: physicians, nurses, advocacy groups, health-tech, and pharma.”
OPPORTUNITIES: HOW LEVERAGING PARTNERSHIPS CAN SUPPORT DELIVERY AT SCALE
As we have seen, there are a number of constraints on biopharma’s ability to act alone to build optimal patient experiences, and equally there are resource constraints that sometimes prevent physicians and the wider hospital/healthcare systems from collaborating with pharma. Some of these constraints, such as those connected to institutional incentives, are not easily overcome. However, many constraints, including overcoming compliance risks, cost concerns, ability to measure, and failing to meet patient expectations can be overcome through systems thinking (understanding patient needs holistically across the interactions) and cross-stakeholder leadership and partnering to improve the situation.
“Intervening in the care path directly as a pharma company is difficult and probably not desirable,” says Marta Lago Arenas, a customer experience consultant. “The opportunity is to collaborate. For example, providing insights, [and] supporting studies or experiences where a new approach is designed, implemented, and tested can improve outcomes in a compliant and evidence-based way. Pharma partners with providers and healthcare systems to create improvements in patient experience and evaluate the approach.”
REAL-WORLD EXAMPLES
Here are just a few examples of how systems thinking and partnering across the health ecosystem have made a real difference in patient engagement in clinical trial and patient support settings.
Boehringer partners with pharmacy chain and trial solutions provider to make clinical trials more accessible
To reach underserved communities in the United States, global biopharma company Boehringer Ingelheim is partnering with Walgreens pharmacies and Emvenio Research, a decentralized trial network, to improve clinical trial recruitment and retention, as well as increasing diversity in Phase III obesity and type 2 diabetes trials. The project aims to educate Black and Hispanic adults, who are more likely to be impacted by these diseases, on clinical trials and empower them to utilize this treatment pathway. By bringing trial sites directly to communities, Boehringer hopes to engage patients where they are in their journey, and make trials more accessible for a wider group of patients.
Amgen partners with hospitals and digital health to improve adherence
Global biopharma company Amgen led a consortium partnership to empower patients at high risk of cardiovascular disease to take control of their recovery treatment plan and reduce the likelihood of further hospital admissions postheart attack. The program, called Rehab+, was based on digital tele-rehabilitation, with Liva Healthcare providing the app technology. Amgen partnered with rehabilitation hospitals in Spain, including La Paz in Madrid, Vall d’Hebron in Barcelona, and Virgen de la Victoria in Malaga, and Zuyderland in the Netherlands. The program was endorsed by the Spanish Society of Cardiology, Netherlands Society of Cardiology, and Foro Español de Pacientes (Spanish Patients Forum).
Partnering with a health-tech company to embed messaging in clinical workflows
MyCareCompass, a digital health solutions designed for oncology care teams, partnered with Kettering Health Network to decrease cancer patient fear and anxiety, improve patient satisfaction and outcomes, and decrease healthcare resource utilization and costs. The collaboration allowed for rich insights from oncology nurse navigators to understand gaps in patient education and associated impact, content aligned with health literacy best practices and cancer patient engagement data, full integration within Kettering Health’s EMR platform and operational workflow, and auto-deployed educational videos and content to patients from Kettering via email/SMS.
DELIVERING ON THE PATIENT EXPERIENCE PROMISE
Pharmaceutical companies are well positioned to coordinate the delivery of next-generation patient support thinking and solutions given their unique strengths including scientific innovation, financial resources, and specialized disease insights. Below are recommendations for flexing Pharma’s systems-thinking and ecosystem partnering muscles in service of better patient experiences.
ADVICE FOR SENIOR LEADERSHIP
Recognize friction and limitations of developing solutions in isolation, and the benefits of a multi-partner approach.
Measure what you need to change. To create solutions that are scalable across therapy areas and markets, understand what you need to change and build success metrics around that. For instance, if treatment adherence is the key issue, identify benchmarks and set concrete performance objectives for a successful program before initiating any partnerships.
Utilize cross functional squads. Involve market research, patient engagement, clinical operations or medical affairs, and communications and IT team members, but ensure there is clear accountability and responsibility in the squad.
Embed ecosystem partnering into job accountabilities. Partnerships may be in place with agencies or digital health providers to support partnerships, but consider explicitly tasking internal teams with ecosystem thinking and partnership formation. Consortiums including hospital or healthcare systems, patient organizations, health tech, and innovation networks should be encouraged. You could even consider creating a role specific to ecosystem integration.
Take an agile approach to partnering. Using lean methodology to build, measure, and learn enables your team to deliver solutions faster, but you want to learn first before you build. Leverage existing knowledge from market research and data from existing or previous programs to drive early decision making, and build solutions in a modular and agile way so new data can be utilized to pivot or adapt quickly.
ADVICE FOR MEDICAL, COMMERCIAL, AND PATIENT PARTNERING TEAMS
Leverage an ecosystem approach to codesign solutions that extend beyond a single market.
Share and learn from partners. Leverage pharma’s market research strengths to understand the intersection of patient journey and care pathway, and share what you learn with partners. Partners may have valuable knowledge to exchange including behavior change approaches, clinical practice data, and gaps in services for high-priority patient needs.
Engage partners early. Too often, partners may not be consulted until near the end of program development, almost always as a validation of the thinking that has gone into developing the program, rather than in shaping the program from the beginning.
Include nurses and front-line staff. Nurses are often overlooked in solution development but they are critical to delivering a great patient experience. Front-line hospital staff are often under-resourced and welcome digital tools and innovations that will enable them to do a better job for patients in critical care or emergency situations.
Leverage digital health partners and start-ups. As you consider build versus buy versus partner, think carefully about buy and partner. The ecosystem of digital health companies and start-ups is well developed and expanding quickly. Chances are there is a provider that would be eager to partner and would save time, energy, and money.
As you embark on 2025 strategic planning, give extra consideration to how you can embed ecosystem thinking and a partnership mindset into your patient engagement ambitions. The building blocks of successful patient engagement solutions are in place, they are just distributed across the healthcare landscape. Let’s continue to flex our partnership muscles to give our patients the solutions they deserve.
Authors
Gregg Fisher, Managing Partner, The Stem – gfisher@thestem.com
Debbie Denison is a Lead Strategy Consultant, The Stem
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Improving Healthcare Provider Connections: The Power of Moments in Biopharma Engagement
Mark Violi | 07.01.24
Originally published in Med Ad News June 2024
In recent years, biopharma companies have been keenly focused on improving customer engagement as a means of bolstering competitive advantage, elevating customer access, engagement, and business impact.
While there is no shortage of customer engagement initiatives underway, we observe that most of these efforts fall short of being truly “customer-centric.” Instead, they tend to be driven by the promise of technology and narrowly focused on brand or business needs, rather than embracing an “outside-in approach” that puts the customer first.
Reflecting on the industry’s interactions with healthcare professionals, Toon De Baere, senior director of digital customer engagement at AstraZeneca, observes, “I believe we struggle as an industry because we think inside out. Our focus is typically on disseminating product-centric messages. Instead, we need to understand the pivotal moments that matter to physicians to craft experiences that make those moments more meaningful and memorable.”
In this article, we look at how biopharma leaders can design distinctive experiences for customers leveraging insights from behavioral psychology. We draw inspiration from “The Power of Moments” by Chip and Dan Heath and look at how memorable and impactful moments are crafted leveraging principles of elevation, insight, pride, and connection.[1] (This article will look at moments for healthcare providers, but a later article in the series will look at patients.)
Building bridges: amplifying HCP engagement through transformative learning
In “The Power of Moments,” the idea of “tripping over the truth” prescribes the transformative effect of encountering an undeniable and impactful truth, leading to a transformative shift in perspective. The book’s three-part recipe – (1) clear insight (2) compressed in time and (3) discovered by the audience itself – provides a blueprint for helping audiences confront realities. For physicians, this type of discovery could lead to more informed treatment decisions and richer understanding of patient needs.
Noemi Pasquarelli, global medical science director for multiple sclerosis at Roche, encapsulates the benefits of “tripping over the truth.” She explains, “Education is individual for every healthcare professional, there are many different learning styles and levels. For example, when you are at a congress and you reveal new data for the first time, how you contextualize that data may impact perceptions around how it can be used in clinical practice. Rather than just presenting efficacy and safety data, we need to help physicians put the data into perspective and anchor it back to their own practice.”
Consider the following two strategies to design create moments that help HCPs “trip over the truth”.
1. Immerse HCPs in patient perspectives to drive shared decision making.
Moment Creation: Bring the physician closer to patients and enhance understanding of patient needs and treatment goals during or following a key congress where new data is presented. Help them have their own “aha moments” by creating a post-congress session, or have these materials available at your booth.
Rationale: One of the barriers around shared decision making is the lack of patient perspective on the part of the physician. Thanks to social media accelerating information transfer, patients are now coming to their doctors more informed about new and pipeline treatments which may influence a doctor’s decision, but physicians often still lack a palpable connection to the patient experience. Understanding the patient perspective can help HCPs better understand patient preferences and communicate new information in a way that drives collaborative decision making.
Example: A great example of this approach was provided by Khurrum Ahmad, senior director, brand lead at Otsuka Pharmaceuticals. Earlier in his career, while working on a binge eating product, his team uncovered a gap in physician understanding of the vicious, compulsive thought process a patient goes through with binge eating. “The aha moment for me was how do you get a physician to see the compulsive nature of patient thoughts, and truly appreciate how deep this trauma goes?” Khurrum explains. “Through virtual reality goggles, we enabled physicians to experience a day in the life of a patient. In a short one-and-a-half minute video, they could hear the thoughts of that patient, understand the triggers and patterns of thinking about food, overeating, and the resulting negative thoughts of shame and guilt.” Khurrum’s team utilized the VR goggles at different psychiatric congresses, enabling psychiatrists to “trip over the truth” in a minute and a half. “From the pre- and post-survey, we could see physicians connecting the dots, and that by understanding the burden of disease better, how they could have better conversations with patients.” As a consequence, a key barrier to prescribing treatment was addressed.
Tactics to consider helping providers “trip over the truth” in the period surrounding a congress include:
- Voice of the patient at booth: Integrate patient perspectives through video, patient-physician fireside chats, or immersive VR experiences, bringing to life specific challenges or unmet needs that may help to change perspectives.
- Session post-congress: Delve into framing risks, benefits, patient goals and preferences from the patient’s perspective. Provide guidance on how to discuss the data with well-informed patients who may have already encountered the information through other sources.
- Repurposed content post-congress: Extend the impact beyond the congress experience by repurposing content that can be shared with a broader physician community through medical science liaisons (MSLs), sales forces, and digital channels.
2. Amplify the voice of early treatment adopters.
Moment Creation: Drive behavior change for late adopters of new therapies by creating patient case studies featuring early adopters of new treatments. Clinicians who are first to adopt a new treatment, drug class or digital therapeutic contribute patient case studies that share their early experiences with the product with those who are “on the fence”.
Rationale: By strategically addressing resistance, skepticism, and misconceptions within a case study, brands can help clinicians “trip over the truth” and make informed, timely decisions about new treatments. Also, peer-to-peer learning speeds up the adoption process, getting new treatments to patients faster.
Example: Many of the clinical support tools today are primarily driven by guideline updates and lack peer-to-peer engagement. We supported a client in developing an interactive patient case tool where oncologists could follow a patient’s clinical journey and learn about how the patient was managed throughout their journey and the resulting outcomes. It provided expert opinion on eligible treatment options and the rationale behind their choices. The tool was adopted by two international oncology societies for use in their own patient cases.
Tactical considerations
Technological capabilities have greatly improved in recent years, and the concept of strategically positioning a case study tool around early treatment adoption, especially with AI integration, has yet to be explored. This is an area of innovation whose time has come.
An early adopter case study tool could include educational information to aid in treatment decision making:
- Videos from researchers or investigators involved in the clinical study.
- Expected side effects and ways of addressing them.
- Methods of patient stratification used in treatment decision-making.
- Practical guidance on how clinicians can smoothly integrate the new treatment into their existing workflows.
- Interactive surveys to benchmark the current practices of each clinician against their peers.
- Ability for clinicians to comment or ask questions of the case study creator (discussion capabilities).
- AI to generate and summarize case studies; and beyond these basic features, AI could be used to detect patterns in pathology images and assess treatment plans based on outcomes of investigations and patient history/comorbidities.
Conclusion
The promise of well-designed “moments” in biopharma customer engagement can inspire and guide biopharma leaders towards genuine customer-centric approaches. By embracing insights from behavioral psychology and understanding pivotal moments that matter to healthcare professionals, biopharma leaders can craft distinctive and memorable experiences that go beyond disseminating product-centric messages.
To act on these insights, biopharma leaders should consider creating a “moments” playbook to provide concrete direction on how to integrate moments into brand strategy and tactical planning. Considerations for teams include:
- Excellence teams: Integrate behavioral psychology and moment design into customer experience (CX) curricula training, baking this into the customer-centricity agenda internally. Utilize playbooks to train cross functional brand teams to adopt an outside-in approach that leverages the pillars of elevation, insight, pride, and connection.
- Cross-functional brand team: Enhance the importance of strategic brainstorming within the organization through tactical ideation sessions in collaboration with agencies and other partners, incorporating principles of moment design and behavioral psychology.
- Impact and intent measures: Look beyond engagement metrics to integrate customer centric measures such as intent and impact, to gauge whether designed moments are moving the needle. Voice of customer tools such as surveys and social analytics (social listening) can be leveraged to measure impact. For intent, desired actions should be integrated into tools, content, and assets. Call requests with MSLs, webinar registrations, case study comments, and input could all apply in the examples given.
Keep your eyes out for our next article on the Power of Moments, which will focus on patient engagement.
[1] Heath, C. and Heath, D. (January 1, 2017). “The Power of Moments.” Random House UK.
Authors
Gregg Fisher, Managing Partner, The Stem – gfisher@thestem.com
Debbie Denison is a Lead Strategy Consultant, The Stem
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icoder | 03.04.24
Revolutionizing Biopharma: Gregg Fisher Explores AI’s Impact in PharmaLive’s Latest Feature
Gregg Fisher, founder and managing partner of The Stem, shares his expert insights on the pivotal role of artificial intelligence (AI) in revolutionizing healthcare communication and patient care to PharmaLive’s “Agenda 2024: Now What?” feature.
Fisher highlights, “NBx (or next best) is fast becoming a standard approach for improving biopharma field force productivity,” reflecting on the transformative potential of AI and machine learning algorithms to improve the quality of customer insights, the relevance of sales force targeting and the impact of omni-channel customer interactions.
Fisher shares several best practices for successfully deploying NBx solutions, including:
Organize and Plan
- Vision: Define clear rationale of NBX value to drive brand objectives. Clarify NBX is the “Intelligence Engine” that provides a continuous, dynamic approach to customer engagement.
- Governance: Define roles across functions to support decision making and collaboration. Assign sponsors and core team responsible for delivering the NBX program.
- Program management: Use agile, “sprint” focused, management for quick builds, learning, and experiments from proof of concept to soft launch to builds. Drive alignment with cross-functional teams for clear scope of work, due date expectations, and regular communications for awareness and agreement to project deliverables.
- Vendor selection: Select for expertise in data science with predictive and generative AI/ML to allow for growth in complex use cases and data. Assess strategic guidance from real-world experiences with data sources, agile design approach, reuse of system connectors, KPIs, and experimentation process for new and refined use cases.
- Field engagement: Drive early and consistent field engagement for buy-in and continued learnings for ongoing NBX value. Use peer-based communications, training, and case studies to build trust in “real-world” field usage.
Design and Build
- Use case planning: Start with “User Story’ real-world design as input to use case requirements. Triangulate multiple, real-time data signals to increase the value of customer intelligence.
- Data and systems architecture: Define an architecture that is flexible with modular, configurable and adaptable features. Prioritize reuse of data connectors for similar data objects to minimize implementation complexities.
- Omnichannel integration: Optimize pre-Launch learning from HCP activity (i.e., channel preference, content affinity and knowledge level) to leverage during launch phase to personalize engagements. Design an activity scoring system across “data signals” to assess HCP targets and digital utilization value to reduce “noise” to field.
- Field interface: Reduce admin and simplify NBX response for field users. Plan for efficient view and access for NBX across Territory, Customer, and First-Line-Manager dashboards.
Measure and Optimize
- Success metrics: Differentiate between response KPIs and quality KPIs. Take an “ROI” approach to each Use Case to verify the value based on outcome intended.
- Operating model: Design an operating model to establish processes to evolve and refine use cases. Educate internal stakeholders and field end-users on the update process and schedule for expectation setting and refinement validation.
Fisher’s commentary sheds light on the urgency for the industry to transition from experimentation with AI to its full-scale deployment, aiming to leverage its capabilities for more personalized and efficient healthcare solutions.
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Practical Applications for ChatGPT and Other Large Language Models in Biopharma
Mark Violi | 02.22.24
Originally published in PharmaLive.com 2/16/24
ChatGPT is the fastest-growing application in history, exceeding 100 million users within two months of its launch on November 30, 2022. Within a year, the application has catapulted artificial intelligence into the mainstream, thrilling and terrifying pundits and the public with its potential. Whether it becomes a bigger boon than the Gutenberg press, as Microsoft CEO Satya Nadella predicts, or results in a dystopian future as Geoffrey Hinton, the “Godfather of AI,” believes, one thing is clear: the “AI Revolution” isn’t just hype.
Whether passing the bar, destroying companies, or spewing “hallucinations,” the awesome power of generative AI, spearheaded by ChatGPT and its rapidly spawning competitors, reverberates throughout society, across industries. Biopharma is no exception. Accustomed to disruption, despite the many limitations and risks imposed by tight regulations, biopharma is eager to benefit from these new capabilities.
Numerous articles have focused on potential applications throughout the drug development and commercialization life cycle, but few have elucidated tangible short- and long-term applications demonstrating its feasible and effective implementation. So we set out to explore specific use cases with industry experts (including Stem consultants and clients) to enable biopharma companies to integrate generative AI across five core functions: clinical operations, medical affairs, sales, marketing, and patient support.
Clinical operations: “Take existing systems to the next level”
The pre-launch phase of the drug development process is arguably the most data- and stakeholder-intensive, lending itself to the benefits of AI. From protocol designs to site selection and management, patient recruitment and retention to drug supply management and adverse event reporting, data collection and analysis to risk management, the sheer volume of data and touchpoints can be overwhelming. Given the magnitude, it should come as no surprise that chatbots have already been used in this context for years.
“AI and chatbots have been integrated within clinical operations for at least the last 10 years,” explains Shwen Gwee, a digital health leader and consultant who has been a senior advisor to major companies and a member of the MIT Hacking Medicine team. “My work with Memorial Health was an example, utilizing technology that analyzed patient history and treatment journey data to predict at which point in their clinical trial participants might experience challenges. The chatbot also proactively engaged participants based on that data to boost study adherence.”
Gwee describes protocol design as another area of clinical operations where legacy AI is now ripe for ChatGPT. “Study designs are written by humans, who either base it on a template or personal experience. That misses opportunities to optimize designs by factoring in everything from patient types to site requirements and past study results. Choosing optimal inclusion and exclusion criteria based on leveraging and analyzing the data from complex disease areas and patient populations will soon be possible with this advanced AI.”
Until recently, specialized chatbots relied on decision trees that responded to specific queries with pre-approved content. They were adept at churning predefined output, making recommendations, and even being predictive. “ChatGPT from OpenAI and their GPT-3 and -4 powered cousins can deliver the power of truly ‘Generative’ AI to biopharma,” says Gwee. “Next-gen chatbots are vastly more complex and natural in their language responses, raising a new set of concerns.”
Regulatory and legal teams demand accuracy and compliance, ensured by reviewing all content in advance. Since the generative power of ChatGPT and its brethren lies in the ability to create customized responses to diverse queries, what assurances can companies have that a bot’s output will never be violative, or become subject to any of those publicized “hallucinations”? “My guidance has been to feed only pre-approved content into any system,” assures Gwee. “They must pull from a restrictive, proprietary, and closed data set.”
Medical affairs: “Listen before you chatbot”
Jennifer Riggins, medical affairs thought leader and expert in medical communications and digital solutions, agrees. “Healthcare professionals don’t have a lot of trust when they don’t know where your clinical answers come from. I’ve seen criticisms around authorship, the belief that robots can’t be an author of scientific papers, or even clinical trial results. So, in addition to only pulling from a closed data set, make sure sources are cited, every claim and detail thoroughly and precisely referenced. Trust is largely based on transparency.”
Like clinical operations, medical affairs is complex and multifaceted, with numerous touchpoints where generative AI could add tremendous value. “An immediate beneficiary would be HCP medical information queries and searches.” For most companies the process is time consuming; with a ChatGPT plug-in, HCPs across multiple specialties can receive instantaneous and personalized support.
Riggins cites examples of this kind of controlled and compliant interaction in the travel and finance industries. “An open-ended interaction that can provide dynamic, efficient, and effective responses to a diverse array of queries would be amazing in med affairs. HCPs might have questions about dosing, patient support resources, sales rep visits, drug supplies, what have you. With everything monitored and recorded, appropriate responses made, risks such as adverse event reporting and other issues could also be better managed and mitigated.”
Unsolicited questions about off-label information are another potential challenge and implicit opportunity. The line between drug promotion and professional education is well-delineated, while an important role of the medical affairs team is to provide HCPs with all the data they need to succeed. “Teaching a bot how to differentiate between solicitation and awareness is subtle, but with the new technology entirely feasible. Welcome to the brave new world of med affairs!”
Making medical affairs liaisons more efficient is another benefit that Higgins cites. “Scheduling calls, keeping track of updates, and finding the right information are all challenging. The advanced search and engagement capabilities that could work so well for HCPs apply doubly so for our internal specialists. Speaking of which, content authoring tools would also be eagerly embraced, saving time in terms of standardization, repurposing, distribution, and authentication. Big companies might someday pool their archives for a truly scalable solution.”
Sales and marketing: “Personal non-personal promotion”
Toon De Baere, senior director digital customer engagement Europe/Canada at AstraZeneca, has a similar vision. “Imagine all pharmaceutical companies providing important clinical information for their products, housed in a centralized, company-agnostic database. Physicians, liaisons, even patients could connect using an interface that independently answers their questions, provides resources, and helps manage these customer engagement relationships. The data would be open-ended, but all pre-approved and compliant.”
In terms of content creation, De Baere is even more focused. Sales and marketing materials are often created in a laborious, time-intensive manner. The review cycles are long, and aside from some market research, the content is rarely analyzed for its effectiveness, or personalized for audience segments. “We’ve struggled to handle increasing complexity with our existing teams. Internal use of AI can heighten efficiencies to get even more done with everyone we have, and external use of AI can boost engagement and personalize each interaction.”
“We’re experiencing a total paradigm shift,” adds Glenn Butcher, another senior industry digital leader. “Before we know it, AI will be ubiquitous throughout our organizations. From content creation to regulatory approval, tactical development to media engagement, we’ll be able to see things and do things we never imagined. Yet, I don’t think that the next six months will be that different from today. Many still assume magic is happening in that black box. So, experts will need to educate all our people on how to think about these things in a more mature and meaningful way.”
Despite the knowledge and skepticism gap, Da Baere and Butcher see immediate opportunities in sales rep management and logistics. Akin to the enhanced operational capabilities suggested by Gwee and Higgins, rep tools such as reminders, schedulers, and even Veeva-integrated ChatGPT functionality could tremendously simplify tasks and provide reps with more impactful collateral. On the receiving end, HCPs could engage with next generation eDetails and practice management tools, which can provide additional dimensions of compelling detail to the data.
“In the old days, we literally spent years and the limited resources of huge teams trying to script every single answer to a chatbot script,” Da Baere says. “This new generation that’s powered by GPT scripts itself, in a way, and all we need to worry about is the data itself. And unlike a Google search, the bot interaction is like you are really having a conversation. Soon we will wonder why we’re building brand sites and doing ‘non-personal’ promotional campaigns.”
Patient support: “The chatbot will see you now”
The potential for improved patient and caregiver engagement seems even more exciting. “In essence, you will not need a patient support program anymore, because your ChatGPT solution would be your patient support program,” Da Baere explains. “All the support resources could be available through the bot, making a website far less engaging, and essentially redundant.” Da Baere also speculates that actual conversations could populate the bot, thereby helping to formulate answers to difficult care questions that are expressed consistently, naturally, and empathetically.
As the power of generative AI expands into patient support and direct-to-
consumer marketing, sensitivity to regulatory and privacy consideration will be vital. Like the evolution of social media engagement and marketing for pharma, integration and adoption must be methodical and iterative. As consumers gradually increase their own utilization of ChatGPT-integrated devices, digital services, and brand experiences, biopharma companies will have an opportunity to meet them in the middle, and by then hopefully be ready in a manner that remains risk-averse and compliant.
“Based on my experience integrating earlier versions of these bots,, my guidance is to start with medical affairs,” Gwee says. “Their data is thoroughly vetted, their audience is professional, and their channels of communication are closed. With limited exposure and approved content, you can then experiment with specific touchpoints, get the legal and regulatory folks accustomed to this new way of communicating, and build the plane as you fly it. Don’t hesitate to bring in outside help, just like the early days of digital and social.”
“This won’t happen overnight,” Butcher insists. “Transformation is inevitable, but it needs to be ushered in with leadership and education.” Da Baere adds, “Disruptive change can only happen from the top, down. I’ve never seen anything effective happen from only grassroots interest or support. Senior leadership must first understand and embrace the possibilities, and then mandate a careful, focused approach to figure out what might work. Outside experts and consultants will have to be brought in at first, so that we can learn and take things from there.”
The good news is that within only the past year, ChatGPT-based startups have mushroomed, integrated across every milestone of development and commercialization. From bots that make EHR information and HCP-patient interactions more conversational, to medical records management and managed care processing more efficient, to introducing the tech as a point-of-care diagnostic and treatment tool, and all the way to the pharmacy, generative AI is entering the treatment journey from every angle. A bit late to the plate as usual, biopharma is stepping up.
Implementation: “One step at a time…”
With the FDA having issued its perspective on drug research and development, the floodgates are already open for ChatGPT into every biopharma function. The ability of AI to integrate, analyze, and simplify voluminous, complex clinical data is unparalleled, but how does one simplify the value proposition, and initiate an implementation within your own organization?
- Step 1: Educate senior leadership
The technology is nascent, and its applications are beta tests at best. Bring in experts to describe the generative AI landscape and demonstrate best-in-class examples of ChatGPT in action at various touchpoints and for various audiences. - Step 2: Choose a pilot program
Work with internal and external stakeholders to identify a potential “quick win” implementing a ChatGPT experience. Gwee recommends starting with medical affairs, but the decision is up to you and your organization’s sweet spots. - Step 3: Crawl, walk, chat
Get buy-in from leadership, specialty teams, and regulatory from the beginning. Determine realistic success factors, and test, test, test before exposing the new technology to any external audiences, especially patients and caregivers. - Step 4: Measure, analyze, iterate
Work in agile sprints, and stay flexible. Your goal is to create your own internal generative AI/ChatGPT expertise that can then be repurposed and scaled throughout your organization, evolving as you go. medadnews
Authors
Gregg Fisher, Managing Partner, The Stem – gfisher@thestem.com
Mike Spitz, Lead Strategy Consultant, The Stem
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Driving Sustainable Omnichannel Change
Mark Violi | 10.11.23
Originally published in Pharmaceutical Commerce 9/29/23
A look into ways to approach change management using three factors.
The change of pace in biopharma customer engagement continues to accelerate, with artificial intelligence (AI) being just the latest tool. As life sciences companies race to shift to omnichannel customer engagement, many may find that they need help.
We find that the hurdles organizations face vary based on their maturity. Less mature organizations struggle with basics of securing senior management support and crafting strategy, while more mature organizations struggle with knottier issues of execution.(1) A universal challenge is moving beyond pockets of innovation to enterprise-wide transformation.
Operationalizing omnichannel requires shifting mindsets and behaviors, pivoting ways of working, recalibrating performance, and finding funding. Taking a whole organization on this journey requires a purposeful change and transition management effort.(2)
In this article, we share insights from the trenches gleaned from clients and experts on how to approach change management along multiple dimensions. We distill three key success factors to move toward omnichannel reality:
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GIRFT(3) the strategy
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Ace the customer roadmap
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Make change a personal journey
GIRFT-ing the strategy
In an age of agile thinking, the approach of “get it right first time” (GIRFT) sounds old-school. But not when looking at defining a global strategy for customer experience. It often takes years get the strategy right before scaling to global operationalization.
Ipsen provides an instructive example. Aurelie Rognon, director of global customer experience notes: “We spent a year working with one brand globally and locally, with different markets, to define an omnichannel strategy: what it means, what needs to change, what we need to avoid. This enabled us to have a win with a big brand, to show how we can make it real and embed it in the global and local brand strategy.”
Luca Frangoni, global head of content & omnichannel excellence at Boehringer Ingelheim (BI) offers another example. BI created an “omnichannel blueprint” which provided the direction for capability-building and change management. In BI’s definition, the blueprint incorporates:
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KPIs and success measures
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Aligned language, end to end process, integrated data flow and platforms
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Change management concept
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Governance rules to ensure integration across product and capability teams
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Communication guidelines on omnichannel
The result was common process, platforms and language across customer experience, advanced analytics, and content management. According to Frangoni, the blueprint was critical to help the organization work in an aligned way and recognize that “omnichannel change is long-term.”
In global organizations, articulating a clear strategy is critical to transition people’s mindset and behavior, by demonstrating value. Co-creating with stakeholders is a best practice that builds a common understanding of customer focus and experience and to provide a solid foundation for operationalization.
For organizations who are working on their omnichannel strategy, be sure to:
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Identify relevant roles in the organization to take ownership of the omnichannel strategy, e.g., global head of franchise, customer experience lead, omnichannel director
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Co-create and show what effective omnichannel strategy means e.g., through testimonials from general managers (GMs) concept boards, events, training
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Forecast impact and set expectations early with GMs, by including budgeting plans
Acing the roadmap
There is no one-size-fits-all recipe for getting to the future state. Some organizations benefit from small steps, while others leapfrog, monitoring and evaluating results along the way. In both cases, the need is to move the whole organization along without getting stuck.
Creating a capability roadmap is a best practice for bringing together different functions and aligning on changes to customer experience over time. It’s also a way to understand the process and technology changes that will occur over time to create the evolved experience.
Daan Vens, the Innovation and Business Excellence Director BELUX at AstraZeneca, attributes a lot of his success to his roadmap. He created a “crawl, walk, run” roadmap that articulated how AZ would change local customer interactions, starting with basic interactions and evolving from there.(4) Importantly, he took an outside in approach that showed how the customer experience changes, he then linked process and technology changes to get there. This approach allowed his team to accomplish a lot in an organization known for its sales force effectiveness (SFE) culture.
“It’s all about the customer roadmap. It’s so simple and few organizations apply it. It may be less shiny at step one, but it’s much more effective in the long term.” says Vens.
To build an effective roadmap:
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Focus first on how customer experience will change over time; then overlay process and technology requirements to get there
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Run road-mapping sessions with medical affairs, market access, legal, privacy, regulatory MMLR functions and commercial together
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Stay focused to achieve a level of mastery in one phase before moving onto the next
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Assign accountability for building the roadmap, e.g., business excellence director, head of business operations, commercial & digital director
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Appoint an accountable role for change management e.g., change officer, change management director, omnichannel operations lead, VP omnichannel
Making change a personal journey
Lasting transitions are achieved by taking people on a journey—extracting the personal drivers from the strategy story. Simply put, define what change means for each person so that benefits are tangible. According to Susana Bento, global omnichannel operations lead at Grünenthal, we “naturally start seeing wins on the journey and we celebrate. As we glimpse adoption, we make all the noise we can.”
Omnichannel change is deeply experienced by sales teams—first line sales managers (FLSMs) are critical to manage the transition journey by bridging the gap between headquarters and sales representatives. “We need to get first line sales managers on board early because they answer rep concerns, e.g., What does it mean for me? What am I expected to do differently?” according to Vens.
“The marketing teams, as content creators, are also challenged,” according to Susana Bento. She says, “As the omnichannel operation evolves, demand for rapid creation of diverse and personalized content delivered grows. In most organizations, marketing teams struggle to cope with this demand. A classic example is the modular content operation, which puts pressure on marketing and medical teams, and MLR functions. Here, change management is key to ensure adoption of new processes.”
While organizations have made quick progress implementing capabilities, bringing people along moves slower. This frequently becomes the greatest challenge, because not everyone understands what omnichannel is. According to Aurelie Rognon, this means repetition is important. “Repeat again and again, through all communications: what we’re going to do, how it’s going to help, what’s in it for us.” Aurelie says.
As you think about the people side of change management:
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Partner with impacted functions to build the personalized omnichannel capability framework and learning plan, e.g., for marketing, sales, medical, HR—through omnichannel centers of excellence, customer experience trainings, cmnichannel capability forums.
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With HR and L&D, build an omnichannel competency framework, update impacted roles across the organization and execute learning journeys.
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Run VoC (Voice of Colleagues) polls, implement improvements and celebrate success.
Most of the ingredients to accelerate from omnichannel strategy to reality are now available, even considering variations among brands and countries. Those who have started to shift mindsets, behaviors, attitudes, and ways of working have already seen the impact.
Authors
Gregg Fisher, Managing Partner, The Stem – gfisher@thestem.com, The Stem
Anca Davies-Rusu is a member of The Stem network and a thought leader in omnichannel customer strategy and an agile change practitioner.
References
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According to Nov 2022 McKinsey survey of 100 Life sciences digital and analytic the organizational hurdles for use of digital and analytics have shifted since 2020 from strategy formulation and executive sponsorship to issues of execution and change management.
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“Change” happens to people, even if they don’t agree with it. “Transition”, on the other hand, is internal: it’s what happens in people’s minds as they go through change. Change can happen quickly, while transition usually occurs more slowly.
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Getting It Right First Time (GIRFT) is a tried and test concept e.g., in the UK, NHS England designed a GIRFT national program to improve the treatment and care of patients through in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change. https://gettingitrightfirsttime.co.uk/
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Daan’s approach was inspired by Ranjay Gulati. https://hbswk.hbs.edu/item/the-outside-in-approach-to-customer-service
icoder | 06.09.23
Ten years ago, The Stem was born as a new breed of consultancy serving customer engagement innovators in biopharma and Health.
Our concept was simple: to enable our clients to partner with the world’s leading independent talent to help them navigate fast-moving changes in customer engagement.
Back then, we anticipated two parallel mega-trends:
- The evolution of bio-pharmaceutical customer engagement, fueled by shifts in technology and patient/customer behavior.
- Changes in the nature of work leading to a growing independent talent force capable of working effectively in a distributed fashion.
We called ourselves a “networked consultancy” to capture the essence of a business model which would provide clients with high quality consulting services, delivered through teams of seasoned independent talent, drawn from a global network.
Our vision was to “Harness the collective wisdom of independent talent to improve health experiences”.
We wanted clients to work directly with world-class experts, and we wanted our independent consultants to be able to work on innovative projects that would change the nature of Health customer engagement.
This month, we celebrate our 10 year anniversary and I couldn’t be more proud of what we have accomplished.
After 10 years, we have:
- Delivered over 500 projects.
- Partnered with over 37 clients.
- Engaged with over 250 consultants.
- Worked in over 35 countries, across 6 continents.
None of this would have been possible without our clients and network consultants.
I am truly grateful to our clients for believing in the strength of our model, the expertise of our talent, and trusting us to work on their most challenging customer engagement projects.
And, I am humbled by our consultants. Your talent, dedication, innovation, versatility and camaraderie never cease to amaze me, and we owe our success to you.
Gregg Fisher
Founder & Managing Partner, The Stem
_______________________________________________________________________________________________________________________
About the Stem
Founded by Gregg Fisher in 2013, The Stem is a global management consulting firm specializing in customer engagement strategy and operations in the health & life sciences sectors. The Stem’s unique “networked model” draws on a senior leadership team and the industry’s most seasoned independent talent, offering clients a nimble, cost-effective and refreshing alternative to traditional consultancies, without sacrificing control.
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Harnessing the Value of AI In Customer Engagement
Mark Violi | 05.17.23
Gregg Fisher, The Stem’s Founder and Managing Partner, recently had the chance to interview both clients and practitioners on the state of Artificial Intelligence/Machine Learning as it applies to customer engagement in BioPharma. Ganes Kesari, one of The Stem’s thought leaders on AI/ML, joined in the conversations.
We identified 4 promising use cases for AI/ML in customer engagement, and 4 critical success factors for execution, and captured these learnings in this article which was recently published in Pharmaceutical Executive. Special thanks to Tom Gaschler and Eduardo Cornejo for contributing.
Read the article on PharmaExec
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Authors:
Gregg Fisher, Managing Partner, gfisher@thestem.com, The Stem
Ganes Kesari, Chief Decision Scientist, Innovation Titan; Consultant, The Stem
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Mark Violi | 02.17.23
Originally published at Pharmaceutical Commerce
Leading brand and commercial organizations are making significant investments in building next generation patient support programs. These programs integrate modern digital, data and behavior science techniques to differentiate brands in a competitive environment, while improving adherence and supporting patient outcomes. But, too often, these programs struggle to realize their promise because of underwhelming enrollment.
Potential solutions to the enrollment challenge are influenced by many factors, including therapeutic area, lifecycle stage, competitive outlook, country-specific market constraints, and corporate culture. Whilst no silver bullet exists, our experience has inspired us to define 7 critical success factors for driving enrollment in next generation PSPs.
The 7 Critical Success Factors for Driving Enrollment in Next Generation PSPs
1. PSPs must deliver compelling value and address a real unmet need
HCPs only recommend PSPs if they see clear potential for it to make positive, tangible differences to the way they care for patients, and the way patients care for themselves. The same goes for patients. Unless PSPs help them improve the way they live with their condition, they are unlikely to enroll or stay engaged. Too often, assumptions are made about unmet need and little regard is given to options currently available to address the issue.
PSP teams should consider two questions: ‘Is this a burning need that, without addressing, the patient will have limited success with therapy?’, and ‘Is there any existing support that our PSP would be competing against?’ Recognize that your competition includes drug companies as well as other content and service providers.
In-depth research will help you to understand the scope and shape of the problem faced by individuals, be they the patient, carer, nurse provider or consulting physician. It makes no sense to create a PSP for a problem or inconvenience that does not exist, or one for which a solution is readily available.
Action: Run co-planning sessions with patients and providers and perform competitive analysis.
2. Integrate PSP messaging into brand strategy, value messaging and communications
Pharma teams put significant effort and spend into brand strategy, value message development, marketing, and communications focused on the product launch, but similar attention is not paid to PSP messaging. If PSPs aren’t prominently factored in as part of strategic launch planning, companies are missing a golden opportunity. PSPs should be an integral part of the messaging architecture and align with value messages.
PSPs should be prominent in the creative assets and communications materials at launch or shortly thereafter to help HCPs and patients appreciate the benefits of a new therapy and the accompanying support being offered.
Action: Create a comprehensive enrollment strategy prior to launch
3. Target the right audiences with a combination of face-to-face and non-personal
Understand who, besides the physician, has responsibility for supporting patients. Promotion of any PSP should factor in communication with the wider clinical team, including nurses, nurse educators and pharmacists.
Sales reps often don’t have the time to integrate PSP messaging into a sales call. So, consider having small teams of virtual reps whose sole focus is reaching out to the wider clinic to talk about patient support. Focusing on the staff that directly engage with patients is important and can be done affordably. Depending on the number of clinics and the therapy area, one person per market can be sufficient, and will make a big difference to patient enrollment.
While face-to-face engagement is the anchor of successful enrollment, don’t assume conversations alone will draw in and maintain patients on your PSP. Ensure influential members of care teams have the right materials and opportunities to actively engage the patient with your PSP. To raise and maintain awareness of PSPs, consider a mix of peer-to-peer educational events, KOL speakers, testimonials, webinars, and rep-generated emails. Finally, don’t assume a digital-only approach will work, as digital channels struggle to drive enrollment unless they form a part of a more integrated channel mix.
Action: Create a targeting and omni-channel enrollment plan for each PSP.
4. Simple enrollment at the point of care (PoC) creates sticky engagement
Enrolling patients at the PoC makes practical sense. This is a time when clinical teams can give influential endorsement and spend time answering any questions. Make sure all areas of the PSP are well covered, but not too onerously described, since patients forget much of what is discussed in a clinic. Providing scripted guidance, information leaflets, brochures and support materials that allow care teams to readily share the benefits of the PSPs helps secure initial patient enrollment and longer-term engagement. Reinforcing the ‘what’s in it for me?’ in follow-up materials and ongoing care team discussions keeps patients engaged.
To make the process of onboarding seamless and effective, consider innovative approaches to transactional confirmation with sign-up at clinics. Alternatively, QR codes on support materials or sample products allow people to connect directly to information on their phone and quickly fill in any required forms. Having patients complete tasks at home, supported by reminders from the clinic and online guidance reassures the patient and extends the engagement beyond the clinic. Making the process as simple as booking a table at a restaurant or buying goods online can be the difference between patients signing up or not.
Action: Map the enrollment flows and patient experience.
5. Co-create and partner with patient influencers and advocacy groups
Many patients look to national and international patient advocacy groups for information and guidance on managing their disease/condition. These groups have access to very specific, and sometimes niche populations. They understand the lived experiences of these populations. Genuine and compelling value can be revealed through direct engagement with patient organizations, either as part of the development of a PSP or through the co-creation of one. Shared ownership of PSPs can solve enrollment issues, as the endorsements of patient advocacy groups creates awareness and credibility with patient groups. If you are looking to run a PSP in a particularly rare or difficult-to-reach population, consider running webinars and/or providing simple brochures or tools to the relevant patient organizations. Similarly, patient online influencers can play an important role in creating patient awareness of PSPs.
Action: Research patient advocacy and influencer partnerships.
6. Monitoring helps drive the evolution of PSPs
To demonstrate that your PSP is delivering value, whether to support resource investment or to showcase your PSP to external customers, you will need to build in processes that allow you to assess and measure the success of the program rigorously and continuously. Such monitoring helps to support decisions concerning the PSP by providing insight into how many people were made aware of the program, how many were trained on it, how many received materials, what proportion of patients were offered the program and consequently signed-up. It also lets you see the percentage of patients that may have fallen out and then explore ways to recapture the attention of these audiences.
In some instances, especially if you have little experience of running PSPs, it might help to run a pilot program to identify unforeseen blockers, determine enrollment drivers, understand how scaling works, and clarify operational efficiencies.
Action: Develop a measurement plan for each PSP.
7. Curiosity, innovation and cross-functional collaboration in the internal culture creates favorable conditions for successful PSPs
Next-generation PSPs can be unfamiliar territory for many organizations, which may result in watered down programs. Innovative PSPs are best realized when teams are aligned with cross-functionally, and with a genuine curiosity to analyze the data and solve problems together. Cross-collaboration takes many forms, depending on the company, but there are a few areas we believe help deliver impactful PSPs, and these revolve around having clear research/customer engagement guidelines that generate favorable co-creation of PSPs with customers. First, ensure that there is a global infrastructure that promotes transparency and efficient knowledge-sharing between PSP teams and affiliates. Second, modernize guidelines and policies for risk assessment that acknowledge the vital role of PSPs. And lastly, explore building a natural ecosystem where PSPs are embedded into a platform-based approach. An initial unbranded offering allows outreach to the public followed by in-platform deployment of content that leads to patient conversations with doctors.
Action: Define internal barriers and plans to mitigate.
Frequently, PSPs are seen as a marketing tactic rather than as “products” requiring careful planning, promotion, and maintenance. When brand teams and commercial organizations have a limited view of PSPs, it often shows up in the limited enrollment and usage the program generates. The seven critical success factors articulated in this article can help you avoid this fate and deliver a program that brings real, differentiated value to patients and providers, which can be seen in enrollment.
It can be difficult to skillfully incorporate these critical success factors as they frequently require significant change in mindset and business practices. Seeking the help of those with extensive experience with PSPs can help you along your journey.
Author
Gregg Fisher, Managing Partner, The Stem – gfisher@thestem.com, The Stem
Gregg Fisher is Managing Partner of The Stem, a global management consulting firm specializing in customer engagement and digital transformation in Life Sciences. The Stem’s unique networked consulting model draws on the industry’s most seasoned independent talent offering clients a nimble, cost-effective, and refreshing alternative to traditional consultancies. The Stem provides specialized expertise in customer engagement insight, strategy and analytics, digital transformation and excellence, program management, and impact measurement.
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The Architecture of Global, Scalable, Next-Generation Patient Support Programs
Mark Violi | 08.15.22
Originally published at PharmaExec
Patient support programs (PSPs) have an opportunity for growth and innovation.
Conditions are ripe for a renaissance in patient support programs (PSPs). Brands are under pressure to demonstrate value by delivering outcomes to justify pricing and grow revenues, and patients support programs offer a path to deliver this value through adherence, persistence, and patient satisfaction.
The pharmaceutical patient support vendor landscape is burgeoning with new-to-world tools offering cross-channel-consumer experiences which integrate behavior change principles, advanced data, and digital technologies. Furthermore, many of these providers can shorten development cycles to three-to-four months from 18 months or more, by leveraging re-usable components and ways of working. Think: social/peer support, smart messaging, content management, machine learning, rapid journey design, agile code development, accelerated review cycles, rapid design, and testing. Finally, innovations in data science and real-world data offer firms the ability to directly measure the outcomes impact of patient interventions, a feat which was elusive even a decade ago.
The Challenges
As with much of digital transformation in pharmaceuticals, we witness pockets of PSP innovation in specific markets and only a small number of leading pharmaceutical companies who are building scalable fourth generation patient support experiences and realizing tangible benefits.1 Many Pharmaceutical companies are offering primarily second or third generation programs, and struggle to scale the isolated third or fourth generation innovations they have.
We observe several barriers that explain the current situation:
- Lack of executive belief in return on investment. While patient engagement managers recognize the missed opportunities, their senior leaders at the global and market levels are frequently not convinced of the ROI of PSP programs beyond supporting drug access. Faced with the choice of prioritizing a promotional effort or a support effort, many leaders will focus on promotion, and be satisfied with the status quo in their PSPs. This occurs even though the body of evidence supporting the return on modern PSP interventions is large and rapidly growing.2
- Lack of global empowered patient engagement teams to support program scaling. While large pharma companies have begun to build global patient engagement functions, in our experience many of these groups are underfunded and lack a clear institutional mandate to elevate patient service quality and efficiency.
- Lack of a global vision and strategy for next generation and scaling. While local efforts are essential to experimentation and demonstrating impact, only through coordinated global/regional and local efforts can organizations hope to scale next-generation patient support experiences.
- Perceived cost. Coupled with the lack of belief in ROI, comes a belief that advanced PSP programs are expensive and not affordable. This leads executives to view PSPs as a one-off marketing expense rather than investments in commercial capabilities that will deliver desirable returns. This mind-set in exacerbated by the fact that leaders often do not have visibility into the redundant legacy PSP investments made in different markets that collectively are more expensive than designing next-generation programs at scale. It also ignores the opportunity cost (measured in missed revenue) of deferring investments that would elevate adherence beyond their legacy programs, which often struggle to produce compelling results.
Recommendations
To overcome these barriers and realize the promise of patient engagement, we recommend pharma patient engagement teams (global and local) together with brand champions and senior leadership sponsors consider the following actions:
- Establish the business justification and centralize insights: through analysis, education, business case building. Proactively analyze business questions like “what are the benefits of achieving better outcomes?”, and “what is the cost of not doing so?”. Elevate the organization’s PSP knowledge by aggregating insights related to PSP performance across the organization, sharing best practices, learnings, and impact metrics. With unified commercial oversight of PSP impact, it becomes easier to develop compelling business cases that generate broad stakeholder buy-in.
- Seek out pilot partners. Many local market or brand teams recognize the need to improve an existing or create a new patient support program, but lack the knowledge, resources, or buy-in to plan and execute. By joining forces, the patient engagement team can provide much needed assistance in gathering patient insights, setting patient experience strategy, developing the business case, and even contributing supportive funds for execution to realize the benefits of scaling beyond the pilot markets.
- Design a patient engagement vision and idealized experience, with patients. Start by gathering insights. Co-design, which involves partnering with patients and HCPs is a preferred practice that enables understanding patient’s authentic needs, the leverage points to focus on and the idealized patient experience. Using input from the co-design process, the enhanced patient experience can be articulated in detail.3 This blueprint can then be used to define an implementation approach and budget.
- Plan implementation with scale in mind, including modular components and vendors. To improve scalability, maximize re-use of PSP components and increase speed to market of PSPs, careful thought must be given to the components and vendors that are used. The design of a cohesive digital experience for patients may involve multiple vendors, each serving different enrollment, experience, and human support functions. A detailed understanding of the vendor landscape makes it clear which vendor capabilities are the most important to apply to the desired patient experience. For example, certain vendors excel in drug reminder programs, others excel in private social network building, and still others excel in peer-to-peer coaching programs. Careful consideration of the PSP implementation architecture will ensure the various program pieces together properly, that multiple markets will be able to reuse the components and avoid expensive duplication of effort.
- Make the case for scale. When seeking funding, tailor the presentation to different stakeholders. To local colleagues, demonstrate how revenue lift will be achieved with assumptions derived from real world benchmarks. Program enrollees. Expected lift in days on therapy, break-even point, ROI. For global colleagues, quantify the savings or cost deferral of building a scalable solution.
- Implement in increments, and measure. Despite the best business case, funding may not be available to implement the full solution right away. Executives will seek evidence of program impact before releasing additional funds. Given this reality, careful thought should be given to what is the minimum viable product to launch with and what do subsequent releases look like. As pilot programs are deployed careful attention must be paid to measurement and optimization so refinements can be made before the program is further scaled.
Recommendations one and two will help you shape the environment in your company for PSP innovation. Recommendations three to six will help you build a patient experience strategy that is aligned to patient needs, has scale and speed to market built-in from the start, and is more likely to get funded.
Conclusion
Good architects know the importance of the adage: “measure twice, cut once.”
The opportunity for patient support innovation is large and growing. The business need is there, the patient need is there, the vendor landscape is there. What’s needed are more innovative programs that get funded. We hope the planning recommendations will inform and inspire bold patient engagement leaders and enable their patient support programs to deliver high quality patient experiences efficiently at scale.
Authors
Gregg Fisher, Managing Partner, The Stem – gfisher@thestem.com, The Stem
Jonathan Olsen, Independent Consultant, Patient Engagement Technology Expert, Member, The Stem
Resources
- Based on an analysis of publicly accessible patient support programs globally. Source: The Stem
- As cited in the Journal of Managed Care and Specialty Pharmacy, Abbvie Care’s 2019 study of its Patients Support Program for Humira demonstrated 29% improvement in adherence for PSP enrollees, 22% lower discontinuation, 35% lower disease-related medical costs, and 48.9 additional days on therapy. See also, BMJ Heart for impact of medication management apps on adherence.
- Ideally this work is done within input from patients from multiple markets with different profiles so the result is a scalable strategy with experience components that will serve small markets as well as large.
Mark Violi | 09.16.21
Originally published at PharmaExec
The COVID pandemic gave a boost to digital medical affairs initiatives. For leading medical affairs teams, it was an accelerant to a process that started long before COVID. The crisis served to fuel changes to customer engagement mindsets, processes, and systems that had been in the works for years.
For many other teams, COVID created a sense of urgency that wasn’t there before and prompted increased experimentation with digital technologies such as virtual meetings, digital congress activity and remote MSL engagement. While these activities were important in priming a digital engagement mindset and behaviors, they are not a substitute for the systematic transformation of leading organizations required to create lasting change.
This article looks at some of the barriers we have seen at different stages of Medical Affairs digitization and opportunities to close the gap between promise and progress. We look at obstacles in both planning and implementation.
Planning opportunities
Visualize what “good” (experiences) look like
Medical affairs teams are traditionally staffed with science, medical information, and health outcomes experts, but not digital transformation experts. To engineer high-quality customer experiences common in the consumer world, med affairs teams must internalize what “good” looks like to their customers, and what it means to their responsibilities. Important actions to prime teams for better customer experiences include:
- Showcase case studies of exceptional experiences outside of pharma and highlighting what makes them good, and expose best practice customers experiences from pharma digital medical affairs leaders
- Educate on digital concepts such as “human-centered design”, “customer journeys”, “content marketing”, “ecosystems”, “personalization” and “omni-channel marketing”
- Embed customer journey and service design techniques into tactical planning
- Work in cross-functional teams to map out content and service experiences around key customer moments and needs
- Expose the organization to new tools and innovations in customer experience
Develop a cohesive plan & put first things first
Many teams are seduced by new vendor technologies exposed at tradeshows. They end up making investments in tools without a proper customer engagement plan in place. What’s needed is a cohesive plan of action to guide investments. A good plan:
- Selects the customer “moments” and the therapeutic areas that will be prioritized (informed by customer research and business needs)
- Chooses tactics best aligned to those moments, considering from the full palette of opportunities, such as virtual congress interactions, medical information services, digital opinion leader activation, remote MSL engagement, disease education ecosystems, and digital health tools
- Defines project outcomes in terms of how the experience will change for customers
- Maps out delivery into “crawl”, “walk”, “run” releases, with a focus on high-impact, high feasibility experiences first
- Defines the expected impact on the business
Sustain the “burning platform”
With the pandemic waning in some areas, sustaining digital transformation momentum is paramount. Change agents should continue to highlight the benefits of closing the gap in virtual interactions desired by health care providers, including live webcasts, virtual two-way peer to peer discussions and on-demand content.1
To sustain momentum, be sure to:
- Monitor and communicate shifting customer preferences for medical affairs interactions, including channel and content topic and format preferences
- Define and track performance metrics and goals tied to quality and volume of engagement to quantify the benefits of changes over the status quo
- Measure satisfaction trends around Medical Affairs customer-centricity
- Benchmark digital activities of comparative organizations
Implementation opportunities
Navigate internal silos and restrictions
Customers do not care about functional departments when interacting with biopharmaceutical companies; they care that they get the information or support they require. Yet, when designing customer experiences, departmental silos2 often get in the way of a seamless experience. Sometimes Medical Affairs teams are limited by a restrictive vision of their responsibilities which prevents necessary participation in planning end-to-end experiences or designing content in multiple formats or standing up new channels. Additionally, Medical affairs teams often struggle interpreting restrictions around proactive versus reactive communications in the context of multi-channel engagement.
To overcome this issue, medical affairs change agents must:
- Embrace digital customer experience as a key part of its responsibilities, especially as it relates to disease education, off-label medical information, and content that supports optimal patient care
- Take steps to update legal and regulatory guidelines related to digital content
- Work cross-functionally across Medical Information, MSLs, and IT to plan and execute seamless experiences.
- Empower leaders with expertise in omni-channel customer experience
Don’t forget change management
Digital transformations are large scale change initiatives, yet many organizations treat them as a series of one-off projects and add-on responsibilities to already busy teams. As a result, the projects don’t get the traction they should. To maximize adoption, recommendations include:
- Assess the organization’s capacity to change, recognizing that change is disruptive
- Identify sponsors across multiple parts of the organization and ensure they understand their role and have the relevant skills3
- Establish governance within Medical Affairs and across other departments to communicate, align and create momentum around projects
- Ensure projects are properly resourced in terms of time, capacity, and financial resources
- Consider a program management office to accelerate execution
- Monitor and address resistance with frequent check-ins
Nurture a culture of customer-centric innovation
The Medical Affairs function is arguably more important now than ever as companies launch more specialized and complex products requiring education and translation of medical information into practical insights to support clinical decision-making and demonstrate value. In this environment customers will expect medical affairs teams to be purveyors of high-quality content and services which are delivered through personalized, virtual interactions in a variety of live and on-demand formats.
References
- https://medicalaffairs.org/reimagining-scientific-engagements-during-covid-19/
- https://www.pharmexec.com/view/implementing-a-customer-centric-mindset-in-medical-affairs
- https://www.ingeniumcommunications.com/wp-content/uploads/2018/10/How-to-Be-an-Effective-Sponsor-of-Major-Organizational-Change-.pdf
