Inspired Health Strategies

So, what is the latest catch phrase?

Patient centricity.

But what in the word does this mean and who is really practicing it?

How many meetings about patient-focused initiatives have you sat in on where there was actually someone representing the patient? In my experience I cannot remember many.

If we are going to be patient-centric we need to change how ALL of us are doing business – pharma, providers, payers, etc  – all of us!

Certainly, supporting the patient may mean a change in definition of the patient care team. This change in definition begins when practitioners are in training. In this recently published overview of three US-based medical schools – “Interprofessional collaboration: three best practice models of interprofessional education” – DR Bridges et al Med Educ Online. 2011; 16: 10.3402/meo.v16i0.6035. This training is focused on delivering professionals who work well with various types of health care professionals, including those that are community-based.

What is interprofessional collaboration and practice?

To quote directly from this study:

“According to the Canadian Interprofessional Health Collaborative, interprofessional collaboration is a ‘partnership between a team of health providers and a client in a participatory collaborative and coordinated approach to shared decision making around health and social issues’ . Interprofessional collaborative practice has been defined as a process which includes communication and decision-making, enabling a synergistic influence of grouped knowledge and skills . Elements of collaborative practice include responsibility, accountability, coordination, communication, cooperation, assertiveness, autonomy, and mutual trust and respect. It is this partnership that creates an interprofessional team designed to work on common goals to improve patient outcomes. Collaborative interactions exhibit a blending of professional cultures and are achieved though sharing skills and knowledge to improve the quality of patient care”

There are a couple words here that those in the business of health care many time shy away from – “community” and “culture”. Once “community” is part of the conversation the business folks assume this means altruism – or free access to drugs and other components of health care delivery. The truth is that patients spend so little time in the provider’s office, they really manage their health inside their own lives, within their communities. Working with patients in the community simply means you are reaching them where they are – and this is not altruistic, it is realistic.

And culture? In this article culture refers to two different aspects of culture:

• a blending of the various cultures of health care practitioners
• the role that culture plays in a patient’s health beliefs and practices and the specific impact culture has on health outcomes

If we are really going to be “patient-centric” all of these aspects have to be taken into consideration. This article does a good job of letting us know what up and coming health care providers are doing to prepare themselves to support the complexities of health care delivery these days.

It would behoove us, those of us in roles to support health care delivery, to pay attention to this interprofessional education trend. The initiatives we develop, the projects we propose would better serve our end-user – the patient – better if we do.

Click on the hyperlink, read the article. Learn how providers are preparing themselves to  improve how they are patient-centric.

Just my thoughts,

Dyan Bryson

The March 2011 issue of Pharmaceutical Executive contains an article about adherence (“Where have all the Scientists Gone” by Dr. Andrea LaFountain, Scientist & CEO of Mind Field Solutions, http://digital.findpharma.com/nxtbooks/advanstar/pe_201103/#/16). In this article Dr. LaFountain refers to the dollars that are left behind each year due to pharmaceutical companies not retaining their customers  - $280 billion.

$280 BILLION!!!

Now, if I thought I was leaving cash behind by simply not paying attention to handling it properly, especially this kind of cash – I’d certainly figure out a way. While I am not a scientist and would love to learn more from Dr. LaFountain about her MOA model (see article for details regarding the MOA model) I absolutely do know that this retention can happen if we pay just a bit of attention to the needs of patients and not just the needs of our brands.

But, I unfortunately agree with Dr LaFountain in her concluding paragraphs – the life sciences quarter-to-quarter thinking has to change to allow focus on the longer term opportunity to focus on retention. After all, including the benefits to patient’s health, there is $280 billion dollars on the line. And here we are looking for profit – try focusing on adherence and the need of the patient – you’ll find profit.

Even some of our customers see the need to change how business is done. On this site, on the News tab, there is a link to a recent New York Times article supported by a study published in the January 2011 edition of  the Journal of Internal General Medicine. In “Moving from Evidence-Based Medicine to Evidence-Based Health”(http://www.springerlink.com/content/u3707228u858604p/fulltext.pdf , David Moskowitz, MD and Thomas Bodenheimer, MD). The authors conclude “evidence-based health, which includes self-management support and community health interventions, can improve outcomes beyond what is possible with evidence-based medicine alone. Implementing evidence-based health requires a re-imagining of the interface between clinical care and community-level interventions. ”

I repeat – “re-imagining of the interface between clinical care and community-level interventions. “. The answer to supporting patients lies in putting patients and their needs at the center, not the needs of the system and this is a change in the current model.

The theme here is that we do need to change how we are doing things in order to get this closer to right. I just hope the prediction of Dr. LaFountain is not true – that this change cycle will take two to three more years to manifest itself.

So, how about this call to action – if you want to be ahead of the competition, if you want to capture your piece of the $280 billion before the competition, and, most importantly, if you want to be seen as the organization upon which patients can rely – step up, take the plunge, focus on adherence TODAY.

Just my thoughts,

Dyan Bryson

March 4, 2011

So, what do you say in your first blog posting?

Well, as I catch up with the world and start to blog I have all kinds of thoughts in my head about the direction this should go. First and foremost, this will be a space that will be worth your time to watch. This space will be informative and current. It will be space that will be a source for you in helping you to help patients AND grow business.

Yes, contrary to most thinking both can be accomplished. I have seen it. I have done it.

AND – one does not rule out the value of the other. In fact, as the life sciences/health care/pharmaceutical industry continues to try to sort out how to grow, or even maintain, margins simply supporting the patient is the answer that seems to be under the radar.

Granted, we have all seen the headlines about the blockbuster days being behind us and have witnessed the panic over the pipelines. I don’t deny patent cliff is a significant issue but we need to look at more than the pipeline  - there are other aspects of the business that demand attention.

As one of my partners says, what would have happened to the 6 billion dollar drug had the brand been able to retain all of the prescriptions that had actually been written? It would have been a 10 billion dollar drug.

So, why not bolster the margins by focusing on adherence? The effect could be positive outcomes for everyone:

• - first and foremost, the patient could have improved health
• - the provider could see the clinical outcomes they were expecting
• - the payer/employer could spend less on the care they provide to their members
• - and, dare I say it , the industry could see the lift that they actually paid for

Patient adherence is positive for every stakeholder focused on a patient’s health, especially the patient. Why can’t this be more a part of the focus of the industry?

This is why we founded Inspired Health Strategies. No one else seems to be laser focused on adherence so we will help you build the business case. Watch this space!

Just my thoughts,

Dyan Bryson