Andy Graves and Dr Clare Moloney of IQVIA discuss how the COVID-19 pandemic accelerated the adoption of digital patient services and how future deployment alongside traditional methods could offer the best of both approaches. They outline how the momentum developed in the utilisation of digital solutions during this period can be built on to create meaningful patient services.
All stakeholders in the delivery of patient services had to react quickly in response to the pandemic. Prior to COVID-19, the overall industry trend had been building towards creating patient-centric, personalised initiatives providing care-management support to individuals across therapeutic indications, states Andy Graves, product and strategy director, patient support and adherence practice at IQVIA.
With the onset of the pandemic, when the need to augment traditional care models became urgent, it was necessary to launch digital enabled services to support people to manage health conditions safely from their own homes. The challenge facing all stakeholders will now be how to leverage learnings from the rapid rollout of remote engagement , determine the most impactful elements and create a robust evidence base for future service evolution and scale-up.
A key philosophy for developing these patient support services going forward will centre on the idea that one size does not fit all and how to successfully engage with the person living with a health condition on an individual basis. To achieve this, the industry is listening closely to patient associations and communities to learn what services suit particular groups and also how best to support family members and care partners, as often they from an integral part of care, but have different needs to the patients themselves.
Dr Clare Moloney, director, behavioural science, medical and patient communications at IQVIA, outlines that this can mean different services offered depending on the age of the individual involved – for instance, the type of service that can support a teenager living with a rare disease to better self-manage and negotiate the healthcare system is very different from that required to support the parents of a young child who find themselves having to deliver an injection every day, even when the condition is the same. This can lead to a real opportunity to learn about and help alleviate the challenges that people living with a health condition face.
The necessary focus on delivering digital solutions is transforming the ways that people can be engaged and supported, through smartphones or smart, technology-enabled solutions. At the same time, maintaining a personal connection through interactions with healthcare professionals (HCPs) and care teams is still of paramount importance.
Converging these engagement models into a ‘multi-platform approach’ has been accelerated by COVID-19 and looks set to continue as the future of patient services, where the strength of both can be brought into play.
The pandemic environment – where solutions were rapidly established and tested in real-world settings – has provided the industry with a lot to evaluate. From a behavioural science perspective, Dr Moloney identifies that the emergence of COVID-19 has even changed the general public’s perception of medicine, including a greater awareness of the process behind drug development, leading to an increase in the need to focus on and facilitate shared decision making
However, in addition to providing a greater sense of empowerment this can lead to people being influenced by negative or incorrect media. This dynamic had already been developing due to the easy access people have to information on the internet, but the health-related concerns of the pandemic drove this to new levels.
In turn, this means that there needs to be a heightened focus on creating credible, evidence-based solutions, explains Graves. “Having credible information well-positioned, through the right channel, in the right time, is essential for healthcare providers and life-science companies to best support their patients” he says.
Within a comprehensive digital service, this can mean providing accurate information that is easily accessible and quick to reference. Beyond providing education, digital services can also be leveraged to deliver a greater range of support and behaviour change techniques. For example, instruction videos as a reference after receiving initial training, or planners and prompts for complex regimen management. It can also provide opportunities for people to learn how to build skills, such as resilience and managing difficult emotions, at a time and place that is convenient for them – enhancing the levels of care they receive.
This kind of remote engagement, where patients can access information without in-person support, is one part of patient support services that is evolving rapidly. However, digital has also facilitated improvements in the more traditional ways of providing support, such as access to HCPs and nurses.
While in-person support remains a core part of healthcare, digital solutions have allowed people living with health conditions to receive a quick response to questions or easily schedule an appointment with their nurse or HCP. By combining both digital and in-person, HCPs can dedicate more time to helping patients. “Pulling those two elements together is where we would suggest, and it’s what the evidence shows, you’re going to get a really impactful support service,” says Dr Moloney.
This multi-platform approach is essential for guaranteeing comprehensive patient support as the relationship with nurses and HCPs is often one of the most valued elements of engagement. For Graves, the support provided by these systems allowed some of the pressure to be taken off healthcare systems during the early stages of the pandemic.
He spotlights the nurse teams and patient service providers here as offering an effective ‘bridge’ within healthcare, highlighting the value and potential of effective patient support services.
This demonstrated value has been established in the pharmaceutical industry in recent years, as the concept of patient-centricity has developed from buzzword to effective action. As a result, it is now increasingly common for companies to create in-house, patient-focused centres of excellence.
These in-house teams ensure that the treatments being developed have the future patient in mind and ensure that the brand strategy is established prior to launch. This can mean making sure that individuals living with the related condition have access to expedited diagnosis, receive the right treatment easily, and self-management and long-term adherence is optimised.
As the industry has moved to embed the concept of patient centricity into their operations, Dr Moloney explains that companies are thinking about patient support services earlier in drug development than ever before – this can mean as early as phase II. It has also seen the planning process change, where running clinical trials has moved beyond just determining the efficacy of a treatment to also be seen as an opportunity to “learn more around the individual’s experience with that treatment,” Dr Moloney states.
One area where this is especially important is in treatments for rare diseases, which by definition means that few individuals are being treated and that their requirements may vary depending on a multitude of factors, including the individual’s age, location and the care providers’ needs. In this field, one size does not fit all, and patient support services have to be tailored in a careful manner.
As Dr Moloney explains, “Companies need to be thinking about being able to offer different support and different services to accommodate for different age ranges, considering both their trajectory through the disease, and the trajectory of growing up as somebody managing a chronic condition.”
Due to this, Dr Moloney believes that there is an opportunity for the industry to provide support between the care that is offered as a paediatric patient and as an adult, as there can often be a number of challenges presented at this transition phase. There is also an opportunity to support the parents and carers who are helping a child to live with their rare disease (read IQVIA’s latest blog). . The type of services that can be offered vary, whether that is helping them navigate the emotional challenge of managing their child’s health, helping the adaptation process from parent to carer, or the fundamental challenge of delivering a treatment confidently.
Patient support services are usually designed around an evidence base for general health conditions, but insight and data can be limited for rare conditions. However, work can be concentrated on some of the common challenges for living with a rare disease, through input from nurse teams and design teams and learning from patient communities.
Dr Moloney notes that on a basic level, one important aspect of support should be to ensure individuals do not feel isolated, whether that is people living with a rare condition or a person living with a more common chronic health issue.
This has become more important than ever due to the pandemic. However, the evolution of patient services to continue to allow access to healthcare solutions, both digitally and in-person, has been invaluable for ensuring that people living with health conditions were able to retain access to support services.
The opportunity now is to understand which digital solutions have been shown to be most effective through this accelerated learning phase, and to build them into existing frameworks of patient support services and provide a more effective means for people to optimise their own health outcomes.
IQVIA is a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry. Powered by the IQVIA CORE™, IQVIA delivers unique and actionable insights at the intersection of large-scale analytics, transformative technology and extensive domain expertise, as well as execution capabilities. Formed through the merger of IMS Health and Quintiles, IQVIA has approximately 68,000 employees worldwide.
Learn more at www.iqvia.com.
Clare is responsible for oversight and strategic direction of patient, caregiver, and healthcare professional programmes that promote health-related behaviour change. Clare has more than 10 years of experience working and consulting as a health psychology specialist in multiple settings, including the University College London, Royal Free Hospital London. In addition, Clare has published work that examined the drivers of adherence in chronic disease, behaviour-change interventions and digital health support.
Clare has designed and implemented a multichannel, pharma-sponsored, patient-support programme that was launched across 23 countries, created a joint working initiative with NHS cardiac centres to offer additional post-discharge patient-support services, and provided oversight of a real-world study to determine effectiveness of telehealth devices in people with respiratory conditions.
Andy is product director for the patient engagement platform at IQVIA. Andy has over 10 years healthcare experience, both in agency and in provider (NHS). With a specialist focus in solution design for adherence and patient support solutions as well as leading product development in digital patient innovation, Andy represents a growing focus within IQVIA for the development of intelligent, impactful, next generation patient adherence and engagement solutions.