Patient journeys in the era of COVID-19

Open Health

Patient journeys in the era of COVID-19

OPEN Health’s Richard Jones and Sumira Riaz assess the pandemic’s implications for understanding patients’ experiences and how the pharma industry can support them

It’s impossible not to view healthcare in 2020 through the lens of the current global pandemic and COVID-19 is certainly set to cast a long shadow over patient needs and engagement.

Even when the virus is tamed, and recent advances with vaccines are grounds for much optimism, the huge societal and healthcare changes that we’ve seen take place this year will undoubtedly have left their mark in all sorts of altered, and new, approaches.

The way in which patients make their way through the healthcare system has shifted enormously, bringing disruption to the patient experience. COVID-19 has driven massive uptake of different types of digital support and interventions, most notably with telehealth.

Patients are now being trained remotely on the use of subcutaneous injections rather than nurses having to go to patients’ homes, and telehealth is also being used more commonly now for treatment reviews and routine appointments that don’t require face-to-face visits or any kind of inspections.

The rising adoption of digital technology is producing a significant and fundamental increase in the digital patient journey, and that’s going to continue.

As more and more data emerges about the impact of COVID-19 and how patients, and healthcare professionals, are managing during the pandemic, there is sure to be more to learn about how patient journeys are changing. For now, here are three standout lessons for patient journeys in the era of COVID-19.

Lesson 1: Take a patient-centric approach

As patients are increasingly involved in their healthcare decisions they have become empowered and informed data-driven advocates of their own health. A patient-centric approach starts with patients being involved with defining the unmet need and acknowledges that they are experts in their disease.

So, when creating a patient journey it’s important to take a ‘mixed-method’ approach, that combines both qualitative and quantitative insights.

Quantitative data tends to align naturally around the clinical transactional process and allows pharma companies to identify what patients’ clinical steps will be, while qualitative research brings forth the narrative story from patients as well as from healthcare professionals.

There is a lot to be learnt from the qualitative data in particular, whether it comes from market research, interviews with patients and healthcare professionals, literature reviews or social listening. Once gathered, it provides a foundation for the understanding that’s needed to start to develop traditional and digital journeys.

From there digital patient personas can be created around the different profiles or personas of patients that are involved in a digital journey, and that can be immensely useful for building a picture of patients, their behaviours, the information channels that they use and the support that they need.

However, to achieve a rich understanding of the patient journey it’s necessary to move beyond research and approach it from both a clinical and an emotional perspective. We try and identify the journey that the patient takes during their disease progression and clearly understand and identify where the touchpoints and areas of unmet need for support exist.

This requires a very collaborative process, working closely with patients and patient advocacy groups, to help populate the journey. It is always illuminating when you ‘stress test’ where the touch points are, what support is currently provided, who patients talk to, who they turn to for support and what additional support needs they have. This sort of approach has proved to work really well in a multi-numbered group where you might be co-creating with four to eight patients, patient advocates or carers. From there, a really rich picture begins to emerge of the true challenges that patients face as they navigate a particular disease course.

The co-creation element of this work is absolutely fundamental. However much research and analysis is done, it’s not until companies talk to patients who are living with a particular condition that they can truly get a rich understanding of the patient journey. It’s only by working with patients, carers and patient groups that the really insightful touch points along the journey begin to be revealed.

Furthermore, the importance of developing personalised patient journeys cannot be overstated. Assumptions are often made that a patient with a certain disease will require a standard set of information to help them feel more educated or empowered, but all of our needs are so very different from those of our neighbours, and this individualisation must be brought into pharma’s work on patient journeys.

One-size-fits-all is not a suitable approach for patient journeys, where companies should be looking for types of services that can be adaptable for different patients. There’s a fine balance to be struck around wanting to empower patients through the use of digital interventions and supporting more traditional approaches. For some patients, the additional control of tasks such as scheduling will be welcomed, but others will certainly need to regularly see their doctor and absolutely rely on the face-to-face support and real human contact those appointments bring.

Lesson 2: Combine traditional and digital patient journeys

To fully understand the patient journey, traditional and digital journeys must be combined. Digital patient journeys are an increasingly important way of approaching this subject, but they are also just one channel.

Pharma companies might typically view the patient journey in terms of being solely a transactional clinical journey that seeks to try and understand the pathway of a patient moving through a healthcare system. But a more up-to-date approach would be one that seeks to create non-traditional journeys that layer traditional best-practice journeys with the psychological-emotional experience of a patient.

Today’s patient journeys are about far more than which doctor or pharmacist a patient sees. They’re about the impact different touchpoints have on an individual. For example, what barriers exist for a patient to even get to the pharmacy?

Particularly now, with all of the huge environmental changes that COVID-19, with its social distancing, lockdowns and other restrictions, has brought, achieving a holistic perspective on patient journeys is vital. The healthcare landscape has seen huge levels of digital transformation and the rise in digital interventions that can support patients and physicians, such as telehealth, has been striking.

Looking at the UK as an example, the NHS has rapidly adopted digital technology in the wake of the pandemic as COVID-19 forced significant changes upon the way health services were delivered. The drive to free up hospital capacity and reduce infection transmission risks in NHS settings saw a surge in remote health services. Primary care was quickly refocused, wherever possible, on remote appointments, and patient uptake of services such as the NHS App and e-prescriptions. The scale of these changes, and the incredible pace at which they have occurred, have massive implications for the patient journey.

The pandemic has forced the healthcare sector to find, and adapt to, digital health solutions that can support patients and their families. It’s enabling fundamental shifts in the way patients and health systems engage, suggesting that things like a two-hour drive to see a doctor might not always be necessary. The changes that we’ve seen put in place, and the acceleration of existing digital solutions, are building a new type of healthcare environment, one that is probably going to be maintained and sustained for a long time.

Lesson 3: Map the patient journey

The reliance on digital media to engage, provide healthcare information and support patients through the COVID-19 pandemic and beyond means that it is increasingly important to understand and map the digital patient journey.

Pharma companies need to understand patients’ interactions with the digital world, the nature of which means that data should have a primary role in mapping the patient journey.

Data can show whether people are disengaging or engaging with healthcare services and how HCPs and other stakeholders can intervene to support patients to find a way to continue their journey.

A number of the elements required to construct a patient journey can all too easily be invisible, but where patients are perhaps unable to really express how an experience is for them, data can definitely interpret disengagement and engagement as well.

The beauty of digital patient journeys is that most of the data required to fill it in is out there in one form or another. Following an evidence-based process for building patient journeys offers a structured way of looking at the available digital data that’s already out there from patients. This can be bolstered by using approaches such as social listening and online landscaping to better understand where patients are going in a digital world for their information and advice.

Developing a patient journey map is hugely valuable and requires a holistic approach that brings together the digital journey and the traditional clinical journey so that clinical and emotional perspectives can be most effectively combined.

It’s so important to have both sides of the story and to be able to understand the impact that it has on an individual’s healthcare and their clinical experience, whether that’s within the healthcare setting or external from it. How patients are at home and at work, for example, must be taken into account if pharmaceutical companies are to best support patients in a holistic approach beyond the medicine.

Applied learning

The way that healthcare systems, and patients too, have been forced to respond to the COVID-19 emergency has fundamentally changed the patient journey.

It is, therefore, vital that pharma companies understand the totality of the new touchpoints that digital health – and traditional healthcare – create and apply these learnings, and the lessons above, to tackling areas of unmet need for patient support.

In doing so this will ultimately allow pharma companies to develop better interventions for patients, support healthcare professionals and improve patient outcomes. In the era of COVID-19, there has never been a better time to take a patient centric approach with patient journeys.

Richard Jones

Richard Jones, managing director, patient engagement, OPEN Health

Richard is a highly successful, commercially astute leader and problem solver with a proven track record in senior roles in the pharmaceutical industry and healthcare agencies. Richard combines 20 years’ commercial pharmaceuticals knowledge from GSK, AstraZeneca and Pfizer with 10 years’ specialist agency experience. This unrivalled pedigree enables Richard to quickly understand his clients’ business and offer innovative, differentiated and effective solutions. A senior executive, comfortable at operating strategically, above practice and respected by C-level customers. Richard has a passion for crystallising issues on patient engagement and developing innovative and effective solutions.

Dr Sumira Riaz, head of health psychology and research, OPEN Health

Sumira is a Chartered Psychologist, Registered Health Psychologist, Cognitive Behavioural Therapist. She has 16 years of experience working within the NHS, charity sector and healthcare agencies. Sumira is also part of the chronic pain team at the Royal National Orthopaedic Hospital, previously at Milton Keynes University Hospital. Here she works with patients diagnosed with pain and other mental health conditions such as depression and anxiety. Trained in Cognitive Behavioural Therapy, Sumira has accumulated 500+ clinical hours and understands the difficulties faced by people experiencing mental health and the complicated pathways when accessing help and support.

Open Health

OPEN Health is a family of expert practices working in partnership to drive positive change in medical communications and market access, globally. Our journey began with a vision to improve the lives of patients worldwide. This vision has become a reality with the integration of experts from Pharmerit and Peloton Advantage to create a new unique entity equipped to be a global leader in HEOR, market access, advertising, medical communications, and digital services. Together, we have grown to over 700 people in 15 locations across 6 countries including the United States, United Kingdom, Netherlands, Germany, India and China.

What makes us unique is our deeply integrated practices that work collaboratively to bring the strategic and technical expertise needed to be a solid partner to our clients. Combined with our broad scope of therapeutic expertise, we produce results and solutions that are of the highest quality. OPEN Health prides itself on having a highly skilled, diverse and connected team working across the globe to deliver truly innovative and best-in-class solutions. This has resulted in long-term, flexible partnerships that span across multiple brands and therapy areas.

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