The Journey Towards Patient Centricity
The journey towards patient centricity has undoubtedly begun.The challenge now is to transition fully from the existing product and services model towards delivering what patients want, as well as how to develop the critical capabilities to enable this transformation.
In this 3 part series, we speak to Jeff Elton, Accenture, Lode Dewulf, UCB, and Pierre Morgon, Cegedim to hear their perspectives on why patient centricity is proving difficult, the barriers to be overcome and the critical stages in the evolutionary journey from product-centric to patient-centric pharma organizations.
This week we interview Jeff Elton, Managing Director of Accenture Life Sciences.
eyeforpharma: Define patient centricity as you see it?
Jeff Elton: As your question implies, there are a number of ways this term is being used now. Accenture sees patient centricity as an organizing construct for life science companies that challenges many of the conventional ways in which they operate. It is a form of operating model, wherein all activities are focused on understanding the real unmet medical needs and those ‘life needs” that have the potential to encumber a patient's ability to be beneficiaries of medical innovations. For example, if a mother of two pre-school children holding two jobs can’t access care providers to initiate, monitor or sustain therapy, what can life sciences companies do to make it more accessible, in essence eliminate the ‘third job?’ A life sciences company that operates as a patient-centric organization has an ability to understand clinical benefit, the complexities of real world therapy management for patients and providers, and how to optimize value for patients, their families, health providers, and health risk bearers. Life sciences companies that adapt as a patient-centric organization are value innovators for patients and their health provider ecosystem supporting the ability to manage disease. This extends from R&D through Medical Affairs, and deeply into the structure and functioning of commercial services.
eyeforpharma: Adding patient centricity to your vision statement is not enough. Rethinking the way business is done will require an holistic approach that encompasses everything from analytics and insights to strategy and patient experience, from operating model design and execution to governance and transformation management. Where do you see the main obstacles to achieving patient centricity?
Jeff Elton: Patient centricity should be deeply engrained in a company’s values and performance management systems. If life sciences companies and also care providers measure value but reward on volume then they are not patient-centric. If life sciences companies purchase real-world clinical and social data but use transaction data for sales force incentive compensation without balance or parity then they are not patient-centric. If Medical Affairs is patient-centric and engaging in new patient and complementary physician communications and engagement platforms but commercial services remains focused on physician influence models then the effectiveness of patient care could be compromised.
Accenture thinks about patient-centric operating models as having multiple levels to their operating models — from top to bottom — accessing real-world clinical, social and economic data; building deep analytics capabilities and seeing trends across multiple data sources; bringing these data and insights into decision making from R&D to commercial services; focusing innovation beyond the pill or device to complement therapeutics with tools and services that improve disease management effectiveness and the burden of disease management for the patient and their care providers; and ultimately evolving toward reimbursement and revenue models directly linked to the value being delivered.
eyeforpharma: What do you see are the 3 or 4 critical stages in the progression from product-centric or physician-centric to patient-centric?
Jeff Elton:Patient-centric does not mean a life sciences company or provider system can’t also be physician-centric — only that the basis for the relationship with physicians is around aiding the effectiveness in providing patients therapeutic approaches and services that aid the patient’s ability to be better managers of their disease. That said, patient centricity is a journey that starts with insight and appreciation — appreciation that success in managing an acute or chronic disease state is not just about medicines but about tools, services, coaches, partners, and social networks that all make disease management less complex and a more integral part of a patient's daily life. This requires an ecosystem of partnerships and a thoroughly outside-in mode of management. So the second phase is creating the vision and practical realization for this more open, networked, ecosystem-dependent management model. This may force changes in key talent roles, intellectual property rules, and redefinition of innovation as being beyond therapeutics R&D to name but a few of the changes. The third phase is the overhaul of performance management and measurement systems — driving down into the sinew and muscle of the organization — toward the key principles of patient centricity until it becomes the new muscle memory. Here the data and analytics that aided the first phase insights and ignited execution passion for the patient is translated into quantitative and qualititative goals, operating reports, and financial model.
eyeforpharma: Why is patient centricity so difficult to implement?
Jeff Elton: In healthcare, it can be difficult to move from volume-to-value and patient-centric in one smooth, paced, transition. For example, our industry analysis shows different regions of the US and Europe are evolving at paces that allow - or don’t allow - a complete implementation or transition. As a reference point, life science companies should not think about this as national but rather as sub-regional — e.g., New England, states in Spain, etc.
A move to patient centricity is probing life sciences companies to operate in dual modes for an uncertain amount of time. Often, healthcare and life sciences companies were focused on scientific insights and the care provider as the centering of how to achieve ‘health’ for a sick patient. The science of medicine was rational, testing with statistical validity, and then translated evidence and guidelines to trained clinical personnel for practice. To incentivize executives during the ‘volume’ phase of healthcare, executives and providers were compensated for doing as much as possible for the patient as often as possible. Patient centricity demands new skills, most not part of the training of those in healthcare and life sciences. The history of other industries going through comparable changes is that not all companies attempting the transition make it — when it fails it is usually because of unaligned or unprepared leadership, lack of commitment in the operating model, and misaligned goals and incentives in performance management systems.
eyeforpharma: What are some concrete initiatives you'd like to see that would advance the cause of patient centricity (e.g. holding a patient centric summit internally, developing a patient charter, appointing a Chief Patient Officer etc.)?
Jeff Elton: We’ve seen quite a few approaches to advancing the cause of patient centricity — bringing real world data in as a requirement for all decisions, having patients attend key management meetings as active and full participants, applauding innovation programs that advance patient-centric services with patients on the review committee, having a rotating Chief Patient Officer (no one individual can really ‘own’ Patient Centricity).
Next week, we talk to Lode Dewulf to get his perspective on the journey towards patient centricity.