Patient Journey and Patient Centricity – I
What is the Patient Journey and Patient Centricity?
It is an open secret that healthcare systems in India have miserably failed to meet patient expectations. Trust in the healthcare system among patients and the public is very low. Patient-centric approaches to healthcare have been neglected. Many pharmaceutical companies engage in unethical marketing practices, and numerous 5-star hospitals focus on health packages to boost their bottom line, patient outcomes have taken a backseat.
However, COVID-19 has been a great equalizer. The current transactional marketing model is poised to shift towards patient-centric marketing. ‘Patient centricity’ involves designing services or solutions around a patient’s wants, needs, and preferences.
NHS, Britain has proposed to make “no decision about me, without me” a reality, all along the patient journey: in primary care, before a diagnosis, at referral and after a diagnosis. Patients become deeply involved in their care, in partnership with professionals and the pharma industry.
In India where the patient: doctor ratio is 1.32:1000 including AYUSH doctors and 1.1:1000 for modern medicine doctors, Pharma India can play an important role in patient-centricity. Their intervention can sometimes be even in the pre-disease stage of the Patient Journey as for example as in pre-diabetics. Has anyone given a thought to this?
The Patient Journey can be defined as the continuous sequence of healthcare events which a patient follows from the point of entry into the health system, i.e. when he first meets the physician, continuing towards diagnosis and care and ending in outpatient care (meaning when the patient is back home).
In reality, this journey is cyclical, never-ending interaction of healthcare events with their healthcare provider. “No decision about me, without me” should become the norm.
Pharma India can help to provide accurate and accessible information during the patient journey so that patients can make informed decisions about their healthcare. This brings us to the journey mapping.
What is Patient Journey Mapping?
Patient journey mapping helps the healthcare leaders to understand how patients interact with a physician or a hospital throughout their healthcare journey. The patient journey map outlines all of the patient touch points during each stage of interaction, aids in the creation of strategic outreach that improves patient engagement, patient satisfaction and the patient outcome.
The patient journey typically consists of six stages. Let us take the example of a person 38-year old Ramesh Gupte, who is a mid-level manager in a FMCG MNC. He has a familial history of diabetes. Let us walk through his journey.
Stage I – Trigger Event/Awareness
Frequent urination and thirst worries Ramesh. Today’s digital savvy patients like Ramesh may self-assesses his symptoms, conduct research, consider potential health conditions that may require treatment, and may even reach out to online communities (posing questions on social media, etc.). Possibly Ramesh may even try to locate and approach a patient support group, as they do in the west.
However, patient support groups are virtually non-existent in India. This is where a brand manager in Pharma India can step in – initiate patient support groups.
Patient support groups have tremendous value in helping patients, especially those with chronic diseases. Pharma India brand managers should be proactive in initiating these groups.
In the Indian context, where the doctor-patient ratio is skewed, such support groups can also help patients share their experiences with others. This experience is unparalleled. Diabetes support groups in the western world and Scleroderma India are good examples.
Stage II – Help
Ramesh may now make initial contact with a doctor via his family physician or through healthcare platforms like Practo, ZocDoc, HoyHealth and so on. Or he may even make an in-person visit.
Stage III – Care
Ramesh is assessed at a medical facility like the outpatient chamber of a consultant doctor, a polyclinic, a hospital and so on.
Stage IV – Treatment
The physician or the hospital’s resident doctor provides Ramesh with both on-site and follow-up care. The physician or the hospitals resident doctor will take a decision in consultation with Ramesh. For example, here the physician will explain to Ramesh why diet and exercise is the first-line therapy and only if that fails oral hypoglycemic agents and or insulin injections will be needed. If Ramesh has to be prescribed insulin injections, it has to be in consultation with Ramesh. “No decision on Ramesh, without involving Ramesh.” The doctor may even suggest appropriate lifestyle changes. The brand manager through patient support groups can organize to help the patient in the first-line therapy – diet and exercise. As an example, Rajashree Menon has done this successfully through her ‘Walk with the Doc’ initiative. (1)
Stage V – Behavioral/Lifestyle Change
Ramesh makes changes in his lifestyle with the help of Patient Support Groups like ‘Walk with the Doc’. He takes part in proactive management of the disorder to reduce the risk of being on insulin injections and for his own long-term wellbeing so as prevent post-diabetic complications like diabetic retinopathy or neuropathy.
Stage VI – On-going Care/Proactive Health
Ramesh manages his care between clinical visits, while the consultant fosters engagement to help him address symptoms and maintain good health.
A brand manager must not lose sight of the fact that in South and Southeast Asia, the key touchpoints in the patient’s journey is the home. It is here that patients receive a lot of personalized attention and care, accounting for 95% of the patient’s journey.
The patient’s near and dear ones are the true caregivers and perhaps the most important stakeholders. This could include the spouse, son, daughter-in-law, mother, and others.
This is an opportunity for the brand manager to support these patients through patient support groups. Digital tools accessible to caregivers at home, home diagnostic kits, smart-watches, and many more innovations in this IoT age are available.
Using patient journey maps as guides, pharma brand managers and marketers through patient support groups can craft strategic, personalized outreach that keeps Ramesh engaged throughout the care journey.
Pharma brand managers must not lose to this opportunity to become patient centric.
Outreach means the activity of providing services to patients that might not otherwise have access to those services. For example, a patient may run short of insulin shots at midnight, he can access the pharma marketer. This is exactly what Novo Nordisk did and went to to become the strong leaders in insulin.
A key component of outreach is that the group providing this service is not stationary, but mobile; in other words, it involves meeting someone in need of an outreach service at the location where the patient is.
Journey mapping can trace gaps in the healthcare experience, giving the pharma brand manager the opportunity to fix the issue. Ultimately, patient journey maps help pharma improve patient engagement and foster lasting patient-provider relationships.
Benefits of Patient Engagement
Patient journey mapping benefits both the physicians and the pharma company that spend time to thoroughly understand the process:
- Patient Engagement creates personalized experiences for each patient by deeply understanding his needs and preferences.
- Helps the physician to understand patient experiences throughout each stage of interaction.
- Helps the physician to keep up with shifting market forces to ensure high rates of patient acquisition and retention.
- Patient Engagement can expose gaps and opportunities for improvement in patient communications.
- Unlocks opportunities to improve pre- and post-clinical patient engagement through timely, targeted outreach efforts and boosts retention rates by reinforcing long-term doctor-patient relationships
A Final Question: If there is no brand promotion, how will ‘patient-centric marketing’ help my brand?
There are two ways to answer this question
I] The Law of Reciprocity
When someone is kind to you, don’t you feel compelled to act in the same manner?
This is reciprocity—the human tendency to want to respond to a kind gesture with one of their own.
If it comes down to deciding between one brand and another, the doctor may be more inclined to reciprocate your patient-centric efforts as it has helped the doctor and made him look like a hero.
II] The Effect of Subliminal Messaging
When you are in pain or distress, the first word which comes out of our mouth is “आई ग” (“Oh! My Mother”), isn’t it? Why? Subliminal messaging!
“Subliminal message,” means a message that you recall and remember even when you are not consciously aware. A subliminal message is very powerful. You cannot become consciously aware of subliminal stimuli even if you look for it. Subliminal perception is believed to be a result of a deliberately designed communication technique aimed at generating a response, so that people will do things they wouldn’t ordinarily do.
And this is what you exactly happens in ‘patient-centric marketing’. Both the perception and reaction to subliminal messages happen at the subconscious level. And this power will carry your brand forward!
This journey can be facilitated when the pharma reps physically interact with the doctors, patients and their visits are augmented by the support from the digital marketing team.
Or in other words, patient’s outcome and the positive experience of the patient at every stage of the patient’s journey are possible only via the phygital route.
Patient-centricity in healthcare is possible only if the tipping point is sensitized. And the tipping-point is the CEO or the owner of the enterprise.
This blog has been inspired by the NHS, UK philosophy of patient centricity – ‘NO DECISION ABOUT ME WITHOUT ME.’