Optimizing Customer Engagement in a Changing Healthcare World · 2020-05-11 · Optimising Customer...

Optimising Customer Engagement in a Changing Healthcare WorldChallenges and solutions from the world of oncology

May 2020

http://www.guidehouse.com

COVID-19 has fundamentally disrupted the delivery of healthcare

Guidehouse sought to understand:

• How oncologists have been impacted

• The concerns and needs of HCPs

and patients

• How pharmaceutical companies can

best support them now and over time

guidehouse.com

Table of Contents



Guidehouse conducted a survey to uncover potential issues related to two important areas of the oncology practice that may be impacted by COVID-19

Healthcare

Optimising Customer Engagement in a Changing HealthCare WorldChallenges and solutions from the world of oncology

Patient Management Safe, timely and informed treatment of patients

Stage of patient journey Potential disruption

PresentationEnsuring patients are presenting and being referred correctly in a timely manner

DiagnosisEnsuring patients are accurately diagnosed with appropriate tools, tests and resources in a timely manner

Initiation

Ensuring patients can be initiated on treatment; awareness of potential risks of treatment and COVID-19

Maintenance/Monitoring

Ensuring patients can continue on therapy with appropriate monitoring and support

Advanced Standards of Care

Development of critical new therapies and staying up-to-date on latest medical advances

Areas of advancement Potential disruption

Clinical trialsEnsuring important trials continue and disruption is minimised

Scientific congress

Ensuring latest information is accessible to HCPs and relevant stakeholders

Peer to peer learning

Ensuring any knowledge sharing platform is active and communication open

Continued Professional Development

Ensuring required learning activities can be accessed and fulfilled

Overview

Overview | 3


Optimising Customer Engagement in a Changing Healthcare World

Impact to Current Practice

• Patient referral and presentation rates

• Technology Utilization

Key Issues/Concerns

• Safe patient management

• Advancing standards of care

Support Received and Required

• What, how and when is support welcomed from industry

Issues & Opportunities

• Optimising engagement longer term

1

2

3

4

Contents:

0

10

20

30

40

50

USA UK France Italy Germany China

Num

ber o

f res

pond

ents

Geography

Survey sample size

Oncologists Haematologists

Methodology: • Online 20 minute questionnaire with consenting physicians

− Survey in field 16-23 April

Screening criteria:• Oncology or haematology specialist

• >5 years as a specialist

• >50% of professional time treating patients (throughout average year)

Average experience as a specialist among sample16 years

N=197

Overview | 4

The survey was conducted among an experienced cohort of oncologists and haematologists across the US, EU4 and China

“The purpose of this survey is to understand pressures on areas of your oncology practice and how pharmaceutical companies can optimise their engagement and provide support in key areas.”


Of respondents experienced decrease in number of patient visits

Average decrease in number of visits

Has led to

Increase in parenteral to oral switching

Increase use of telemedicine and mail-

order prescriptions

Delays in non-essential procedures, treatments

and visits

78% 34%

1. Impact to Current Practice

Impact to Current Practice | 5

Patient visits have decreased in an effort to reduce COVID-19 exposure; use of telemedicine and mail-order prescriptions has increased

A significant decrease in number of patient visits

Click on the chart below for detailed info on each category

“Patients with non-emergent issues are being seen with telemedicine. We are triaging patients based on urgency.”


2. Key Issues and Concerns

Key Issues and Concerns | 6

Oncologists are most concerned about the impact on treatment initiation & patient maintenance/monitoring

Patient Journey Step

Presentation Diagnosis Treatment Initiation Maintenance/Monitoring

Level of Concern Med Med High High

Top Issues Highlighted

1. Increased patient anxiety

2. Reduced referral rate

1. Delayed diagnosis

2. Limited availability of diagnostic tools

3. Constrained resource – lack of space

1. Delaying start of therapy

2. Unknown risk of contraindications with COVID-19 treatment

3. Availability of finance for treatment (US only)

1. Increased patient anxiety

2. Delayed treatment

3. Ongoing patient safety monitoring (lack of patient touchpoints & care)

Patient Journey

Click on the chart below for detailed info on each category

“We’ve observed an almost complete elimination of follow-up examinations and checks.”


3. Support Received

Digital CommunicationEmail and teleconfernce updates, teleconferences to discuss medical information17%

of respondents

Online ResourcesScientific information related to COVID-19, webinars, e-brochures, etc.20%

of respondents

None47%of respondents

Support Received | 7

Nearly half of all oncologists have received no support from industry related to COVID-19; others received online resource and digital communication

Click on the charts below for detailed info on each category

“I have received information brochures on the use of chemotherapy during pandemic which was useful.”

“I have not received much useful support.”

WHAT support have you received?

No support received


3. Support Required

Information on COVID-19 Impact on Oncology, Medical

and Scientific Updates

• Data sharing on COVID-19 impact on disease biology

• Drug-drug interactions

• Latest scientific updates from oncology congress

33%of respondents

Remote Working Tools

• Remote patient monitoring

• Multidisciplinary Team information sharing

• Clinical trial monitoring 33%

of respondents

Protective Equipment30%of respondents

Support Required | 8

All-in-one digital repository of medical and scientific information (related to COVID-19) and remote working tools would be useful to HCPs


“We need precise information on the use of chemotherapy after the first phase of the pandemic.”

“Information on COVID-19 and drugs from pharmaceutical companies for patients and doctors.”

WHAT support do you need/want? Of respondents requested support

~95%

• Masks

• Gloves


3. Support Required

Frequent communication/updates >50%

of respondents

Digital Tools

• Remote patient support and monitoring apps

• Customized content to download (updates on congress highlights, latest medical information etc.)

• On demand

• Weekly

>50%of respondents

Virtual communication (phone/video) ~50%

of respondents

Support Required | 9

Having information available on demand via a digital repository would be beneficial with more regular communication/updates preferred


“Contact with medical information, ideally once a week, sharing specific COVID and cancer data, would be really useful.”

“Self service access to comprehensive medical information on all products and other resources .”

WHEN would support be needed? HOW should support be delivered?

• Increased availability of medical information staff, single point of contact


4. Issues and Opportunities

Issues and Opportunities | 10

Issues raised by COVID-19 offer opportunities for industry to re-evaluate their engagement strategy with HCPs and optimise these relationships (1 of 2)

Identified Issues Potential Opportunities

Impact of COVID-19 on disease biology and cancer treatment

Proactively provide information and research related to:

• Drug-drug interactions and pharmacovigilance

• COVID-induced pneumonia and impact on tumour types and treatment

Financial concern for patients impairing access to treatment

Prioritize patient access through payer negotiation, rebates and access schemes to maintain patients on treatment

Disruption to clinical trials Issues Highlighted

Prioritize key trials, and invest in remote digital tools to enable continuation:

• Utilizing remote patient monitoring to enable pharmacovigilance during at-home trial continuation

NE

AR

TE

RM

1

2

3


Capacity constraints — dealing with patient backlog

Audit capacity models and patient throughput for oncology services

• Explore options such as mobile infusion clinics and at-home care delivery

Difficulty staying up-to-date with current advances in oncology

Facilitate easy access to latest scientific news and trends

• Sponsor virtual congress registrations

• Provide daily debriefs and downloadable resources

• Develop easy-to access, peer-created and accredited CPD for oncologists

ME

DIU

M T

ER

M

1

2


4. Issues and Opportunities

Issues and Opportunities | 11

Issues raised by COVID-19 offer opportunities for industry to re-evaluate their engagement strategy with HCPs and optimise these relationships (2 of 2)


Treatment continuity due to limited access to hospital

Adapt commercial model for at-home care

• Invest in homecare solutions, virtual or homecare nursing services

• Develop medical information and patient support materials to facilitate at-home care

Reduced patient touchpoints

Explore telemedicine as an enduring solution to maintain patient contact

• Conduct patient-focused research to understand preferences for remote engagement from HCPs

• Digitize patient support materials

Provision of relevant information

Shift communication platform to HCP led, on-demand information with regular updates

• Online portal with digestible scientific and medical updates on company medicines

• Prioritize Medical vs commercial information, limit ‘push marketing’ and additional noise

LON

GE

R T

ER

M

1

2

3

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©2020 Guidehouse Inc. All rights reserved. W187218

This content is for general informational purposes only, and should not be used as a substitute for consultation with professional advisors. This publication may be used only as expressly permitted by license from Guidehouse and may not be otherwise reproduced, modified, distributed, or used without the expressed written permission of Guidehouse.

About Guidehouse

Guidehouse is a leading global provider of consulting services to the public and commercial markets with broad capabilities in management, technology, and risk consulting. We help clients address their toughest challenges with a focus on markets and clients facing transformational change, technology-driven innovation and significant regulatory pressure. Across a range of advisory, consulting, outsourcing, and technology/analytics services, we help clients create scalable, innovative solutions that prepare them for future growth and success. Headquartered in Washington DC, the company has more than 7,000 professionals in more than 50 locations. Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and diverse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies. For more information, please visit: www.guidehouse.com.


http://twitter.com/guidehouse

http://linkedin.com/company/guidehouse



Appendix | Survey Data

Appendix| 13

The survey consisted of four main sections, each with a series of questions

Section Key Topics

1 Impact

• Has the volume of patient visits changed since the COVID-19 pandemic? If so by how much?

− Has your use of telemedicine or mail-order prescription services increased?

− Have the reasons for patient visits changed? If so how?

2 Issues, Unmet Needs & Concerns

• Within safe patient management and advancing standards of care, which areas have been impacted most?

− On a scale of 1 (low impact) to 5 (high impact) how much of an impact do the following potential issues have in the current situation related to your oncology practice

3 Support & Solutions • What support do you want to receive from industry (what, how, when)

− What support have you received already that has been useful?

4 Future Perspectives• Of all of the areas of support or means of engagement highlighted in this survey as a current

need, what would have the most benefit for the longer term?


A high proportion of oncologists observed decrease in patient visits with an average decrease of 34%

0

10

20

30

40

50

60

70

80

90

100


%

Geography

Change in oncology/hematology patient visits since COVID-19

% of responsends who observed a decrease Average % decrease

0

10

20

30

40

50

60

70

80

90

100


%

Geography

Change in oncology/hematology patient visits since COVID-19

% of responsends who observed a decrease Average % decrease

Has the volume of patient visits changed since the COVID-19 pandemic? If so by how much?

Appendix - Impact | 14


Most oncologists have observed increased use of telemedicine and mail-order prescriptions

No significant differences observed across markets

Has your telemedicine or mail-order prescription services increased?

Appendix - Impact | 15

Increased85%

No change14%

Decreased1%

Change in use of mail-order prescriptions (% of respondents)

Increased93%

No change7%

Decreased0%

Change in use of telemedicine (% of respondents)

Optimising Customer Engagement in a Changing Healthcare World Appendix - Impact | 16

Half of the oncologists believed reasons for patient visits had changed, with only complex/urgent cases visiting clinic

Have the reasons for patient visits changed? If so, how?

Very different25%

Sligthly different24%

Not different51%

Change in reasons for patient visits Common reasons stated for change

Aftercare visits are postponed

Complex and urgent cases still present in clinic, including adverse events

Greater proportion of acute cases

Routine appointments conducted via telemedicine

“I only see patients who have side effects or who must start therapy.”



Treatment initiation and patient maintenance/monitoring were most impacted by COVID-19

Within safe patient management and advancing standards of care, which areas have been impacted most?

Treatment initiation and patient maintenance/monitoring were most impacted by COVID-19

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Patient presentation

Diagnosis

Treatment initiation

Maintenance/monitoring

Clinical trials

Scientific congress

Peer to peer learning

CPD

% of respondents ranking importance

Ranking of areas by impact of COVID-19

Ranked as most impacted

Ranked as least impacted

2

Pat

ient

m

anag

emen

tA

dvan

cing

st

anda

rds

of c

are

Appendix - Issues & Concerns | 17



Increased patient anxiety is the major issue preventing patient presentation

On a scale of 1 (low impact) to 5 (high impact) how much of an impact do the following potential issues have in the current situation

related to your oncology practice



0 1 2 3 4 5

Reduced referral rate

Increased patient anxiety

Score

Average score (1 low impact -5 high impact) for specific issue

“The patients are more anxious but what affects the rate of presentation is not the severity of the case but how each individual patient perceives the worry of the infection.”


Delayed diagnosis and lack of availability of diagnostic tools may have detrimental impact on patient care

On a scale of 1 (low impact) to 5 (high impact) how much of an impact do the following potential issues have in the current situation related to your

oncology practice



“Delay of radiological examination to assess cancer.”

0 1 2 3 4 5

Lack of risk stratification guidance

Lack of availability of diagnostic tools

Constrained capacity – lack of space

Constrained resource – lack of staff

Delayed diagnosis

Score



Delaying therapy and the risk of contraindications with COVID-19 treatments are areas of concern and uncertainty


oncology practice



0 1 2 3 4 5

Lack of risk stratification guidance

Unknown drug interations with COVID-19

Unknown risk of contraindications with COVID-19treatments

Delaying start of therapy

Score



Increased anxiety and worry among patients in the maintenance phase is a major worry for HCPs


oncology practice



0 1 2 3 4 5

Delayed treatment

Reduced patient touchpoints

Reduced adherence

Reduced pharmacovigillance

Disrupted supply chain

Increased anxiety and worry

Diminished protective equiptment

Lack of caregiver assistance

Restricted budgets

Score

Spe

cifi

c is

sue



Clinical trials remain an important issue, with delays to timelines and reduced participation having a high impact


oncology practice



0 1 2 3 4 5

Reduced willingness/ability to participate in clinicaltrials

Challenges with maintenance/monitoring

Issues with data collection

Delay to overall timeline

Score



Scientific learning remains important, and missing out on key events has a significant impact


oncology practice



0 1 2 3 4 5

Missed key scientific information

Delayed or cancelled key events for career progression

Score



Disrupted access to meet as a MDT may impact on knowledge sharing and treatment practices


oncology practice



0 1 2 3 4 5

Inability to meet as a multi-disciplinary team to discuss emerging data,latest guidance and decisions on adoption of latest treatment

methodologies in oncology

Score



In CN, preference was for support on information on COVID and oncology rather than patient or physician support reflecting post-peak status

What type of support would you like to receive?

“Hope to have more medical information support such as damage of COVID pneumonia on related systems and effect on drug use.”

Information

Patient SupportCare

PhysicianSupportEquipment

None

USA EU4 China

31%28%

53%

31%

23%

17%

26%

35%33%

21%

33%

27%

12% 12%

0%0%

20%

40%

60%

Information Patient Support Physician Support Equipment None

Appendix - Support & Solutions | 25


Support was requested largely in digital formats, with communication preferences on a weekly basis, with information available on-demand

What frequency/how often would you like this support? Through what channel(s) would you like this support?

Freq

uenc

y of

Sup

por

t

Weekly/ On-Demand

• Respondents stated that communication would be welcome on a weekly basis

• A high proportion also mentioned that on-demand availability of information and support would be beneficial

Cha

nnel

Digital

• Digital communication was the predominant preference across geographies

• Many physicians expressed the preference for information and contact to be available in a single location, with on-demand functionality



Most HCPs have not received any specific support from industry; online resources and digital communication have been provided in some cases

What support have you already received from pharmaceutical companies that has been particularly useful?

47%

20%17%

3% 3% 3% 2% 2% 2% 1% 1%0%

20%

40%

60%

80%

100%

None Online Resources

Digital Communication

Medical Reps Equipment Printable resources

Psychological support

Remote patient monitoring apps

Training courses

Convenient dosing/

administration

Drug delivery

“Sorry I have not much useful support.”



Areas of required support were mentioned again as longer term solutions – initiatives put in place now may have longevity in improving engagement

Selection of impactful responses:

Of all of the areas of support or means of engagement highlighted in this survey as a current need, what would have the most benefit for

the longer term?

“Highlighting the need to get information about COVID19 and a variety of cancers.”

Appendix - Future Perspectives | 28

“People have a strong interest in the field of digital medicine and report a positive attitude. Global medical information resource sharing is bound to be a trend.”

“Self service access to comprehensive medical information on all products and other resources that can support healthcare professionals in their efforts to deliver better outcomes.”

“The ability to contact medical representatives on-line.”

“Online medical information to keep up to date with the news.”

“Precise indications on the use of chemotherapy after the first phase of the pandemic.”

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