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Optimising Customer Engagement in a Changing Healthcare WorldChallenges and solutions from the world of oncology
May 2020
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.”
Optimising Customer Engagement in a Changing Healthcare World
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.”
Optimising Customer Engagement in a Changing Healthcare World
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.”
Optimising Customer Engagement in a Changing Healthcare World
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
Optimising Customer Engagement in a Changing Healthcare World
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
Click on the charts below for detailed info on each category
“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
Optimising Customer Engagement in a Changing Healthcare World
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
Click on the charts below for detailed info on each category
“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
Optimising Customer Engagement in a Changing Healthcare World
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
Identified Issues Potential Opportunities
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
Optimising Customer Engagement in a Changing Healthcare World
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)
Identified Issues Potential Opportunities
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.
Optimising Customer Engagement in a Changing Healthcare World
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?
Optimising Customer Engagement in a Changing Healthcare World
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
USA UK France Italy Germany China
%
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
USA UK France Italy Germany China
%
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
Optimising Customer Engagement in a Changing Healthcare World
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.”
No significant differences observed across markets
Optimising Customer Engagement in a Changing Healthcare World
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
No significant differences observed across markets
Optimising Customer Engagement in a Changing Healthcare World
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
Appendix - Issues & Concerns | 18
No significant differences observed across markets
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.”
Optimising Customer Engagement in a Changing Healthcare World
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
Appendix - Issues & Concerns | 19
No significant differences observed across markets
“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
Average score (1 low impact -5 high impact) for specific issue
Optimising Customer Engagement in a Changing Healthcare World
Delaying therapy and the risk of contraindications with COVID-19 treatments are areas of concern and uncertainty
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
Appendix - Issues & Concerns | 20
No significant differences observed across markets
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
Average score (1 low impact -5 high impact) for specific issue
Optimising Customer Engagement in a Changing Healthcare World
Increased anxiety and worry among patients in the maintenance phase is a major worry for HCPs
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
Appendix - Issues & Concerns | 21
No significant differences observed across markets
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
Average score (1 low impact -5 high impact) for specific issue
Optimising Customer Engagement in a Changing Healthcare World
Clinical trials remain an important issue, with delays to timelines and reduced participation having a high impact
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
Appendix - Issues & Concerns | 22
No significant differences observed across markets
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
Average score (1 low impact -5 high impact) for specific issue
Optimising Customer Engagement in a Changing Healthcare World
Scientific learning remains important, and missing out on key events has a significant impact
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
Appendix - Issues & Concerns | 23
No significant differences observed across markets
0 1 2 3 4 5
Missed key scientific information
Delayed or cancelled key events for career progression
Score
Average score (1 low impact -5 high impact) for specific issue
Optimising Customer Engagement in a Changing Healthcare World
Disrupted access to meet as a MDT may impact on knowledge sharing and treatment practices
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
Appendix - Issues & Concerns | 24
No significant differences observed across markets
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
Average score (1 low impact -5 high impact) for specific issue
Optimising Customer Engagement in a Changing Healthcare World
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
Optimising Customer Engagement in a Changing Healthcare World
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
Appendix - Support & Solutions | 26
Optimising Customer Engagement in a Changing Healthcare World
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.”
Appendix - Support & Solutions | 27
Optimising Customer Engagement in a Changing Healthcare World
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.”