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Healthcare Experts Share the Latest Thinking & Insights

 

A horizontal image of a woman handing over an appointment slip to the receptionist for her medical check. She looks very cheerful and positive.

Improving Healthcare Transparency to Build Trust and Engagement

By | Global Healthcare Trends, Healthcare Access, Healthcare Technology, Informed Patient, Patient-Driven Healthcare | No Comments

Throughout the healthcare industry, there is a growing demand for greater transparency. Today’s healthcare consumer is savvy and well-researched, so the days when a doctor, hospital, or pharmacy could dictate medication recommendations and treatment methods and expect a patient to blindly follow advice are mostly over. Patients also have a variety of options, so supplying valuable information can help a brand to stay competitive.

Medical Billing Transparency

Medical billing transparency is in high demand. Customers expect to know what they will have to pay for a doctor’s appointment, medication at a pharmacy, or treatment ahead of time. Since procedures and medications can vary widely in price, even within the same locale and network, detailing pricing points up front can help a practice to attract and retain customers. By working closely with insurance companies, practices can help customers discern complete out-of-pocket costs ahead of time and plan for those costs.

Health Information Accessibility

Since healthcare practices are required to make meaningful use of electronic health records (EHRs), these records are more easily shareable now than in the past. Making it possible for patients to view these records online at their convenience can help to drive better healthcare outcomes and can create an atmosphere of trust between healthcare providers and patients. When patients can view their own information and do research about conditions and other health factors, it can also drive engagement.

Online Presence and Familiarity

Having a company website or app can help a patient to feel familiar with a practice office, hospital, or pharmacy before visiting. Showing pictures of the building, waiting office, and possibly medical equipment or rooms can help a patient to feel comfortable when arriving at the location. Supplying a bit of information about doctors and staff can help patients to feel greater trust and reassurance about the quality of care that they will receive.
Setting Patient Expectations In Advance
No patient enjoys arriving to a scheduled appointment on time and then having to wait for hours to see a doctor. Allowing patients to download, print, and fill out patient forms ahead of time can help to expedite appointments and save on office crowding, enhancing the patient experience and making the best use of staff time. Any further information that can be furnished to help patients know what to anticipate, such as standard wait times and average length of time for certain procedures, will further develop patient expectations and improve satisfaction with services.

 

References:
Why Price Transparency Matters Now / Healthcare financial Management Association http://www.hfma.org/content.aspx?id=28785
Meaningful Information for Better Healthcare / The Network for Regional Healthcare Improvement http://www.nrhi.org/work/multi-region-innovation-pilots/center-healthcare-transparency/

Lack of Diversity among Healthcare Providers Impacts Healthcare Disparities

By | Diversity & Inclusion, Health Insurance, Healthcare Access, Healthcare Providers, Patients | No Comments

The U.S. faces great changes in the 21st century.  High levels of immigration from Asia, Central, and South America have dramatically shifted U.S. demographics.  According to the U.S. Census survey, the U.S. may be a majority non-White nation by as early as 2043.  By 2060, the relative percentage of non-Hispanic Whites in the population is expected to decrease to just 43% from 63% in 2010, whereas the relative percentage of Hispanics will nearly double, from 17% in 2010 to a predicted 32% (1).  Despite the rapidly growing minority populations within the U.S., there remain relatively few minority healthcare providers, such as nurses, physicians, and technicians.  For example, as of 2013, 70% of physicians identified as White, while only 6.4% identified as Hispanic and 5.9% as African American (2).

 

The lack of diverse and culturally competent healthcare providers may adversely impact the efficacy and frequency with which this care is administered.  A patient’s language and culture dictate how they express and explain their symptoms, as well as the degree to which they are comfortable seeking medical assistance.  Patients and providers who understand one another’s core principles – especially with regards to medicine – and can communicate effectively have a better chance of achieving a better patient outcome (3).  When asked the question, “do you think that African American and Hispanic patients receive a lower quality of care, the same quality of care, or a better quality of care than White patients?”, A majority of African American patients answered lower, along with around 40% of Hispanic patients (4).  Even 25% of White patients felt that they received a higher quality of care than their minority counterparts (4).  Perhaps even more convincingly, as early as 2005, over 75% of physicians felt that minorities were receiving a lower level of care than White patients, and that figure has been steadily rising (4).  This is an alarming trend.  While these numbers do not necessarily indicate a systemic discrimination within the healthcare industry, it may show a mistrust and lack of communication between minority patients and the mostly White male dominated healthcare industry.

 

This mistrust and miscommunication can manifest itself in other ways, such as insurance coverage.  While Hispanic people make up a mere 17% of the U.S. population, they represent 33% of all uninsured Americans (4).  Lack of insurance coverage, borne of distrust for a largely White-dominated medical system only makes access to adequate care more difficult for minorities.  While the solutions to such endemic issues cannot be solved overnight, the first steps can be taken to rebuild trust between the healthcare industry and minorities, beginning with making provider diversity a priority to bridge the many cultural gaps spanning this great melting pot of a nation.

 

On June 22, 2016, the Center for Healthcare Innovation will be further exploring these issues at the 6th annual Diversity, Inclusion & Life Sciences Symposium, which is the leading annual, collaborative event for life sciences and healthcare executives, physicians, HR professionals, clinical trial professionals and patients, entrepreneurs, patient groups, researchers, academics, and diversity and inclusion advocates to discuss diversity and inclusion in healthcare. Please visit chisite.org/education/diversity-symposium/ for more information.

 

 

References

  1. U.S. Population Projections: 2012-2060 | George Washington University https://www.gwu.edu/~forcpgm/Ortman.pdf
  2. Diversity in the Physician Workforce: Facts and Figures 2014 | AAMC http://aamcdiversityfactsandfigures.org/section-ii-current-status-of-us-physician-workforce/#fig16
  3. Missing Persons: Minorities in the Health Professions | Sullivan Commission on Diversity in the Workforce, pgs. 13-27 http://health-equity.pitt.edu/40/1/Sullivan_Final_Report_000.pdf
  4. Eliminating Racial/Ethnic Disparities in Healthcare: What are the Options? | The Henry J. Kaiser Foundation http://kff.org/disparities-policy/issue-brief/eliminating-racialethnic-disparities-in-health-care-what/
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What Changing U.S. Demographics Mean for Clinical Trials

By | Clinical Trials, Diversity & Inclusion, Healthcare Access, Informed Patient, Patients | No Comments

The Food and Drug Administration has declared a renewed focus for 2016 exploring diversity in clinical trials. [1] Data gathered from FDA shows that there is still a significant lack of patient diversity in clinical trials.  “While African-Americans/Blacks represent 12% of the total U.S. population, they comprise just 5% of clinical trial participants. Hispanics account for 16% of the total population but just 1% of trial participants.” [2]

 

As researchers aim to understand how a drug’s effectiveness can vary in different patient groups, it is important to consider how U.S. demographics have begun dramatically shifting. According to the U.S. Census Bureau’s latest projection “It is predicted that by 2043, the U.S. will be a majority non-white nation. [3] White Americans will have gone from comprising 85% of the U.S. population in 2012 to just 43%. Hispanic and African Americans/Blacks will have grown substantially over that period, together making up 45 percent of the population with Hispanics being one of the fastest growing groups making up 31%.”[4] Therefore the inclusion of minorities in clinical trials will only become more critical. To demonstrate the safety and effectiveness of a new treatment, healthcare industry leaders should ensure the inclusion of a diverse population in clinical trials. Underrepresentation of minorities can skew vital trial and treatment data.

 

Some causes for lack of diversity and inclusion in clinical trials stem from lack of trust in trials, lack of awareness of what trials are, and barriers to participation of minority population in trials. For example, based on the history of medical research in the Tuskegee study, an infamous clinical study conducted between 1932 and 1972 by the U.S. Public Health Service studying the natural progression of untreated syphilis in rural African-American men in Alabama under the guise of receiving free health care from the United States government, there is a fear of exploitation in medical research.[5] Second, there is often a lack of misunderstanding about the process of clinical trials. Third, there are barriers to participation or feasibility for minority populations to enroll in clinical trial.

 

To attempt solve these complex diversity and inclusion issues, it is critical to go beyond the current one-size fits all approach and raise awareness, build trust, and reach out to under-represented population. Increased diversity in the population pool of clinical trials might just even result in greater confidence in the results and benefits of drugs to the population.

 

The Center for Healthcare Innovation’s Diversity, Inclusion, & Life Sciences Symposium on June 22, 2016 will address these issues in-depth. The Symposium is the leading annual, collaborative event for life sciences and healthcare executives, physicians, HR professionals, clinical trial professionals and patients, entrepreneurs, patient groups, researchers, academics, and diversity and inclusion advocates to discuss diversity and inclusion in healthcare. Please visit chisite.org/education/diversity-symposium/ for more information.

 

 

References

  1. 2016: The Year of Diversity in Clinical Trials | FDA Voice. http://blogs.fda.gov/fdavoice/index.php/2016/01/2016-the-year-of-diversity-in-clinical-trials/.
  2. Bridging the Diversity Gap in Clinical Trials | Thought leadership and innovation for the Pharmaceutical Industry – EyeforPharma. http://social.eyeforpharma.com/clinical/bridging-diversity-gap-clinical-trials.
  3. Census: White majority in U.S. gone by 2043 – U.S. News. http://usnews.nbcnews.com/_news/2013/06/13/18934111-census-white-majority-in-us-gone-by-2043.
  4. A Study On The Changing Racial Makeup Of “The Next America.” http://www.huffingtonpost.com/2014/04/13/changing-racial-makeup-_n_5142462.html.
  5. https://en.wikipedia.org/wiki/Tuskegee_syphilis_experiment

 

Diversity2

Improving Access for LGBT Clinical Trial Initiatives

By | Clinical Trials, Diversity & Inclusion, Patients | No Comments

In early April of 2016, Washington State lawmakers passed a bill to improve health research for individuals of the Lesbian, Gay, Bisexual, and Transgender community. Since the state of Washington has a significant LGBT population (more than 173,000 LGBT individuals in Seattle alone), Washington State lawmakers felt it was time to include the LGBT community into patient-centered research initiatives. The legislation requires the National Institutes of Health to coordinate a research strategy that addresses the lack of minority patient populations in current clinical trials in the state of Washington, promoting a more inclusive health-research environment where the needs of the LGBT community are specifically assessed in different clinical trial initiatives.

 

The importance of inclusive legislation in regards to clinical trial participants cannot be understated. A large percentage of clinical trials are failing to meet benchmarks necessary to represent patient populations as a whole. In fact, for clinical trials across the United States, it was determined that less than two percent of trials funded by the National Cancer Institute reached the benchmarks the NIH has set for including minority participants. By excluding minority populations from clinical trials, the health of LGBT members, as well as the health of men and women of color, are put at risk.

 

While Washington State has passed legislation to require inclusive clinical trials for LGBT members, the vast majority of the U.S. has not seen a similar progression. To accurately represent the U.S. patient population, both the federal government and state governments should make it a priority to pass legislation that requires LGBT member participation in clinical trials. Other state governments and the federal government could utilize the bill passed in Washington State as a model to catalyze bipartisan collaboration between the NIH and the minority populations across the nation. Diversity in clinical trials is not just a necessity for the LGBT population, but it is also a necessity for men and women of color and expecting mothers. Legislation is necessary to ensure the validity of clinical trial findings; clinical trials must represent patient populations in their entire diverse nature. The state of Washington has taken a step in the right direction towards promoting more inclusive clinical trials, will the rest of the nation follow suit?

 

The Center for Healthcare Innovation’s Diversity, Inclusion, & Life Sciences Symposium on June 22, 2016 will address these issues in-depth. The Symposium is the leading annual, collaborative event for life sciences and healthcare executives, physicians, HR professionals, clinical trial professionals and patients, entrepreneurs, patient groups, researchers, academics, and diversity and inclusion advocates to discuss diversity and inclusion in healthcare. Please visit chisite.org/education/diversity-symposium/ for more information.

 

 

_________

http://www.bizjournals.com/seattle/blog/health-care-inc/2016/04/washington-state-lawmaker-pushes-bill-to-improve.html

 

healthcare-providers-role

The Evolving Role of Healthcare Providers

By | Affordable Healthcare Act, Collaboration, Global Healthcare Trends, Health Insurance, Healthcare Innovation, Healthcare Providers, Patient Engagement, Patient-Driven Healthcare | No Comments

The Evolving Role of Healthcare Providers

We are in an age of healthcare consumerism where patients’ interests are more vested than ever. It’s important for providers to accommodate the power shift. This means increasing transparency, finding new ways to facilitate communication, responding directly to patient concerns and questions when raised, and being proactive in staying ahead with new innovations in health and medicine.

Patients are also now more informed than ever, which has helped to create a competitive atmosphere in the world of healthcare. Patients can compare services and prices, so healthcare providers must be able to meet expectations and show how they will work with patients to achieve the best outcomes. Healthcare providers can no longer afford to stay on the sidelines and wait for patients to interact; they must actively engage patients regularly.

Attracting New Patients

In the past, healthcare providers could depend on word of mouth and a small ad in the local phone book to bring in patients. A passive approach like this will not work anymore. It is imperative for healthcare providers to carefully create and refine their online presence, not only providing basic information, but also working to appeal to patients. Social media interactions and patient testimonials may help to make an office or provider seem more accessible and attractive.

Working with Health Insurance Agencies

Most patients now have health insurance, thanks in part to the Affordable Care Act. It is wise for healthcare providers to work closely with health insurance agencies to create a seamless experience for patients. Being “in-network” will help patients with particular plans learn about healthcare providers. Being knowledgeable about what services will cost patients out of pocket and taking steps to make the claims process simple for patients may help to distinguish one in-network provider from the rest.

Facilitating Meaningful Engagement

There are now many different options for engaging with patients, so sticking to only contacting patients via telephone sends a message that a provider is behind the times or not willing to make an effort to engage patients. Providers should find out patients’ favored method of communication when gathering basic personal and health information and use those methods to communicate regularly between visits. Patients want evidence that their healthcare providers truly care about their health.

Anticipating Future Changes

The healthcare landscape is becoming ever more connected and comprehensive. Taking action to keep up with current industry trends-such as making information easily accessible by other providers during transitions of care and allowing patients to access information online – will help healthcare providers to stay relevant and in business. Since healthcare is rapidly changing, it is also important to stay one step ahead and anticipate future changes so that it is easy to continue to adapt as shifts occur.

Diversity2

The Urgency in Increasing Diversity in Clinical Trials

By | Clinical Trials, Diversity & Inclusion, Health Insurance, Healthcare Access, Healthcare Quality, Patients | No Comments

 

The Food and Drug Administration (FDA), the key regulatory authority in bringing new drugs to the market, must balance between introducing life-saving treatments to people who need them as soon as possible and ensuring that these drugs have been thoroughly tested and are safe for the general population. A drug must undergo extensive testing in clinical trials before it gets approved as both safe and effective. These trials document how well the treatment works on individuals and also of the likelihood of the occurrence of severe side effects.1 The FDA has programs to accelerate the usually rigorous process needed to test drugs that are the first proven treatment of an ailment or have a significant advantage over already approved drugs.2

Often clinical trials fail to achieve adequate representation for minorities. African Americans represent 12% and Hispanics represent 16% of the U.S. population, but are only represented as 5% and 1% of clinical trial participants, respectively.3 Caucasians are still overly represented in clinical trials.4 The FDA and National Institute of Health (NIH) must urgently address this situation.

Significant genetic variations in various ethnic groups may cause different reactions to certain treatments. This difference puts people at risk as certain treatments’ side effects affect various groups differently. Differences in individuals’ genetic codes can alter the effectiveness of drugs as genes affect how a drug is metabolized and how an individual responds to a drug.5 A recent study on anti-HIV drugs revealed that genetic differences could render drugs completely ineffective in patients.6 These genetic differences can differ between individuals of difference races and/or ethnicities.5 Thus it makes difficult for the physician to determine if the drug will be effective for their minority patients if minorities are not tested thoroughly with that drug in the clinical trials.

One of the reasons as to why there is a lack of minority representation is mistrust of the established medical system. This is most notably seen with the infamous Tuskegee Syphilis Study in which physicians knowingly withheld treatment for African Americans infected with syphilis.7 Physicians’ bias also plays a role in the low amount of minority participants in trials. Physicians combine prior experiences treating patients of similar race, age, gender, and socioeconomic status into a stereotype in how to treat their current patients.8 Physicians use this bias to determine which patients to recommend for clinical trials. A study determined that physicians believe African Americans are two-thirds as likely to adhere to a clinical trial regimen compared to their Caucasian counterparts.9 In addition, minority populations have historically had poor access to healthcare. Minorities are less likely than Caucasians to have access to health insurance, a requirement for some Phase III clinical trials. This lack of insurance restricts many minorities to only receive health care in emergency rooms and unable to participate in trials.10

These and other obstacles prevent accurate minority representation in clinical trials need to be addressed and solved. The NIH Revitalization Act of 1993 by Congress meant to solve this problem by mandating women and minority representation in clinical trials, but the results are not promising as the proportion of minorities in clinical trials is still significantly lower than the proportion of minorities in the United States.11 Thus, before different methods other than passing acts in Congress will be implemented, minorities will continue to be at risk with their treatments.

References

  1. “Clinical Trials: MedlinePlus.” S National Library of Medicine. U.S. National Library of Medicine, 21 July 2015. Web. 5 Aug. 2015.”U.S. Food and Drug Administration.”
  2. Fast Track, Breakthrough Therapy, Accelerated Approval, Priority Review. 18 Sept. 2014. Web. 4 Aug. 2015.
  3. “U.S. Food and Drug Administration.” Clinical Trials Shed Light on Minority Health. 1 Apr. 2015. Web. 4 Aug. 2015.
  4. Culp-Ressler, T. “There Are Too Many White People In Clinical Trials, And It’s A Bigger Problem Than You Think.” ThinkProgress RSS. 4 Apr. 2014. Web. 4 Aug. 2015.
  5. Bradford, L. DiAnne. “Race, Genetics, Metabolism: Drug Therapy and Clinical Trials – MIWatch.” Race, Genetics, Metabolism: Drug Therapy and Clinical Trials – MIWatch. MIWatch, 10 Apr. 2008. Web. 18 Aug. 2015.
  6. “New Evidence That Genetic Differences May Help Explain Inconsistent Effectiveness Of Anti-Hiv Drug.” John Hopkins Medicine. 15 July 2015. Web. 4 Aug. 2015.
  7. Corbie-Smith, G., Thomas, S.B., Williams, M.V., Moody-Ayers, S.(1999) Attitudes and beliefs of African Americans toward participation in medical research.  Gen. Intern. Med.14, 537–546.
  8. Smedley, B.D., Stith, A.Y., Nelson, A.R., editors. ,Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academy of Sciences; 2003.
  9. van Ryn, M., Burke, J.(2000) The effect of patient race and socio-economic status on physicians’ perceptions of patients.  Sci. Med. 50, 813–828.
  10. Regenstein, M., Huang, J.Stresses to the Safety Net: The Public Hospital Perspective. Washington, DC: Kaiser Family Foundation; 2005.
  11. Chen, M.S., Lara, P.N., Dang, J.H. T., Paterniti, D.A. and Kelly, K. (2014) Twenty years post-NIH Revitalization Act: Enhancing minority participation in clinical trials (EMPaCT): Laying the groundwork for improving minority clinical trial accrual. Cancer 120, 1091–1096.
Blog-pic3

3 Ways Robotics are Advancing the Healthcare and Life Sciences Industry

By | Healthcare Access, Healthcare Quality, Healthcare Technology | No Comments

Blog-pic3

Robots like the healthcare companion Baymax in Disney’s animated film Big Hero 6 are not too far from reality. In fact, the inspiration for the inflated robot physician came from the robotics lab of Pittsburgh’s Carnegie Mellon University. As more industries converge with one another, robotics innovations like Baymax are becoming more and more common in the healthcare and life sciences sectors. Innovators are creating new robotics technologies that could transform the way that we provide health care, treat diseases, conduct research and approach a number of other life science procedures.

The market for medical robotics is opening up too. A recent report estimates that the market for surgical medical robots alone will be over $20 billion by 2021. And in 2014, venture capitalists (VCs) invested over $341 million in robotics, $77 million of that went to medical robotics startups. How will robotics continue to make a mark in healthcare and life science innovation?

Assisting In Surgery

According to the Princeton Journal of Science and Technology,the first robot-assisted surgery actually took place over 30 years ago, in 1985. Medical robotics have come a long way since then. In recent years, robotics have assisted in a number of surgeries in gynecological, gastrointestinal, urological, and other areas. They have been most helpful with highly precise and minimally invasive surgery.

Robotics has allowed surgeons to visualize certain areas of the body more clearly. One of Pittsburgh Life Sciences Greenhouse’s portfolio companies, Medrobotics, is one company that is using robotics to improve how surgical procedures are conducted. Its Flex® System uses surgical robotics with a flexible endoscope technology to enable surgeons to visualize hard-to-see anatomy and perform surgery.

Catalyzing Life Science Research

Robotics have helped life science research companies and other scientists handle and study hazardous materials more efficiently and safely. For instance, a team of scientists from the University of Manchester have developed a robot called Eve that is helping to accelerate the drug discovery process. Eve’s design aims to automate early-stage drug development to make testing new treatments faster and more economical. At a screening rate of over 10,000 compounds per day, the robotic system could help identify new drug candidates for diseases like malaria and Chagas’ disease in record-breaking time.

Advancing Telehealth

Interest in telemedicine has surged in recent years. Studies have shown that there is a high level of interest amongst both consumers and healthcare providers and organizations seeking telehealth innovations. According toSoftware Advice, 75 percent of patients express at least a moderate interest in using telemedicine solutions. When it comes to providers, a 2013 study by Healthcare Intelligence Network found that 67 percent of providers have used telehealth, and 74 percent of them are planning a telemedicine initiative in the next 12 months.

The need for robotics in telemedicine exists now and will likely continue to grow with the market expected to increase at a compound annual growth rate of 18.5 percent through 2018.

But how these robotics technologies are used in healthcare will continue to evolve. Telemedicine robots have been used to help physicians diagnose concussions, increase the productivity of staff in hospitals and clinics and have even helped in slowing the spread of deadly diseases like Ebola. As the technology and automation behind them gets more sophisticated, their possible applications in healthcare are expanding.

Now more than ever before, the healthcare and life science industry is converging with other sectors like technology and robotics. Patients and providers are showing more interest in high-tech tools that have the potential to improve healthcare and life sciences. Both of these factors are igniting a growing entrepreneurial interest in robotics technologies that will ultimately revolutionize the way the current system operates.

drugprices

Examining the Cost of Drugs

By | Drug Costs, Healthcare Access, Healthcare Costs, Rising Cost | No Comments

drugprices

In a previous blog post, I discussed the complicated nature of drug pricing and the public relations issues that the biotech and pharma industries face. Issues include high-priced drugs and accusations of price gouging as well as unusually or unnecessarily high profits stemming from supposed greed within the biotech and pharma industries. In this blog, I want to provide a few examples of profits, how these profit margins compare to other industries, and the ethics of profiting from potentially life-saving and necessary therapies.

As I pointed out previously, drug pricing is unusually complex. While it is true that manufacturer pricing tends to be a black box, that is, pharma companies closely guard how they price their products, this price is rarely passed on, in full, to the patient. Instead, insurers cover what co-pays do not which is typically a fraction of the whole cost. The involvement of insurance companies as well as government entities (Medicare and Medicaid) are also undoubtedly taken into consideration for drug pricing. Other complicating factors such as intellectual property, foreign market pricing, and drug development costs must be factored in to how drugs are priced by the manufacturer.

In large part due to this lack of transparency, consumers have griped about drug pricing and pointed to pharma profits as being too high, excessive, or, perhaps, unethical.   

An article posted by the BBC [1] in 2014 took the pharma industry to task by highlighting Pfizer’s 2013 profit margin of 42% as evidence of their greed and profiteering. However, as stated in the same article, this figure is inflated due to Pfizer’s spin-off and profit from their animal health branch, Zoetis, which netted Pfizer $10.5B that year. Neglecting this influx of cash, their profit margin came in at 24% which the author claims as “spectacular”. While higher than some industry peers, or other biotech/pharma companies, this is not atypical from profit margins of other industries according to BusinessInsider [2] listing “Software and Tech” at 26.9% and “Beverage and Tobacco” at 29.2%. In terms of industry peers, BI lists pharma and biotech’s average profit margin at 19.3% which is generally in line with most other S&P500 sectors.

In terms of sales, from 2010 to 2013, Pfizer’s sales revenue dropped from $67B all the way to $52B, a drop of over 22% [3]. Since 2013, Pfizer’s profit margin has dipped as low as 9.4% in the 4th quarter of 2014 [4]. In fact, by their financials, in addition to the cash influx from Zoetis, Pfizer cut roughly $5B from their liabilities in 2013 by reducing “Unusual Expense” which inflated their net income for the year, thus boosting their profit margin. So, while their overall revenue was declining, their net income shot up for one year, and the BBC decided to pick this anomaly as their benchmark.  

In terms of increasing profits year over year, a recent article from Forbes [5] suggested that biotech and pharma companies are facing an uphill battle to increase yearly profits. From their calculations, the top 15 biotech companies only posted a year over year profit increase of 2.4%; dramatically lower than annual profits Apple posted between 2010 and 2012 at 78.5% 66%, 44.6%, and 9.2%, respectively [6]. So, while their sales and revenues are in the billions of dollars, their revenues, over a yearly basis, are not increasing as dramatically as the public may perceive them to be.

The underlying issue here, however, is the ethicality of profiting, no matter to what extent, at the expense of patients in need. The argument boils down to if an average profit margin of 19.3% for the biotech/pharma industry is too high and ethical to do so. On one hand, cutting-edge therapeutics should be provided to patients in need at the lowest cost possible. Therapies should never be a burden to the patients that require them. After all, if the cost is too prohibitive to even get it to a patient, what is the point of developing a therapy? On the other hand, these industries are still composed of businesses that rely on profits to continue to develop innovative technologies, attract the best qualified, most intelligent talent to the their organization, and deliver on the promise to save lives and improve global health.

Of course there’s always room for criticism and room for improvement. Non-profit entities have shown promise for reducing costs associated with drug development and reducing risk for larger companies, but their effectiveness has yet to be proven as the number of non-profit companies remains low. Also, many companies such as Pfizer and Abbvie participate in prescription assistance programs that provide their drugs for free to needy patients unable to afford them.[7,8] In these cases, the drug industry has provided ways to reduce the price burden on the patient.

The Center for Healthcare Innovation remains unbiased, objective and neutral. In future posts, I will continue to look at drug pricing and focus on the issue of high-priced drugs and how this affects public perception of pharma as well as increases costs throughout the healthcare system.

References

  1. http://www.bbc.com/news/business-28212223
  2. http://www.businessinsider.com/sector-profit-margins-sp-500-2012-8
  3. http://www.marketwatch.com/investing/stock/pfe/financials
  4. https://ycharts.com/companies/PFE/profit_margin
  5. http://www.forbes.com/sites/johnlamattina/2015/03/23/big-pharma-but-not-such-big-money/
  6. http://www.wikinvest.com/stock/Apple_(AAPL)/Data/Revenue_Growth/2012
  7. http://www.pfizer.com/health/financial_assistance_programs/patient_assistance_programs
  8. https://www.pparx.org/prescription_assistance_programs/list_of_participating_programs
Young smiling doctor consoling patient sitting on wheel chair outdoor

How Can We Boost Patient Engagement?

By | Healthcare Innovation, Healthcare Quality, Informed Patient, Patient Engagement, Patient-Driven Healthcare, Patients | No Comments

Young smiling doctor consoling patient sitting on wheel chair outdoor

Many industries today focus on strengthening consumer engagement with their products and services. Whether it’s via social media, websites, mobile apps, video media, or televised commercials, companies across the globe know the importance of marketing their products, services, and technological advances in maintaining profit margins and consumer satisfaction levels. The healthcare industry would be wise to follow similar industry strategies in order to strengthen patient engagement.

There are a numerous views on what exactly defines patient engagement. Broadly speaking, patient engagement is defined as the degree to which patients are involved in their own care. A generally accepted, comprehensive definition provided by HIMSS Analytics states “An organization’s strategy to get patients involved in actively and knowledgeably managing their own health and wellness and that of family members and others for whom they have responsibility. This includes reviewing and managing care records, learning about conditions, adopting healthy behaviors, making informed healthcare purchases, and interacting with care providers as a partner.1 Essentially, patient engagement refers to the tools and technologies healthcare organizations use to engage patients before or after acute episodes of care and during the time between in-person visits.

The time between visits is a particular challenge in patient engagement. During provider-patient visits, discussions with care providers and increased involvement with the patient tends to lead to higher levels of engagement. As months pass after visits, active participation is no longer necessary and engagement becomes less of a priority. The result is often forgotten instructions provided during the visit. The effectiveness of continuous engagement with patients after their treatment was tested with a program that delivered text messages three days a week to 700 gastroenterology patients who were trying to lose weight during a six month period from November 2012 to April 2013. The objective was to analyze the effectiveness of prolonged engagement by comparing the success of the treatment between those who received texts and remained engaged with a control group who was left alone. The results showed that patients who received the text messages dropped 0.5 more on the Body Mass Index (BMI) than patients who did not participate.2 This simple example of increased communication depicts the drastic impact that engagement can have on the patient’s long-term, perceived value of the treatment and instructions given.

The ability to remain in contact with patients through text messaging is an example of how changes in technology offer new opportunities to increase patient engagement. Yet, despite numerous new systems used today, raising patient engagement remains a challenge. In part, this is due to the complexity and scope of effective long-term engagement. According to Dan Housman, Director at Deloitte, the biggest challenges of the historically accepted model of provider and patient relationships stem from assumptions which fail to account for the uniqueness of the individuals involved. These assumptions include that a patient must be obedient and that a physician should act with authority.3 This way of thinking undermines patient-centricity and fails to develop a healthy relationship which promotes patient engagement. By addressing the flaws in the traditional model and revising those to better reflect trending patient-focused values, healthcare providers can more effective communicate the value of continued patient engagement, which ultimately results in its increase.

IBM Watson Health is an example of one of the countless companies in healthcare making efforts to change this model and enhance patient engagement initiatives. This September, they launched a population health program, expanding their online cloud capabilities to provide a more accessible, relevant platform for accessing industry-specific trends and innovations. It is staffed with a team of professionals that engage with users, answering any questions very quickly. This results in more informed patients and addresses the issues with the assumptions in the traditional provider-patient relationship model. Furthermore, the program promotes and records user feedback on treatment which can be used to further improve the methods of care and provide tangible results in healthcare outcomes. Michael Rhodin, Senior Vice President of IBM Watson Group, stated in a press release “This newest expansion of the IBM Watson Health Cloud makes it an even more robust and flexible platform for the life sciences and healthcare industries and explains its rapid adoption among leading organizations in these fields.4 The value added to the interaction helps to promote further patient engagement over time.

Patient engagement is an important aspect the healthcare. It leads to better health outcomes for patients by increasing their understanding of the value in instructions from providers and promotes adhering to suggested preventative measures. Healthcare providers must continuously reach out to patients, keeping them motivated and increasing both parties understanding of the other. CHI will be further exploring patient engagement and its challenges in today’s dynamic healthcare industry at its upcoming Healthcare Executive Roundtable on October 15, 2015 in Manhattan. For more information, please visit http://www.chisite.org/education/healthcare-executive-roundtable.

References

  1. Noteboom, Michelle Ronan. “From Patient Engagement to Telehealth, What Does It All Mean?” Healthcare   IT News. 18 Sept. 2015. Web. 2 Oct. 2015
  2. Fellows, Jacqueline. “Meeting the Challenge of Patient Engagement.” HealthLeaders Media. 26 Aug. 2015. Web. 2 Oct. 2015
  3. Gruessner,Vera. “What Obstacles Stand in the Way of Patient Engagement? ” MHealth Intelligence. 16 Sept. 2015. Web. 2 Oct. 2015
  4. Gruessner, Vera. “Could a Population Health System Improve Patient Engagement?” MHealth Intelligence. 14 Sept. 2015. Web. 2 Oct. 2015.
Happy senior citizen having a casual small talk with the friendly doctor

How Do You Define and Measure Patient Experience?

By | Healthcare Quality, Healthcare Value, Patient Engagement, Patient-Driven Healthcare, Patients | No Comments

Happy senior citizen having a casual small talk with the friendly doctor

In today’s dynamic healthcare industry, with fundamental policy changes and ground-breaking technological advances occurring more than ever, it is vital to reevaluate the metrics used in determining the quality of care given to patients. Determining and measuring healthcare quality is a multi-faceted challenge, which must consider all aspects of care from patient treatment to administration and policy. The patient experience is among the core metrics used today, which is considered the sum of all interactions, shaped by an organization’s culture, that influence patient perceptions across the continuum of care.1 The continuum of care considers every step in the healthcare process from arrival to outcome. As trending healthcare values continuously place a heavier focus around patient-centricity in all aspects of care, accurately measuring the patient experience is increasingly vital. This begins with addressing value discrepancies between provider and patient perspectives, assessing limitations in traditional data gathering methods, and better understanding patient standards of evaluation. A higher level of patient experience has shown yield direct benefits in long-term recovery, compliance with recommended treatment, and many other care outcomes dependent on trust and acceptance from the patient.2

The patient experience is influenced heavily by the culture and policies set by the provider. Whether a county hospital or day clinic, the success of various patient-centric initiatives and, in turn, impact of the overall atmosphere determined by administrators contributes directly into how personnel view and interact with patients. Yet these are a reflection of the staff’s values, which are not necessarily aligned with the values of the patients they treat.3 Therefore, it is imperative to give proper consideration to patients’ perspectives. The healthcare industry’s recent policy changes reflect this ever-growing necessity by offering new reimbursement programs for providers based on metrics that evaluate the patient experience.4 Yet, policy changes at the top can take a long time to trickle down and to patients. By continuously working to understand the difference between the patient’s and provider’s perspective, and its value in relation to patient experience, all healthcare providers can begin to bridge the gap by providing a higher quality level of care that is focused on the patient’s needs.

Understanding the value of the patient’s perspective in the quality of healthcare is limited to the effectiveness of the means used to gather the data. The Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey stands as the current standard in gathering data on patient experience. However, the data gathered is greatly dependent upon the level of patient satisfaction; which, while important, does not consider all the elements of the continuum such as quality, safety, and service outcomes.5 This results in a skewed assessment of the current level of patient experience and leads to new initiatives and corrective actions that do not properly address the needs of the patient. To address this disconnect, providers are encouraged to create patient advisory councils that add power to the voice of the patients, adjust CAHPS analysis techniques to account for known limitations, and increase the frequency of leadership rounds that prompt patient interaction.6 These suggestions are based on current efforts that have been implemented based on patient-centricity and represent just a few of the countless possibilities.

Regardless of the accuracy of the data gathered, properly evaluating the level of the patient experience requires understanding what quality of care is to the patient. An extensive research initiative in 2014, led by the Patient Experience Journal, highlighted six key performance indicators patients used when assessing the quality of their care. These were the level of provider participation in care, staff courtesy, self-reported health status, staff follow-up, waiting, and medical explanations.7 Based on these findings, it is apparent that patients place a much higher value on interpersonal interaction than the provider. This is understandable considering the limited knowledge they often possess regarding healthcare services coupled with stress and anxiety that come with health issues. Given an a greater appreciation of these key performance indicators used by patients in evaluating their experience, researchers can better differentiate between patient experience and patient satisfaction while properly aligning efforts to reflect a more accurate picture of patient values.

As the healthcare industry continues to drastically evolve, the challenge of effectively keeping the focus on the patient has grown equally complex. Factors and metrics long since accepted as industry standards have come into question at the same time that industry innovation has created entire new directions to consider. Regardless, the patient experience remains as important as ever. It serves as an essential gauge of quality, that when properly managed, can have profound effects on long-term recovery, patient follow-through, and overall care success. CHI will be further exploring the issues and values associated with the patient experience and many other related topics at our upcoming Healthcare Executive Roundtable on October 15, 2015 in Manhattan. The Roundtable will discuss what patient-centric healthcare value means in the 21st century. This consumer-focused Roundtable Discussion brings the best and brightest healthcare leaders from around the globe together to share their ideas and expertise on the intersection of healthcare value and patient-centricity. Please visit chisite.org/education/healthcare-executive-roundtable for more information.

References

  1. The Beryl Institute. “Defining Patient Experience.” The Beryl Institute. 28 Sept. 2015.
  2. Beattie, Michelle, Douglas J. Murphy, and Iain Atherton. “Instruments to Measure Patient Experience of Healthcare Quality in Hospitals: A Systematic Review.” National Center for Biotechnology. US National Library of Medicine National Institutes of Health, 23 July 2015. Web. 28 Sept. 2015.
  3. Brown, Claire R. “Where are the Patients in the Quality of Health Care?” International Journal for Quality in Health Care3 (2007): 125-26. Oxford University Press. Web. 28 Sept. 2015.
  4. “Consumer Assessment of Healthcare Providers & Systems (CAHPS).” Centers for Medicare & Medicaid Services. 8 June 2015. Web. 28 Sept. 2015.
  5. Wolf, Jason A. “Patient Experience, Satisfaction Not One and the Same.” Hospital Impact. 24 July 2014. Web. 28 Sept. 2015.
  6. Merlino, James I., and Ananth Raman. “Understanding the Drivers of the Patient Experience.” Harvard Business Review. 17 Sept. 2013. Web. 28 Sept. 2015.
  7. Van De Ven, Andrew H. “What Matters Most to Patients? Participative Provider Care and Staff Courtesy.” Patient Experience Journal1 (2014): 131-39. Print.

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