Patient and Healthcare Professional Insight: A Role in Business Strategy
The benefits of patient insight and what role it might play in building a patient-focused business strategy.
The global healthcare industry is in the midst of a radical change, with greater-than-ever pressures on resources. This is mainly due to the cost dynamics of healthcare changing, being driven by people living longer and the ubiquity of chronic illness and infectious diseases (Harper, 2014). In the UK, this is allied to the challenge of the government’s demands to reduce overall spending on healthcare to the tune of £30 billion, while also improving the quality of delivery and health-related outcomes (Appleby, 2013). A focus of attention in many areas, therefore, is to redefine and develop more effective insight strategies that focus on both the physician and the patient (and their interactions) in an attempt to enhance patient outcomes (Pozzar et al., 2014) and that also allows maintenance of an acceptable company growth rate.
In this 21st century, there is broad agreement among health service professionals that delivery strategies and solutions that involve, provide support and ultimately empower patients and HCPs, are all essential to health system reform (Angelmar and Berman, 2007).
Nowadays, terms such as patient engagement, patient involvement and patient empowerment are used to describe these efforts, although HCPs can just as readily be interposed. Thus, the focus is on the patient as an active and self-determining part of their own healthcare pathway, rather than a passive recipient of professional support and health care that, until recently, has generally been the norm (Patel, 2012). As such, patient power plays an increasingly important role in informing both clinical development and effective marketing strategies. Beyond marketing, effective insight into both HCP and patient engagement with the brand contributes to the overall business strategy, enabling early identification of opportunities and/or threats to business growth.
Alongside this increasing focus on patient empowerment, there has, of course, been a revolution in the role that digital has played in people’s lives, with social media opening up new and unique opportunities for the generation of insight into patients’ and HCPs’ behaviours and attitudes.
This paper will discuss the strategic role of patient and HCP insight and what operational functions are needed for its generation and implementation. It will also consider approaches to navigate the challenges inherent in using social media as a research methodology.
What do we mean by insight?
The term ‘insight’ is bandied about in a fairly cavalier manner by many marketers and agencies, its meaning stretching from a blinding flash of inspiration, through a subtle shift in understanding, to a representation of something we knew all along.
Essentially, the dictionary definition of ‘the understanding of hidden truths’ is probably the most helpful in our context, but there are various other expressions we may consider. (See below).
Understanding stakeholders’ (patient or HCP) requirements, viewpoints, predisposition and future intent within the areas of diseases and treatment options is essential for success in all aspects of the healthcare industry (NICE Guidance, 2012). Gaining this understanding is the key to successful product strategy (life cycle, new developments, line extensions etc.,) and/or education, product launch and communications campaigns. This is even more important today, when competition in the healthcare industry is greater than it has ever been (Gaynor and Town, 2012). This competition is sustained by governing healthcare bodies with a view that it will ensure the provision of better products and services to satisfy the needs of stakeholders (Rivers and Glover, 2008).
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Definitions of Insight |
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But general understanding can only go so far, and is unlikely to be the basis of delivering competitive edge. One of the key aims of market insight research is to discover information about that market or that audience that has not previously been identified or utilized, but which – when leveraged – will benefit the company in terms of increased profits and greater or wider market penetration (Smith and Albaum, 2010). Insight can be used to discover a penetrating truth about stakeholders, their objectives and driving forces – which can, in turn, be analysed and developed to provide knowledge that can be used to generate growth/sales. As such, these insights should be credible, actionable and practical, providing a sound basis for actions that will make a real difference to developing and enhancing the core business of the company.
Patient Empowerment
A critical context of the dynamic changes continuing to take place in healthcare is the rise of consumerism. This is because patients (consumers) are ready to become more active, informed health care decision-makers and are amenable to using continually evolving technology that improves their ability to engage with providers, health plans, employers, and government (Powers and Chaguturu, 2014). The effect of this evolution is that patients have more exacting expectations of healthcare companies and services – exactly as they are demanding (and getting) more from their bank, their car dealership and their supermarket.
In fact, the only division between patient and consumer is that, in the healthcare industry, physicians call consumers “patients”; health plans call them “enrollees” or “members”; and bio-pharma companies refer to them as “users” or, if they are involved in a clinical trial, “subjects". As a consequence, and more importantly, there is the impact of patient empowerment and experience (Keckley et al., 2012).
Patient empowerment consists of the patient taking an active role in choosing their own healthcare options, with guidance from their healthcare provider (Coulter et al., 2008). Thus, empowerment can be initiated by patient engagement and activated by education, including learning and understanding more about their own disease prevention or treatment. A successful patient empowerment approach should result in a better experience and improved health related outcomes (NICE Guidelines, 2012). The focus on preventive health care and self-care in conjunction with improved access to health care information has benefited and clarified the multiple dimensions of patient empowerment as being patient participation, patient control and patient education (Ouschan et al., 2000).
In the healthcare service today, there is broad agreement at most levels that strategies and solutions that engage, support and empower patients are essential to health system reform. This is underlined in a recent All Party Parliamentary Groups report (May, 2014). “Patient empowerment: for better quality, more sustainable health services globally”. This report takes a global perspective on how to empower patients to play a more active role in their care. These rights form part of the NHS Constitution, which states that everyone who is cared for by the NHS in England has formal rights to make choices about the service that they receive. These include the right to choose a GP surgery, to state which GP you'd like to see, to choose which hospital you're treated at, and to receive information to support your choices (NHS Constitution for England). Therefore, a patient-centered commercial strategy is a prerequisite to enable a revenue generating growth.
Healthcare Professionals are Consumers, too
Healthcare professionals provide a unique challenge to marketers in terms of their specific requirements. Evidence-based medicine is the keystone of their decision-making process with regards to what treatment option they might choose. It has been said that “the adoption of evidence-based medicine by individual healthcare professionals can help ensure the limited resources available are used efficiently, enhancing confidence that additional funds will translate into more people receiving better (wound) care and having better health” (Al-Benna et al., 2010). Evidence, broadly construed, is anything presented in support of an assertion. This support may be strong or weak. The strongest type of evidence is that which provides direct proof of the truth of an assertion.
Insight into what evidence is required, and how it may be presented to, and used by, the HCP is valuable information that may provide a strategic framework for marketing a specific health related product or treatment option. The demand for product differentiation is particularly important in today's crowded and highly competitive markets. By developing and implementing strategies that are successful in converting evidence into behavioral change (patient or HCP) in a clinical setting, then healthcare companies can instigate an evidence strategy that can leverage increased sales. This can be done by, for example, development of peer reviewed articles, promotional pieces, new/updated guidelines; and education programmes about products/treatments and diseases (Ware et al., 2008).
But, of course, HCPs are consumers too, and insight into the context of their consumption and usage of evidence can provide valuable direction into the way in which we can effectively communicate that evidence to make it as relevant and engaging as possible. Thus, for example, some companies will concurrently run qualitative interviews with clinicians conducting clinical evaluations, in order to deliver an additional dimension to the understanding of the resultant data.
Quality of Insight
Of course, not all insight is created equal. Whatever method is used to research customers, it will involve an investment. So it is important to design any research study to seek to deliver genuine insight (the hidden truths), rather than returning a confirmation of what is already known, thus simply propping up existing thinking.
In practice, this is about identifying the right questions in the first instance or having the degree of distance/perspective that allows the researcher to identify findings that are new, interesting or actionable (or ideally, all three). One potentially fruitful approach is the exploration of issues beyond the immediate interaction between the patient/HCP/brand. For example, the wider lifestyle context of these interactions such as the associated physical or emotional impacts of managing a chronic condition.
In a mature market, with a mature product, a common mistake is the assumption that all the customer insight that’s needed is already there. However, even if a product formulation is unchanged, or the demographic definition of the audience is unchanged, it is indubitable that the environment and the context of patient/HCP interaction with a product or service is changing constantly, particularly as more and more discourse takes place online. The space opening up with these contextual changes is where the opportunities for product or service innovation can often be found.
The Importance of Insight to Business Strategy
Maintaining a business at the forefront of health care is challenging and requires a strategy for understanding the market place with regards to existing and future business. Therefore, drawing out and collecting information is important. In the past, insight was generated by a focus on verbal/written enquiries for opinions and suggestions as input. In the 21st century, establishments use insight to understand how people think about their experience, and then develop the customer experience accordingly. However, many companies in healthcare have not yet made this transformation and have a dated viewpoint of thinking in a commercial world that is changing apace.
In terms of supporting strategic marketing and core business, patient insight can change the direction of the development and/or marketing effort for a brand. While becoming more patient focused, it supports a process of achieving better patient outcomes.
In terms of supporting strategic marketing and core business, patient insight can change the direction of the development and/or marketing effort for a brand. While becoming more patient focused, it supports a process of achieving better patient outcomes.
Specifically, such insight will help a business:
- Gain a competitive market edge
- Optimize marketing budget
- Understand stakeholder preferences
- Identify potential product/service development opportunities
- Focus strategies on specific stakeholder behavior
- Measure brand value and build brand equity
A greater recognition and reflection of patient empowerment can also be a valuable currency in terms of an organization’s interaction with HCPs. Ultimately, both healthcare company and HCP are united in the same aim of a positive outcome for the patient. So focused sharing of patient insight can potentially deliver real added value to HCP communications.
Insight also provides a valuable tool for a healthcare company in terms of new product development. A recent paper (Cook et al., 2014) noted the importance of aligning scientific opportunity with commercial insight and position.
In this article, they state that “We use the term ‘right commercial potential’ to describe confidence that a project would ultimately deliver a medically differentiated and commercially viable product”. Therefore, underpinning the business strategy with scientific understanding and medical need (insight) is a prerequisite for success.
Delivering Value from Strategic Insight
Gaining insight is, however, only the first step along the pathway. Having obtained the preliminary insight data, it must be analysed in such a way that it will ultimately provide value to the business. Termed analytics (which may be descriptive, predictive or prescriptive), this is the systematic use of data and related business insights developed through applied analytical disciplines (e.g. statistical, contextual, quantitative, qualitative, predictive, cognitive, other [including emerging] models) to drive fact-based decision-making for strategic planning, management, measurement and learning.
Finally, it’s important to recognize that insight findings can never be static. There is, therefore, a need to regularly monitor opinion to ensure that shifts in market or audience perceptions or activity can all be reflected in marketing strategy.
Insight Research Methods
Insight research is typically conducted using a qualitative methodology as this allows for non-linear questioning of respondents to elicit a deeper understanding of the motivations that sit behind behaviours or attitudes.
Traditional qualitative research approaches involve either face-to-face contact or verbal conversations in real-time such as:
- Qualitative focus groups – A group of selected people are asked about their perceptions, opinions, beliefs, and attitudes towards a product, service, concept, advertisement, idea. This format allows the sharing, building and challenging of ideas and can be particularly useful for enabling concept generation.
- Depth interviews – Conducted either face-to-face or via telephone, these allow a more intimate conversation with an individual. The format is particularly suited to confidential and sensitive topics, such as personal health. If conducted in a respondent’s home, cues from the environment can provide a further layer of context to the findings.
Qualitative data analysis includes findings and interpretations that are based on what the contributors are saying, but also includes non-verbal indicators (facial expressions, body language, general behavior and voice intonation). A study has shown that body language, tone-of-voice accounts and words account for 55, 38, and 7% respectively of received communication thus highlighting the importance of non-verbal communication to give a deeper level of insight (Albert H. Mehrabian).
The Digital Research Revolution
While traditional qualitative methodologies offer a valuable and robust approach to delivering customer insight, the advent of digital media has generated many novel methods of engaging with consumers. This flowering of options allows researchers to cherry-pick and interweave different methodologies to track customer behavior and attitudes both passively and via curated interaction.
Some of the main qualitative online research approaches available are:
- Online focus groups – real-time online discussions with a limited number of people over a set period e.g. 2 hours (so-called synchronous research). Essentially, an online version of the traditional focus group, this approach can be useful to bring together geographically disparate or difficult-to-find respondents.
- Online communities – respondents are co-opted to a community and set topics to discuss and tasks to complete, interacting with each other and the moderator over a period of days or weeks. Useful for gauging reactions to communications and products, ‘pressure testing’ plans and co-creating ideas. The output generated by a community generally expands beyond straightforward discussion to incorporate diaries, photos and videos, which deliver another dimension to the findings.
- Bulletin boards – these are password-protected forums, accessed via a browser, where respondents login at any time and respond to a moderator-led discussion. These usually last from 3 to 6 days (so-called asynchronous research).
These online research methodologies make it easier to cover a wider geography and cultural diversity than traditional methods, and the extended length of engagement with the project (particularly in the online community) means that researchers can follow the development of a thought process in response to a series of stimuli in a way that is not possible within the confines of even a half-day focus group. On-line anonymity can also encourage participation of those who might normally be shy or unwilling to participate in traditional research. However, the corollary of this is the comparative difficulty of validating the credentials of participants, particularly where monetary incentives are involved.
Social Media
Of course, the opportunities for utilizing the digital space for insight research are wider than the simple shift of traditional market research methodologies to a different environment with a different set of protocols.
The healthcare sector has been relatively slow to embrace social media as a marketing channel for a variety of reasons, including understandable concerns about regulatory issues. However, consumers are less reticent, with more than 80% of US 18- to 24-year-olds likely to share health information through social media (PwC Health Research Institute Social Media Consumer Survey 2012). The increasing willingness for people to share experiences, thoughts and opinions, and to interact via social media, opens up a massive seam of potential understanding and insight for researchers. And, unlike methodologies where discussion is directed by a third-party moderator, these conversations are unfiltered, generally peer-to-peer interactions.
Added to this is the fact that social media tends to bring together pools of people who were previously unconnected, and the potential for the discovery of ‘hidden truths’ through these interactions is clear.
The challenge of social media research is one of curation – the sheer volume of social media traffic is mind-boggling, and it is the ability to meaningfully analyse this traffic that is the key to the generation of genuine, actionable insight.
Conclusion
Today, there are increased pressures on healthcare sytems, including rising costs and resource utilization, an ageing population, financial pressures on governments to decrease healthcare spending and the desire to make treatments more cost-effective. Therefore, to be competitive in such an aggressive market, healthcare companies have to find new and better ways to market and sell their products.
Previously, healthcare marketing has very much focussed on the clinician. However, alongside the development of WWW and the explosion in social media, coupled with governmental requirements for more patient involvement, emphasis on the patient is rapidly becoming an integral part of business strategy.
The changing digital landscape has opened up the field of qualitative research, creating new opportunities to understand patients and HCPs at a number of different levels. Both now and in the future, undertaking effective insight research into patients and HCPs will ultimately enable development of insight-based strategies and tactics that have the potential to deliver real competitive advantage and market leverage, enhancing business profitability.
About the Authors:
Dr Mark Rippon is Director of Medical Marketing, Foundry Healthcare and Julie Neilson is Strategy and Research Director, Foundry Healthcare.
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