Trends in the life science industry point to patient centric-healthcare as the revolutionary approach to medical treatment. This affects how everyone from pharmaceutical companies to patients are involved in providing medical solutions, and carries with it vast implications for incorporating language and cultural factors to ensure commercial success.
What’s Driving Patient Centric-Healthcare?
Life Science and Pharmaceutical industry trends point to “Patient First” as the new focus of both medical companies and healthcare providers alike.
While patients have long been the focus for healthcare providers, the patient centric healthcare approach puts them in the position of influencing medical treatments and outcomes based on their own, individualized input.
Patient centric healthcare, or precision medicine as the concept is also referred to, would not just require a perceptual shift by pharmaceutical companies and other healthcare providers, but a technical one too.
Technology and data analytics will need to be leveraged as tools to both increase patient participation in healthcare, and to collect the necessary data to tailor treatments to individuals.
While there are many factors influencing why trends in the life sciences are shifting to the patient centric healthcare model, two extremely important ones outlined by PWC’s 2017 Pharmaceutical and Life Sciences report include:
1. Patients wanting a bigger role in their healthcare, access to individualized communication, and data supporting more informed decisions.
2. The measure of success for providers being focused more on the quality and effectiveness of health solutions as opposed to sales figures.
Such a shift will require responding to individual patient needs in a targeted manner – from the right treatment plans to addressing language and cultural competence in healthcare services.
However, before unpacking the linguistic and cultural aspects of an increasingly personalized medical system, we must first understand how the biggest changes of patient centric healthcare will be seen and felt.
Bigger Roles and More Communication For Patients in Patient Centric-Healthcare
Patients want a bigger role in managing their health. This means greater demand for communication, information about positive outcomes of treatments based on factors influencing the individual patient’s health.
For pharmaceutical companies and other healthcare providers and payers, allowing patients access to health management tools individually tailored to their particular medical backgrounds is one solution to this new development.
Such tools (including medical devices and implants) can be incorporated with already existing online patient portals and mobile applications to provide a seamless flow of data and communication between the patient and provider.
Utilizing these tools, patients would have access to their own medical records and other health information, as well as a simple way to communicate with doctors and researchers.
Such an ecosystem would also allow providers the ability to collect the data necessary to provide increasingly personalized health solutions.
For pharmaceutical companies, this means more data to support experimental treatments and better monitoring of individuals participating in clinical trials. Conversely it means more information and control for the patient over their health plan in said trial.
For other healthcare providers, the patient becomes the focal point for the provision of information and care. They are integrated into the whole healthcare delivery process, sometimes driving it with their personal preferences and goals, as opposed to being a passive recipient of health information.
What is patient centered care? The NIH’s definition of Patient Centered Care places the patient as a partner in decision making. Patient Centric healthcare places the individual patient as the main driver of adaptation in medical treatments, as opposed to groupings of patients.
Importantly, both efficient communication and personalized monitoring can translate into increased patient compliance and adherence to prescribed treatments. These factors ultimately improve medical outcomes and facilitate monitoring of adverse effects.
Providing patients with more access to their health information in this way is also expected to increase engagement and commercial success of products, due to the shift towards a more value-based measurement of a treatment’s worth.
A Shift To Value-Based Measures
In the past the commercial success of any pharmaceutical company centered on the sales of its treatments. The main drivers of these sales?
Doctors and other healthcare providers.
However, as patient centric medicine becomes popular, and as budgets tighten on healthcare spending, this model will also need to adapt to placing the patient as the central focus of the industry’s products and services.
Healthcare payers (such as insurance agencies) will need to be sure that they are choosing the treatment options that give the best results for their value – within the constraints of available healthcare spending and while preserving their reputation with patients.
As mentioned, patients are demanding more information regarding what they can expect when using a given treatment and data regarding previous successful outcomes. In short they want proof of brand value.
Healthcare payers will accordingly demand the same through an outcome-based pricing model.
In the coming years it is expected that finding information related to a pharmaceutical company’s brand value will only get easier to obtain. Electronic medical records, e-prescribing, and remote monitoring will increase the amount of accessible data concerning the safety and cost of certain medications.
In fact PWC predicts that outcome-based pricing is expected to be in full effect by 2020.
Thus, the commercial focus of the pharmaceutical industry necessarily switches from volume sold to overall success when it comes to proving the worth of their products – inside and outside of clinical trials.
The same technologies that allow for more effective ways to communicate and collect individualized data will also allow for the monitoring of patient compliance, both for prescribed and experimental treatments.
With greater access to each patient’s progress in a given treatment, and the ability to intervene when needed, researchers have greater control over the treatment’s overall rate of success and thus value.
Greater access to treatment outcomes also has broader impacts for healthcare providers. They must now work with a more informed patient along with tailoring treatments to better fit individual needs.
Providing up-to-date information as well as interpreting patient health options, and adjusting care to encourage adherence to treatment plans will be necessary to prove value.
While seemingly straightforward, it is in the overarching goal of proving value, and the underlying focus on the patient, where linguistic and cultural barriers can make or break the success of a treatment.
An effort to account for cultural competence in healthcare isn’t a new approach in the medical world, but it is one that will certainly gain importance in a patient centric one.
Diverse Patients Seek Personalized Medicine
With high patient diversity in the United States, and so many life science firms operating in multiple countries, the patient centric healthcare model is further complicated by the vastly diverse linguistic and cultural backgrounds of its end users.
As stated before, a consumer-driven world for pharmaceutical companies and healthcare providers needs to take into account:
- Patient communication
- An increasing patient knowledge base and involvement in one’s own health
- Tracking patient adherence to treatments and adapting to individual needs
- Proving value to the patient to ensure commercial success
Traditional sales and marketing will also still be important to increase awareness and reach of a given trial or medication. That being said, every single one of these factors will be influenced by the patients’ cultural and linguistic background.
Not only do individuals prefer to engage in their native languages, thus creating linguistic barriers to patient communication, education, and health involvement, but cultural perceptions of health will change how effective a treatment is among different patient populations.
Everything including the reporting and analysis of patient behavior, communication outlets, the UI and UX of patient tools, and the actual value proposition of treatment options presented to patients will need to adapt to the unique language and culture of end users.
Then there is the well known fact that one’s genetic makeup will change how responsive to a treatment a patient is. Thus the question of diversity in patient centric healthcare is not only one of how to best communicate with those of different backgrounds, but how to provide the most successful treatment for them as well.
All in all, the solvency of pharmaceutical companies and healthcare providers is now, among other things, dependent on the perception and involvement of uniquely diverse patients.
Patient-Centric Requires Understanding Who The Patient Is, And How To Speak Their Language
In the two instances discussed above regarding how pharmaceutical and healthcare providers will need to adapt to a patient-centric environment, there are key areas where language and cultural adaptation will play a huge role in determining success.
1. Bigger Roles and More Communication
Medical document translation will lead to better a understanding overall.
Data from the 2017 US National Survey suggests that currently one in five people in the United States speak a language other than English at home.
For the pharmaceutical industry and other healthcare providers and payers alike, this means a significant portion of their clients are non-native English speakers.
As patients demand more autonomy over their healthcare, full comprehension will hinge on access to medical information and health related data in their native languages.
Adapting information to patients’ native languages also increases the likelihood that they will fully understand how to use prescribed medication and its outcomes. This will have a direct impact on increasing adherence to treatment plans and helping pharmaceutical providers work towards successful outcomes for their treatment methods.
What languages need to be accounted for when providing patient centric healthcare?
A good place to start would be accounting for the top 14 languages other than English spoken in the United States. These are (in order of prevalence):
- Cantonese and Mandarin Chinese
- French and French Creole
(Top 14 languages spoken in the U.S. Reference 2017 World Atlas)
That being said, these are by no means the only languages that should be considered when it comes to translating patient material and communication platforms.
Pharmaceutical companies and other healthcare providers need to look at their current patient populations to accurately identify and assess which languages will be the most beneficial in promoting better communication and understanding.
Translating important patient data and information leads to better data collection.
While leveraging technology to increase patients’ ability to record their own health data is tremendous in terms of the implications for tailored treatments, it isn’t helpful if the patient is not inclined to record such data.
Surveys, questionnaires, interviews, recordings, and any other form of patient data capture can be ineffective if the patient does not understand them, or if they are not relevant to the patient’s lifestyle.
Therefore, translation, localization, and even linguistic validation (such as in the case of Quality of Life patient questionnaires) may be needed to adapt these materials and make them more relevant and user friendly for ESL or non-English speaking patients.
Doing so will allow pharmaceutical companies to trust that the data they are gathering is accurate and representative of the actual outcomes of a trial or treatment plan across diverse patient populations.
Adaptation and localizing improves user experience.
and other related materials plays a critical role in the way that patients receive and perceive information from the pharmaceutical industry or other healthcare providers and payers.
The number of patient-provider touch-points is increasing via new health-related mobile apps, medical and data collection devices, telemedicine systems, online health education materials, and online patient portals.
Adapting these platforms is a must, going beyond simply translating words to considering the overall design and functionality of a system to make it familiar and easier to use for diverse patient groups.
Not only is it a more effective way to reach a broader audience, but it is also part of creating a positive company image focused on patient centric healthcare.
Interpretation technology is a necessity with the rise of telemedicine.
Telemedicine is one example of how technology has allowed for greater communication between patients, providers, and medical professionals all around the world.
However, it is far from a cure all solution to remote healthcare, as language barriers still make it difficult to interact with ESL or limited English proficient (LEP) patients.
In some cases, language barriers on telemedicine platforms are dealt with by employing a more diverse, multilingual staff or by selecting healthcare providers that speak the language of their patient populations.
However, this is not possible in every instance or for all of the languages required by patients. Moreover, it is not a practical solution as bilingual medical professionals can’t be counted on to always be available when they are needed to interpret.
To date, there are not many automatically integrated solutions for telemedicine users, but rather coordinated services using various available apps. As such, many look to telephonic interpreting (one of the most common choices) or applications that allow for better digital communication via texting or emailing.
One such example, Canopy, is a mobile app that offers live interpreting assistance in fifteen languages, including Spanish, Chinese, French, Arabic, Russian, Haitian Creole, Hindi, Japanese, Korean, and Vietnamese.
Video remote communication is also gaining popularity to help bridge language barriers in healthcare.
Video remote interpreting services allow for on-demand access in numerous languages, at a lower cost than on-site interpreters. This option is quickly becoming the preferred method in areas such as Pediatrics, Internal Medicine, ObGyn, General Medicine, and Dentistry, and is in high demand across others.
According to Dr. A. Virk, an ED physician working largely with Brazilian populations in Massachusetts, there is an urgent need for integration of video remote interpreting technologies with current offerings.
In a personal interview, he explained:
“The visual cues are missing between the patient and the interpreter, and, as a result, the communication between the patient and the physician is compromised with telephonic interpreting. Although this serves as a resource to overcome language barriers, it is not sufficient to ensure that information is accurately relayed and can be frustrating both for the physician and the patient. There are several medical interpreting apps such as remote video interpreting technologies that can better serve to overcome these issues, depending of course on budget constraints.”
With the expanding use of telemedicine systems, language solutions such as video remote interpreting must be fully integrated to ensure accurate communication with LEP patients.
Telemedicine not only provides the opportunity for ESL and LEP patients to interact easily with medical providers, but it also allows for remote consulting between physicians from around the world.
With the varying cultural and genetic differences in patients, having access to global medical knowledge is vital to providing more tailored, patient centric healthcare plans.
It’s important to point out that, while such instances also need to be coordinated with appropriate language services, international physician-to-physician consultations in general also demand greater attention to cultural differences.
Often specialists are consulted in their area of expertise, but in order to provide appropriate guidance, an understanding of medical practices in the context of diverse cultural perceptions is vital.
Cultural training allows for more focused treatment from doctors and professionals.
Cultural sensitivity also plays a large role in patient centric healthcare.
This is especially true when pharmaceutical companies need to show proof of effectiveness for treatments, and when effectiveness can be largely based on a patient adhering to a treatment plan.
Cultural factors such as religion or medicinal beliefs may prevent a patient from fully following a prescribed treatment plan.
Take the following scenarios:
When treating a Muslim patient’s diabetes, taking fasting rituals during Ramadan into account when scheduling blood sugar measurements makes good sense.
Knowing whether a patient uses traditional medicinal therapies in addition to an experimental therapy or that prescribed by their doctor, is important in order to prevent any potential interference with current treatments.
Incorporating the Family
Understanding the role that family members play in the decisions regarding medical treatment and knowledge of a patient is vital in communicating appropriately with patients from different cultures. This does not only relate to children and their parents, but is also impacted by hierarchies established within the family structure.
In each instance a lack of cultural awareness could result in a failed treatment plan for the patient as well as poor results for pharmaceutical companies and other healthcare providers.
As awareness increases, life science companies and healthcare workers are being trained in integrating this aspect into their patient centric approach.
Many in the life sciences are choosing to employ a more diverse, multilingual and multicultural staff to help address some of these barriers.
2. A Shift To Value-Based Measures
Testing of diverse populations ensures that targeted therapeutics are tailored to differences that can arise in different ethnic and racial groups.
Demand for pharmaceutical services in the developing world is increasing – thus diversifying individual patient needs. Even on U.S. soil, patient populations are growing increasingly diverse.
For healthcare providers and payers, this means that racial and ethnic differences must be taken into account when it comes to providing personalized medical treatments.
Increasing the number of clinical trials targeted at minority populations, adapting medical offerings to reflect the outcomes of such trials, increasing the availability of new data collecting technology, and hiring a diverse medical staff are all ways in which ethnic and racial diversity can be incorporated into patient centric healthcare.
Learn more about accounting for diversity in clinical trials:
Marketing promotions are still essential for sales – but translation and localization will be needed to support an individualized approach.
While the days of appealing directly to medical staff may be gone, pharmaceutical companies will still need to rely on marketing and promotions to advertise their treatments to patients.
As with any targeted marketing, strategies will need to be translated and tailored to unique patient audiences in order to provide a good return.
The messaging of these promotions will no doubt focus on the successful outcomes of products to promote value to patients, but examples of where further tailoring may need to be done include:
- When deciding what benefits to highlight: some patient populations might value different treatment outcomes more so than others.
- When promoting the overall treatment: be aware of the target user and what is considered “appropriate” in terms of engaging them about certain issues.
- When writing the message and designing the creatives: identify native languages and use culturally appropriate images and content.
Moving Toward a Patient First World
The change to patient centric healthcare only seems natural. Adaptation on the part of healthcare providers and payers will occur in tangent with the shift to precision medicine and patient self management.
As patient populations increasingly diversify, in the U.S. and abroad, consideration for language and cultural traits, and how they impact individuals, will be necessary to prove value and gain commercial success.
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