There’s a Disconnect Here

This is an excerpt taken from our article in the October issue of Quirk’s. To read the full article, click here

Twenty minutes, tops. That’s the average interaction between doctor & patient in a typical office visit. But what if it’s not typical because the patient has just been diagnosed with a disease? Discussions regarding diagnosis, treatment, possible medication and recommendations may occur, but it’s hard to understand what is resonating with patients who are given so much information in such a short period.

We know gaps in communication occur and effective patient-physician communication is often linked to adherence. In fact, our study on adherence last year found that at the point of diagnosis, patients frequently leave a physician’s office not knowing what condition the doctor diagnosed, not clear on what they should do, and not even knowing if they’ve gotten a prescription. Research has shown that comprehension, retention and action can improve through the use of visual stimuli in physician-patient interaction.[i],[ii],[iii] We’ve also found visual stimuli to be highly effective when uncovering patient and practitioner insights. Using images as catalysts helps engage study participants and can also help them open up around a sensitive topic to further identify what’s driving behavior and emotions around treatment.

For more details, download our Communication Gaps eBook now
 

For the purposes of our Communication Gaps study, we partnered with one of the top 25 pharmaceutical companies to conduct qual-quant research with chronic obstructive pulmonary disease (COPD) patients and health care providers to find out how both sides viewed their relationship and what communication gaps exist before diagnosis, at diagnosis and as treatment continues.

The online methodology integrated interactive exercises – including a retrospective diary, projective thought bubbles and a collage-building tool – with standard measures in order to explore this relationship. More specifically, we looked at what doctors believed they were communicating effectively and what information patients were really retaining. We asked about experiences with COPD, the point of diagnosis, experiences with their PCPs, and communication around medication. For more details, access our Communication Gaps eBook immediately or click here to continue reading.


[i] Kessels, 2003
[ii] Annemiek 2013 (Journal of Crohn’s and Colitis)
[iii] Danielle M.McCarthy, ED discharge instructions, “Emergency Medicine International”

 

comm gaps

Bridging the Gap Between Doctor & Patient

Physicians – on average – spend 15-20 minutes with a patient for a typical office visit[1]. While 15-20 minutes may be sufficient for a general health checkup, for people dealing with a chronic condition (or multiple conditions) this time can seem limited.

Now imagine that you, yourself, are sitting in your doctor’s office and you have just been diagnosed with a chronic condition. The doctor was running 5 minutes late, and after some introductions and the information about your diagnosis, you now have 10 minutes left of your appointment. What is your doctor telling you about your condition – which, until 5 minutes ago, you may have never heard about? What do you want to know?

BuzzBack has been hard at work developing a methodology that gives us both the patient and physician perspectives on these issues, highlighting specific areas where there are gaps that may be able to be addressed by other stakeholders (e.g., pharmaceutical companies, health insurance companies, etc.).

For instance, our research found that when talking to COPD patients, while PCPs and Pulmonologists tend to focus a lot on treatment options, symptoms, and the origin of the condition when diagnosing a patient, there is less of a focus on overall health, which patients indicate being the top thing that they wish their HCP had spoken about when they had been diagnosed.

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Check back here for more information about our upcoming webinar, where we’ll be presenting our research findings on Patient-Physician Communication Gaps. 


[1] http://www.ajmc.com/journals/issue/2014/2014-vol20-n10/the-duration-of-office-visits-in-the-united-states-1993-to-2010; http://khn.org/news/15-minute-doctor-visits/

Doctor Patient Communication Gaps

Hysteria or Validated Concern? You Be the Judge.

As of October 19, 2016, there were 4,016 cases of Zika in the continental US. Of these cases, 137 were acquired in the US, and the remaining 3,878 cases were acquired in other countries[1].  Despite the low prevalence, Zika has gained wide media coverage across the US and is seen as a significant threat to many.

Here at BuzzBack, we were interested to find out what residents in the US and Brazil understood with regards to symptoms, transmission and prevention of Zika. According to our study, when asked to select the most severe among a list of outbreaks/pandemics, Zika was a close second to HIV/AIDS, selected by 20% (HIV/AIDS was selected by 24%). This may be surprising, given that HIV/AIDS impacts millions of people in the US[2].

Brazil, on the other hand, has faced far more Zika cases than in the US – over 90,000 new cases reported from January to April 2016 alone[3].  When asked to identify the most severe outbreak/pandemic, 24% listed Zika as their top concern (similar to that of the US) – whereas 44% indicate HIV/AIDS as the most severe.

zika graph

Data collected from PAHO & WHO: http://www.paho.org/hq/index.php?option=com_content&view=article&id=12390&Itemid=42090&lang=en

While it is not surprising that Zika is particularly top of mind and viewed as relevant at the moment, what is surprising is that (1) the concern in the US appears to be comparable to that of HIV/AIDS – despite having FAR less of an impact and (2) the general concern in the US appears to be comparable to that of Brazil – despite vast prevalence.

By utilizing BuzzBack’s eCollage (a non-lexical, indirect format to reveal personal feelings, using images as metaphors to reduce dependency on rational thoughts), the drivers of concern in the US are identified. The key source of fear in the US is the unknown. Individuals know there is a lot of information on Zika, but they are unsure of what is true or false. They worry about how much the virus will spread, and fear they will not see it coming or would not know they’re infected until it is too late. Not understanding the disease fuels fear – Are there clear signs of infection? Can it be stopped? Is there a cure?

Does Zika warrant this grave concern?  Or is this more of a reflection of people in the US being impacted by heavy media coverage?  Will the media ultimately help give individuals a greater understanding of what Zika is all about? Are there certain organizations (e.g. CDC, WHO) who can help clarify concerns about Zika? Only time will tell…

If this topic interests you, head over to watch our latest webinar which features more insights from our Zika study.


[1] http://www.cdc.gov/zika/geo/united-states.html

[2] In 2014, 44,073 people were newly diagnosed with HIV infection in the United States; in 2012, 1,218,400 people were reported living in the US with HIV; and in 2013 there were an estimated 12,963 HIV/AIDS-related deaths. http://www.cdc.gov/hiv/statistics/overview/ataglance.html

[3] http://www.rte.ie/news/2016/0427/784704-brazil-zika/

zika warning

5 Milestones in the Patient Journey Every Healthcare Marketer Needs to Understand

Healthcare marketers are increasingly focused on more patient-centric approaches in order to develop effective ways to bridge gaps between patients & healthcare practitioners (HCPs). What used to be solely directed to physicians as prescribers and influencers for patients, now starts with patients.

Here’s why: understanding the patient experience involves understanding emotions around different milestones –   [1] pre-diagnosis suffering through [2] diagnosis, [3] post-diagnosis (3 months after), [4] living with the disease and [5] looking to the future while managing outcomes and treatment. And Patient Journey research is about focusing on these different milestones, in order to develop communications to improve the patient-doctor dialogue at each stage.

DOWNLOAD NOW!   'Mapping the Patient Journey' White Paper

And while we’ve developed our own approach to Patient Journey research, at BuzzBack we’re also focused on the changing consumer. Millennials, Gen X, and even Boomers are turning to digital tools, relying on smartphones and apps for news, weather and increasingly health info.

With more than 64% of adult US households having smartphones, the patient experience is no longer solely about the doctor relationship.

According to Hospitals & Health Networks, today’s patients are searching for doctors online, making appointments online, finding urgent care centers, monitoring their activity with wearables, etc. Healthcare marketers are creating detail aids and journal pieces, but also new apps and web-based support programs to get closer to patients. However, the underlying emotions driving their behavior are still similar. That means an even greater need to identify and deep dive into the patient journey. Developing effective tools, digital or other, stems from identifying insights linked to consumer emotions.

To find out more about how we obtained in-depth feedback by using imagery as a catalyst to map out the these 5 milestones of the patient experience, download our Patient Journey white paper now.

patient journey milestones

Population Health and Meaningful Use: Where is the patient?

The Meaningful Use criteria for implementation of electronic health record systems will be getting a new set of standards next year. MU offers $30 billion in subsidies to doctors who get their electronic systems up to speed… Previously, doctors have only had to prove installation and usage of EHR to get subsidies; now they need to implement Physician Quality Reporting System (PQRS) reporting. PQRS requirements are being pitched to doctors as helping them focus on patient outcomes. However, according to the new value model imposed by ACA, doctors will be reimbursed on outcomes demonstrated in PQRS reporting. Medicare reimbursement will be prorated at certain quality levels, rather than given simply for treating a patient, and many insurance companies have adopted value standards as well.

Population health metrics are important from a micro and macro perspective. Some doctors are already using population health. Most are either annoyed or confused by the transition, and don’t understand their patients any better after implementation. Doctors really don’t have time. Institutions are under-staffed. The imperative goes unfulfilled.

As information technology has evolved, it certainly became possible to analyze massive datasets, and “big data” is all the rage. In addition to the government, others are driving their understanding of patients through massive databases. Big pharma and health insurers are two examples. On the other hand, it is also becoming easier for computers to analyze “soft” data, like written texts,  images, or even facial expressions. IBM’s Watson famously relies on  unstructured data, and IBM is focusing a lot of energy on understanding the healthcare universe. Further out, sentic computing systems are being developed to understand, and respond to, the emotional state of the user.

The incredible growth in social media proves that it is already possible for people to develop and maintain emotionally satisfying relationships via computer interface. Most of the communities are heavily based in visual imagery as the primary vector for communication.

While it isn’t possible to replace physicians with computerized simulacra of them (but will this really always be true?), it could be possible to provide patients with a focused forum to engage in rich communication about health and illness. This forum doesn’t fulfill the role that physicians still occupy, but enhances it in a way that patients associate the online activities with the provider. This would be a real model of patient engagement.

BuzzBack has long focused efforts on integrating quantitative analysis with “softer” variables. How does the respondent (doctor or patient) feel and think when we let them play with pictures, or ask them to write a story? How do these creative and unconscious processes relate to a drug, disease or medical situation? Then, what happens when we quantify the results of these creative exercises across hundreds, or thousands of people? We have done work like this for pharmaceutical companies to understand how physicians and patients interact with, and feel about, each other. How well do they understand a product promise and what does it mean to them? There are many different contexts and situations where BuzzBack integrates image-based and story-based methods into quantitative studies. These help our clients get a deeper understanding of the customer.

EHR and PQRS certainly perform extremely important tasks. However, they don’t really help understand patient motivations and needs better unless system designers find ways to step outside the box of straightforward rational thinking. At BuzzBack we’ve been stepping outside the box for a while, understanding patient behavior in ways that matter. For example, we’ve looked at the emotions that drive dialog between patients and physicians in multiple therapeutic areas. Using pictures as a vector to communication of underlying feelings, we’ve looked at how doctors feel about medication treatments in a variety of disease categories. What works for them, what doesn’t, and why do they choose different drug brands? We’ve worked with both patients and doctors, asking them to tell stories about each other, or to imagine conversations about difficult situations. The results of these studies are usually pretty surprising. We access the kinds of things missing from how the industry at large looks at patients and physicians: as a collection of myriad data points. They “forgot” to build in the vital human qualities, but we’re trying to patch the gaps, piece by piece.

EHR

Humanizing the Patient-to-Medicine Connection

One of the challenges facing the healthcare sector at large is patient adherence. It’s a topic of continuing importance and increasing interest.With on average 50% of patients not taking their medication as prescribed (and 33% never even filling their prescription in the first place), there’s much work to be done in understanding how to drive compliance.

We recently explored the impact of emotions when it comes to adherence, co-presenting our new study with Merck at the Pharma MR conference. We found that diving deep into patient feelings about their experience provides clues to how to positively influence their behavior and affect better outcomes. For example, in this study, we explored how they feel about managing their condition and their feelings about their physician relationship.

But what about the roles other individuals play in the complex puzzle? For example, what is the role of the pharmacist? Recent industry data shows the pharmacist holds an influential position. For example, a 2013 study by the National Community Pharmacist Association identified patient connectedness with their pharmacist as the leading predictor of adherence.

This pharmacy/pharmacist connection was the focus of a Wall Street Journal article that caught our eye here at BuzzBack earlier this month. It featured CVS CEO, Larry Merlo, who focuses on this exact issue: the need to humanize the patient-to-medicine connection with a clearer understanding of emotions. He sees the role of CVS as one to “help people on their path to better health.” Mr. Merlo believes that one of the ways CVS can truly make a difference is in making sure people take the medications they are prescribed.

CVS has made improving adherence a central goal, looking to improve it as much as 15% over the next two years by working on the pharmacy-patient relationship, and not just the administration of the drug. Mr. Merlo sees the pharmacist as integral to the equation: “CVS figures a one-on-one conversation with a pharmacist is two to three times more effective than any other method to change patient behavior – in a way, the human element that often goes missing in the U.S. health-care debate.”

At BuzzBack, we are excited to be part of the debate. Through innovative tools and creative expression techniques, we help consumers find the language to articulate the obstacles that need to be removed on their road to better health. And we uncover more effective ways that pharma companies can prepare physicians and pharmacists to communicate and lead patients on their adherence journey. In fact, we’ll be conducting an upcoming webinar presenting the results of our study around this important topic. Click to attend the webinar on Wednesday, March 4th or Thursday, March 5th.

patient taking medicine

Oh, I See Now! – Using Visual Communication to Improve Adherence

The high level of nonadherence across all therapeutic categories is a hot topic, and becoming hotter.  It’s a question of enormous cost on one hand (to patients, insurers, CMS, hospitals, families…) and a serious question of lost revenue for the pharmaceutical companies. The team at BuzzBack has been working on nonadherence related issues for a number of years, and we utilize our tools to interpret how patients with a given disease understand and feel about what, exactly, they are going through.

In that light, a recent article in the New England Journal of Medicine by Lisa Rosenbaum, M.D. caught my attention. Dr. Rosenbaum, who writes on medicine for many publications and is a cardiologist at the University of Pennsylvania, explores how patient feelings impact adherence to medication for cardiovascular disease. The author cites a study that suggests that “one way to address medication avoidance is to better communicate the benefits of a drug. Although such communication is essential, so is the understanding of what beliefs contribute to avoidance of cardiovascular medications in the first place.” What’s exciting about that statement is that an increasing number of pharma companies are working with firms like us to dig deep into the “why” behind patient nonadherence. In fact, BuzzBack is currently working on a study (which we will present at the Pharmaceutical Market Research Conference on February 5) in which patients express feelings about their relationships with their doctor, their disease, and their therapeutic regimen, using visual imagery as well as direct questions. We are looking into how strongly positive and negative emotions can influence adherence, and whether it is related to usage of alternative medicine.

In her article, Dr. Rosenbaum recalls conversations with patients about why they abandon their regimens. She observes how some patients cite an interest in “natural” solutions. Patients see their prescriptions as “chemicals” to avoid – the drugs intrude upon the natural state of things. Other negative feelings and associations that reduce adherence include suspicion, shame, failure, aversion, fear of risk, and loss of control. Patients also say that today’s advanced medicine and its apparent speed of effect makes adherence seem less important (paraphrased as “I feel so much better leaving the hospital than when I came in – I don’t need to take the drugs anymore”). Related to that idea, patients who begin to feel better once on their own often become nonadherent. This is especially true for asymptomatic patients who lack concrete evidence of their improvement.

The article advocates what we often find when studying adherence. Pharma companies need to better articulate the purpose of their drugs to patients. They need to explain how both the obvious and unseen changes are both important. The article confirms what we have worked on for many years: visual metaphors and the visual delivery of this information can improve compliance. Dr. Rosenbaum writes about how patients on clopidogrel frequently explain why they take their medicine and what the benefit is to them. These patients use visual language (from Plavix ads) to paint the “here’s why I do it” picture: “It keeps my blood flowing. “It keeps the pipes from clogging.” The distinct visual lexicon creates a compelling mental image that seems to encourage adherence. Other research over the past 30 years has confirmed that visual imagery helps patients understand their disease better and adhere better to treatment. Rosenbaum proposes creating visual communications that make an emotional and personal patient-to-prescription connection that literally illustrates the purpose and benefits of the treatment. This begs the question: what visual metaphors can help companies outside Dr. Rosenbaum’s cardiology realm? How can visual and latent emotional insights improve diabetes adherence? Adherence with asthma therapy? What pictures should be included in communications that will ultimately improve and even save patient lives?

Dr. Rosenbaum’s conclusion echoes the spirit of BuzzBack’s mission when working with healthcare companies:

“Although we tend to view nonadherence as patients’ failure to know what’s good for them, learning about people’s feelings about medications has made me recognize that my ideas of good and bad were defined solely in my terms. What I’ve learned is that if I felt what they feel, I’d understand why they don’t.”

When innovating insights for pharma, we are driven to get at the why so we can influence better outcomes – often uncovering the visual language that will resonate profoundly with patients. As an insights professional, I often find those projects the most meaningful and memorable because they do the most good.

If you’re interested in learning more about BuzzBack’s own study on adherence, get in touch with us below.

man taking pills

Articulating The Patient Journey & Why It’s So Important

I am just returning from the annual PMRG Institute, interfacing with peers in the pharmaceutical sector around a series of new topics & challenges in market insights. The theme of the conference was a 360º View, and many of the presentations focused on storytelling and the current wave of patient-centric initiatives impacting global pharma leaders such as Merck, Teva, UCB, Boehringer-Ingelheim to name a few.

It’s no surprise then the New York Times also recently published an op-ed on the importance of storytelling with Why Doctors Need Stories. This piece by Peter D. Kramer talks about Danish psychiatrist Per Bech, an innovator in clinical psychometrics, which is the science of measuring change in conditions like depression. Per Bech generally focuses on statistics, but more recently he’s shared stories about patients and case vignettes.

This Per Bech example reflects many of the exact challenges of our industry today – how we are changing our perspective in treating specific conditions, shifting to more patient-centric and relatable materials. That’s something we do first hand at BuzzBack. Our eCollage™ is a unique storytelling technique – in research-speak, it’s an enabling technique that helps both patients and physicians open up and express themselves more authentically. We use this technique in our Diabetes study and much of the other healthcare work we do. It helps clients get to the ‘power of the narrative’ and the ‘texture’ alluded to in Why Doctors Need Stories.

The narrative completes the job – it fills in the blanks between clinical facts and data points.  For pharma marketing, the article’s author articulates it beautifully, “But vignettes can do more than illustrate and reassure. They convey what doctors see and hear, and those reports can set a research agenda”.

The physician author admits that vignettes about cases and outcomes augment evidence-based medicine and inform his decision making. In our daily work, we have seen how stories tell the big picture, while also capturing the details of a smaller snapshot too. Time and again, stories provide opportunities for the audience to recognize themselves – and in this case, for the physician, his patient. Stories help individuals connect on a deeply personal level. For marketers, this is the gold they are mining for when weaving their brand narrative.

patient-story