Collectively, we have many more years of experience in medical education than we care to admit. So perhaps we are well-placed to reflect on what we might expect in the coming year in the pharmaceutical industry.
Certainly, one of the biggest trends in the industry - that looks set to continue for the foreseeable future - is the search for value in medicines. It is important to continually ask: value for whom? Typically, the beneficiaries are healthcare systems, or even societies. Unfortunately, incorporating outcomes that represent value to the individual patient are often an afterthought.
Patient-centred care has now made it to centre stage in discussions of quality and value; it is enshrined by the Institute of Medicine's 'quality chasm' report. However, lost in the many discussions is the essential meaning of what it means to be patient-centred. We know from numerous Roper surveys and many other sources of information that a disconnect exists between what is important to patients (and even between different patients) and what is important to physicians. So, what does patient-centred value really mean in practice? And how do we as medical education professionals ensure we do our best to incorporate this viewpoint into our daily work?
In practice, providing quality care usually means adhering to evidence-based guidelines, with measurement focused on processes rather than outcomes. Furthermore, patient-centred care, with its focus on individual needs, can appear at odds with an evidence-based approach that tends to focus on populations. In addition, many of the measures we utilise today confound outcomes and behaviours, leading to even more confusing results.
In any complex system, attempting to control behaviours without measuring results will limit progress and incremental improvement. Without a feedback loop, providers lack the information necessary for learning and advancement.
One of the biggest trends in the industry is the search for value in medicines
At Lucid, our suite of offerings - which includes our Advance Outcomes approach - has shown first-hand how incorporating the patients' point of view into the goals of a programme can change clinical outcomes. For example, asking physicians to routinely use a treatment target that combined a simple, standardised quality-of-life measure with clinical measures resulted in a significant improvement in patient outcomes compared to using clinical measures alone. Identifying barriers to adoption of this combined target - including awareness of current standards of care, peer influence, infrastructure needs and simply awareness of the benefit - were instrumental in broad global adoption.
We start by setting the goal of changing the patient's outcomes, informed by the patient's point of view. We then define the behaviour change needed to achieve this outcome and identify the barriers to that change. This allows us to develop targeted interventions that are designed with the end-goal in mind, ensuring that value to the patient is put front and centre, and that benefits to the patient can be measured. Collecting these metrics also provides feedback to healthcare professionals and further reinforces the behaviour.
In 2017, Lucid aims to advance its approach to measuring the impact of its behaviour-change programmes, building on the existing evidence-base to develop new approaches to capturing metrics on value and outcomes for patients. This unique vision is one of the reasons we joined Lucid and we look forward to successfully putting this into practice next year.
“Joining the leadership team of an award-winning agency pioneering medical education that changes behaviour by placing the patient at the heart of its programmes was a proposition neither of us could resist. Lucid's single-minded approach to medical education means all our teams share the same vision and passion for improving patient outcomes. Consequently, this unique alignment in culture, values and vision throughout the organisation allows us to spend more time innovating and creating clinically meaningful programmes, as we are all starting on the same page. 2017 is set to be an exciting year for Lucid: not only does Lucid turn ten, but we now have a whole year ahead of us to make our mark and demonstrate that we can change lives with medical education.”
Shula Sarner is an executive scientific director and Tanya Goodyear is division director, immunology at Lucid Group