This year, Malcolm Cox, M.D., Chief Academic Affiliations Officer for the Veteran’s Health Administration, administered $30 million in competitive grants to establish five primary care centers of excellence. Cox’s goal, as identified by the Secretary of Veterans’ Affairs, is to begin to fix the U.S. healthcare delivery system. As the focus of this work, Cox and his team are placing the patient at the center of care at the pilot VA hospitals via improved healthcare communication.
Cox shared a little about the project’s successes and learning opportunities when Columbia University’s Narrative Medicine Program hosted him as part of their public lecture series, Narrative Medicine Rounds. The information he shared has implications across the healthcare continuum – from other providers that want to emulate the VA’s internal communications strategy to pharmaceutical companies who will be affected by the initiative.
Improving healthcare delivery in the U.S. is important for the VA because it is the nation’s largest integrated healthcare system, consisting of more than 1,000 primary care sites, including 152 hospital-based outpatient clinics and more than 900 community-based outpatient centers. The VA cares for more than 8.3 million veterans every year. Its size alone makes the VA the perfect pioneer to test new ways to improve communication, and ultimately, patient outcomes.
The VA’s model can have far-reaching implications for all facets of healthcare.Take, for example, the issue of patient adherence. The National Center for Biotechnology Information contends that open physician-patient communication is essential to patient adherence. When patients have clear, easily understandable information from a team of experts – and when those experts are communicating consistent messages to the patient – they are better informed and motivated to successfully complete a prescribed course of treatment. In fact, there is a 19 percent higher risk of nonadherence among patients whose physician communicates poorly than among patients whose physician communicates well.
This is important to pharmaceutical companies because, according to a recent CapGemini report, nonadherence has two major affects on the industry:
- The obvious result of nonadherence is that sales will drop as fewer prescriptions are filled.
- However, there is a less obvious, longer term repercussion to nonadherence – a loss of brand equity due to incorrect assumptions of drug inefficacy.
This perceived lack of efficacy leads to lower reimbursements and prescription-switching by physicians. And losing patients is costly; CapGemini reports that gaining new patients costs pharma companies an average 62 percent more than retaining existing ones.
In addition, a third of all prescriptions are never filled, and over half of prescriptions that are filled are associated with incorrect administration. Nonadherence contributes to direct annual costs of $100 billion to the U.S. healthcare system.
With statistics like these, it’s obvious that pharma companies should be as motivated to implement patient-centered care as physicians and other caregivers are. On a small scale, improving patient adherence leads to improved prescription compliance and the accompanying sales; over time, it lowers the cost of healthcare.
Pharma companies should follow the lead of the VA and other major healthcare providers by supporting the community of care model for healthcare delivery. Pharma can support this initiative by offering supplemental communication resources for members of a community of care, including:
Expert-led workshops and roundtables
Companies can identify experts working in the continuum of care for a specific condition, then recruit these thought leaders to present their views. These presentations could take the form of continuing education events, either in conjunction with an industry meeting or as a webinar. Some topics to cover include condition-specific dietary updates, health coaching and motivational interviewing and inter-practice communication skills.
Downloadable collateral material
Videos, illustrative posters, printed materials and other collateral material are all great supplementary methods to reach those not at industry meetings. Useful material could include dietary guides, prescription recommendations and motivational interviewing techniques.
What are other ways that pharmaceutical companies can support the clinical community in its push for patient-centric care?