Patient pathway

The Alcimed Healthcare team has established acknowledged expertise in the analysis and optimization of patient care pathways, and helps its clients to interpret and improve patients’ therapeutic and emotional pathways, as well as the role of key stakeholders (healthcare professionals, patient associations, relatives or caregivers, etc.) in patient pathways, starting from the pre-diagnosis phases to palliative care.

Challenges related to patient pathways or care pathways

What is a patient pathway?

Patient pathway or care pathway refers to all the stages a patient experiences in the management of his or her disease, from pre-diagnosis to palliative care. Thus, the various stages of a patient’s care pathway are mainly carried out by private healthcare professionals, in hospitals, in healthcare establishments, in medico-social structures or at the patient’s home: consultations with general practitioners or specialists, diagnostic or screening procedures, various treatments, home monitoring, etc.

What are the challenges related to the patient pathway and to the care pathway?

The efficiency of care pathways is a key problem area for all those involved in the healthcare system, who face their own challenges:

Patients who, while they become increasingly involved in their care, are looking to access the best treatments, to improve their quality of life, to better control their emotions, and to access to a comprehensive service with coordinated care, in order to maximize their chances of recovery.
The foregoing necessarily implies increased clarity of the care pathway, the roles of each stakeholder involved throughout the patient care pathway, the solutions (products and services) available to patients, and an understanding of the emotional impact of their disease.

Healthcare authorities, who are tasked with making the healthcare system more efficient and modern, by optimizing patient care at the local, regional and national level, curbing inequality in access to care –which varies greatly from one territory to another– while limiting healthcare expenses and specifically hospitalization expenses (the shift to outpatient care, for example, represents one of the solutions for reducing hospitalizations implemented by many countries).

Accordingly, healthcare professionals, seek ongoing improvement in their practices in order to provide the best possible care for their patients, better coordination with all the stakeholders in a sector (private, hospital, medico-social, institutions, health insurance and insurers, etc.), and support from state structures to facilitate patient management, for example by managing patient data.

Healthcare manufacturers, suppliers of drugs and medical devices, who play an active role in the process of improving care pathways through various actions bringing value to patients, doctors, healthcare authorities, and beyond their products: through funding and implementing patient pathway optimization programs, by developing solutions and services (e.g. mobile applications for monitoring treatment, medical telemonitoring solutions, etc.) or, for example, by setting up new roles at the interface between industry and private/hospital (e.g. MSL –Medical Science Liaison– wo are becoming fundamental stakeholders in regional healthcare ecosystems). All of these actions help to establish the healthcare industry manufacturers in an even more public position.

And many other stakeholders who face their own challenges and have a fundamental role in care pathways, such as home care providers, pharmacists, insurers, etc.

More generally, many challenges affect all the stakeholders involved, starting with the patient, and can be optimized by establishing a process to optimize the care pathway:

Cutting diagnosis time by providing better information and training

Diagnosis time is a major problem area in many care pathways, leaving patients in “therapeutic wandering”, while they impatiently wait to be informed of the causes of their symptoms and to receive the appropriate treatment. One of the mainsprings for reducing diagnosis time is informing and training healthcare professionals. Therefore, many diseases are either simply undiagnosed, or confused with others, through ignorance of their existence, or a lack of knowledge or expertise to detect them. Many tools can be used to conduct a quicker diagnosis and, thus, maximize the chances of recovery.

What tools or methods should be implemented in order to speed up diagnosis? How do you inform and train healthcare professionals in order to reduce diagnosis time?

Fostering patient orientation through better coordination between healthcare professionals in order to streamline the patient pathway

Coordination and referral between healthcare professionals is another major challenge in the patient pathway, insofar as the management of a chronic disease requires a multidisciplinary approach and coordinated care, thus, involving several stakeholders throughout the care pathway. Many treatment plans remain complex, underinformed or completely lacking information and clear processes, consequently leading to patient stagnation in their care pathways or major delays in accessing the right healthcare professionals and the right treatments.

How do you set up a clear and shared referencing process at the local level? What tools can facilitate exchanges between healthcare professionals throughout the care pathway?

Fostering the “activation” of patients

Although many patients are increasingly active in managing their pathology, many obtain little information besides their interactions with healthcare professionals. There are several means in place today to: keep up-to-date on new treatments, discuss and share daily life and best practices with other patients, become involved in a patient association to help other patients, and thus improve well-being and quality of life.

What actions should be implemented in order to foster patient activation? By what means and how should direct action be taken with patients?

Identifying and sharing data efficiently between stakeholders in order to streamline the patient pathway

Another major challenge is the management and use of data gathered over the course of patient pathways. Large amounts of data from patient files are gathered by various stakeholders regarding patients and the evolution of their diseases (age at diagnosis, type of screening, side effects, disease progression, etc.) and could provide for cross-analyses with a view to global innovation and improved pathways. At present, well beyond ethical debates, a large amount of data is underused and remains compartmentalized. In France, for example, initiatives such as the Health Data Hub –a platform for centralizing data from various organizations– has emerged and paves the way for new projects with varied perspectives: basic research, drug development, monitoring of their real-life uses, and optimization of care pathways (prevention, hospital care and patient monitoring).

What data can be shared between those involved throughout the care pathway? How is this data collected and used to improve the pathways?

Implementing performance indicators for the care sectors and fostering ongoing improvement

lastly, in order to optimize the care pathways and channels, it is necessary to monitor over time the performance of the actions implemented and ongoing improvement of the processes. Accordingly, defining indicators and sharing them within the multidisciplinary teams involved means the optimization process can be preserved over time. The indicators can include: the number of patients involved in a framework, the satisfaction of patients and/or healthcare professionals, cutting waiting time, or the number of patients monitored in a department. These indicators make the change tangible and quantifiable and make it possible to forecast the evolution of sectors over time.

Which indicators should be defined for optimizing care pathways? How do you bring to life the sharing and monitoring of performance within a sector?

How do we support you in your patient pathway or care pathway optimization projects?

The core goal of the projects we conduct regarding patient pathways is to improve a healthcare sector’s performance at the local or regional level, in order to create value for patients, healthcare professionals, healthcare authorities and pharmaceutical companies.

Alcimed has developed a “Care Pathways Efficiency Program” (PEPS) which makes it possible to improve the performance of care pathways inside and outside the hospital, by implementing a proven methodological approach, working in close collaboration with the various stakeholders involved throughout the pathway (diagnostic centers, hospitals, home care workers, patient associations, etc.).

We audit patient pathways, identify optimization mainsprings, and generate action plans for improvement at various levels of healthcare systems, which we implement in close collaboration with the various stakeholders.

Most of our projects are initiated at the local or regional level. Since issues and contexts often differ from one geography to another, it is important to consider the context of each center or each branch locally before extrapolating care pathway optimization levers to a higher level.

Alcimed has already conducted more than a hundred “PEPS” initiatives worldwide (in Europe, the United States, Latin America, Asia, the Middle East, etc.) on many issues and in various pathologies (e.g. respiratory diseases such as pulmonary arterial hypertension or interstitial lung diseases, cardiovascular diseases such as stroke or hypercholesterolemia, but also in oncology, neurology, gastroenterology and hepatology, etc.).

We have conducted more than 100 projects up to now for different stakeholders such as: pharmaceutical laboratories, medical device players, biotech companies, healthcare authorities, national and regional institutions, and patient associations.

Beyond our PEPS offering, here are other kinds of projects we conduct for our clients regarding care pathways:

Patient experience
Product innovation
Product launch
Strategic foresight
Roadmap
Benchmark

Commercial strategy
New services
New offers
Open innovation
Patient activation
Opportunity evaluation

Cluster study
Market study
Collaborative projects
Search for partnerships
Competitive analysis
Market access

A project? Contact our explorers!

EXAMPLES OF RECENT PROJECTS CARRIED OUT FOR OUR CLIENTS IN PATIENT PATHWAYS

Optimizing the care pathway for rare disease patients in Europe

We assisted the European Medical Management of a pharmaceutical company to optimize the care pathway and emotional management of patients suffering from a rare respiratory disease in several European countries.

As this rare disease is difficult to diagnose and often confused with more common respiratory diseases, the time required to diagnose patients was too long (2 to 3 years). Our client wished to position itself as a public health player by providing hospitals (3 centers per country, in different countries) with Alcimed's service for :

Diagnose the current coordination of care between the different healthcare actors involved in the patient pathway.
Co-define with this multidisciplinary team an ideal patient management model and an associated action plan.
Implement the actions defined at the local and national level.

The result for our client? A reduction in patient diagnosis time and an overall improvement in physician coordination, an increase in therapeutic management and a change in the sales team's stance.

Optimizing the emotional journey of patients with rare diseases

One of our clients, a leading pharmaceutical company, wanted to improve the care of patients suffering from a rare disease by developing a high value-added service offering that would improve their well-being or quality of life throughout their care pathway (from diagnosis to palliative care).

To do this, our team interviewed patients, patient support workers and associations in each country involved in order to map their emotions and to identify the levers for improving their well-being and quality of life that could be addressed by developing services. Following this, our team pre-tested these service ideas with healthcare professionals, before organizing a workshop to co-construct a service development roadmap with our client's medical and marketing teams.

Ultimately, several services were deployed in the pilot countries and then extended to other countries in the zone, improving the emotional pathway of patients and positioning our client as a major player in public health.

Supporting a pharmaceutical company in optimizing the care pathway for patients with chronic diseases in a dozen French regions

Noting numerous local problems in the patient care pathway (abnormally long diagnosis time, problems with referrals between caregivers, poor legibility of the pathway, etc.), a leading pharmaceutical company called on our team to optimize the care pathway of patients with chronic diseases and facilitate their global management at the local level in a dozen regions in France.

Following our PEPS methodology (Patient Pathway Efficiency Program), the first step of our project consisted in selecting pilot centers and training multidisciplinary teams within these centers. Our team then conducted a diagnosis of the care chain by discussing with all key stakeholders involved in the patient pathway, and then co-defined with the pilot teams of each center an ideal operating target to be reached and an associated improvement action plan. Finally, we supported the center teams in the definition of key performance indicators (KPIs) and in implementing the co-defined actions through to the analysis of the impacts of these actions, in order to finally implement the most value-creating actions at the regional level.

Deciphering the patient pathway of persons with type 2 diabetes in Germany

For a medical device player wishing to enter the type 2 diabetes market in Germany, Alcimed analyzed the key stages of the patient pathway, from diagnosis to therapeutic follow-up, the stakeholders involved and the main barriers and uncovered patient needs.

As a result, we were able to identify that our client's product in its current version did not meet market expectations, and recommended to our client the target characteristics that were essential, and those that were less of a priority, to successfully enter the German market.

WHO IS ALCIMED?

Founded in 1993, Alcimed is an innovation and new business consulting firm, specializing in innovation driven sectors: life sciences (healthcare, biotech, agrifood), energy, environment, mobility, chemicals, materials, cosmetics, aeronautics, space and defence.

Our purpose? Helping both private and public decision-makers explore and develop their uncharted territories: new technologies, new offers, new geographies, possible futures, and new ways to innovate.

Located across eight offices around the world (France, Europe, Singapore and the United States), our team is made up of 220 highly-qualified, multicultural and passionate explorers, with a blended science/technology and business culture.

Our dream? To build a team of 1,000 explorers, to design tomorrow's world hand in hand with our clients.