Once touted as an industry buzzword, patient-centricity is fast-becoming a robust and core strategy for pharma brands. The shift in the delivery of healthcare services to more patient-centred care and the growing partnership between the patient and physician for treatment decision-making prove that putting the patient at the heart of what we do in pharma is more critical than ever before.
But while the overall approach is well on its way to becoming a mainstream strategy, market research and working with patients to gather insight aimed at transforming brand communications, is a little more delicate.
Using market research to gain a deeper understanding of patient journeys and experiences is becoming increasingly popular and ethical guidelines are in place to protect the confidentiality and anonymity of patients throughout this process. However, seldom do we consider the impact interview techniques and settings have on patients and the quality of the output.
Addressing the issue
In recent years, qualitative market research has increasingly fallen into a stimulus response trap. Looking for quick answers to specific questions with a specific output in mind can certainly offer feedback on a business issue, but the feedback does not necessarily yield valuable insight. In fact, such direct questioning can often lead to a patient over-exaggerating the situation or the factors under investigation.
Furthermore, in order to understand the true impact of the disease, it’s important to be able to identify the coping mechanisms at play. The challenge though, is identifying those coping mechanisms, which have become part of the person’s everyday life and are not part of conscious decision making. For example a patient with psoriasis may wear long sleeves to cover their elbows, but it is has become so entrenched in their routine, they don’t even think about it anymore. So how do we access this? The answer lies in observation.
Traditional ethnography, where one adopts a ‘fly on the wall’ approach and fully immerses themselves in a respondent’s life is not to be undertaken lightly however. While it can provide a wealth of data, it can often be like trying to find a needle in a haystack and consequently can be very time and cost intensive. Further, the commitment required from the patient is above and beyond that of traditional research, and ethically, we need to be able to justify asking our patients to do this.
Clearly then, there is a need to cultivate methodologies that provide a more cost and time efficient solution, but which don’t compromise quality and the possibility to uncover those light bulb insights.
To get the right research solution, the following factors need to be considered:
Fly on the wall vs. targeted observation
Acting as a fly on the wall is the best way to uncover those light bulb moments and identify information that you didn’t even anticipate uncovering. It allows us to really get under the patient’s skin and explore decision-making rituals, the impact of their condition and even relationships with specific treatments/brands.
But without the luxury of time, it may be relevant to hone in on a specific event/area to ensure that the insights and data collection is focused on the business question. For example, we may ask patients to complete a specific activity (i.e. taking a medication) or provide a monologue focused on a specific issue.
However, it’s important to consider that too narrow a focus enhances the risk of missing crucial details, insights and evidence. For example, one patient describes a coping mechanism that opens up an entirely new perspective on the condition in question, thus giving healthcare providers and treatment developer’s critical insight into how to provide better support for many patients.
To get the right balance it is about establishing a clear framework for analysis so we know where the focus needs to be, but also ensuring that there is flexibility in approach to uncover those ‘hidden gems’.
Utilising technology
Technology helps us to capture more with less: smartphones, blogs, and cameras are all examples of useful tools to help both engage the patient and capture ‘in the moment’ thoughts and emotions.
Patients can often post rationalise an event meaning that you miss out on those critical emotions that can be better captured using these platforms. For example;
- A video camera can be used to truly understand the immediate impact that medication (eg self-injecting) can have on a patient
- A smart phone gives patients the control by allowing them to capture those activities, people and things that have an impact on how they cope / struggle with their chronic condition
- A blog gets us closer to identifying pressing emotions which can be missed in an interview environment. It can also provide an easy to access setting that patients will feel more comfortable opening up / sharing their thoughts with others in a similar situation.
These simple routes allow us to capture those golden nuggets without following the patient around for extensive periods of time.
A 360 perspective
How patients interact with others in their daily lives is also an important piece of the puzzle. This insight is often too tricky to obtain in a face-to-face interview setting, meaning it must be observed to be fully understood.
Whether through video diaries, online tasks or other modern ethnographic techniques, encouraging patients to bring others into the conversation is key. Carers, family and friends’ points of view are important, as is viewing how they interact and their perspectives on the routines and rituals.
By observing these interactions we see both the real patient experience and the wider impact. Such nuanced behaviours could be missed via direct questioning.
Applying a behaviour change lens
Taking into account the irrational thoughts of a patient eliminates the risk of only gaining partial insights. Typically this form of questioning is missing unless the problem is viewed from a behaviour change perspective.
This lens provides a more holistic view of the problem and a more realistic account of patient behaviour, filling the gaps, left by traditional insights.
Decision making is entirely dependent on the situation and the nature of the decision can be defined using either a system 1 or system 2 way of thinking. System 1 is less effortful and because we are inherently lazy, this is often the mode of thinking that we employ when making decisions.
By applying a behaviour change lens to modern ethnographic approach, we challenge the view that system 1 thinking can be understood with system 2 questioning. Essentially, we move away from a more rational approach to uncovering insights and dig deeper into the subconscious system 1 thinking.
View the patient as a person
While the relationship between the researcher and the patient is by no means fragile, the fact that patient-centricity is the aim does make it a delicate one. In order for brands to improve communications, it is imperative to view the patient as a person – and whilst listening to what patients say will always be important, listening to what they don’t say will be equally so.
By striving to get the right balance between observation and intervention and steering away from stimulus response traps, brands can continue to make progress and develop patient-centric strategies further without jeopardising the integrity of results.
