Redesigned Care Delivery: New Influencers Emerge

This post is part of a series analyzing the impact of the changing healthcare landscape on the pharmaceutical industry. In our examination of healthcare stakeholder dynamics, it is important to consider the new roles and responsibilities that are becoming standard, and gaining prominence within Payers and Organized Customers.

As we have seen over the past few years, practice transformation has become one of the cornerstones of redesigned care delivery. Organized Customers have restructured care delivery and their approach to patient care, which includes multiple touchpoints outside the physician’s office and addresses many non-clinical elements of patient care. For this reason, an entirely new group of influencers has emerged within today’s Organized Customer, significantly impacting the account management customer engagement model. This group of influencers includes the following roles and responsibilities:

Chief Patient Engagement Officer

Engaging patients has been a growing focus in healthcare since value-based care has emerged as a priority. As this role has matured, through best practices and effective knowledge-sharing, the quality of patient engagement is improving. We are starting to see data that correlates improved patient engagement with improved outcomes, and the influence of patient engagement teams is growing as a result.

Director of Information Technology

Many systems have joked that they no longer manage patients, but they now manage data. Clearly the role of IT in healthcare has been elevated significantly, through the incorporation of pathways, clinical decision support, and population health management applications.

Director of Innovation

Many Organized Customers have carved out a specific role for innovation. A Director of Innovation may have responsibilities outside of reshaping care delivery, but any Innovation Director or officer is an important component of optimal engagement.

Director of Nursing

The Director of Nursing serves Organized Customers by ensuring that nursing care provided by staff members meets various safety, quality, and cost efficiency metrics. Nursing Directors must excel at communication and negotiation tactics, as they are often the communication bridge between front-line caregivers and upper administration. They are responsible for ensuring that new initiatives are operationalized, and address any opportunities for improvement that arise in the process.

Director of Population Health Management

The ability to effectively manage populations is a cornerstone of the Quadruple Aim (Improved Physician Experience → Improved Patient Outcomes → Improved Patient Experience → Lower Cost of Care). While there are numerous definitions for Population Health Management (PHM), value-based care imperatives dictate managing the right patient at the right time with the right intervention. Organized Customers have numerous roles to address PHM, but any Director of Population Health Management will have significant influence within the Organized Customer hierarchy.

Patient Experience Officer

Another emerging responsibility is patient experience. Unlike patient engagement, which focuses on the clinical aspects of patient care, patient experience is the growing trend of bringing hospitality to healthcare. The patient experience is directly tied to quality improvement initiatives – including HCAHPS and CAHPS – which are a direct result of the prioritization of this role. While Patient Experience Officers approach patient care through a different lens, they can hold tremendous influence.

Transitional Care Expert

Transitions of care support continues to receive a great deal of attention because of the cost savings associated with readmission reduction. Transitional Care Experts may be clinical or non-clinical staff members who are dedicated to ensuring patient safety during transitions across the care continuum. Areas of focus for these staff members include education, follow-up appointment coordination, and medication reconciliation/provision.

VP of Quality

Although this position has existed within Organized Customers for a long time, its organizational influence has never been stronger. Many of the pillars of value-based care are led by the VP of Quality in order to ensure successful performance in the relevant quality improvement domains.

These roles and responsibilities provide a glimpse into the evolving influence dynamics within payers and Organized Customers. Unfortunately, for account planning, no two systems are alike, and a meaningful phase of due diligence that precedes effective engagement is required. Regardless of the structure and the titles of these emerging roles, the themes outlined above will be evident among any customer. Developing a narrative and resources to address these imperatives will set life science commercial organizations on a course for success.