Someone asked me yesterday if I could come up with 100 questions on one topic that I would want answered. I started by thinking about Rx adherence, but I evolved it to a broader topic (patient experience) to get to 100 questions. This is my list of 100 questions I would want to evaluate to understand the patient experience with a disease and what factors are relevant to segmentation and differentiation.
This exercise also led me to this equation as a strategic framework (not a mathematical algorithm…yet).
Patient Data (Demographics):
- What is their age?
- What is their gender?
- What is their income?
- What is their highest level of education?
- What is their race / culture?
- Are they married?
- Do they have kids?
- Do they work in healthcare?
- Where do they live?
- Are they in a rural, urban, or suburban setting?
- Have they ever had a medication before?
- What has their prior adherence been on other medications?
- Does the patient go to multiple pharmacies?
- Do they have multiple MDs?
- What type of insurance do they have – commercial, individual, Medicare, Medicaid?
- Do they have a family history with the disease?
- Have they ever done a genetic test to know they were at risk for the disease?
- Do they have friends with the disease?
- Are they a caregiver for others?
- What is their health literacy?
- Have they enrolled for the website for their payer?
- Have they downloaded any mobile apps?
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How often do they exercise?
Patient Beliefs:
- What is their Patient Activation Measure (PAM) score?
- What stage of change are they in? (TTM)
- Are they a fatalist?
- Are they actively part of any social groups (e.g., church)?
- Do they have motivation to change?
- Have they successfully changed behaviors before?
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Do they perceive the change as achievable?
Diagnosis Attributes:
- What type of disease is it?
- Is it a mental health disease?
- Is there a social stigma associated with the diagnosis (e.g., obesity)?
- Is it a “social” disease (i.e., lots of active communities to create P2P support)?
- How long since they were first diagnosed?
- Is the disease progressive?
- Is this a rare disease?
- Is this a curable disease?
- Will this disease kill them?
- Does there a mechanism for feedback on the drug – blood pressure cuff, blood sugar monitor, scale?
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What are the total costs of the disease – Rx, lab, MD visits, behavior change?
Treatment (Prescription) Attributes:
- Does the patient’s treatment plan include behavior change – diet, exercise, smoking?
- Did the physician provide them with any information (i.e., Ix or information therapy)?
- Did the physician direct them to any resources (e.g., prescribe apps)?
- Did the physician write a prescription?
- Did the physician give them samples?
- Is this a new prescription or a refill?
- Are they on other medications?
- How many other medications are they on?
- Was it prescribed by a PCP or a specialist?
- Was it prescribed in the hospital or on an outpatient basis?
- Was it an eRx or a paper Rx?
- Is this a first-line of therapy or a second-line?
- Is the medication contra-indicated with another other medications they are on? (DUR)
- What is their copay?
- Is there a copay card?
- Where there any utilization management requirements (PA, ST)?
- Is it a brand or a generic?
- What is the form of administration – pill, injection?
- What is the size of the pill?
- Does the medication require specific times to be taken?
- Is the medication once-a-day?
- Is there a delay between starting therapy and feeling better?
- Is there an adherence program that surrounds the drug?
- Does the adherence program integrate with the physician?
- Did the physician tell them the name of the drug or just write the Rx?
- Did the physician explain any side effects of the drug?
- Does the drug have any side effects?
- Is the drug being used off-label?
- Is there a REMS program for the Rx?
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Is this a clinical trial?
Care Team Attributes:
- How long have they gone to this physician?
- Is this a single practitioner or part of a group practice?
- Is the physician group owned by a hospital?
- Is the physician group an ACO or PCMH?
- How old is the physician?
- What gender is the physician?
- How long was their visit to the MD when they were diagnosed?
- What type of pharmacy was it filled at?
- Do they have a relationship with the pharmacist?
- Are they in a disease management program?
- Are they in a care management program?
- Do they have a caregiver to support them?
- Was the caregiver at the MD visit when they were diagnosed?
- Have they articulated their life goals to the team?
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Do they have an advance directive?
Technology Attributes:
- Does the patient use healthcare websites?
- Does the patient use healthcare mobile apps?
- Is there a mobile app to support this disease?
- Is there a mobile app to support this drug?
- Is there a mobile app to support their behavior change?
- Does the patient have and use a PHR?
- Does the physician use an EMR?
- Did the patient’s “self-diagnosis” with Dr. Google match the physician’s diagnosis?
- Is there anything unique about the pill bottle to support engagement?
- Are the patient’s programs about the disease multi-channel?
- Are the patient’s preferences used to evolve how they are communicated with?
- Are the patient’s communications tailored to them based on their data?
- Do they use SMS?
- Do they have a smartphone?
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