Excellence in the era of precision medicine

Robert Groebel, VP of global medical strategy at Veeva shares insight on how communications in MSL can improve

Pharma IQ

Medical affairs is at the leading edge of a trend. As the life sciences industry shifts towards precision medicine, its investment in medical and scientific affairs has steadily increased. From 2014 to 2016, MSL teams grew by 12% overall, and 31% in specialty areas such as oncology. 

However, studies show that only a third of scientific experts are satisfied with their MSL experience. In addition, those who found little value from their MSL interactions also had negative perceptions of the associated company or product. Part of the challenge is that the expectations of experts have evolved significantly in recent years. MSLs must accurately uncover and deliver on the individual’s scientific need.

Medical affairs can serve these needs by training MSLs with better listening and probing skills, and developing a more strategic mindset. In addition, MSLs are expected to know what their company counterparts are doing. This lack of visibility has long been a pain point for industry and a source of frustration for experts, especially when multiple product teams are involved.


Patient-centricity taking center stage

The range of medical stakeholders has expanded in the past decade beyond just regulators and physicians to also include payers and health authorities. Even patient advocacy groups have grown in influence as they increasingly participate in shaping the care paradigm. The industry is rapidly learning what it means to be patient-centric. With the overwhelming growth of clinical data and the expansion of clinical care teams, life sciences companies will need to reconsider how they align information to diverse stakeholders in each stage of the product life cycle. This requires identifying the right stakeholders, assessing scientific need, and commanding solid knowledge of the data—all with the goal of impacting patient outcomes. Within the life sciences industry, medical affairs is best positioned to lead this shift.


Getting scientific value from vast troves of data

With medical literature doubling every three years, pharma now has access to unprecedented amounts of scientific data. For the industry, this is an opportunity to gather actionable insights, leading to strategic interventions. But companies struggle to make sense of vast amounts of data and to leverage it to meet scientific experts’ needs. This often results from technological barriers. Disconnected systems and fragmented data sources limit the flow of information and the development of scientific insights. Unfortunately, such incomplete views also prevent medical affairs from being fully optimized.  

Companies understand that scientific insights often lead to better medical outcomes. Obtaining quality insights has never been easy. And knowing how to leverage them is even more complex. MSLs frequently do not know where to report insights back to the organization or who needs to know key information. There is an opportunity for the home office to improve the communication loop with MSLs, informing them of the results and value of the insights they generate in the field. This open feedback flow has the potential to lead to additional, new insights.  


Actionable insights as strategic value drivers

Insights provide a complete view of the patient journey over time, covering the spectrum from early disease state education, to management goals, therapeutic choices and therapy-specific outcomes, and future goals. While many insights are observational in nature, the goal is to identify actionable insights that inform medical strategies, leading to improved interventions and better patient outcomes. This requires a combination of both human and artificial intelligence (AI) to generate and understand the insights.

With thousands of accessible data sources, technology plays an important role to help analyze and identify actionable insights. Once tagged and compiled, artificial intelligence tools that employ natural language processing help mine the data for new information. And while the practice of using free text for insight collection is not universal across the industry, companies such as AstraZeneca view it as an important means of maximizing the value of the information they gather, especially in the context of sentiments and perceptions. 

However, the industry cannot fully rely on technology alone. MSLs need to be trained to recognize and follow-up on “aha” moments. Sales reps are already really good at asking probing questions that lead to additional information. Some companies actively cross-train their field medical teams to acquire the same capabilities through role-play and development of probing skills. Finally, to ensure appropriate follow-up, MSLs also need to understand the internal escalation process for new insights—an area frequently overlooked. With sufficient training, field medical teams can develop an “insights-biased” point of view.


The Role of AI in Evolving Medical Affairs

With the growth of scientific evidence, the life science industry can use AI to guide care, improve comprehension, analyze trends, and identify opportunities for further research. It already has impacted other parts of the healthcare ecosystem. Payers leverage therapeutic information, as well as patient and claims data, to recommend treatments and impact outcomes. AI also helps inform provider therapeutic choice by presenting evidence-based recommendations to reviewers at larger, institutional networks. 

The impact this new virtual “influencer” may have on product choice and patient outcomes must be accurately understood and addressed. Companies can also optimize the effect their medical teams can have. How do they compile credible data and insights? How do they ensure awareness of the data and insights by internal stakeholders while providing access in a consumable and actionable manner? Can AI ensure that the most relevant data and insights rise to the top to enhance guidelines, pathways, and treatment algorithms?

AI-powered engagement helps guide customer-facing resources through the planning and execution process; surfacing actions, evidence, and insights based on real-time, integrated data. Acting as a “virtual mentor,” technology can guide engagements to meet both customer expectations and organizational objectives today, while further future informing decisions.


Better understanding scientific experts

One of the keys to success for medical affairs is to help the organization better understand the scientific expert. It is no longer sufficient to simply engage on an ad hoc basis when the company needs information. Experts seek deeper relationships that add value to their particular role in the treatment journey. This type of relationship development has to be done in person, though it can be augmented through digital channels if the individual is open to utilizing them.

The challenge is that parameters for the MSL-expert relationship are not always clearly defined.  Medical can expand beyond the traditional ‘reach and frequency’ types of measures and become more consistent about defining the desired relationship outcome. MSL measurements can be linked directly to the scientific and patient impact they are having, including knowing if the expert visited the medical portal, opened an email, or requested additional information.

MSLs are expected to know more than just what the expert does, but how they behave and how others behave around them. This is especially true for specialty care areas where a small community of experts are closely connected to each other. There is significant value in understanding those networks of interactions. Yet, many companies still rely on web searches to find basic expert information, such as where someone is published. Because this is insufficient for getting an

accurate profile, some companies are turning to modern tools to bring together various sources of information, including claims and referral data, trials, publications, clinical guidelines, and many other sources. This provides a much more sophisticated, complete, and current expert profile view.


Evolving Field Medical Teams to Adapt to the New Reality

Companies are evolving beyond the simple ad hoc transactional encounters of the past. Sustained MSL-expert relationships, complemented by multi-stakeholder engagement, is the way forward.

As the industry continues to rethink the profile of the MSL, it will also reevaluate and seek out new competencies, technology solutions, and data sources that better support patient-centric outcomes. Medical affairs leaders are at the forefront of this evolution and newly positioned to rewrite the traditional corporate formula for success