Medical affairs organizations continue to further their use of data and analytics in demonstrating value. The availability of novel data sources holds the promise of enhancing strategies and engagement impact. When considering these new sources of knowledge, one must ask, what is the strategic application of medical claims via medical affairs?
Simply put, a medical claim is a record submitted to a payer organization that demonstrates the various levels of service addressed via a healthcare provider. Leaders across the (bio)pharmaceutical industry are beginning to see the potential medical claims offer to those driving awareness and understanding of novel approaches to patient care. However, the questions must be asked, how can this data be used effectively and how will it enhance insights into the world’s experts, improving one’s ability to identify, prioritize, and engage differently? Monitoring of behavioral trends over time may yield important insights into care at a community or sub-specialty level as well as differences in scientific activity compared to clinical care. Using new resource as well as insights from scientific exchange, real world evidence (RWE), and expert profile activity can allow medical affairs to identify novel activity patterns. Organizations offering more targeted therapies can expand their reach to healthcare providers who are managing challenging issues and would benefit from access to emerging data and innovation. Additionally, teams can identify clinicians that may not have risen to the level of a traditional (scientifically recognized) expert but may be managing the daily array of complex patient issues thus benefitting from a much closer relationship with medical affairs. By leveraging this expanding set of data, medical organizations can enhance insights into existing care patterns, address gaps in knowledge, and improve impact. Ultimately, this information can be used to improve strategic planning, enhance external engagement, and provide education and outreach, with services targeted to different sub-populations, care providers, or at-risk patient groups in order to improve overall outcomes.
To make this onerous task easier, we developed a new data extension which can be seamlessly added to Monocl Professional and which utilizes the industry leading medical claims data set from Definitive Healthcare. With this data, users can now utilize Monocl Professional’s powerful features to analyze experts’ clinical activity through an array of clinical data in their profile overview. As always, there are no restrictions to therapy area or location and all data is 100% available in real-time.
Identify and prioritize clinical leaders
Monocl Professional contains information on many millions of medical and scientific experts. To be included in the database a researcher/scientist needs to fulfil a number of criteria, e.g., have published a minimum number of publications in peer-reviewed journals. These inclusion criteria allow Monocl’s powerful algorithms to analyze billions of datapoints and ensure a very high degree of accuracy when building and updating its millions of profiles. The addition of claims data has expanded the volume and types of experts included in the platform. Our profiles illustrate clinical behavior from not only physicians but other types of care providers including nurse practitioners, pharmacists, pathologists, etc. who may be involved in diagnostic or procedural care. This enhancement ensures that the experts you are looking to identify have the right experience and you can understand how their care choices changed over time.
Monocl Professional offers the option to filter experts by the number of patients and while that is a first step, there is a better way to find experts relevant to you.
Start just like you would start any search for an expert with a relevant keyword, e.g., a therapeutic area, disease, drug or alike. For this example, we are looking for Experts in psoriasis research and find globally just over 53,000 in the database.
In the next step we can now narrow this list down using the location filter to the United States (only geography with available claims) and then consider the experts’ clinical footprint by way of total patients.
To understand the role this group of physicians plays in the treatment of psoriasis more specifically, we can filter on the specific diagnostic code for plaque psoriasis, L40.
Working down the list of experts and analyzing their patient volume as well as their specific clinical activity allows user to exclude those that may not be as relevant.
Searching for experts that treat specific diseases or perform certain procedures can help you identify experts who are more receptive to engagement on a focused topic. For this example, an organization involved in genetic testing or other diagnostic procedures may look to target experts who have clinical activity with companion diagnostics or other emerging tools to align treatment. Using the sort and refine features of Monocl Professional Claims Extension has allowed us to narrow down the field of over 53,000 experts with activities related in psoriasis to individuals that match specific profile requirements.
Starting with a list of experts and then focusing on those with a significant care footprint offers a smart and streamlined way of identifying and prioritizing clinical leaders without the need for other 3rd party tools or a large investment in time or deep analytics.
Understanding Care Relationships
The Monocl Claims Extension seamlessly identifies high-impact practitioners and quantifies patient volumes by diagnosis and procedure to optimize planning and outreach efforts. When it comes to accessing the physician referral patterns, teams can further understand how providers collaborate on care decisions. Understanding how patients are referred is just another foundational piece of information that medical affairs should understand and apply strategically. This evolving dynamic could provide opportunities for a company to improve education, resource deployment, and therapeutic interventions. Applying this type of knowledge will make you more likely to understand critical healthcare providers and the challenges they face.
Understanding referral relationships and an Experts’ treatment “reach” has the potential to ultimately help medical affairs partner with care providers to improve treatment outcomes and provide a more effective allocation of medical resources.
Comparing Scientific Expertise
The Monocl Professional Claims Extension provides the ability to compare an expert’s scientific activity with that of their own clinical practice as well as the behaviors of community level healthcare providers. Unlike academic research, clinical practice isn’t about developing new innovations or furthering existing knowledge. It’s about the current standard of care and understanding how evidence has impacted decision-making. Identifying clinical leaders provides a new avenue to share emerging evidence to enhance care choices in the future. Historically, insights have been generated via traditional experts, yet clinical practice involves innovation in terms of translating evidence into effective patient outcomes. Expanding awareness of clinical decision making can augment insights, validate the impact of current evidence and generate opportunities to enhance understanding in the future.
These are just a few examples of how to find and prioritize clinical leaders to create competitive advantage through the identification of HCP’s working in rare disease, immuno-oncology, co-morbidities, etc.. If you have specific questions or would like a closer look at Monocl Professional and our new Claims Extension, one of our specialists is happy to give you the grand tour.