Using Evidence from the Exam Room to Shape RWE Strategy

Traditional methods for generating real-world evidence (RWE) from patient-physician conversations largely depend on self-reported data from post-visit surveys or interviews, which are prone to recall bias and alterations due to social desirability. This indirect input often misses out on the rich context of exam room conversations, including nuanced interactions and non-verbal cues critical for fully understanding communication dynamics and real-world patient narratives.

At KJT, we believe it is our duty to emphasize the patient voice in real-world evidence development, and a key way to do that is by capturing authentic patient-provider conversations. Privacy regulations and concerns typically restrict the direct observation or recordings of these interactions, posing challenges in capturing the true complexity of patient needs, language, and key topics such as therapy effectiveness and adherence barriers. This deficit is a call to action for RWE consultants to innovate new methodologies that balance privacy integrity with the acquisition of deeper, more accurate insights and nuances of physician communication.

DialogueDx^SM is our unique methodology designed to capture and analyze evidence from within the exam room, directly from patients and providers. This approach leverages authentic patient-provider conversations, enabling a holistic understanding of various aspects of treatment experiences and outcomes. 

Use Cases of DialogueDx^SM in Generating Real-world Evidence

• Capturing the patient voice in real-time: DialogueDx^SM provides a unique platform to capture unfiltered patient narratives, as they occur. Patients discuss their experiences with different treatments, offering direct insights into the success or failure of these interventions. This real-time information is invaluable in understanding the impacts of treatments.
• Assessing treatment benefits, drawbacks, and efficacy: Through organic patient-physician conversations, we can gather detailed testimonials on the effectiveness of treatments and any side effects or disadvantages experienced by patients. These discussions often provide deeper insights than quantitative studies alone.
• Evaluating the impact on quality of life: DialogueDx^SM helps assess how treatments affect patients’ daily lives. Patients share their experiences about how therapies have improved or worsened aspects such as mobility, mental health, and overall life satisfaction.
• Understanding the role of therapy in reducing burden: Patients discuss how treatments have helped manage the symptoms of their conditions, potentially reducing the overall burden of treatment, including discussions on the effectiveness of therapies in alleviating disease symptoms and possibly reducing the need for additional interventions.
• Navigating access and barriers to therapy: Real-world evidence is uncovered on the logistical barriers patients face in accessing treatments such as the availability of treatments, geographical challenges, and provider limitations.
• Understanding cost and coverage discussions: DialogueDx^SM allows patients to voice their concerns and questions about the costs associated with their treatments and the extent of insurance coverage. Understanding these financial barriers is crucial for assessing treatment accessibility.
• Exploring barriers related to Social Determinants of Health (SDOH): Issues such as socioeconomic status, education, and community safety, which significantly impact health outcomes, are discussed, providing a clearer picture of the challenges patients face outside of direct medical care.
• Understanding barriers to adherence and compliance: Through these patient conversations, we can identify factors influencing adherence to prescribed treatments, including ease of use, side effects, perceived effectiveness, and psychosocial impacts.
• Exploring reasons behind treatment switches: DialogueDx^SManswers questions like “What triggers a switch? What do patients want to know so they can evaluate their options? Who ultimately makes the decision, and what drove their choice?” This feedback can inform the development and positioning of new therapies.
• Informing expectation setting: Understanding what patients hope to achieve with new treatments and educating providers on what to expect can guide clinical practices and help pharmaceutical companies properly position their products.
• Identifying unmet patient needs: Dialogues often reveal gaps in current treatment options, highlighting areas for innovation or improvement in patient care.

In summary, DialogueDx^SM serves as a powerful tool in real-world evidence generation, capturing authentic conversations, offering deeper insights than traditional evidence methods, and leveraging generative AI to analyze these interactions at scale. Our HIPAA-compliant, AI-driven, approach to speech recognition transcribes recorded patient-provider interactions. We then employ state-of-the-art generative AI technology to summarize and analyze these transcripts thoroughly. DialogueDx^SM discovers and further explores the themes discovered during exam room dialogues during later research phases. 

Our expert researchers ensure that DialogueDx^SM is custom-tailored to provide answers to unique business questions. The solution is made up of the following four phases:

• Phase 1: Patient-Provider Observation: Decodes authentic patient-provider conversations to understand how the conversation naturally unfolds, which topics are discussed, and what triggers action from the provider.

• Phase 2: Patient Video Diaries: Explores the patient’s perspective on the successes and failures of the visit with their provider and uncovers gaps in the conversation, along with other reactions they may have to their visit.

• Phase 3: Provider Interviews: Strives to better understand real-time provider experiences and the decision-making process in more depth and investigates behaviors identified in video diary recordings.

• Phase 4: Quantitative Validation: Focuses on validating the language used around symptomatology and treatment decision-making and triangulating other key observational and qualitative findings.

A Final Note

The insights sourced via DialogueDx^SM are utilized differently across various teams within client organizations. Medical affairs and RWE teams can focus on refining educational content and supporting patient advocacy, using real-world data to enhance treatment paths and informing the design of clinical trials to better meet patient needs. Altogether, DialogueDx^SM allows stakeholders to better understand the complexities of patient-provider interactions, and unmet patient needs, and to apply these insights across commercial, medical, and research areas to foster better health outcomes and business strategies.

RWE generated from the exam room using DialogueDx^SM helps develop educational materials for patients and physicians, provides evidence for pharmaceutical organizations to advocate for the patient voice, extend or revise label indications, and contribute to the improvement of health outcomes.

Click here to watch our latest webinar on the DialogueDx^SM solution and learn more about how understanding these important interactions between patients and healthcare providers can revolutionize healthcare and improve patient outcomes.