Patient pathways promise improved treatments and outcomes, yet they often lead to a maze of access, equity and service issues where great intentions hit dead ends.

Wreathed in innovation, lived experience and market intelligence, these pathways can be transformative across conditions and patient groups, but for too many people they appear like decorations for a feast to which they are not invited.

Digital advances, both in technology and its delivery, have been remarkable in recent years but, with ten million people in the UK lacking foundation-level tech skills, there is growing concern that the groups often most in need of healthcare, such as the elderly and socially disadvantaged, remain on the outside.

A degree of soul-searching is needed and Rachel Harris, Brand and Strategy Director at leading healthcare communications agency Page and Page, observes: “People have a right to live their healthi-est possible lives and, while the demands of ageing populations and strained healthcare systems present challenges, that is what we should be aiming for.

“We have failed or, at least, we are failing in this vital responsibility. Advances in digital technology should be helping us but we are lagging behind other industries in deploying digital. We are six or seven years behind and that is having a huge impact on the efficiencies and effectiveness of patient pathways.”

The ABPI Patient Advisory Council, drawn from charity CEOs, published a report earlier this year highlighting the corrosive damage on the uptake of innovative medicines caused by lack of access and equity along pathways.

It stated: “We have long been aware of the human cost of NHS decisions and processes that fail to ensure equitable access and timely uptake of proven innovative treatments. This is a problem that compounds already deep-seated health inequalities across the UK.”

These multi-faceted issues are not confined to the UK. Countries across Europe and the world are try-ing to wrangle the tantalising potential of genetic and digital advances into a dynamic service design that encourages innovation R&D and eliminates access and equity choke points.

‘Patient pathways promise improved treatments and outcomes, yet they often lead to a maze of access, equity and service issues’

A perfect system is unlikely to exist but European Commission research showcases the lucrative op-portunities to energise performance and outcomes across a suite of touch points, including home mon-itoring, medical imaging and e-prescriptions, where annual savings of €2-3bn annual savings from cross border prescriptions alone are predicted.

Increased efficiencies, accelerated access, targeted treatments and enhanced data collection, leading to even better care, should inevitably follow but a reality check is advisable to manage expectations of the digital surge. For example, registrations for the NHS App in England and Wales have increased from two million in 2021 to 30 million in 2023, yet some sectors of the population experience exacerbating challenges to access healthcare and develop the skills and capabilities to navi-gate and use services, and the general resources needed to lead a healthy life.

A report published earlier this year in the Health Policy Journal examining digital healthcare readiness cautioned: ‘For most EU countries, there is still a need to build digital infrastructure for the healthcare industry, which in the long term may increase the number of digital solutions used by both patients and healthcare professionals.’

Page and Page, an independent creative agency specialising in healthcare communications across pharmaceuticals, medical technology, digital health and lifestyle and well being, has been challenging the root causes and applying creativity and AI analysis to foster greater understanding of the behavioural and structural forces in play.

“If you look at all of the various initiatives and things that are put in place on paper for patient pathways, they absolutely should work. But it is clear that we are not overcoming the various barriers and challenges that are complex and nuanced,” says Rachel. “It’s not just one thing that’s stopping services being implemented or people accessing them, it’s an orchestra of lots of things clashing and colliding.

“It is impossible to break down each individual, each stakeholder and every patient journey, but we have to find the straightest route to making these pathways reach their full potential and that is where data comes in.”

Page and Page, like other agencies, is making use of healthcare’s reservoirs of data and has developed a proprietary AI engine, PIRL, which analyses 27 billion data points and programmes ma-chine-learning tools to enhance audience segmentation, targeting and messaging for clients wanting to elevate campaign reach.

“It optimises every aspect of a campaign and then we bring in the human element,” adds Rachel. “Having aggregated and analysed that data from an objective point of view, we can build a more educated and informed picture of what is influencing HCP and patient behaviour and have a deeper understanding of why a particular audience responds in a certain way. These are insights into why roadblocks occur and often they are in places or in a manner we couldn’t envisage without the data.

“We carefully craft our AI to interrogate influences and behaviours across a wide playing field in a completely objective way and this delivers answers that enable us to think about what is impacting the desired behaviours we are looking to influence.

“It gives us a 3-D view and a better starting point, free from assumptive bias or the subjectivity that can derail initiatives.”

Pharma is growing more adept at using leading edge computing to close the gap and the commentary in a recent EU report on harnessing healthcare data stated: ‘Today’s EU health sector is rich in data, but poor in making it work for people and science.

‘Ten million people in the UK lack foundation-level tech skills, leaving groups in need of healthcare, such as the elderly and socially disadvantaged, on the outside’

The EU needs to tap into this huge potential to turn the wealth of health data across Europe into knowledge at the service of citi-zens, and to better prevent, diagnose and treat diseases. Health data can help achieve more efficient, higher-quality, safer and more personalised care, and help improve healthcare delivery.”

This comes with benefits for all, emphasises Rachel: “There is a real dividend in connecting with hard-to-reach communities and we can do that by really understanding the HCPs who serve them, be-cause they are often at the epicentre of their community, particularly in areas where health literacy is lower,” she adds. “By engaging with them, you can radiate information and education out across communities and patient groups.

“The client feedback from our work has been excellent, because they are getting more effective targeting and can reach more people more quickly and that leads to greater pathway efficiencies. The approach is growing all the time – we learn something new every day and we are really excited about its potential to overcome the gaps and problems. It is making a difference.”

She adds: “We are not doing our job properly if we don’t utilise all the data we can get.  This is a something you keep developing with an open mind because there are still insights into patient pathways that have yet to be considered. We keep learning and adapting, revising and being alive to what we can do.

“We have to close the gap by removing access barriers and inequalities for patients, improving com-munications with HCPs and supporting industry to realise its missions to develop transformative therapies.”

References are available on request.

Danny Buckland is a freelance journalist specialising in the healthcare industry