Key Takeaways
- Shift organizational focus from volume-based metrics to patient-centric programs that offer measurable financial returns, as evidenced by case studies showing substantial ROI when engagement is prioritized.
Patient engagement isn’t just a buzzword—it's a business imperative reshaping healthcare’s future. With rising payer pressures, more complex patient needs, and mounting demands for health equity, the question on every executive’s mind is: How can we move beyond the “checkbox” approach and make patient engagement both real and profitable?
That’s exactly what we unpacked in a recent episode of The American Journal of Healthcare Strategy podcast, featuring Dyan Bryson, MBA, Vice President of Diversity Services at TOTAL Diversity Clinical Trial Management and founder of Inspired Health Strategies. With three decades in pharmaceutical leadership, Dyan has seen the industry from every vantage point—launching blockbuster brands, pioneering diversity initiatives, and, most importantly, learning where organizations fail and how they can succeed.
This conversation isn’t about generic advice. It’s about what actually works, what fails, and how you—whether you’re leading a hospital, running clinical trials, or managing a biotech startup—can operationalize engagement for impact and ROI. Dyan’s hard-won insights, from million-dollar failures to industry-wide transformations, will challenge your assumptions and point the way to sustainable change.
Patient engagement often lags because it’s historically been underfunded, undervalued, and hard to measure. But that’s changing—thanks to both financial proof and culture shifts at the executive level.
Dyan Bryson opens with honesty about her early career: “I was a typical sales, marketing, sales leadership person launching brands… and sad to say as I look back, I really didn’t do much for patients.” For decades, engagement initiatives in pharma and health systems were “about checking the box,” not delivering results.
So, why weren’t organizations investing seriously in patient-centric approaches? Dyan breaks it down:
Measurement Difficulty: “It’s easy to see whether or not the prescription is filled. We don’t have any way to measure what happens with the patient once that prescription gets filled.” Traditional ROI tracking focuses on script volume, not real outcomes.
Cultural Inertia: Most companies were stuck in an old paradigm. “The industry wants to put the prescription at the center and not the patient.”
But the turning point came when real investment—*“$3.4 million”—*was put behind a patient-centered program. The results? “We returned more than a hundred million. We helped to improve relationships between patients and physicians.” This proved that engagement isn’t just ethical; it’s lucrative. Now, post-COVID, Dyan notes, “Everything I’ve done has become important to my clients or potential clients.” The market finally sees the value of engagement done right.
Genuine patient-centricity requires executive champions, continuous feedback, and alignment with both business and patient outcomes—not just policy statements.
Dyan describes the pattern she’s witnessed: organizations think they’re patient-centered, but “those things that you perceive... are not helping with patients.” She references Estellis, a Japanese pharmaceutical company, which hired a physician consultant to audit their patient engagement efforts. The findings? Initiatives meant to support patients were really supporting internal engagement or compliance metrics—not true impact.
The key ingredients for meaningful change:
Internal Champions: “It usually takes champions within a company to really decide they want to fight for it.” True change agents influence at the executive and board levels.
Cultural Wake-up Calls: Dyan highlights a story where a pharma CEO’s hospital stay prompted a total company pivot: “He came back to his company and he changed it… That’s what it really takes: a real change in mindset, a change in culture.”
Metrics That Matter: Traditional patient adherence is often misunderstood. “The patient support team is telling the C-suite, ‘We have great patient adherence,’ and they said, ‘We know that we do because we have delivered the drug to the patient’s house.’ No—you have no idea if the package was even opened.” Real engagement measures are two-way, not transactional.
Measuring patient engagement requires a mix of adherence tracking, real-world feedback loops, and willingness to accept imperfect but actionable data.
Bryson outlines the challenge: “We depend on companies like IMS or now IQVIA to give us data... what the prescription behavior is like. That process is not as clear for patient data.” Even claims data has blind spots.
How are leaders closing the gap?
Adherence Rates: The closest proxy is adherence, but only if you track it meaningfully—“Ask people: Did you open the package? What was your experience?” Digital apps, nurse outreach, and even pill counts in the exam room can give directional data.
Two-Way Communication: “If you have a two-way conversation with people and ask… and stay engaged with them instead of just throwing the drug at them and just waiting for them to get another refill… that’s where most patient support programs are right now, unfortunately.”
Patient Support Centers: Organizations with support centers who actively follow up—by text, phone, or app—see better adherence and experience metrics.
Qualitative and Quantitative Mix: Executive teams need to look beyond the data dashboard. As Dyan says, “It comes down to actually listening and understanding what works for the patient, not just what is easiest to measure.”
Pro tip: The more you engage in real conversations, the richer your qualitative data becomes—which often uncovers root-cause barriers quantitative data misses.What Actually Works: Designing and Delivering Effective Patient Engagement
Effective patient engagement strategies are built on three pillars: ask questions, listen actively, and personalize by channel—without making ageist or technocentric assumptions.
Bryson doesn’t mince words: “The first thing is to ask a question and listen—and actually listen. The patients are the experts.” Too often, healthcare professionals assume they know what works, missing critical details about patient realities.
She calls out common engagement tactics—and their pitfalls:
Technology Isn’t One-Size-Fits-All: “Just because someone’s older doesn’t mean they won’t use technology; there are younger people who won’t use it too.”
Multi-Channel Is Essential: Mix nurse check-ins, apps, text reminders, and good old-fashioned face time to meet people where they are.
Ongoing Pulse Checks: “For initiatives that don’t include platforms, it’s still asking people along the way—taking a pulse check.” Never assume last year’s patient journey still fits.
Ask, Don’t Assume: Always start by asking the patient what works for them.
Support Social Determinants: Dyan lauds the field’s recognition of “social determinants of health.” Housing, work, and family all affect adherence and engagement.
Iterate Based on Feedback: Patient journeys shift—sometimes overnight. Build flexibility into every engagement plan.
Patient-centric programs don’t guarantee financial success, but when designed collaboratively, they dramatically reduce the risk of costly missteps and unlock hidden value.
Bryson is clear-eyed about risk: “I think there are times when there are losses—usually those are the times when we are not engaging with people and asking them what works for them, that we are making assumptions.” The antidote? Engage directly with patients and caregivers before you invest heavily in solutions.
She shares a case where a small biotech was about to launch a new drug for an ultra-rare disease. The plan was to make the drug “hard and enteric-coated, could not be crushed”—to mask a bad taste and smell. Through a simple, technology-enabled focus group (costing nothing but time), they discovered “80% of our potential audience has a feeding tube. Smell and taste mean nothing.” Without that direct feedback, the company would have wasted millions on an unusable product.
Lessons for Executives:
Engage early, even on a shoestring budget.
Leverage advocacy groups and direct patient input, not just provider proxies.
The right listening session can be more valuable than a year of data modeling.
Even organizations with limited resources can drive world-class engagement by rethinking workflow, leveraging volunteers, and making every interaction count.
Dyan offers concrete, no-excuses advice for small organizations:
Human Touch Matters: In community clinics, “the intake person’s eyes are on the iPad, not on the person, and they feel shut out.” Simple fixes—such as employing scribes or splitting intake and engagement roles—can make a big difference.
Volunteer Engagement: Leverage scribes, interns, or even volunteers to free clinicians for real patient connection.
Creative Research: Technology allows for low-cost virtual focus groups with advocacy groups and caregivers, bringing invaluable insights at little cost.
“Just that small time, an hour of listening to patients and understanding where they really are, what their lives are really like… if they didn’t do that, they would have completely missed the boat for both the business needs and the patient needs.”
If you’re early in your career or seeking to pivot into patient engagement, start by building empathy, learning directly from patient communities, and investing in practical training.
Dyan’s advice is grounded and actionable:
Get Certified: “Look up this organization called the Patient Program at the University of Maryland… it’s about a five-week certificate program, but it’s an eyeopener.” Programs like this offer real tools and community connections.
Volunteer with Purpose: “A lot of this is going to be volunteer, and that’s what I did. I didn’t make a lot of money—I just found opportunities to learn and understand.”
Start with Small Advocacy Groups: Especially in rare diseases, these organizations are eager for help and offer hands-on experience.
Join Industry Networks: Groups like Global Genes offer education and connections across the rare disease landscape.
“It does pay off. And I’ll tell you, Cole, I never remember that until someone like you says that to me… all I’m doing is what I think is the right thing to do.”
In a post-pandemic world, U.S. healthcare organizations cannot afford to treat patient engagement as an afterthought. The leaders who win will be those who embrace humility, invest in listening, and build programs that respond in real-time to patient realities—not just metrics.
Action Step:
Audit your organization’s engagement strategy today. Ask not just what you’re measuring, but how you’re listening. Find one process where you can insert a feedback loop, focus group, or patient survey this quarter—and commit to acting on what you learn. That’s where transformation begins.
For more leadership insights and real-world case studies, subscribe to The American Journal of Healthcare Strategy’s podcast or newsletter. Together, let’s move the needle on what patient engagement really means—and make it a strategic, measurable advantage.
<p>[Music] hello everyone this is Cole from the American Journal of healthc care strategy and here with me is Diane a healthc care patient engagement Savant with many years of experience Diane please go ahead and introduce yourself hi Cole first of all thank you so much for having me I am Diane Bryson uh my consultancy is called inspired health strategies and this has grown up after more than 30 years in the pharmaceutical industry I was a typical sales uh Marketing sales leadership person launching Brands and sad to say as I look back I really didn't do much for patients um it took a project that I did with um uh a drug company that asked me to come in and do a a community- based effort and we we I was able since I'm as a black person in PHA especially when I started there were very few black people let alone women so I was always asked can you help us out with the diversity thing or the Multicultural thing in addition to my real job so I saw all kinds of efforts that were not well funded and just about checking the Box in this case this pharmaceutical company was was serious they were they were investing $3.4 million and since the program was going to be around the patient putting the patient at the center they had no hopes of making any money at all because of course when we talk about patients we're talking about altruism well we returned more than a hundred million we helped to improve relationships between patients and Physicians we thought all P all the Physicians uh just kept seeing patients at at a fast clip not a lot of time because of course the payer pressure and any corporate pressure and that is still true but we also learned that the Physicians will give the patients more time if they see that the patients actually becoming to doing what they're supposed to do and being an empowered patient and uh so that with that model I couldn't go back to the typical marketing and I figured wow this is a great business model it worked out for the brand it worked out for the patient why aren't we doing this it took me a year pounding through this industry to realize that nobody was doing it so since that time that had to be 15 years ago I have just been pushing and finding opportunities where I could and I feel like I guess I'm really pushing a rock uphill in an industry that wants to put the prescription at the Center and not the patient things have happened over the years where there have certainly been patient centricity efforts and they've been again check the box but I've still been in there and making sure that we had kpis and they could see that there was a business value to this as well as a value to the patient and now fast forward to covid helped whole helped everybody realize we were not putting the patient in the center and so now everything that I done has become important to um to my clients or potential clients and um I'd say then that the way that I learned was through hard knocks and being hard-headed I I have to ask that's an incredible experience that you've had with that that realization why aren't we spending money on patients why are we spending money on prescriptions I don't understand well when we're spending money to get the prescription because it's easy to see where whether or not the prescription is filled we don't have any way to measure and that's where even your questions one of your questions talking about technology we don't have accepted ways of measuring what happens with the patient once that prescription gets filled it's easier to measure what we see and I remember someone being incredibly clear with that with with me about that at one point when I ex was very fr frustrated but that's that's probably the bottom line we we don't know how to measure it and then also I think and what I'm seeing now I think it takes a change in culture in a company um I've seen one company I worked with the CEO went into the hospital and he's a CEO of pharmaceutical company so there's nothing he needs to learn going into the hospital he knows everything and he got there only to realize oh my God this is what it means to to be a patient when he when he finished his stay he came back to his company and he changed it and that's what it really takes a real change in mindset a change in culture it usually takes Champions within a company to really decide they want to fight for it I can think of um uh do you mind if I name any companies no please okay so I can um uh and as I say that so one company that I I didn't work directly with but I've gotten to know and got to know the story of is EST stellis EST stellis is a japanese-based pharmaceutical company and they had uh thought that they were being patient centered until they hired a consultant a physician consultant to look at all the ways they that Estell was measuring how it is patient centered and the consultant came back and said those things that you perceive that are patient centered that are helping with patient engagement help with your own engagement are not helping with patients so the person who managed that process internally had enough heft within the company to go to to the executive board and say look we need to change how we're doing things and so again there's that champion in the company and that had to be four or five years ago since then Estelles has been just trudging away trying to ensure that everything that it's doing is patient centered um and so again that's what it takes the champion inside who wakes up to the fact yes we're getting the prescription and that's important that's the business but we can serve the patient at the same time I guess what worries me a little bit too or what probably worries some of these Executives is like you said it can't necessarily be measured or it couldn't be measured what what are you using are are there's new technologies how are you measuring the success of these initiatives so I have within Pharma uh we depend on companies like IMS or or now iqvia to give us data to let us know how we're performing whether or not the what the prescription behavior is like and that again that process is not as clear for patient G patient data even using claims data is not as reliable however you can start to measure adherence rates and there are ways to do that and where way I've seen it work best is using some kind of platform but because it's and that that though is at the individual level and you have to have patients who are were using that platform but I think adherence rates come down to it and then also it's a perception what is a what is an adherence rate I've been in a meeting where the support the patient support team is telling the SE Suite we have great patient adherence and they said we know that we do because we have delivered the drug to the patient's house no you have no idea if the package was even opened you have no idea if anyone took the pills you have no idea so if you don't have two and that's that's actually another way that you can start to see a difference in adherence through the patient support centers if you have a two-way conversation with people and ask people did you open the package what was your experience you know and stay engaged with them instead of just throwing the drug at them and just waiting for them to get another refill and that's where most patient support programs are right now unfortunately that is uh I I've had experiences working in neurology um and then of course in population Health we see the metric side of that but in neurology you actually see like what the patients are actually experiencing they can't always remember if they took it they don't even I mean one time this patient was having this terrible time and figuring out whether he took it or what the medication was and the doctor said okay let's look at it and they poured out the pills and they're you know the doctors counting them I mean sometimes that's what you need to do but if you can just check off that box from a metric perspective and say oh he took it you know don't don't worry about it at it's very very interesting um so I guess what I'm wondering is you know you said that this company they changed their approach they had great Revenue great Pro you know it went well financially how how often is that the case is every time we take a patient focused approach does it result positively or are there times where there are are losses I think I think there are times when there are losses and usually those are the times we are when we are not engaging with people and asking them what works for them that we are making assumptions um let's go back to the pill counting you're right sometimes it's not even though I can give you an app and that has that has a timer on it and you can check it off that's not good for everybody you have to reach them in the channel that works for them and I believe in every single Channel possible and not make the Assumption just because someone's older that they're not going to use technology there's going to be younger people who won't use won't use it too but usually whether or not you use technology whether or not you have a nurse that checks in with people whether or not that doctor sits down with them and counts the pills out as long as you do it from the patient's perspective and not make assumptions of your own you one of your questions was what are the components of good patient engagement strategy the first thing is to ask a question and listen and actually listen the patients are the experts um there's this all whole other component it's not just about taking the pills it's about also what's going on in people's lives so finally now when I first started at this there was no term for this but thank goodness Public Health has come up with a term the uh social determinance of Health I used to say there's a formal Health Care system and an informal Health Care System the informal Health Care system is the social determinant of Health whether or not the person has a steady home whether or not the person has a job whether or not the uh they they um whatever's unsettled in their lives is can be managed and we have to also take that those things into consideration um I'm frustrated when people build initiatives based on a static patient Journey that patient journey is not static it's like a shooting ladders table a game it changes all the time and if we make decisions and I've seen this where we make decisions based on the patient Journey that someone did like a year ago no it's not it has changed even as I am cognizant patient I hope if and I have a couple cats if my if one of my cats get ill the journey I was on before they got ill I was good but then now they're ill can I afford to take care of them is it am I going to find the right reource to take care of them I'm off my journey so everything that you collected about me as of yet as of before I knew that they were ill is now wrong so again that means you have to communicate with people to understand where they are understand what else is going on in their lives and take those things into consideration one of the questions I had that relates to that that you know patient journey is never really unique um I asked what can providers do I guess another kind of question on on that is how much should we tailor things what are different ways we can tailor things to each patient and each experience and how much is needed do you know what I mean I know that that this is where the investment comes in I think it depends on the channel that you take I'll take I there are two apps that I really like that have ways of people interacting so that it's not just one way um that and they can interact not just with the provider but they can interact with other people like them one is Health story lines and the other one is now included from a company called alanate and that those two apps allow the patients the users to customize that that they experience for themselves so we're not dependent they're not dependent on us pulling any levers or making any changes they make it so that uh they'll the user experience is positive for them and then with that they're more apt to stay with the app for not for initiatives that don't include platforms it's really still asking people along the way taking a pulse check um for instance if in a a doctor's office they put it one this was a wave at one point it looks like it's coming back that doctors would put televisions in the office in the waiting room so that people could learn about their diseases or learn about drugs probably in the office learn about different things in the office and and that's great but how about if somebody shows up who can't hear very well or doesn't see can we do we have anything to adapt for that those people and are we asking are we asking will we put a TV in the office do you like it is it of any value to you what have you what have you learned from it and and a and ask them what more could we share what more could we do to make this experience of waiting more um not enjoyable but more pleasant sometimes you know with the population Health metrics it can make it really hard on these small institutions and kind of what you're saying I you know I really appreciate from a big institutional perspective like yeah let's put a few million dollars into this let's you know really ask our patients how they feel we could hire people to do that that's not really a problem but these Community Access hospitals which have 100 employees or you know even a thousand employees that is a huge you Monumental task for them what I guess as a consultant do you tell some of the smaller organizations you work with if you do work with you know smaller pharmaceutical companies how are they able to do things to raise their patient engagement levels and raise the accessibility levels oh interesting because I was thinking about it from a doctor's perspective so I'll share that first I'll share the office experience first what I find is the engagement in the office can be better you have to do some data intake and many times they're using an iPad therefore the intake person's eyes are on the iPad and not on the person and they feel shut out just that one simple thing changing that maybe bringing in someone who could take the notes and one other person ask the questions and that even could be a volunteer or but there are people who are out there who are scribes who are there just to take notes therefore they can the the health care provider can engage directly with the patient that's an I actually have seen that at the Ed down uh at the Ed here in Center City and that's that's incred I have never thought of that but I've actually seen it but I never connected that so that's a that's a great example somebody's asking you questions they're critical to your treatment and they're not looking at you and then people of color who are used to not being seen and what a wall that puts up you know wow so for a farmer for small companies I I have I have found okay for instance let's see I was working with one company a small biotech and they were going to do some patient research their market research they're preparing for a brand to Launch and I asked I said look I can help you with that I work with advocacy groups I can set up focus groups for you and they said no no no no I'm going to talk to the doctors about the patients well let me tell you the doctors don't know fully about the patient's experience so what I did in that case since I had such a good relationship with um ad the advocacy groups I was able to set up Global um a global uh focus group basically where I got advocacy people from the advocacy group caregivers and patients on a call with people from the pharmaceutical company this cost no one anything except the use of the technology to run the uh to run the teleconference and we were on a path at that point of developing a drug for an ultra rare disease where we were concerned about how it tasted and how it smelled because it stumped to high heaven and it tasted poorly so the pharmaceutical company was in the process of making sure that the tablets were hard and Interra coded could not be crushed to improve the patients's experience we did this focus group and they and they were reticent the company was reticent but I ended up having almost every stakeholder almost every Silo in the company sitting in listening to this and they heard the patients and caregivers talk about how they use feeding tubes they don't smell or taste anything 80% of our potential audience has a feeding tube smell and taste means nothing so the CMC folks the farmer folks in charge of formulation went back and said oh my God we're going we're on our path to serving our audience our patients and our shareholders and we're going to go to market with a drug in a formulation where we can only serve 20% of our patients wrong they they didn't realize okay just that just that small time an hour of listening to patients and understanding where they really are what their lives are really like they would if they didn't do that they would have completely missed the boat on for both the business re needs and the patient needs they did end up making this into a syrup so that they could so patients could easily put it in a um a feeding tube wow that's that's very interesting so that's huge returns for them then yes they were actually able to have a product that worked cost them nothing wow again just in process of finding a way to ask people what's good for you how I'll I'll leave you with one question because we're trying to keep these uh under 20 minutes but I I really want to get your perspective on this um if you had to give advice to someone like me now I'm very early in my career but I want to make this impact on patients through all your experience what's so a little bit of advice you could give to somebody like myself so I could make this impact so first I would I would look up this organization called the patient program at the University of Maryland they help industry and researchers uh connect with communities connect with patients and under and build the tools to learn how to really connect with people how to communicate with people it's a free program because it's paid for by the sponsors um and the patient Pro you apply to the program patient program decides whether or not you're in it's about a five-week certificate program but it's a it's an eyeopener if you haven't had this experience that and they run that program right now it's it's once a year as a matter of fact where're we're in March right now they'll be sending out applications for that program um probably April starting in April or May that's where I would start um then I would start a lot of this this is going to be volunteer and that's what I did I didn't make a lot of money I I just found opportunities to learn and understand I mean um start working with some nonprofits who focus on patience um who really get in there not just the big uh uh advocacy groups the smaller mom and pop probably advocacy groups that could really use your help and um are not well funded usually this is in the rare disease space they would be glad to have your help and you would be able to learn at their at their knes another organization is probably GL Global genes and that's GE nees they represent all of the rare diseases they aren't they aren't therapeutic area Focus but they work a lot in training people training advocacy groups on how to serve their patients those programs have some cost attached I'm not sure where they are right now but I would definitely look them up so those are places that I would start that you could that are easily accessible that I don't think will cost a fortune and like you said it takes a few years of that volunteering not making a lot of money but then you you know you've been able to have a huge impact on on countless people's lives and lots of organizations so it does pay off it does pay off and I'll tell you Cole I I never remember that until someone like you says that to me and people say that to me and all I'm doing is what what I think is the right thing to do incredible thank you so much for your time Diane I I couldn't be more appreciative and hopefully we can have you back on again to talk about more in-depth topics as I become more knowledgeable in this area all right thank you so much I really appreciate it you great</p>
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