Clinical Health Educator—A Key Player in a Patient-Centric Approach

Improving patients’ health is the cornerstone of treatment strategies. In this patient-centric era, a huge opportunity exists to help patients achieve better health through patient and caregiver education.

Patient/caregiver education and support programs help healthcare providers (HCPs) improve treatment outcomes.

In order to improve treatment outcomes through appropriate use of interventions, the healthcare industry employs clinical healthcare educators (CHEs) (also known as or patient educator, nurse educator, clinical nurse educator, nurse advisor, clinical educator, patient navigator, patient services liaison, etc.) to engage with HCPs, patients, and caregivers in a non-promotional manner.

CHEs are usually registered nurses, or other healthcare/life sciences professionals, or people specialized in a disease area who meet the needs of the specific patient education program (i.e., certified diabetes educators, nutritionists, physical therapists, etc.).

The CHE position may be a permanent or part-time position either employed directly by pharma companies, or contracted through organizations such as IQVIA, Publicis Touchpoint, Ashfield, etc.

This article explores the role of CHEs within the healthcare industry.

Role of a Clinical Health Educator

In order to achieve the ultimate goal of improving patient outcomes, depending on their portfolio, CHEs may provide one or more of the following services:

  • Provide patients/caregivers with disease- and therapy-specific education through pre-approved materials, signposting to appropriate electronic resources, support groups, patient associations, etc., and help them with better understanding of the disease state and treatment plan.
  • Help patients maximize benefit from treatments through:
    • Appropriate usage and administration of the product
    • Side-effect recognition, adverse event management, and labeled safety information
    • Improved treatment adherence
  • Supports HCPs, by helping patients correctly initiate and maintain the usage of the therapy.
  • Deliver non-promotional educational programs on various topics such as lifestyle changes in line with the disease state in order to improve health outcomes.
  • Communicate with internal colleagues and provide key insights pertaining to patients’ needs and pertinent information to patient services.

CHEs also build long-term relationships with the HCPs, patients, caregivers, and patient advocacy groups through a variety of patient education programs. Due to their non-promotional role, CHEs work across different stages of the product lifecycle, such as the launch and post-launch phases.

Value Added by CHEs

Numerous studies involving hospital or practice nurse-led patient programs have demonstrated that education and social support to the patient and their caregivers can improve patient adherence,1 survival, and self-care behavior as well as reduce the number of events, readmissions, hospital days, and utilization of healthcare resources, especially in chronic conditions such as diabetes, asthma, and cardiovascular diseases.2-7 Since CHEs are predominantly focused on delivering patient support programs, they directly contribute towards improving patient outcomes thereby reducing associated healthcare costs.

From an organizational perspective, CHEs add value by building lasting relationships and good will with HCPs, patients, and caregivers. CHEs also bring valuable insights through their customer engagements. Such insights are critical not only in developing patient support/educational programs but also the overall product or device strategy or design.

As discussed earlier, the CHE role is non-promotional in nature and predominantly customer facing. In the healthcare industry, the other non-promotional, customer facing role is the Medical Science Liaison (MSL). The MSL role is a field-based extension of the medical affairs function—predominantly involved in advocacy development—engaging with a variety of external stakeholders and focusing on balanced and unbiased scientific exchange of clinical data, primarily with key opinion leaders (KOLs). The MSLs work closely with the clinical studies unit to aid evidence generation. Much like the CHEs, the MSLs too add value to business by gathering actionable insights. Unlike the MSLs, the CHEs directly engage with patients and caregivers to deliver educational content aimed at improving treatment compliance and outcomes.

The Future of CHEs in the Healthcare Industry

There appears to be a trend that pharmaceutical and medical device companies are increasingly hiring CHEs.8 In a 2015 Pharmaceutical Commerce article,9 Mary Anne Greenberg from Ashfield highlighted that the company had seen substantial growth in its nurse educator services, with a tripling of staff in the past three years with many major pharma companies actively recruiting CHEs to deliver their patient support programs. The Bureau of Labor Statistics rates nurse educators (including pharma and healthcare institutions) as one of the fastest growing occupations between 2012 and 2024 with a predicted growth of 19% in the number of workforce.8

Salary

The median pay for a CHE is around $74,280 per year.10 However, the CHE salary can vary by experience, disease specialty, and can include other package compensation items (such as bonuses, commissions, etc.).10,11

Conclusion

The CHE role provides a two-way communication platform with the patient, and allows the CHE (and sponsor) to get direct feedback from the patient and provide a clearer understanding on the patients’ needs, perceptions, actions, and decision-making process.

The education and support services that the CHE provides can improve outcomes for patients, and enhance patient satisfaction. It can also provide valuable support for time-constrained HCPs and their practices.

There appears to be an increasing trend for companies to hire CHEs. The CHE thus plays an important role in a patient-centric strategy.

References:

1. Lynggaard V, Nielsen CV, Zwisler AD, et al. “The patient education – Learning and Coping Strategies – improves adherence in cardiac rehabilitation (LC-REHAB): A randomised controlled trial.” Int J Cardiol. 2017; 236: 65-70

2. Strömberg A, Mårtensson J, Fridlund B, et al. “Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure. Results from a prospective, randomised study.” Eur Heart J. 2003; 24: 1014-1023

3. Rothrock JF, Parada MA, Sims C, et al. “The Impact of Intensive Patient Education on Clinical Outcome in a Clinic-Based Migraine Population.” Headache. 2006; 46: 726-731

4. Moran K, Burson R, Critchett J, Olla P. “Exploring the cost and clinical outcomes of integrating the registered nurse-certified diabetes educator into the patient-centered medical home.” Diabetes Educ. 2011; 37: 780-793.

5. [No authors listed] “Home-taught paediatric asthma program improves outcomes, cuts hospital, physician visits.” Health Care Cost Reengineering Rep. 1997; 2: 40-43

6. Tzeng LF, Chiang LC, Hsueh KC, et al. “A preliminary study to evaluate a patient-centred asthma education programme on parental control of home environment and asthma signs and symptoms in children with moderate-to-severe asthma.” J Clin Nurs. 2010; 19: 1424-1433

7. Bosworth HB, Dubard CA, Ruppenkamp J, et al. “Evaluation of a self-management implementation intervention to improve hypertension control among patients in Medicaid.” Transl Behav Med. 2011; 1: 191-199

8. Weselby C. “The Rewarding Career of Nurse Educator.” Nursing Community Journal 2017. Available at http://onlinenursing.wilkes.edu/filling-the-nurse-educator-void-requirements-and-career-info/ (Last accessed: 08/04/2017)

9. Basta N. “The evolving CSO landscape.” Pharmaceutical Commerce 2015. Available at http://pharmaceuticalcommerce.com/brand-marketing-communications/the-evolving-cso-landscape/ (Last accessed: 08/04/2017)

10. PayScale. Clinical Health Educator Salary (Updated: 26 Jul 2017). Available at http://www.payscale.com/research/US/Job=Clinical_Health_Educator/Salary (Last accessed: 08/12/2017)

11. Glassdoor. Publicis Touchpoint Solutions Clinical Nurse Educator Salaries. Available at https://www.glassdoor.com/Salary/Publicis-Touchpoint-Solutions-Clinical-Nurse-Educator-Salaries-E380173_D_KO30,53.htm (Last accessed: 08/12/2017)

  • Kumaran Krishnan

    Kumaran Krishnan is Director EU Medical Affairs at Teva Pharmaceuticals, Netherlands. Kumaran is a pharmaceutical clinician with significant Medical Affairs experience in a regional and global setting. He is considered as an opinion leader in the area of field medical affairs and a distinguished speaker.

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