Hospital & Account Management:

Module 1 – Understanding accounts

and customers

Module 1 Page -
Guidance
► All activities must be conducted in accordance with GSK policies, codes and SOPs, and with
applicable local laws and regulations. If there are differences between the GSK requirements and
the local requirements, the stricter standard will apply.

► The collection or processing of personal information must be carried out in accordance with
applicable data protection laws, and with GSK’s Privacy Policy (GSK-POL-010).
o Personal information may only be processed where necessary to serve GSK’s specific,
legitimate business purposes.
o Only the minimum amount of personal information necessary to achieve those purposes
should be collected.
o Any personal information collected must be stored securely. Personal information should
not be shared with any other company without the appropriate controls in place.
o Personal information collected should be factual.
o Note that the individual concerned may ask to see a copy of the information that GSK holds
about them.
o GSK Legal should be consulted in advance on any proposal to establish a database of
personal information.

► Managers should ensure that their teams are adequately trained on the applicable requirements.

► This module is for GSK internal training purposes only. Any case studies used are for illustration
purposes only and should not be taken to be applied as endorsed strategy

Module 1 Page -
 Understanding accounts and customers

Drivers of the Account

Patient Flow Customers
Patient Flow insights

Patient Flow
Learning
Objective
Be able to identify the most important steps in the patient flow
► Map the patient flow in your accounts
► Estimate the potential impact of different steps in the patient flow
► Identify major opportunities for GSK to add value / support customers

Module 1 Page -
 The Patient Flow in a hospital / account is formed of a
sequence of steps
This is an example, your
hospital/account maybe different
Lab testing

Initial
Seen by a Correctly Treated with Prescribed with Prescribed prescription Remains on
specialist Diagnosed prescription category GSK brand filled treatment
Patient

Spec. Spec. Spec. Spec. Pharm HCP

Misdiagnosed Sent for Prescribed Prescribed Pharmacy Fails to

surgery / alt. alternative other brand switches due follow up or
treatment category to lack of stock repeat

There are many points where

patients can appropriately
leave the flow

What are the most important steps in the patient treatment flow in your
hospital / account?

Module 1 Page -
 Simple questions can help you to understand the Patient
Flow in your hospital / account

Example of Patient Flow within an Account Questions

How many, patients seeking treatment, are seen by a
Patients seen by a specialist
HCP?

How many, patients seen by HCPs, are correctly

Patients correctly diagnosed
diagnosed?

Patients Treated with Prescription How many, diagnosed patients, are treated with the
prescription?

Patients Prescribed with Category How many, patients, treated with the prescription are
prescribed with category?

Patients prescribed GSK brand How many, patients treated with prescription, are
prescribed the GSK brand?

Patients with initial prescription filled How many, patients with GSK prescriptions, have the
prescription filled?

Patients with treatment maintained in How many, patients have the treatment maintained in
Primary Care the primary care setting?

Module 1 Page -
Brand plans contain a lot of information that will help you
complete Patient Flow for your hospital / account
Patient Potential
Tower Knowledge Map
Prevalence Account
Seeking Treatment

Consulting Physician
Patient Flow
Diagnosed Patients seen by a healthcare provider
Treated with Prescription

Prescribed with Category Patients diagnosed

Prescribed with Brand

Prescriptions filled with Brand Patients Treated with Prescription

Patient Adherence

Patients Prescribed with Category

Patients prescribed GSK brand

Other
Treatment Patients with initial prescription filled information
Pathway
Patients with treatment maintained in Brand plans contain a lot of information
that will help you complete this module
Primary Care and plan your account

Brand
There is a lot plans contain
of information a lot of
available toinformation
thatyourself
you, refreshing will helpon
youmaterials
complete this module
and plan your account
such as your national brand plans will
help you to complete the exercises
There
throughout this may be helpful graphics:
module
• Reducing what you have to start
from scratch, saving time
• Raising issues you may not have
considered
• Ensuring consistency with your
Business Driver
national strategy

•Bran Plan. Take it, it’s yours!

•Bran Plan. Take it, it’s yours!

Before starting, review your brand plans and other relevant materials

Module 1 Page -
The Patient Potential Tower can be used to get
information for the Patient Flow within your hospital /account
Patient Flow within an account
Patients seen by a healthcare provider
Patients correctly diagnosed
Patients Treated with Prescription
Patients Prescribed with Category
Patients prescribed GSK brand
Patients with initial prescription filled
Patients with treatment maintained in
Primary Care
Module 1
Patient Potential Tower
• An analytical tool that models
the flow of patients for a brand
and patient segment
•Typicaly part of the Brand
planning process and used to
understand national / regional
opportunities
• Viewed through the lens of
your local environment, can be
valuable way of understanding
your local opportunities.
Page -
Analyse how much positive change is possible
Illustration
and what the opportunity is for GSK to support
Brand X Patient Flow
How much positive How much can GSK
change is possible? support a change?
Patients seen by a healthcare provider (HCP) Low
35 Almost 85% seen patients are No reason to engage
correctly diagnosed
5 Patients diagnosed Low
30
90% diagnosed patients are No reason to engage
treated with prescription
3 Patients Treated with Prescription Low
27
90% patients are prescribed No reason to engage
with category
3 Patients Prescribed with Category
High
24 Need to investigate reason for
No diagnosed patients are
not prescribing
prescribed Brand X
24 Patients prescribed GSK brand
0
N/A N/A Key step in
the patient
- Patients with initial prescription filled flow
0
N/A N/A
Patients with treatment maintained in
-
Primary Care

Module 1 Page -
Focus on steps in Patient Flow where you can bring added
value for Patient, Customer and GSK Illustration

Brand X Patient Flow

Patients seeking treatment

40

5 Patients seen by a healthcare provider (HCP)

35

5 Patients diagnosed
30

3 Patients Treated with Prescription

27

3 Patients Prescribed with Category

24

24 Patients prescribed GSK brand

0

- Patients with initial prescription filled

0

Patients with treatment maintained in

-
Primary Care

Module 1 Page -
Patient Flow
Exercise: Patient Flow Multiple points where
patients are lost, what
could you do to improve?

Account:________________
Brand ________ Patient Flow How much positive How much can GSK
change is possible? support a change?
Patients seen by a healthcare provider

Patients diagnosed

Patients Treated with Prescription

Patients Prescribed with Category

Patients prescribed GSK brand

Patients with initial prescription filled

Patients with treatment maintained in

Primary Care

Draw star(s) next to

Module 1 priority point(s)Page -1
 Understanding accounts and customers

Drivers of the Account

Patient flow Customers
Patient Flow issues

Drivers of the Patient Flow

Learning
Objective
Be able to identify and prioritise the drivers of the most important
step(s) in the Patient Flow
► Understand and identify different drivers
► Sort them by whether they support or hinder the appropriate use of GSK
brands
► Prioritise the most important drivers

Module 1 Page -1
There may be multiple drivers and obstacles for a particular
change in the Patient Flow

Group decisions

Patient Flow
Change

Individual decisions Circumstances

What drives current step in the Patient Flow?

Module 1 Page -1
Drivers can support or hinder the ideal Patient Flow
Illustration
and with varying strength of importance
Drivers that currently support Drivers that currently hinder
Increasing number of patients
appropriately prescribed the
GSK brand has multiple barriers

Most customers are Protocols recommend

aware of the product competitor

Patient Flow
Prescribers are willing to Not listed on the hospital
prescribe the product Change formulary

Product is reimbursed Unavailable in pharmacy

Which drivers are the most important? Do they help or hinder?

Module 1 Page -1
 Illustration
Evaluating Drivers of the Patient Flow
Drivers that currently support Drivers that currently hinder
Engagement Engagement
Driver Importance Driver Importance
process process
Protocols Low → Med. Hard – Once on
Most customers are
High N / A (already aware) recommend (formulary is the formulary, get GSK
aware of the product
competitor barrier) recommended

Prescribers are Easy – Can visit

Not listed on the High – Barrier to Medium – Lengthy
willing to prescribe High prescribers, product
hospital formulary prescribing and complex
the product benefit is clear

Product is N/A Low → High

Unavailable in Easy – Once on
reimbursed High (already reimbursed) (formulary is the
hospital pharmacy formulary
barrier)

Patients prescribed GSK brand

Module 1 Page -1
Drivers of the Patient Flow
Exercise: Drivers of the Patient Flow
Drivers that currently support Drivers that currently hinder
Engagement Engagement
Driver Importance Driver Importance
process process

_________________________

Draw star(s) next to

Module 1 priority driver(s)
Page -1
 Understanding accounts and customers

Drivers of the Account

Patient flow Customers
Patient Flow insights

Customers
Learning
Objective
Be able to identify the most important stakeholders of the decisions
behind the priority drivers and understand the customer networks they
sit within
► Understand and identify the different stakeholders in decision making
within the Patient Flow
► Map the relationship between customers

Module 1 Page -1
It is critical to understand how a decision will be made in a
hospital / account environment

Decision process

?
► How is the decision made?
► Who is involved in the decision?
► What are the main steps and when will they occur?

You can ask

► GSK colleagues
► Customers with whom you have established relationship
► Other customers from hospital / account

Do you understand how the decision will be made? How can you learn
about the process?

Module 3 Page -1
You may have multiple stakeholders in decision making within
Illustration
a step in the Patient Flow

Product is listed / not listed in the hospital formulary

New product is Product is Formulary Product Committee lists Product is

approved for sponsored by committee send evaluation is product on available in
use specialist for evaluation successful formulary hospital

Formulary Formulary
Specialist Pharmacist Pharmacist
committee committee

Pharmacist fails
Product is not Committee Evaluation is Committee
to make
sponsored rejects request unsuccessful rejects product
available
Multiple stakeholders are
involved each with a
different role and varying
degrees of importance

Who is involved in driving practise? What is their role?

Module 1 Page -1
Any individual stakeholder involved in decision making may
Illustration
consult with multiple other people

Surgeon Dept.
s Head

Pharmacis Fellow
t specialists

Even in individual
decisions, there may be
many others who may
affect the outcome

Nurse Junior
s physicians

Patient
s

Module 1 Page -1
 Typical roles can help identify all of the stakeholders
involved in decision making and split out those who are key Illustration
1
Potential roles considered 2 Key stakeholders in formulary decision
 Initiator(s) 3 Name: Dr. S Name: Ms. P
Position: Consultant Position: Department Pharmacist
 Decider(s) Role in decision making: Role in decision making:
Initiator of inclusion request; Co- Co-Decider on formulary
 User(s) Decider on formulary committee committee decisions; Decider of
 Implementer(s) decisions initial evaluation; If approved,
Implementer of formulary
 Impactor(s) inclusion

 Gatekeeper(s)

Decision
Name: Dr. A Name: Dr. D
Position: Consultant Position: Consultant
Role in decision making: Role in decision making:
Co-Decider on formulary Co-Decider on formulary
committee decisions committee decisions

Other stakeholders
Name Position Role in decision making
Name: Dr. B Name: Dr. C
Mr. S Surgeon Impactor of Dr. S Position: Consultant Position: Consultant
Role in decision making: Role in decision making:
Miss. N Ward Manager Gatekeeper to Dr. S
Co-Decider on formulary Co-Decider on formulary
Dr. E Consultant Impactor of Dr. S; Potential User committee decisions committee decisions
Dr. R Specialty Registrar Potential User of product

Dr. Q Specialty Registrar Potential User of product

Module 1 Page -2
 Customers
Exercise: Stakeholders in decision making
Potential roles considered Key stakeholders in _________________
• Initiator(s) Name: Name:
Position: Position:
• Decider(s) Role in decision making: Role in decision making:
• User(s)
• Implementer(s)
• Impactor(s)
• Gatekeeper(s)

Decision
Name: Name:
Position: Position:
Role in decision making: Role in decision making:

Other stakeholders
Name Position Role in decision making
Name: Name:
Position: Position:
Role in decision making: Role in decision making:

Module 1 Page -2
 Understanding accounts and customers

Drivers of the Account

Patient flow Customers
Patient Flow insights

Account issues
Learning
Objective
Summarise insights about hospital / account in one place
► Step(s) in the Patient Flow
► Priority decision(s)
► Key stakeholders

Module 1 Page -2
It is useful to summarise all of the insights about your
Illustration
hospital / account into one place
Step(s) in the Priority
Key stakeholders Role in decision / factor
Patient Flow influences / drivers
Initiator of formulary inclusion request; Co-Decider on formulary
Dr. S, Consultant
committee decisions

Ms. P, Department Co-Decider on formulary committee decisions; Decider of initial

Pharmacist evaluation; If approved, Implementer of formulary inclusion

Dr. A, Consultant Co-Decider on formulary committee decisions;

Not listed on the
hospital formulary
Dr. B, Consultant Co-Decider on formulary committee decisions;

Dr. C, Consultant Co-Decider on formulary committee decisions;

Patients Dr. D, Consultant Co-Decider on formulary committee decisions;

prescribed
Ms. P, Department
GSK brand Pharmacist
Initiator and Implementer for getting product in the pharmacy

Mr. M, Purchasing
Implementer for getting product in the pharmacy
Manager

Unavailable in
hospital pharmacy

Module 1 Page -2
Account insights
Example: Hospital / Account insights table
Step(s) in the Priority
Key stakeholders Role in decision / factor
Patient Flow influences / drivers

Module 1 Page -2