Medical Consulting and Advisory Services

A treatment plan may rely on clinical expertise; however, a considerable number of decisions in the healthcare industry are now made well before reaching a patient. Program design, evidence, and implementation require hospitals, life sciences companies and healthcare organizations to make complicated decisions. Therefore, the use of medical consulting and advisory services has been extended to decision-making phases. When new healthcare programs are designed, medical advisory firms often get involved in evaluating the evidence and clinical pathway in order to make sure that all available facts are considered. In addition, a lack of data may prevent making a recommendation. It is helpful, especially for healthcare organizations that work with limited resources or apply a novel clinical approach. Unlike management consulting, advice provided by medical advisory firms is based on clinical practice and scientific evidence. Medical advisory teams are often able to consider a clinical pathway along with processes in a hospital or organization. Furthermore, healthcare organizations are under great pressure to justify their clinical decisions. When taking certain actions, healthcare professionals need not only published data but also the feasibility and local needs of care, instead of general assumptions. Hence, the use of advisory services is a way to evaluate these issues before a major investment. In addition, life sciences companies that prepare to enter the market often experience similar problems. There may be sufficient scientific information about a product; however, in order to provide healthcare professionals with a guide, it is necessary to interpret scientific findings. In most cases, medical advisory firms help to format communication so that a conversation will stay evidence-based. Therefore, the increased involvement of advisory specialists is caused by the growing complexity of healthcare decisions. There may be several factors, including new therapy options, changes in clinical standards and environment, and so on. Hence, when advising an organization, it is necessary not only to interpret clinical evidence but also to consider implementation aspects. Advisory work has become more interactive. Instead of developing recommendations on their own, consultants usually work together with physicians, researchers and the internal healthcare team during the planning process. Thus, a question can be raised during early phases of the process in order to avoid complications at later stages. Buyers of medical advisory services pay more attention to the quality of clinical reasoning than to the amount of supporting documents. However, detailed reports are still very important. Currently, healthcare organizations need advice explaining the reasons behind a recommendation and possible areas of uncertainty. Medical consulting cannot replace the internal clinical expertise of healthcare organizations. However, its increased role shows that many organizations are interested in clinical advice at the early stage of decision-making.

Choosing an advisory company has changed its meaning significantly for healthcare organizations; currently, people seek advice that they can implement in real healthcare institutions, rather than receive another expert opinion. Healthcare institutions pay more attention to the applicability of recommendations and less attention to their assessment. Clinical guidance may be provided to healthcare organizations in reports, scientific reviews and strategic recommendations. But the real challenge lies in implementing the recommendations made in these documents in the existing clinical reality of the organization. In other words, healthcare institutions need to know how they can integrate the suggested recommendations into their existing practice. Medical consultants try to adapt recommendations to the environment in which they should be implemented. Recommendations made for one institution should not always be adapted to another one since the differences may lie in the availability of certain specialists, patient population, or clinical practice. In addition, there may be other differences that should be considered when implementing the recommendations. In addition to the accuracy of the scientific information, recommendations should now consider implementation issues and take into account some limitations. A recommendation that looks appropriate at first glance from the scientific point of view may turn out to be hardly implementable because of the lack of possibility to integrate the recommendation into daily clinical practice. Implementation issues are now discussed at an early stage of advisory cooperation. Communication skills have become very important for medical advisory companies. Clinical evidence is quite sophisticated sometimes, especially if there are some new studies available. An external advisor should be able to explain clinical evidence to the healthcare professionals in such a way that it allows them to make informed decisions without distorting scientific findings. Current medical advisory engagements are becoming more interactive; healthcare organizations often reconsider assumptions based on the appearance of some new evidence or new internal priorities. Therefore, advisory relations that include continuous discussion may help healthcare organizations to adjust recommendations without repeating all the procedures of the evaluation process. The purchasing process has become much more conscious now. People try to find out whether the advisory company understands the problem that is under consideration, and do not only pay attention to the expertise of the company. It is very important to have experience in the field, but it is even more important to show the ability to implement recommendations in a real healthcare environment. It is expected from the medical advisory service to acknowledge the fact that there are no clear answers to many clinical questions. Consultants who show this fact by providing an explanation of available evidence may gain more trust than those who make recommendations that are accompanied by unnecessary certainty. The current trend towards more practical medical advisory services is caused by changes in healthcare rather than any changes in the field of clinical science. People appreciate the importance of specialist expertise, but they expect from this expertise a recommendation that could be helpful in their practice.

Even the most evidence-based clinical recommendations can start losing ground when the time comes for actual implementation of those recommendations. As it turns out, there is often a need for further coordination and collaboration after conducting the initial assessment in healthcare organizations. This fact has an impact on how medical advisory consulting is designed nowadays. There are many instances when advisory projects now go beyond giving recommendations. There is a frequent request for continuation of cooperation from healthcare organizations while the recommended changes undergo further planning, internal reviewing and first stages of implementation. It is not only about validating the scientific evidence but also interpreting the questions that arise. It is quite rare when the environment of the healthcare organization stays unchanged throughout the whole process of advisory consultation. Sometimes the clinical guidance needs revision in case new information becomes available or when some issues appear while implementing the recommendations. Continuation of the advising allows the discussion of these issues without making it an entirely new project. Another aspect that medical consultants have to take into account is communicating with stakeholders who are engaged in the delivery of healthcare services. The same piece of scientific evidence may be interpreted by clinicians, administrative leaders or researchers differently. The work of the advisor includes explaining how recommendations connect with certain roles and responsibilities of stakeholders without undermining the evidence. Implementation of the recommendations poses another problem. Even the most simple recommendation may raise questions when it comes to practical implementation. Continuing the cooperation of the advisor with the organization may help to interpret the recommendations without changing their scientific justification unless new evidence appears. There is a growing tendency in healthcare organizations to choose the areas of advisory consulting services. While before they used to ask for advisory consultations for all areas at once, now the clients tend to concentrate their efforts on making the decisions that carry significant clinical meaning and need special expertise. This allows for a deeper analysis of the most important areas. Also, there are increased demands from clients for the transparency of the consultants. The clients want to know what the evidence-based conclusion is and what the professional judgment of the consultant. It is important for the advisor to keep this difference to preserve the trust in the recommendations despite some aspects of the decision-making that still need interpretation. The more complex role of the medical advisory firm in the whole process does not mean that this kind of consulting replaces the internal clinical leadership. The advisors give their expertise, but the clinical decisions are made by the healthcare organizations and medical practitioners. The future demand for medical advisory services will probably be connected with providing assistance in making decisions rather than writing lengthy reports. While the clients still use external expertise, they also require continued assistance with the implementation of the recommendations in the routine work of the organizations.