Why Patient Engagement Breaks At The Handoffs: The Infrastructure Problem No One Wants To Admit

Patient engagement has become pharma's priority. Every brand team has a strategy. Every budget includes digital platforms, hub services, patient support programs, education initiatives.

You're investing. You're building. And you should keep going.

But first: pause.

Not because you're doing it wrong. Because as you build patient engagement infrastructure over the next 1-2 years, the vendors you choose and how they connect will determine whether you're optimizing for the 10% or actually supporting the 90%.

Here's the uncomfortable question: Is your infrastructure serving patients, or just serving vendor scopes?

What Patients Actually Experience (Not What Vendors Report)

A patient starts a specialty therapy. They're enrolled in your hub (Vendor A), receive copay support through a foundation (Vendor B), get medication from a specialty pharmacy (Vendor C), and access education through a digital platform (Vendor D).

Each vendor is excellent at their specific function. Each reports strong performance metrics.

But the patient experiences this:

The hub says the PA is approved and medication will ship. The pharmacy says they're waiting on the hub. The copay program doesn't know the patient exists yet. The education platform sends injection training materials for a medication the patient hasn't received.

Your infrastructure is optimized for vendor excellence. Your patient needs ecosystem coherence.

And that gap? That's where discontinuation actually happens—in the 90% of their journey that happens between your touchpoints.

Why Pharma Built Fragmented Infrastructure

This didn't happen because of poor planning. It happened because pharma solved problems sequentially, not systematically.

The evolution:

• 2010: "We need benefit verification" → Contract a hub
• 2013: "Copay is a barrier" → Add copay assistance program
• 2016: "Patients need education" → Launch digital platform
• 2019: "Adherence is dropping" → Add nurse support program
• 2022: "We need data" → Implement analytics tool

Each decision was sound. Each vendor delivered their scope. But no one owned the patient experience between the vendors.

The result: Five excellent point solutions creating multiple handoff failures in the 90%.

What Fragmentation Actually Costs

Patient experience degradation: A patient calls your hub with a question. "That's the pharmacy, I'll transfer you." The pharmacy says, "That's about copay, contact the foundation." The foundation says, "You're not enrolled yet, talk to the hub." The patient gives up.

You measure each vendor's call resolution rate (excellent). You never measure how many times patients get bounced between systems before giving up entirely.

Data blindness: Your hub knows enrollment dates. Your pharmacy knows fill dates. Your copay program knows claim denials. Your digital platform knows email opens.

No single system knows: This patient enrolled 6 weeks ago, has had 3 PA denials, hasn't filled, stopped responding to emails, and called twice asking the same question because no one captured it the first time.

You're flying blind on the 90%.

What "Seamless" Actually Requires

Most pharma companies hear "fragmented infrastructure" and think: "We need to integrate our vendors" or "We need a unified platform."

They're not wrong. But they're solving it backwards.

The sequence matters:

First: Understand the patient experience - Map where handoffs actually break and why

Second: Design what needs to connect - What data, workflows, and ownership solve those breaks?

Third: Implement the technology - Platform, APIs, integration that enables the design

Most pharma skips straight to technology ("integrate our vendors!") without understanding the experience or designing the solution. The result: expensive platforms that integrate the wrong things.

The Three Questions That Expose Infrastructure Gaps

Before your next vendor decision or platform investment, ask:

1. Can you answer: "What happened to the 47 patients who enrolled but never filled?"

Not "they didn't fill." Why didn't they fill? Which specific handoff failed? If you can't answer this, your infrastructure has visibility gaps in the 90%.

2. Can you intervene before discontinuation?

When a patient misses their second refill, do you know it in time to intervene? Do you know why they missed it? Do you know which system should intervene?

3. Can you test what works?

If you want to pilot proactive outreach for high-risk patients, can you identify them across vendors? Can you coordinate the intervention? Can you measure the outcome?

Strategic Planning for 2026-2027: The 90/10 Framework

As you build patient engagement infrastructure over the next 1-2 years, every vendor decision should answer: Does this support the 10% or the 90%?

The 10%: Activation moments—enrollment, first fill, initial training. Your vendors excel here.

The 90%: Everything between those moments—daily decisions about refills, questions about side effects, benefit issues that take weeks to resolve, care coordination when patients travel.

Most pharma infrastructure is optimized for the 10%.

Before you add your next vendor, ask:

• Does this address the 10% we already do well, or the 90% where patients struggle?
• Will this create new handoffs in the 90%, or connect existing ones?
• Can this vendor see what happens across the ecosystem, or only their silo?

Before you invest in platform integration, ask:

• Are we connecting vendors because it's technically possible, or because it solves a real patient handoff problem?
• Have we mapped where the 90% breaks, or are we integrating blindly?
• Will this integration help us see discontinuation patterns, or just create cleaner reports?

Linked Patient Learning's Ecosystem & Stakeholder Mapping doesn't stop at your vendors.

We map the entire patient ecosystem and identify intervention points that drive patient access and outcomes across the full journey.

Then we design strategic frameworks that address the 90% of patient experience (diagnostic acceleration through sustained support), integrating digital tools and AI platforms where they create maximum value, not just where they're technically possible.

Finally, we create measurement frameworks that connect this infrastructure to clinical and business outcomes—the data your CFO and payers will demand.

We design the strategy, integrate the technology, measure the impact.

That's how patient programs evolve from tactical support into strategic outcomes drivers.

Because patient engagement isn't about having the best vendors. It's about patients experiencing a coherent journey from diagnosis through sustained treatment success.

And that only happens when someone maps the handoffs before designing the infrastructure.

Before your next vendor decision: Pause and map the 90%

Schedule a 30-minute consultation to discuss your patient ecosystem and whether your 2026-2027 infrastructure strategy is optimizing for the right 90%.