Nmblr Pathfinder Step 1: Patient Flow

Guidance: what you do in this step

Build a flow diagram that captures what happens to patients, how they move, where they move (or fail to move to).

1. Define where patients flow at each stage and show them as branches off the same point in the flow.:
   • Origination / at-risk / symptoms
   • Presentation / help-seeking and where they go
   • Diagnosis (and misdiagnosis / late diagnosis) and where
   • Treatment decision - how many patients get what
     • Key regimens/alternatives
     • Our drug and key competitors
     • No treatment / generic / suboptimal standard of care
   • Access / fulfilment
   • Monitoring/Adherence - how many continue use / switch / discontinue. Where do patients go when they leave us or a competitor?

This is where the flow becomes a competitive map, not just a clinical pathway.

Keep it simple and clinically true. This is your backbone.

As soon as you are happy with the ‘flow’ that has been created, select ‘ready for input’. The markets (or countries) involved in the development of the strategy are now invited to ‘quantify’ this flow. They need to estimate patient numbers at each step and how they progress.

For each stage and branch, estimate:

• How many patients reach each stage (volume).
• How they split between the branches at each stage.
• Epi, claims/EMR, audits, RWE, internal analytics, market research, expert panels.
• Where data are missing, use ranges and explicit assumptions rather than false precision.

Document every assumption. That transparency is a competitive strength later.

Mark 2–3 leverage points You want people to see, at a glance, where patients are gained and where they leak.

Once the markets and/or the global team have quantified the flow, members are required to:

• Compare absolute patient loss and conversion rates at each stage and branch to see where they could unlock the largest number of additional patients to increase that either the market potential or share.
• Use the ‘star’ in the top left hand side of the block, where they should focus to unlock the growth.
• Only once each market has done this should everyone return to the global view, discuss, debate and align around the most compelling ‘key leverage’ points.
• Use patient flow to select 1–3 leverage points as your potential “focus for growth”. Mark these leverage points in the global view (using the ‘star’).

Critical success factors

• Good-enough data discipline. You will never have perfect data; progress depends on making assumptions explicit, triangulating sources, and updating as evidence improves.
• Cross-functional ownership. Patient flow only becomes a growth tool when medical, access, marketing, field teams and patient support use the same picture to guide choices.
• Comfort with iteration. Teams treat the flow as a hypotheses to be tested and refined, rather than fixed truths or static funnels.