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New realities require new business intelligence

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Recently a family member of mine received an Rx. She was expecting a diagnosis but had no knowledge of the categories of drugs that were relevant - consequently, she just accepted the first recommendation from the physician. It was a paper script. The pharmacist let us know the drug wasn’t covered and that there wasn’t a generic; not mentioning that we could fill in a prior authorization form. We filled the script, needing the medication immediately. On calling the insurer, a convoluted set of conversations ensued leading to an ‘override’ of the initial block and first purchase and several forms and calls to make to make the prior authorization happen. All of this driven by the patient, not the doctor, his staff, the pharmacist, or the insurer. This personal experience brought the macro shifts in care – particularly around Rx decision-making - front and center. 

For years we’ve researched messaging from pharma to patients and pharma to physicians, following the chain of influence. The landscape is shifting dramatically - where as one pharma client put it to me, “physicians are just employees of their institutions and told what to do by formularies”. The recent release of our new Taking the Pulse® Formulary Decision Makers research could not be better timed. This study examines the complex world of P&T Committees and analyzes the information channels and sources used to make formulary decisions. Physician and consumer marketers will also have to figure out how to stay relevant in a world where the epicenter of Rx decision-making has shifted. Patients and physicians are going to fight a lot harder to get the Rx they prefer. See highlights of the study here.

Posted by Monique Levy, VP of Research

Patients and physicians talking outside of the office visit?

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We were lucky to have Dave Chase come in to the office to talk about his product, Avado, a Patient Relationship Management (PRM) tool. The Avado team was recently accepted into the New York Digital Health Accelerator program, a program run by the New York eHealth Collaborative and the Partnership for New York City Fund for early- and growth-stage digital health companies that are developing technology products in care coordination, patient engagement, analytics and message alerts for healthcare providers. 

Dave mentioned that the basic building block to the patient-physician relationship outside of the office visit is a secure messaging system. Avado allows for even broader functionality on top of secure messaging including such features as appointment notifications, medication reminders and information delivery. We found in our Taking the Pulse® US 2012 study that only 1 in 6 physicians used a secure messaging system in the past year to communicate with their patients, but as more solutions enter the marketplace this share may grow. It is yet to be seen if a majority of physicians or patients will want this type of communication. Will physicians want an additional burden to their already over-capacity workloads? Will patients want to be in communication with their providers on top of their already complicated lives?

Managed care organizations are moving from a fee-for-service model to a model that promotes greater coordination and accountability among care providers, and patient-physician and physician-physician messaging systems can play a critical role. Technology can help facilitate these new models, but should focus on enabling the real driving force behind the new care models: the providers and caregivers. Incentives and penalties from the Affordable Care Act will likely require that these technologies be used in the new healthcare marketplace, the question is how effective will they be at making progress on some of the main goals of health reform: improving  patient outcomes and reducing healthcare cost growth?

Posted by Shawn Dimantha, Principal Analyst

Key trends from Cybercitizen Health® Europe 2012 

We have just released the data from Cybercitizen Health® Europe 2012 – our latest round of European research, looking at the digital behavior of online consumers in France, Germany, Italy, Spain, and the United Kingdom. It is my great pleasure to share key trends from the study:

The Digital European: In 2012, we saw broad smartphone and tablet adoption across the five markets surveyed. In addition to that, EU online consumers’ digital horizon has broadened with significant user rates for connected TV and advanced online activities such as listening to streaming music. 

Online Health Market: Among other things, we did a deep-dive into online health video this year, as production costs for this type of media can be considerable and many marketers wonder about the effectiveness of their investments. The good news is that watching online health video prompts EU online consumers to take a variety of desirable actions such as talking to doctors or family members about the content they watched, or sharing the video on social networks.

Online Patient Journey: EU online consumers rely on the Internet when they have medical concerns or want to inform their health decisions, plus they tend to go deep in their research – especially when they have been diagnosed with a medical condition. Top condition segments using five websites or more when looking online for health info are consumers with acne, insomnia, hypermenorrhoe, erectile dysfunction, and depression. 

Care Everywhere: In 2012, we wanted to get a better understanding of healthcare touch points beyond the physician’s office that are relevant to EU online consumers. Looking at interactions with pharmacists, one interesting finding is that in addition to providing patients with info about prescription drugs, pharmacists in the EU also provide basic diagnostic procedures such as measuring blood pressure.

European Pharmasumers: One highlight from this piece of the study is our findings around the kinds of pharma materials EU online consumers are looking to receive via their doctors or nurses. Overall, six in ten consumers are interested in receiving pharma material by way of their providers. The materials in high demand include disease or condition and prescription drug info. Next to that we also continue to observe significant adoption of online pharma resources such as watching online video about prescription drugs or using prescription drug or refill reminder services on desktop or laptop computers as well as on mobile devices.

Posted by Christina Anthogalidis

Smartphones empowering health today

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Consumer adoption of mobile phones for online health resources has grown rapidly over the past four years – from 10 million mobile health users in 2008 to 75 million in 2012. However, a considerable share of mobile health behavior is centered on info gathering - we’re still a good 3-5 years away from phones being leveraged for self-tracking and real time data capture by a critical mass of consumers. Despite this, research shows that smartphones are empowering consumers today – 55 percent of online consumers¹ say using their smartphones for health info makes them feel more in control of their health as a result.  

While there is a lot of excitement about the Quantified Self movement and the potential for using mobile to track and share data, we shouldn’t forget about the power of “just in time” access to relevant info at the moment it’s needed. We’re seeing consumers use their phones at critical decision points including at the pharmacy, in the waiting room before seeing the doctor and after receiving a diagnosis and while managing a condition. This article on Huffington Post of a  mother trying to quickly determine the cause of her daughter’s mysterious symptoms is one of many illustrating the importance of contextually relevant information. 

Dear Apple, please get into the EHR business

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I’ve recently had a series of visits to the doctor for various checkups for myself and others and even one Emergency Room visit (which turned out fine) and have noticed many exciting changes. 

One practice had an announcement that they were now an ACO, emphasizing that this will lead to higher quality, more coordinated care while not impacting their Medicare Benefits. A couple of practices gave me little sheets of paper with instructions on signing up for an online portal to get access to test results, appointment scheduling and even the ability to email a doctor. I also noticed flat screen monitors in the waiting room of one practice, which had a slide show of flowers at the time, but supposedly will be showing health education and messaging soon.  And, in one case, a dermatologist merged patient education and her personalized recommendations on a document within the EHR and printed it for me. Beyond my own experiences, our newly released Cybercitizen Health® U.S. study found that among consumers who have seen a doctor or nurse in the past year, nearly 3 in 5 of them said their healthcare provider used an EHR during the consult. 

But. 

In all cases, EHRs were used, and in all cases the way in which the HCPs used them was discouraging – not from a content point of view, but from a usability point of view. I made sure I was positioned to view the screens and it seemed that each stage of the consultation required 3-5 clicks and as many windows to retrieve or input data. Many times, I had to tell the doctor they had information or past records in the system, as the system didn’t display or indicate historical data. Finally I made a remark to one physician:  “If only Apple would design these for you.”  The physician half laughed and half looked longingly. 

Improving usability of these systems – while not a straightforward endeavor – will be critical in driving patient adoption. The recent uproar over the Apple Maps debacle on the iPhone 5 release is useful to keep in mind as a benchmark of consumer expectations about how well their digital tools should work. 

From Dr. Welby to Dr. Walgreens

Image courtesy of time_anchor on flickr

One of the trends we’re talking about following the release of our Cybercitizen Health® U.S. study is this idea of “Health360” - that medicine has moved beyond the doctor’s office, and is taking place where we “work, play and pray”, to quote Jane Sarasohn-Kahn. A trend that is clear from our study of over 8,000 consumers regarding their health behaviors was that urgent care clinics, pharmacies, and other points of care are increasingly being used by patients - and they plan to become even more reliant on them in the future. Additionally, remote care and the digital exchange of medical data between HCPs and patients, though still in their toddlerhood, are poised to further connect the dots for a reality of “always on” care.

The New York Times reports that this is especially common in lower Manhattan as a result of the void left with the closing of St. Vincent’s Hospital. I, for one, have been happy to see the influx of urgent care facilities to our fair city - we no longer have to rely on the ER for weekend ear infections or injuries. As consumers are becoming more aware of the costs associated with their various care options, expect these facilities to play a much larger role in how care is delivered in our country.

Posted by Meredith Ressi, President

ePatient empowerment in the news

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We write so often in general terms about the Internet and patient empowerment, it’s always nice to see this play out in real life. Former talk show host Rosie O’Donnell blogged about her recent heart attack scare – and that Googling “womens heart attack symptoms” gave her a hint that she could be having one (she also credits a TV ad for prompting her to take an aspirin.) However, she didn’t see a doctor until the next day, and urged women to go with their gut and seek help immediately in these situations.

We explored the E-Empowered Patient phenomenon in the 2010 version of our Cybercitizen Health® U.S. study – and found that 99 million U.S. consumers changed their behavior as a result of info they found online. We’ll be revisiting this topic once again in our 2012 Cybercitizen Health® study, particularly the role of the Internet in influencing choices about health providers and services.

Posted by Maureen Malloy, Senior Healthcare Analyst

ePharma Physician® - New trends for 2012

Our VP of Research Monique Levy recently gave a webinar on our new ePharma Physician® study, which explores how physicians use digital channels to research prescription drug information and to connect with pharma companies and reps.

In case you missed the session, here are a few key trends that popped from this year’s research:

• iPad Rep audience doubled between 2011 and 2012 – among ePharma Physicians who have seen a pharma sales rep in person, 65 percent have interacted with one carrying an iPad.
• iPad Reps are influencing physician behavior – among ePharma Physicians interacting with an iPad Rep, 35 percent say they are more likely to request a sample and 29 percent say they are more likely to consider prescribing the drug.
• Physicians shifting online for pharma info and service needs – ePharma Physicians currently use digital sources just over half of the time when accessing pharma product info (as opposed to traditional offline or print sources), but would like to increase this to two-thirds.
• Strong interest in pharma online promotion – 4 in 10 ePharma Physicians have participated in an online promotional program (self-directed, webcast, or live one-on-one) in the past year, and an additional 5 in 10 ePharma Physicians are very interested in connecting with manufacturers in this way.
• Tablets see traction for online journal reading – while desktops/laptops are the leading device for reading journals online, tablets show promise in 2012, with about 4 in 10 online journal-reading ePharma Physicians using tablets for this purpose. 

If you’d like to hear the entire webinar – feel free to email us and we’ll send the recording your way.

Posted by Maureen Malloy, Senior Healthcare Analyst

Watch out QR codes, a new kid is coming to town

Image courtesy of tillwe on flickr

Personally I’ve never been a huge fan of QR codes. They can be a bit clunky to scan and usually the effort of doing so doesn’t give me anything all that compelling in return. However, they became a bit of a marketing darling a few years ago as brands found them a relatively inexpensive way to integrate mobile into a campaign, popping up everywhere from magazine ads to beer bottles to t-shirts to even airplanes (though I would definitely pay fifty bucks to the person who can hold their phone steady enough to scan that…). Pharma marketers have also tested the QR code waters and our ePharma Consumer® 2011 study found that about six percent of online consumers have accessed pharma resources via a QR code.

A new QR alternative made news this past week - BBC News reported that Korean scientists are introducing a new printing method that facilitates the exchange of digital info via mobile devices when swiped. While near field communication is not a new concept, this development is unique in that it allows for NFC to be implemented at a very low cost (less than one penny per printed rectenna) – which may prompt more businesses and organizations to adopt this technology. Gyoujin Cho, co-author of the study, predicts “the application of NFC technology with the smartphone will be limitless in the near future” and that “the medical, automotive, military and aerospace industries will benefit greatly.”

The digital printing technique will be featured in this month’s journal Nanotechnology, and we’ll be keeping our eye on this and other disruptive technologies changing the game for marketing and medicine.

Posted by Maureen Malloy, Senior Healthcare Analyst

Digital doc infographic

Thanks so much to our friends at inVentiv Health for visualizing our data in such a cool way! This infographic highlights some the latest physician digital trends from the new Taking the Pulse® U.S. 2012 research. Let us know if you have any suggestions or requests for future infographics! 

Posted by Maureen Malloy, Senior Healthcare Analyst