Share of Screen: Prioritizing Electronic Health Records

When asked why he robbed banks, Willie Sutton supposedly responded: "Because that's where the money is." Anyone who has seen a doctor in the last couple of years knows that the computer screen gets more face time than the patient, so it follows that pharma ought to be prioritizing the EHR channel as a way to deliver timely messages to that critical customer, the one holding the Rx pad. Right?

Ben Comer

Maybe. Discussions about EHRs can get complicated quickly, due to the sheer technological heterogeneity among EHR providers, not to mention their differing business models; free and ad-supported, or expensive and ad-free, for example. That's in addition to other important considerations such as, what stage of Meaningful Use has the physician's practice or hospital obtained? Or, how does the EHR fit into a given physician's workflow, and what tasks are delegated to administrative staff?

Don't be bedeviled by the details, says Ed Fotsch, CEO at PDR Networks, a provider of drug label information and product support that now partners with EHR providers to deliver services to physicians and patients. Between 60 and 70 percent of physicians have now adopted some form or EHR, and as a result, their workflow has altered ­dramatically, says Fotsch. Now, "it's all about information flow into and out of the EHR." For those early-adopting physicians and hospitals that have already been using EHRs, Stage 2 of Meaningful Use is just six months away, and that requires physicians to send "customized patient education" to at least 10 percent of their patients, or sacrifice the Meaningful Use incentive payment. Where will docs get the patient education and resources they'll be required to distribute?

Pharma, if the industry plays its cards correctly. Drug companies have spent untold millions on developing patient education materials, a lot of it never seen by actual patients. These materials—in addition to financial assistance programs and co-pay cards—can be repurposed to meet the needs of physicians who want to qualify for Stage 2, says Fotsch. The key is to support the doctor's decision to prescribe a given product by providing services that help patients afford a medication, remain adherent on therapy, and understand the risks and benefits of a product.

Despite a lot of talk (and conferences) about the need to transform industry from product peddler to service provider, you don't hear that many CEOs regaling analysts on earnings calls with stories about what's happening above and below the pill. Some brand managers still don't understand why services like customized patient education matter after a physician has already chosen what to prescribe. Fotsch says he asks these brand managers why they return to the same restaurants, or buy a certain kind of car. "It's because of a good experience" with that restaurant or car, and it's the same for medicine, he says. "If you can help a doctor and a patient at the time of prescribing—with an adherence program, or financial assistance, et cetera—that's a better drug," says Fotsch.

But patient materials don't appear in EHRs by magic; there's a lot of work that goes into it. Fotsch says Bristol-Myers Squibb and AstraZeneca are two examples of "forward-looking clients that are thinking like service companies" with respect to EHR. Fotsch says biopharma EHR initiatives should consider a physician's full range of prescribing habits, and not try to push single-drug materials into EHRs. It's also important to understand the level of EHR adoption in a given specialty, and to identify opportunities that engage physicians in context-appropriate ways. Finally, it's a good idea to understand the Stage 2 requirements in order to meet the needs of physicians, says Fotsch.

As more and more physicians spend more and more time looking at a screen, it makes sense to support their prescription decisions through the EHR channel. Newly covered lives coming into the system next year will need to be educated about their diseases and treatment. At the point of care though, patients might find it harder than ever to make eye contact with a doctor.

Ben Comer is Pharm Exec's Senior Editor. He can be reached at bcomer@advanstar.com.