A well-designed, well-managed clinical education program can increase market share, increase adherence, and boost the satisfaction of patients, providers, and office staffs. Here are guidelines to help you decide whether clinical educator programs will boost your ROI and burnish your brand’s image.

With the decline in sales-force support of product promotion, pharmaceutical, biotech, and device manufacturers are looking for innovative ways to provide information to their customers. Conversely, physicians demand better education and patient-support programs from manufacturers.1 So how do organizations provide this offering with fewer sales professionals, who may not have the training and skill set to deliver such services? The clinical educator (CE) or nurse educator role has been providing that solution for over a decade, delivering meaningful product and disease-state education to physicians, nurses, staff, and even patients.

The device industry is well versed in the CE model. Many device makers use the CE to provide end-user or patient training. Only recently, however, has the pharmaceutical industry started incorporating CEs into their mix of promotional education strategies. The concept of the contracted CE originated in the United Kingdom and migrated to the United States in the late 1990’s, a by-product of the pharmaceutical contracted-sales model. The resource has evolved over the past decade with additional contract sales and marketing service organizations providing versions, coupled with a growing number of pharmaceutical and device organizations hiring their own in-house CE teams.

CLINICAL EDUCATOR ROLE AND DIFFERENTIATION

Clinical Educators are primarily responsible for providing diseasestate education based on professional guidelines. They also provide product-education regarding dosing, administration, titration, and side-effect management, using clinically focused product presentations. CEs may also provide teaching strategies to enhance effective communication among physicians, nurses, and patients concerning the patients’ care. This is intended to make each visit more effective and enhance the overall patient experience with an eye on the ultimate improvement of outcomes.

CEs work in many settings— clinical-trial sites, academic and community institutions, long-term care, specialty and primary care offices, infusion centers, clinics, managed-care organizations, and pharmacies. CEs are usually registered nurses or registered dietitians (depending on the therapeutic area), with baccalaureates and extensive clinical experience, certifications, and proven presentation and teaching skills.

How does this differ from a Medical Science Liasion (MSL) or a sales role? MSLs tend to have doctoral training with extensive “high science” backgrounds. They cultivate relationships with a limited number of key opinion leaders while providing scientific and research-based information and support. Sales representatives provide targeted physicians and staff/officebased personnel with product details, incorporating tools or resources for the healthcare professional —along with reimbursement and other support information.

A clinical educator borrows elements of both roles while reaching a wider audience that may include the patients themselves. (NB: any patient contact has to meet organizational, legal and compliance requirements, as well as all local, state, and federal laws [i.e., HIPAA, PhARMa, etc].)

WHAT’S IN IT FOR ME?

Every audience that the CE touches may benefit from this resource:
• Physicians and prescribers get up-to-date professional guideline presentations from a credible, licensed, expert healthcare professional. The experienced educator brings the patient perspective to the management of acute or chronic diseases. The educator acts as an advocate for the early initiation and modification of therapy to improve outcomes, and provides strategies to enhance the patient-provider dialogue.
• Nurses and other office staff receive expert education, increasing their knowledge of a disease. They, too, can be taught to improve patient-provider communication. This, in turn, can smooth office workflow, providing a “win-win” situation—a better prepared patient coupled with a more efficient office visit.
• Patients usually benefit from basic disease state education that healthcare professionals (HCPs) and office personnel may be too busy to provide. They also receive training on the prescribed product or device. The CE is never meant to replace the healthcare provider, but rather to provide the education patients need to successfully incorporate a manufacturer’s or distributor’s products into their treatment regimens.
• The sponsoring organization benefits from both improved ROI and a higher profile as well as a better image within the healthcare community, known for making education a priority.

FACTORS TO CONSIDER WHEN USING A CE TEAM

Ultimately, the CE program design reflects the brand’s short- and longterm brand needs. For example, a CE team can be deployed during phase III clinical trials, pre-launch, at launch, mid-lifecycle, or at the end of a product’s lifecycle, all with different strategic objectives. Is the therapeutic area under-diagnosed or misdiagnosed? Does your physician base treat to guidelines? Is there a specific stage at which you notice the greatest drop-off in patient adherence? Is your brand an injected, infused, or simply a new entrant to the market? Does the product have a new indication? Are there Risk Evaluation and Mitigation Strategies (REMS) requirements for your brand? Is this a new therapeutic area for your company? Does the competition offer similar educational resources? Ask all of these questions as you consider building an educator team.

When you have decided to add this type of resource to your marketing mix, you will need to evaluate internal capabilities and resources. If your pipeline contains additional knowledge-dependent products, it may make sense to hire a CE team directly for long-term efforts. Consider, too, your organization’s bandwidth: If you already have someone in-house who has designed, deployed, and managed this type of resource, it might again make sense to hire a team directly. If you lack in-house experience, though, you may want to take the contracting or consulting route. Contracting makes the most sense for small or start-up organizations without the infrastructure to support another field force. Conversely, large organizations sometimes contract the work out to minimize internal and field sales disruptions.

Contracting also makes sense if the need is short-term, or if the long-term prospects are uncertain (may be the case with some launches).

CRITICAL SUCCESS FACTORS

Strategy is the key. CE teams are custom-built for the job…and they’re not just another sales team. Rather, they are designed to meet the brand’s immediate and continually changing marketplace needs. Be sure to deploy them for maximum effect: Too often, CE teams are focused on a single task (patient device training for example), while they might have much greater impact by incorporating disease state education or even staff education into the mix. A productive and cost-effective CE team is not merely “fluff” and goodwill for the pharmaceutical company but also an important educational resource that can boost product success.

Managing CE teams is a far cry from managing sales professionals or MSLs and can challenge the inexperienced. CEs have different motivation, coaching, and counseling needs, different compensation packages, and different job responsibilities. All of these need to be addressed and managed properly. Failing to take these into consideration increases the risk of lackluster performance. CE efforts must also address and constantly manage unique regulatory and compliance concerns; ignoring these can put the sponsoring organization at risk. The closer any employee or agent of any manufacturer or distributor comes to the patient, the higher the organization’s level of risk. Proper reporting structure within the organization (sales/marketing/medical) and managerial experience greatly reduce the exposure.

In summary, a well-analyzed, well-designed, well-executed, and well-managed clinical educator team can provide a long-term stream of value to both the sponsoring organization and its customers.

REFERENCES
1. “TNS Healthcare Study Reveals Physicians Want Education and Patient Support Services from Pharmaceutical Companies,” Business Wire, May 15, 2006.

  • Jen Bonsall

    Jen Bonsall is president of HealthStar Clinical Education Solutions, based in Mahwah, NJ. She brings more than 10 years experience designing and offering full-time, part-time, and per diem Clinical Educator solutions, as well as providing consulting services for organizations who wish to design or optimize Clinical Educator teams.

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