You can tell it’s the end of the year. Office parties are in full swing even as we all rush to complete those final to-dos on our list of year-end objectives. I hope 2013 has been a great year for you. I’m willing to bet it was a busy one, and that 2014 will be just as fast paced and full of new challenges and opportunities. I assume that, like many of our clients, you will find yourself in kickoff meetings come January, and there’s a strong probability that EMRs will be at the top of the list regarding HCP and patient engagement channels and new developments. In anticipation of those conversations and the questions they will create, here’s our take on a few EMR-related developments you can expect to see in the coming year.
Data released from Surescripts earlier this year showed that 69% of physicians were engaged in e-prescribing with 44% of all prescriptions being routed electronically. We believe that this growth continued throughout 2013 and that e-prescribers now account for almost 75% of all U.S. physicians, with about half of all Rxs now arriving at the pharmacy through an electronic channel. It is also important to remember that some physicians still create the Rx using their EMR/e-prescribing system, but then print the Rx and give it to the patient or electronically fax it to the pharmacy. Neither of those methods is accounted for in the published electronic routing numbers, but an opportunity to engage the prescriber or educate the patient (perhaps using the same printer used for the Rx, for example) still exists. Based on that, EMRs and e-prescribing are likely responsible for more than 50% of Rxs, even as this year started, and that trend will continue in the coming year.
More Industry Consolidation
If you reviewed the requirements facing HCPs and hospitals to qualify for government incentives under Stage 2 Meaningful Use criteria (which become operational in 2014), you know that the requirements are more stringent than those for Stage 1. And who is responsible for helping them meet those requirements? The EMR suppliers that produce the software, of course! But some of the companies that sprang up in response to the influx of government-funded Meaningful Use incentive money will find that Stage 2 requirements are harder to meet than they anticipated. But will they just fold up shop and leave their customers “high and dry”? Not likely.
The more likely scenario is that 2014 will see some of these smaller companies being acquired by larger players to gain their prescriber user base, which in the long run is both expected and good for the industry as the market matures. We will also likely see some deals between larger, well-run EHRs who could easily meet MU2 requirements for their customers but that elect to combine their efforts and assets to better meet customer needs and capture market share. This industry consolidation is good news for pharma, because stronger companies already see the need to engage HCPs and patients via their EMR products, and that trend will continue to develop and grow, often with pharma support.
Growth in Patient Engagement via EMRs Could Be Dramatic
Until very recently HCPs have been focused on simply qualifying for their Stage 1 incentives under Meaningful Use and getting accustomed to working with their EMR software. Routine users of patient portals still numbered in the single digit percentages, and despite the dramatic growth we’ve experienced in office-based patient engagement via EMRs, most physicians still lack the ability to communicate with their patients using their EMR for things like education and driving adherence.
However, that is going to change, thanks to Stage 2 Meaningful Use requirements. Among several other measures designed to improve patient engagement, the Year 1 Stage 2 requirements of Meaningful Use include a requirement that the HCP must provide patient-specific education materials for 10% of the patients seen during a 90-day contiguous measurement period. In other words, if the HCP wants to receive their incentive payment, they need to figure out how to deliver patient-specific education materials, and fast!
Thankfully, pharmaceutical companies excel at developing patient-specific educational materials, and there’s absolutely no reason these can’t be used to help fulfill this requirement for appropriate HCPs and patients. In fact, many EMR suppliers and HCPs welcome that assistance, and we believe many more will actually depend on it to help meet this metric. Given the high bar to which pharma is held in terms of content standards, this is great news for everyone. Patients become better educated while HCPs meet their requirements and get their incentive payments, and the pharma company benefits by having a better-educated patient who may be more likely to remain on therapy. It’s a “win” for everyone concerned, and we think it’s a preview of one of the ways pharma can contribute to the healthcare system of the future.
Continued Growth in Pay for Performance
Paying physicians based on patient outcomes is not entirely new, as many pharma executives can remember the heyday of capitated payment plans from 20 years ago. Now EMRs have given both HCPs and payers the ability to better measure HCP and hospital performance. 2014 marks the last year that the Medicare system will offer the “carrot” of physician incentives for delivering higher-quality care under the Physician Quality Reporting System (PQRS), as the system switches to the “stick” of lower reimbursements beginning in 2015 for those who don’t satisfactorily report quality data. There are also many private sector initiatives with similar goals in mind.
EMRs give HCPs the ability to both deliver better care (the delivery of patient education materials noted earlier is a good example of that) and also record their quality care as they deliver it. HCPs who wish to maintain their incomes will take these requirements very seriously. In addition, many will look to pharma to help them in this effort to improve patient outcomes, often through EMR-related programs and opportunities, to better engage patients in their care.
2014 will be here before we know it, and we can expect EMRs to play an even bigger role in the delivery of care. We hope your company is either already involved in programs that support HCPs or actively seeking to become involved. Based on how things went in 2013 and the forecast for the coming year, you will be met with open arms by HCPs ready to join forces to help drive better patient outcomes.