How pharma marketers can use E-Prescribing, Electronic Medical Records and Electronic Health Records to increase the value of their Point of Care communications.
As pharmaceutical marketers search for optimal ways to demonstrate the value of their brand to both physicians and patients, Point of Care (POC) communications are increasingly viewed as an ideal way to interact with these important audiences. POC allows the brand to contribute to the physician-patient relationship, and marketers have significantly increased their level of interest in a variety of POC communications options. One POC channel that has experienced especially high levels of interest is communication within the physician’s office that is driven—and delivered—by the physician’s electronic prescribing (e-Rx) or electronic medical records (EMR) system. Having background knowledge of EMR and e-Rx helps to accelerate the marketing team’s thinking about the ways the channel can be utilized. There is also keen interest in seeing that communications within the channel ensure value for both the physician and the patient, as this supports the high value that both providers and patients place on these communications. Marketers need to understand EMR/EHR systems and e-prescribing along with the ways this channel can be utilized to educate and inform both providers and patients.
THREE INTERWOVEN PLATFORMS
Systems that seek to “digitize” health data within the Health Care Provider (HCP) setting are best described as three interwoven platforms: Electronic Prescribing Systems (e-prescribing, or e-Rx), Electronic Medical Records (EMR) and Electronic Health Records (EHR). These three platforms are interrelated but have distinct differences in capabilities and market penetration. While there are many nuances specific to each of these platforms, the following definitions establish a clear distinction that marketers must understand to make optimal decisions about their use of electronic communications and programs within the physician’s office. Marketers can develop effective, robust communications programs using each of these platforms, but knowing the key differences between them can avoid unnecessary expense and delay caused by inaccurate assumptions based on faulty data and definitions.
• Electronic Prescribing (e-Rx) Systems
E-Rx is the most widely-adopted element of the three platforms and the primary channel for provider and patient communication. It is also a major component of the two other platforms—EMR and EHR—so it can be considered the foundation of these platforms.
E-Rx systems allow a prescriber to create a prescription and (often) to send it to the patient’s pharmacy electronically. These systems have experienced rapid adoption in the past 3-4 years. Over 91% of community pharmacies accept e-prescriptions, and at the end of 2011, 58% of office-based U.S. physicians were using e-Rx systems to create prescriptions. By the end of 2012 about two out of three physicians will likely e-prescribe, and this number will continue to grow due in large part to penalties imposed by the Centers for Medicare and Medicaid Services (CMS) on HCPs that do not utilize e-prescribing.
E-Rx creates a data stream and communication channel that can be used to deliver information to a HCP as the Rx is being created and to the patient after the medication has been prescribed. In these scenarios information that supports the prescriber’s decision is embraced by both the HCP and the patient, and is also valuable to the sponsoring pharmaceutical company.
• Electronic Medical Records (EMR)
EMR systems allow a provider to replace their patients’ paper charts with an electronic record. Approximately 46% of office-based physicians in the U.S. utilized some type of EMR system as of early 2012. 82% of e-Rx systems also exist within a larger EMR system, demonstrating the relationship between the two platforms. EMR systems rely heavily on their e-Rx component when it comes to delivering information to the physician and the patient.
The opportunity for EMR data to be shared with other HCPs is signiﬁcantly enhanced compared to paper records. This has caused many patients and providers to assume that EMR data can be easily viewed and shared between providers and between the provider and patient. Unfortunately, that is not yet true. Most EMR systems work only within the physician’s ofﬁce or within a closed health system. But if the patient is seeing multiple HCPs, the data is often no more accessible than if it were in a paper chart. This will change over time, but for now utilizing this data to improve provider and patient education requires the creation of software systems (such as LDM Network software) designed to communicate through a wide variety of different EMR systems and vendors.
• Electronic Health Records (EHR)
Many people erroneously use the terms EMR and EHR interchangeably. This can be misleading so marketers should apply a strict standard to the term “EHR” because these systems are more advanced than EMR systems. EHR systems allow for the delivery of greater amounts of information to, and foster greater interaction with, both the patient and with HCPs compared to EMR systems. In fact, the portability of data (called “health information exchange”) is a hallmark of a true EHR system which allows patients to view their own health data through “patient portals.” But the current standard for their use in guidelines established by the U.S. government for “meaningful use” of EMR few years away from true EHR systems being the norm. There have been instances in which marketers were developing programs that relied on EHR technology but were basing their market impact on the penetration of EMR systems. The disruption that resulted could have been prevented had their team created a program designed around e-Rx and EMR capabilities instead.
COMING IN FEBRUARY: A LOOK AT HOW AN EPRESCRIPTION IS BORN
The next part of this series will appear in the February issue of PM360 and will focus on how an e-prescription is created using typical e-prescribing and EMR systems, and the opportunities for both physician and patient communication this creates.