Three Key Questions About Point of Care

PM360 asked experts in point of care to address key issues marketers should know about the space in 2018:

  1. How important will point of care (POC) channels be for marketers in 2018? Where will they find the most value
  2. What new developments/innovations in the point of care channel can marketers expect in 2018 that could be game-changing?
  3. What are the biggest challenges facing marketers in the point of care space in 2018, and how can they overcome them?

Karima Sharif

The average patient spends 20 minutes in the waiting room and about 19 minutes with the HCP. That’s an eternity for marketers to provide brand messaging at the point of practice to two very distinct and critical audiences at the most important decision-making time. And HCPs are noticing and remembering the active players and programs in this space. According to CMI/Compas 2017 Media Vitals research, the top three POC sources HCPs notice are patient support programs (samples, copay cards, and financial assistance programs), prescription pads, and professional wallboards.

Among our own clients, we have seen a 65% increase in POC marketing from 2013 to 2016 and believe that the growth will continue, especially as EHR continues to be an active platform within this channel.

The value will come from marketing programs that help support the patient and HCP convergence with relevant and timely messaging. An example of a perfect (and typical) scenario: Person with type 2 diabetes sees relevant content in waiting room about Brand X and disease info, researches Brand X on mobile device, confers with HCP and receives an Rx for Brand X with a copay card and enrolls in Brand X support program on mobile device for additional patient support and education.

Anthony J. Schueth, MS

The EHR will be a key point of care channel for all of 2018. Why? EHRs now affect every step in the pharmaceutical decision process. Every marketing plan now needs to consider the EHR and how it can be leveraged to positively affect brand performance.

For example: Marketers need to thoroughly grasp the EHR workflow for prescribing decisions, which vary according to the system that is used by the individual practitioner and integrated delivery network. They need to understand how their drug is displayed in the EHR and whether all the information needed to prescribe their drug is available and accurate. If not, there are actions they can take to correct problems. Clinicians will not prescribe a drug that cannot be easily identified and prescribed within the EHR workflow.

Marketers can also leverage the EHR to help clinicians identify appropriate patients for their drug. Information and clinical tools within the EHR are being used by clinicians to proactively determine patients in need of specific drug treatments. Clinicians must be educated on how the EHR can be used to efficiently and effectively implement a drug regimen. This in turn can help more patients receive a drug therapy as well as help marketers meet their business objectives.

Nadine Leonard

The opportunities within POC marketing are massive. But we think marketers should be digging deep in two areas.

The first is abandoning the currently disjointed POC marketing executions littering doctors’ offices, and instead, formulating purposeful point-to-point narratives that can influence healthcare decision-making. Imagine a situation in which both patient and doctor are experiencing educational information (disease state or branded) at every micro-moment leading up to appointment day. When they finally meet (briefly!) they’re on the same page and can have a productive dialogue. We call this “in-the-moment marketing.”

The second area is for brands treating conditions that can drag down entire systems of care (SOCs)—e.g. diabetes, COPD, etc. In order to help SOCs deliver against clinical needs and reduce financial risk, we suggest gaining buy-in from the C-suite on a value proposition that includes tools and services to “pull through” a protocol, and then facilitating rapid adoption throughout the SOC via bespoke POC programs designed to improve health outcomes and reduce costs. This is a true win-win scenario, yet brands have barely scratched the surface.

Jacque Fisher

Increasingly, consumers are thinking about their health plan as their point of care because it determines who can be their doctor, where they can access healthcare, and which medications are covered for treatment.

With the recent news of the mega-merger of CVS and Aetna comes the game-changing potential for a new, coordinated point of care. The “medical” and “pharmacy” one-stop-shopping model could be the wave of the future. It would connect the dots between the health plan and a more accessible provider network, resulting in closer touchpoints with consumer/member/patient and improved care outcomes.

By providing stronger, team-based support (case management, medication therapy management, etc.), population health models and care coordination can be strengthened through better sharing of real-time data across these vast organizations—a long-overdue capability.

Patient access services can play a bigger, complementary role in this new model. Patients can become engaged in decision making and ownership of their healthcare through innovative tools and technology, and marketers can take the opportunity to broaden their reach to those who influence the patient and script journeys.

Minimizing healthcare costs is a critical objective for payers and providers. Consumers want reduced premiums and out-of-pockets expenses. In theory, this model is a game changer.

Richard Nordstrom

Point of care patient engagement is an essential media channel for inclusion in every integrated media plan. Technology and distribution at POC will continue to improve as will the importance of participation by pharma. POC marketing is going to expand because technology is changing the in-office experience.

We received fantastic market insight about the value of recording the HCP patient conversations from a recent JAMA article. It showed “15% of patients are recording discussions and the motivation is reasonable: Patients want to listen again to improve their recall and share the information with family.”1

Innovative POC technology along with impactful distribution will be used to increase recording activity and put control of the conversation into the hands of more HCPs. Some insurers provide physicians who record a 10% reduction in the cost of medical defense along with $1 million dollars in extra liability coverage. Pharma companies are able to leverage this channel to increase the presence of their highly valued education content to improve treatment adherence and health outcomes. The emergence of these platforms are a win-win for patients, doctors, pharma, and insurers.

Reference:

  1. “Can Patients Make Recordings of Medical Encounters? What Does the Law Say?” July 10, 2017. doi:10.1001/jama.2017.7511.

Mike Byrnes

In 2018, we will see the pharmacy continue to transform into a total healthcare and community hub. The CVS/Aetna combination that brings together managed care, a pharmacy benefit manager (PBM), and a large network of retail pharmacies is of course a major factor, but the trends were already in place. For the past several years, pharmacies have been making a major push to provide a much wider range of healthcare services, including in-store clinics, immunizations, and screenings. And for patients who regularly see more than one doctor to manage their chronic conditions, the pharmacy is already the coordinating glue that holds their healthcare regimen together.

To be clear, this change isn’t just about one merger. We do expect that a large and vertically integrated healthcare organization will position its network of more than 9,000 retail pharmacies as destinations for a much larger slate of primary care services. More important is that this transition will happen in a seamless and patient-friendly fashion because all pharmacies are already so naturally positioned as central points of coordination for even the most complex health conditions.

Neala Havener

The biggest challenge: Disrupting inertia in treatment decision-making. When it comes to patient care, physicians typically use mental shortcuts to help them make efficient decisions. Physicians make assumptions about treatments based on previous experience. They also make assumptions about patient needs and preferences based on what they know and observe about each patient. In fact, about 95% of physician decision making takes place using short cuts or habit-driven reasoning.

So how do we disrupt biases and make physicians aware that their patients may benefit from treatment, and want to be on a different therapy, or at least that they might want to discuss their needs and goals?

The answer involves using evidence-based strategies that go beyond pushing information.  Through behavioral strategies such as Cognitive Forcing and Bias Inoculation, pharma can create “aha” moments during which physicians can overcome their biases and make more deliberate decisions with patients about optimal treatments. Pharma can develop in-services and tools incorporating these behavioral strategies that open the dialogue so that patients and providers can align on concerns, goals, and preferences to arrive at a shared decision. When marketers offer these types of support and solutions to patients and physicians, the value of the product is magnified as it delivers beyond the treatment.

Amanda Rhodes

Gone are the days when professional marketing strategies solely relied on prescribers to share important branded information with consumers. Reaching patients in-office and at the pharmacy through EMR/patient portal integration or mobile engagement platforms allow patients accessibility to support resources, such as copay cards, which deters abandonment when they arrive at the pharmacy.

Allowing patients to self-select the level of support they are interested in receiving—whether adherence calls, text reminders, or in-bound support—is the new reality, but there is also a risk with “choosing your own adventure.” Behavior change is hard. It’s hard for all of us. And as with any sustainable changes, comes hard work. Some patients may choose this, while others may “opt out.” While consumer choice is king, including what patients need—in addition to what they want—will drive long-term positive health outcomes.

Too much self-selection leads to a disparate patient experience, and a handful of tactics that are no longer connected to a broader strategy. So, as we once relied solely on the prescriber to share information, we have to resist placing all of the behavior change responsibility on the patient.

Joe Meadows

The biggest challenges boil down to relevance and engagement. HCPs are increasingly too busy to pay attention to interruption-based marketing (e.g., ads), and only a very limited number of them will accept advertising within their patient care tools or even the physical environment surrounding the point of care. And some recent, possible missteps by prominent point of care companies may have damaged the reputation of marketing suppliers within the space to the point that physicians and staff are especially wary and cautious.

To overcome these challenges, marketers need to focus more on delivering useful content and information that HCPs can use to educate patients. We see continued interest in unbranded tools that HCPs can use to help a patient self-assess their progress or identify a problem as early as possible. And helping a patient understand their medication, or improve appropriate adherence, continues to be welcome. We also see continued interest from many HCPs and staff in savings offers that can help to lower out-of-pocket costs for medication, but some care settings now actively oppose these offers. Improving delivery of savings offers into the hands of providers that will actually use them is likely to be a good investment for most brands—and is an area that is often overlooked.

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