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The Pharma-tization of ACOs

Posted on May 18, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was sitting in a session at a conference recently that included a representative from a large pharma company. The actual individual and the pharma company are unimportant, but I thought that the comment they made was quite interesting. I don’t think I should have been surprised, because you can turn anything into pharma if you want. Just like I can turn anything into a blog post if I want.

The pharma executive commented on how her pharma company was a little too early to jump on the ACO (Accountable Care Organization) bandwagon. They were going to doctors to tell them about the need to use different drugs in order to provide “more effective” care for patients. By so doing, the doctor will provide better care to the patient and receive a better reimbursement because in the ACO model you’re paid for quality of care not volume.

Let me translate what I believe pharma’s intent really is (although I think it’s quite apparent) in these comments. “You shouldn’t be using our competitors drugs, you should be using our drugs because they’re more effective.” or “You should be using our more expensive drugs because it’s more effective than this cheaper drug.” While a strong generalization, remember the first rule of pharma: Sell more drugs. If this means using the new ACO models to push more drugs so be it. Thus the Pharma-tization of ACOs.

The interesting end to this story was why the pharma executive told us this story. She was really telling us about physicians lack of response to the ACO messaging. Basically this pharma company was ahead of the curve on using the ACO and value based care messaging out there, because physicians aren’t seeing their reimbursement influenced by either today. My guess is that many barely even see ACOs and value based care on the horizon. So, the above pharma messaging was given to deaf ears.

Social Media for Patient Recruitment

Posted on May 1, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I previously posted about Patient Recruitment & EHR where I talked about some of the intricacies of patient recruitment and use of EHR for clinical study patient recruitment. While I’m certain that EHR will be a major player in the patient recruitment of the future, I saw a tweet today that made a great case for social media being the go to platform for patient recruitment today.

Here’s the tweet from @JeffBrittonMD:

70% of patients were recruited on Facebook. That number hit me when I saw it. Although, after thinking about it a little bit it makes a lot of sense. The real key to Facebook recruitment is that they know a lot of information about you which advertisers can use to target their ads. So, it makes perfect sense for Facebook to work for patient recruitment.

I think we’ll see other social media channels prove beneficial to patient recruitment as well. Although, it’s still early for many of the other platforms that I think will prove most valuable. Keep an eye on Twitter to start. Also, don’t underestimate the power of mobile apps and even a physician’s social media presence.

Patient Recruitment & EHR

Posted on April 25, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For some reason I’ve been recently talking and reading more and more about patient recruitment. I’ve been fascinated by the creative ways that those doing the clinical studies use to be able to recruit patients that fit the very specific needs of most clinical studies. Plus, I’ve been amazed at how much money is required to be able to recruit patients for these studies.

There’s so many interesting quirks involved in the whole patient recruitment business. In most cases, it’s very large companies trying to recruit individual patients. Many of the chronic patients want to know about and be involved in the clinical study. In many cases, it can lead to a great mutually beneficial outcome for both the company that’s doing the clinical study and the patient who receives care that they wouldn’t have otherwise received. Of course, there are A LOT more intricacies involved in patient recruitment, but those are a few of them.

The biggest challenge with patient recruitment is usually finding the right patients for the clinical study. I think we’re on the brink of technology largely solving this problem for clinical researchers.

EHR Software for Patient Recruitment
When you think about the volume of data that’s going into an EHR system, you can see how valuable the granular EHR data could be in identifying which patients are eligible for a certain clinical study. Certainly there are plenty of nuances to when and how you can use this information. I won’t get into those in this post, but I think it’s quite clear that EHR software will be essential to patient recruitment in clinical studies.

I’m sure that some won’t like to hear this. My first response is that this doesn’t have to be a bad thing. In fact, if done right it can be a great thing. We just need to be involved in the discussion so that patient recruitment with EHR software is done the right way. My second response is that this is going to happen whether people like it or not. Instead of trying to stop it, we should focus on how to make it work well for everyone.

EMR and Pharma

Posted on December 9, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

In a post on EMR and EHR about Pharma and Health Plans paying for EMR software, I got the following comment from Aaron Holloway:

I am partnered with a Practice Management/EMR/EHR platform and we are in negotiations now with Pharma companies who are interested in subsidizing the platform from many perspectives:
1. Integration option of a sales visit app for rep’s (details, samples, etc.)
2. De-identified data procurement (measure brand impact)
3. Ad placement (lessor priority/ROI)

I’ve previously posted about the riskiness of pharma ads in EHR, but also have commented on how pharma ads in EHR are inevitable. However, I thought Aaron’s comments provided some interesting new ways I hadn’t heard for pharma to interact with a doctor thought an EHR than I had heard before.

I’m sure some people like Bruce Friedman from Lab Soft News will still be a little concerned whenever Pharma puts their fingers into things. Bruce has a right to be concerned. However, I still believe that it’s going to happen. So, I’d rather be part of the discussion than to sit back and say it shouldn’t happen while it happens anyway.

Riskiness of Pharma Ads in EHR

Posted on November 23, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been having a number of really interesting conversations with people about Pharma ads appearing in EHR and other clinical software. Most people’s gut reaction is that they don’t want their doctor seeing a pharma ad while he’s ePrescribing. However, most people also agree that there’s too much Pharma money for it not to happen.

In an article at Lab Soft News a few months back, they discuss the challenge and issues surrounding Pharma ads in an EHR:

Very distressing to me, however, is the clear link of the company, and its software, to the pharmaceutical industry. I have blogged on numerous occasions about some of the ethical and legal lapses of some of these companies (see, for example: On the Corrosive Influence of Big Pharma on Academic PhysiciansMerck Creates Phony Peer-Reviewed Medical Journal to Dupe PhysiciansDetails Emerge About Ghost-Written Medical Articles for Wyeth). I have also reluctantly come to the conclusion that even apparently trivial advertising connections to Big Pharma can lead to mischief. I had previously thought that inconspicuous advertisements in EMRs by drug companies might be tolerated if the companies were to bear the costs of these systems. I now believe that allowing these companies even a tangential relationship to physician-office electronic medical records is too risky.

Certainly there are some really great points made. Absolutely there’s a risk that a doctor could be influenced by a pharma ad in an EHR. Will it make them provide a lower quality care because of the ad? I’m not sure it would. Could the care cost more because of the pharma ad? Possibly so. Do we not trust our doctors to do what’s best for us regardless of the other outside influences?

Back to the initial premise, many are concerned with Pharma ads, but they’re bound to happen anyway. So, I ask you the question, is there any way to have Pharma ads without compromising the integrity of the visit? Is there a way to minimize the influence of Pharma while still allowing them a way to talk with the doctor?

No doubt this discussion is going to come up again and again. With Pharma unable to even give a doctor a pen we’re going to see new creative ways for Pharma to be seen by doctors. Advertising Pharma products to patients won’t be enough.

Epocrates EHR Should be Free

Posted on September 14, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I came across this article on Lab Soft News (he does great work) that talked about some Ethical Questions that related to Epocrates recently launched EHR software and their existing pharmaceutical relationships. Here’s one section from the post:

Very distressing to me, however, is the clear link of the company [Epocrates], and its software, to the pharmaceutical industry. … I have also reluctantly come to the conclusion that even apparently trivial advertising connections to Big Pharma can lead to mischief. I had previously thought that inconspicuous advertisements in EMRs by drug companies might be tolerated if the companies were to bear the costs of these systems. I now believe that allowing these companies even a tangential relationship to physician-office electronic medical records is too risky.

I’ll leave the highly discussed topic of pharmaceutical influence for another post and the comments section. However, when I read this I couldn’t help but wonder why Epocrates isn’t offering a Free EHR.

If you think about most Free EHR models, one of the core revenue paths is through advertising. Let’s not kid ourselves here. When they talk advertising, they’re talking about pharmacy ads. Sure, they might sell some other ads, but the majority of the big dollars for EMR advertising is from pharmaceutical companies.

With this understanding, doesn’t that mean that Epocrates relationships with these pharmaceutical companies would be perfectly positioned to execute on the Free EHR model?

I just checked the Epocrates EHR pricing page and it has the pricing as a $359 monthly subscription per seat. It’s also interesting that they’ve chosen to integrate with Nuesoft’s PMS which will cost $200/month per seat. They also require the purchase of the Epocrates EHR Quick Start Package. Not sure the cost on that. Sounds a bit pricey to me, but that’s a topic for another post.

I keep asking myself as I’m writing this post, Epocrates is perfectly positioned to execute the Free EHR Pharma advertising model and yet for some reason they’ve chosen not to do it. Remember, Epocrates has been executing the free software for Pharma advertising for a long time. Why did they choose not to do the same model with their EHR? Do they know something we don’t know?

I don’t know the answer to these questions, but I’m sure to ask them next time I see them. Maybe they’ll be at AHIMA or MGMA.