The digital age has transformed numerous industries, and healthcare is no exception. As pharmaceutical marketing seeks more effective ways to reach physicians, Point Of Care Decision Support Tools are emerging as a powerful and necessary evolution. Traditional methods are losing their impact, and clinicians are increasingly reliant on digital workflows, creating a prime opportunity for innovative solutions.
The Shifting Sands of Pharma Marketing
For decades, the pharmaceutical industry has leaned heavily on a conventional marketing strategy. This model, centered around expensive clinical trials, journal publications, and conference presentations, aimed to educate healthcare providers. Brands then amplified this evidence through marketing campaigns and direct physician detailing. While once effective, this approach is increasingly struggling to deliver the desired results in today’s complex healthcare environment.
The challenge arises from several converging factors. The sheer volume of treatment options has exploded, making it nearly impossible for physicians to retain every detail about each drug. Faced with information overload, physicians often default to familiar, older, and often cheaper medications, even when newer brands offer tangible benefits for specific patient groups. This leads to underperforming brand uptake despite clinical advantages.
Furthermore, in many therapeutic areas, multiple drugs may be indicated for the same condition. The subtle yet crucial differences between these alternatives, vital for optimal patient care, are easily lost in the daily pressures of a physician’s workflow. The modern physician’s day is dominated by digital interactions – reviewing patient data and navigating Electronic Health Records (EHRs). This shift towards digital workflows presents both a challenge and a significant opportunity for how pharmaceutical companies engage with healthcare providers.
Point of Care Decision Support: A Timely Opportunity
So, how can pharmaceutical brands effectively cut through the noise and ensure their therapies are considered when physicians make critical treatment decisions? Investing even more in traditional physician education might seem like a logical step, but it quickly encounters diminishing returns. Human memory and information retention have limits. Physicians, despite their best efforts, cannot be expected to recall every nuanced detail of every treatment option in every clinical scenario, especially at the critical point of care.
While eDetailing, offering digital content for clinicians to review at their convenience, has been met with some positivity, its Return on Investment (ROI) remains uncertain. Regardless of the delivery method, the fundamental problem persists: ensuring physicians remember and apply crucial information precisely when they are making treatment choices, often between very similar therapies with subtle differences for specific patient populations.
However, recent advancements offer a promising new avenue. The widespread adoption of Electronic Health Records (EHRs) over the past decade has been transformative. Modern EHR systems boast enhanced functionalities, making vital clinical data, including radiology reports, pathology results, and lab values, readily accessible within the digital system. Given that clinical workflows are already heavily digitized, a natural and powerful opportunity emerges: to deliver timely and relevant education about treatment options directly within the EHR, at the point of care, when it matters most. This is where point of care decision support tools come into play.
Navigating the Challenges of Point of Care Support Tools
Despite the clear potential, widespread implementation of point of care education and decision support tools has been slower than anticipated. While EHRs theoretically offer immense capabilities, the practical reality is more complex. A primary obstacle lies in the inherent difficulty of interfacing with diverse EHR systems.
Numerous factors contribute to this challenge. EHR vendors often create barriers to accessing their proprietary databases, hindering seamless integration. Healthcare institutions, with their multitude of competing IT projects, may struggle to prioritize and resource EHR integration initiatives. Furthermore, a staggering 80% of the data within EHRs is unstructured. This unstructured data, including physician notes and narrative reports, is challenging to analyze and utilize without significant manual conversion or advanced Natural Language Processing (NLP) techniques.
These hurdles understandably give pause to Life Sciences companies. They are significant contributors to the historically uncertain ROI associated with point of care decision support projects. However, these challenges are not insurmountable. Experience from companies like Kinders and Hiteks, focused on leveraging technology to enhance healthcare business models, demonstrates that with the correct strategy, technology, and workflows, Life Science companies can develop highly effective point of care solutions that function as powerful marketing vehicles.
Evaluating Effective Point of Care Support Tools
When assessing potential partners and systems for point of care decision support, pharmaceutical companies should prioritize the following key features:
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Seamless EHR Integration: The EHR landscape is notoriously fragmented and complex. If a point of care solution doesn’t readily integrate with the EHR systems prevalent in target medical centers, implementation costs can escalate dramatically. Hiteks, for example, prioritized building software that integrates seamlessly with major EHR vendors, particularly Epic, which holds a significant market share. By fully integrating into the Epic platform, they created a solution that can be widely adopted without requiring extensive local installations, offering a turnkey technical solution.
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Robust and Effective Methodology: False positives and irrelevant alerts are a major pitfall of poorly designed point of care support. To minimize alert fatigue and override rates, the development process must involve healthcare providers from the target health systems. Collaborative creation of decision support logic ensures that reminders are highly relevant and aligned with existing clinical workflows. A strong methodology should encompass: thorough analysis of clinical guidelines and drug labels, understanding current institutional decision-making processes for the specific condition, mapping existing EHR workflows, pinpointing crucial decision points, and developing logic to trigger reminders at the optimal moment.
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Comprehensive ROI Measurement Tools: Continuous improvement and justification for expanding point of care support initiatives require rigorous performance tracking. Solutions that combine deep EHR integration with a robust logic-building methodology enable rapid and consistent deployment of point of care decision support reminders. Crucially, they should also incorporate tools to meticulously monitor engagement with these reminders. By leveraging EHR logs, it’s possible to track physician acceptance of the advice and measure resulting behavioral changes, providing concrete ROI data.
Case Study: Realizing the Impact of Point of Care Tools
Real-world experience validates the effectiveness of well-designed point of care support solutions. Consider a pharmaceutical brand with a novel sepsis treatment. Despite clinical evidence demonstrating significant advantages – a 25% reduction in progression from sepsis to septic shock and a half-day reduction in hospital stay – 72% of physicians continued to rely on traditional antibiotics, the long-standing standard of care for sepsis.
Through careful analysis of clinical workflows and physician decision-making in sepsis management, all critical data elements used in treatment selection were identified and mapped to their locations within the EHR. Leveraging up-to-date clinical guidelines and the drug label, logic was developed to generate timely EHR reminders for clinicians at the appropriate junctures in the patient management process. These concise, evidence-based reminders highlighted the benefits of the novel therapy for relevant patient populations and provided a seamless pathway for physicians to act on the recommendation and prescribe the medication directly from the reminder.
Key elements contributing to the success of this point of care decision support intervention included: triggering reminders only at the most impactful moments in the clinical workflow, avoiding lengthy and time-consuming narratives, emphasizing key supporting evidence, and facilitating an efficient workflow for acting on the recommendation. Within just 12 months, this targeted point of care solution resulted in a remarkable 27% increase in the therapy’s utilization as a first-line treatment for sepsis.
Written by Ronald M. Razmi, MD, and Gerry Petratos, MD
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About the Authors
Dr. Ronald Razmi’s career spans cardiology, consulting with top life sciences companies on strategy and product development at McKinsey and Navigant, and independent consulting assisting BTG clients with market assessments and data strategies. Dr. Gerry Petratos, his business partner and co-author, brings expertise as a Master of Medical Informatics and 9 years of experience leading Data Analytics at Roche and Genentech.
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