6 Degrees of Health Care Separation: How Pharma Needs to Close the Gap

You’re probably familiar with the concept of six degrees of separation, where everyone in the world is six or fewer connections from any other person. While that’s a fascinating construct, I believe health care delivery is plagued by it.

Here’s what I mean: Six steps to make a connection isn’t bad if you’re linking a tuk-tuk driver in Bangkok to the CEO of a Fortune 500 company. But it better take a lot fewer than six steps for a physician to access a necessary resource. Unfortunately, the separation between that doctor and the end goal is expanding. And that’s inexcusable.

In the business of health care, where connectivity is king, the idea of redundant steps to coordinate care—or simply to get the information needed—can be fatal. For business and, potentially, even for patients.

A wide variety of demands in health care has brought a deluge of increased complexity into the already-confusing mix: New government regulations, shifting reimbursement models, pricing pressures and cost controls, an overburdened provider population… all of these have widened the separation between pharma, prescribers, and patients. And an increasing number of acronyms (ACO, ACA, FFS, MCO, PCMH) is creating a barrier between pharma and a healthy revenue stream.

So what happens from here? In my view, something radically better.

I envision a boom in the levels of integration and connectivity across the mHealth and EHR space. Think direct messaging medication adherence services, ways to bring each message as close to the point of decision as possible. It’s every pharma marketer’s dream, and good for providers and patients as well.

With that in mind, here are my thoughts on how to bring you and your prescribers much closer and reading off the same script:

1. Deliver A CURE
“A CURE,” is the central principle that guides our Epocrates medical editors when developing and presenting the proprietary clinical content in our references. It stands for Accurate, Current, Unbiased, Relevant and Essential. Pharma would be well-advised to plaster the walls of your office suites with this acronym, to chant it at corporate outings. Figuring out how to get your product and message across in a non-toxic and contextually relevant manner is the cost of admission to the exam room in this day and age. (For more on the A CURE framework, see “Delivering A CURE for Medical Information Inaccuracy and Overload.”)

Once you apply this concept, even at the most basic level, it’s time to consider ways to close the gap between you and your prescribers.

2. Provide Physicians with Rx and Cost Data
In this new reimbursement landscape, where caregivers can be rewarded for cutting costs and achieving better health outcomes, doctors want answers. And pharma can deliver.

In Accountable Care Organizations, each health care dollar spent is an opportunity to control costs and make money. As a result, doctors are weighing the quality of care versus the economic efficacy of drug treatments: Does this drug work best for this patient profile? What is its long-term economic effectiveness? Will this medication reduce hospitalizations or keep patients coming back?

This is where you can provide a street-level view of what doctors should prescribe — and investigate the impact your drugs have on patients and the bottom line. As more physicians take part in risk-based payment models, that big blockbuster brand from the past may not be the best answer for doctors and their patients today.

If you can show that your drug will lower patient cost over a generic or other brand in the long run, and that fewer healthcare dollars will be spent overall, then you’ve hit the jackpot. This kind of information is pure gold –prescribers are hungry for it, and will pay for it.

3. Add Insight Into Moments of Care
Pharma is now in the business of population health management, like it or not. Once you understand how your drugs impact the total cost of care, you should add your insight directly into the moments of care. Get your intelligence in front of providers and high-prescribers by leveraging your technology partners. Not only do they have access to your target audience, but they are also building better channels with which to reach them.

As a long-time strategic partner and trusted drug resource for doctors, Epocrates has been helping pharma achieve measurable objectives for years by delivering pharma-sponsored content to physicians at the point of care—and doing it in an unobtrusive, contextually relevant way. But the connections can go even deeper.

Imagine your content (that treasure trove of research detailing a drug’s cost-effectiveness) embedded into an interconnected, cloud-based EHR and care coordination service, and woven throughout a clinician’s daily workflow. Even during transitional hours, that content is still working for you via relevant messages integrated into secure text messaging, e-mail, and enhanced provider-provider communication services, addressing extended moments of care where prescribing decisions are also made.

Invest in services and partners who are building channels that can adapt quickly, without the need for hundreds of millions of dollars and countless man hours in HIT expenditure. As a comparative example, cloud-based services can respond and integrate quickly, whereas enterprise software is static, cannot keep pace, and prevents the timely sharing of health information (talk about adding several degrees of separation).

4. Set the Scene for Patient Adherence
Fast-forward. You have given providers what they need to make educated choices and they have chosen you. Now you must ensure that all the right things happen. Enter patient adherence.

Engage, track, and follow up with your prescribers to confirm that your drug works for real patients who live real and complicated lives.

Bottom line: New factors are influencing prescribing decisions. Pharma needs to cut the degrees of separation between the industry and physicians, fill in the gaps, and reintroduce itself to its high-prescribers by giving them what they desperately need—intelligence.

By: Jonathan Bush, CEO,  of Athena Health, a ePharma Summmit 2014 keynote.