Monday, February 8, 2016

Oh, The Problems Connectivity Can Solve!

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This is the sixth entry in a series of blogs for ePharma Summit 2016 to explore ways the pharmaceutical industry can maximize the promise of digital health.
How many times have you heard the term “silo” in reference to your organization? I’m going to bet your answer is: More than once. No matter whether your organization is hanging on to its outdated org chart or not, those days are in the rearview mirror. The walls are coming down not just inside your organization. They are coming down among industry sectors and geographic areas, as well.

The interconnectivity and connection among healthcare payers, providers, industry and patients are organic. Simply, individuals are hyperconnected, and so the environments where they live, work, play and heal are, by extension, hyperconnected, too.

What Hyperconnectivity Means to Health Care

Within Provider Organizations: Work groups and teams throughout an organization can literally always be on the same page, because that page is electronic. Ideally, entries and updates in documentation of all types are instantaneous across teams and within them. For patient care, providers are working off the latest information across the organization whether that information is clinical or claims related. We aren’t there yet, but we can see it from here.

Among Provider Organizations: When interoperability is in place, providers will be working off the latest information across health systems, across the country and eventually around the world. We aren’t there yet, either. The barriers will be more regulatory and legal than technological, but it’s possible.

Outside Provider Organizations: Patients and the industries that support them are rapidly becoming integrated into provider health systems via their digital imprint. Eventually, when the walls come down and the proper security is in place, patient connectivity to their record through their biometric device(s) provides real time feedback and recommendations to maintain wellness and manage illness. Industries that support the health system, including biopharmaceuticals, are beginning to understand and develop ways to leverage the connectivity advantage and provide support to providers and patients as 24/7 patient management approaches.

The pace of change is exponential. Just because it took us 30 years to get here from the birth of the Internet, does not mean change will continue at that pace. The mere fact of hyperconnectivity accelerates progress at a mind-boggling rate. If you can imagine it, it is happening somewhere already.

Sales, marketing, product research and development, patient care, provider access to patient and clinical information and payment systems are mutually supportive in a hyperconnected environment. When the health system is integrated into the fabric of an individual’s daily life and into the fabric of society, it erodes silos that interfere with optimal care.

 The harbingers are already in place.


Peggy Salvatore MBA is a healthcare writer and trainer specializing in pharmaceutical managed markets sales training and health IT. She also has authored books and training programs on leadership and working with subject matter experts. You can read her blogs at www.healthsystemed.com and www.workingwithsmes.com

Friday, February 5, 2016

The Forgotten Organ?

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Individuals who battle multiple chronic diseases are more than familiar with having to juggle symptoms that fall on various parts of the body and points on the health continuum. There might be a central disorder with the spine, but that can affect the lungs since the rib cage is connected to the spine, the head with spinal headaches, the heart with decreased flexibility, the stomach and intestines with increased inflammatory diseases, etc. So, we've covered the spine, the heart, the lungs, the stomach, the intestines, but if you notice, we have missed one key ingredient here. The brain.


When treating and managing chronic diseases, physicians and the overall care team are typically stellar at understanding the physical symptoms associated with the disease; however, there remains a large hole in care and whole body health management. What about our mental health? I asked fellow chronic disease fighters what they believed there care team does well, or what their team misses, when it comes to their mental health.


One thing that I have noted over the last 10 years with Crohn's Disease is that although there are treatment methods, like Remicade, doctor's don't always take the whole picture into account. I also have problems with my back, my skin, and my hip joints. It's wonderful that these things can be treated, more or less individually, but I've really had to take it on myself to try and think more holistically. It seems so obvious to me that all of these issues are connected, but sometimes that isn't the way it's perceived. ---Rori Leigh Meyer

I can go on for ages on this, but here's a real life illustration of the problem: I have a handful of people I see, but the two I see most frequently are a rheumatologist and a psychiatrist. Rheumatologist: asks nothing about my mental health, other than checking medications and possible interactions. Psychiatrist: asks about physical health, physical symptoms that could be related to mental illness, and vice versa. We talk a lot about stress. I only have that "luxury" having been diagnosed with mental illness prior to "physical" illness. For those who may just be struggling or in need of emotional support, stress management, but not with a clearly evident mental illness, in the current environment it's a crapshoot. ---Cyrena Gawuga

Being newly diagnosed with a chronic disease I feel that the doctor doesn't always listen when I tell him how I'm feeling and what's bothering me. It gets brushed off sometimes as oh it could be something else. It's not related to your illness blah blah blah. But in turn this hurts my mental health and becomes frustrating and you feel alone. Like a liar sometimes. And I feel mental health at least for me magnifies other symptoms and or the underlying issue itself which makes mental health and physical health worse. I have not been diagnosed with any mental health issues but I have felt at times my mental health is poor. ---Chris Bronner

Very little focus on it in world of diabetes/celiac; oddly enough, endocrinologist failed to see vitamin D deficiency=depression for me. ---Brianna Wolin


Cyrena, above, brought up another key point: mental illnesses are also chronic illnesses. When I say that I myself suffer from 7 different chronic diseases, I include Depression and Anxiety in that list. This may not be the case for everyone, but for me my mental health and my physical health play a cyclical role with each other. They play off one another: when my depression is bad, my physical health gets worse, and when my physical health is bad, my depression gets worse. Additionally, when both of those issues occur, my anxiety increases. Mental illness is only addressed when I'm seeing a psychologist. I can probably count on one hand how many times my other physicians have inquired about my mental health. I have even had many "cry for help" moments, blunt emails saying that I was really struggling, but it was met with a nonchalance as "part of the deal" of my disease.

In fact, many pieces of literature link the occurrence of chronic pain and mental health, specifically depression. From WebMD:
-According to the American Pain Foundation, about 32 million people in the U.S. report have had pain lasting longer than one year.
-From one-quarter to more than half of the population that complains of pain to their doctors are depressed.
-On average, 65% of depressed people also complain of pain.
-People whose pain limits their independence are especially likely to get depressed.


How do we start talking about mental health in the same breath as diabetes, or arthritis, or other diseases? I encourage everyone to share their story. It's tough to be open, and transparent, but I remind myself of this: if one person can feel less alone, if one person can feel empowered, then my daily struggle is validated, and maybe even diminished just that much.

Share your story. Be a voice. Our voices are what will make change in the system. 





About the author: 
Kristin Coppens is a social media and digital communications professional, a health activist, an ePatient, and a multiple chronic diseases fighter and blogger. You can read more about her chronic illness journey on her blog, Chronically Kristin, or follow her on Twitter.
She will also be joining us this year at ePharma as an official guest blogger sharing insights from the event. ePharma will take place February 29 - March 2, 2016 in New York City. As a reader of this blog, when you register to join us with priority code EPHARMA16BL, you can save $100 off current rates!


Thursday, February 4, 2016

See Who's Attending ePharma 2016

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With ePharma 2016 only a few weeks away, on February 29-March 2, it seems as if anyone who's anyone in the pharma marketing world is coming-except YOU!

ePharma brings you three days of strategic and tactical learning, peer exchange, and dialogue that actively dissects current trends, marketplace needs, evolving customer bases, and explains how you can harness these new opportunities to build stronger, more cost efficient marketing campaigns.

Join the growing list of ePharma attendees from...


3M Drug Delivery Systems Division
About.com
AccentHealth
Actavis
AdhereTech
AlertMarketing Inc
Alliance Health
Amgen
Aquent
ASPiRA LABs, a Vermillion Company
Astellas Pharma
AthenaHealth
Bayer
Biogen
Bristol-Myers Squibb
BTG International Inc
Butler/Till
C Space
Cadient
Closerlook Incorporated
Cohen Health
Communications Media Inc
Concentric Healthcare LLC
Confideo Labs
Crossix Solutions
Curatio
Daiichi Sankyo
Doctor on Demand
Dovetail Health
Eli Lilly & Co
Endo Pharmaceuticals
Epocrates
Epsilon
Espero Pharmaceuticals
Evolution Road Consulting
Facebook Health
FCB Health
Ferring Pharmaceuticals Inc
Fisher Clinical Services
Flashpoint Medica
Gilead Sciences
GlobalData
Google Incorporated
Grifols Inc
Hashtag
Hospira a Pfizer Company
IDC Health Insights
Intouch Solutions
Ironwood Pharmaceuticals Inc
Janssen Biotech Inc
Janssen Pharmaceutical Inc
Janssen Therapeutics
Johnson & Johnson
Leerink Partners LLC
Leo Pharma Inc
LevLane
Lexalytics
Lilly
Lundbeck LLC
M3 USA Corporation
Makovsky & Co
McCann Human Care
MedImmune
MedPoint Digital
MedSphere
Medtronic
Merck
Meredith
Merz
Merz Pharmaceuticals GmbH
Mylan Pharmaceuticals Incorporated
Neon an FCB Health Company
New York Presbyterian
Not Standing Still's Disease
Novartis Pharmaceuticals Corp
OPEN Karachi
Opera Mediaworks
Oracle Marketing Cloud
Pfizer
PhillyCooke Consulting
Point of Care Partners
Publicis Health Media
Purdue Pharma LP
QualityHealth
Redi-Data
RepEquity
Savor Health
SensisHealth
Shionogi Inc
Shire
Siemens Healthcare
Spredfast Inc
SSCG Media Group
Sunovion Pharmaceuticals Inc
SuperBetter
Takeda Pharmaceuticals USA Inc
Tecnoquimicas
Ten Health
Teva Pharmaceuticals
TGaS Advisors
The Authentic Storytelling Project
The Stupid Cancer Show
Thomas Jefferson University
Twitter
UCB Incorporated
Univision
Veritas Health
Vitiello Communications Group
WEGO Health
West Pharmaceutical Services
Zipdrug
ZS Associates


Register now with the code EPHARMA16BL and save $100 - Click here to register!

Wednesday, February 3, 2016

Free Tech Geek Resources to Prep for ePharma Summit 2016

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This is the fifth in a series of blogs for ePharma Summit 2016 to explore ways the pharmaceutical industry can maximize the promise of digital health.

Everywhere you look this year, all the talk is about “digital” health. That’s no surprise because today almost everything in life is digital. We’re all about connectivity as a human culture and nowhere will this development have more positive impact than in the way we practice personal and professional healthcare.

Wearables, IoT, genetic personalization, data management and analytics…they all tie into the massive potential of collecting health information from a wide variety of sources and parsing it in a way that promotes lower cost, higher quality healthcare. From a 30,000 foot view, it sounds so simple and logical. Don’t be fooled. We have to build a lot of rocket platforms before we’re going to launch this baby.

On the ground, staid, old healthcare businesses and crazy, innovative individuals are working hard together to find the best ways to leverage the digital advantage in healthcare. That’s why I am looking forward to spending three days in Manhattan from Feb. 29 to March 2 at the ePharma Summit 2016 . The schedule is packed with education and discussions with key decision makers. I’ll be blogging out of the sessions and talking to people during the event.

For nearly 20 years, I’ve been studying the impact of technology on healthcare and now the whole field is breaking wide open. In preparation for the event, I am reading the thought leaders in this space.

Get Up To Speed Quickly

If you really want to hang out on the precarious leading edge of healthcare technology, spend a few minutes reading Peter Diamandis’ email each week. Diamandis, who got a master’s in rocket science at MIT and an MD from Harvard, went on to challenge himself. He has a lot of credits to his name including two inspirational and groundbreaking books, Abundance and Bold. He is Chairman and Co-Founder with Ray Kurzweil (The Singularity is Near) of Singularity University, and Co-Founder with J. Craig Venter (The Human Genome Project) and Vice Chairman of Human Longevity Inc. HLI was founded with the goal of making 100 years old “the new 60”. His weekly newsletter is a compilation of some of the leading-est of leading edge tech projects. You can go here to subscribe to his email, hear his podcasts, and learn more.

For those who want to stick a little closer to terra firma but still live on the edge of what is possible in healthcare, check out Fard Johnmar of Enspektos. Johnmar is a digital health futurist and author of ePatient2015: 15 Surprising Trends Changing Healthcare. He puts out some free educational materials and a daily newsletter that I can recommend. He has a resource, The Digital Health Innovator’s Mini-Handbook that is well worth a few minutes of your time.

For a bit of perspective on all this excitement, PharmaVOICE featured a thought leader retrospective this month on where healthcare has been since the magazine’s inception. The article states

When PharmaVOICE launched 15 years ago, Facebook was but a twinkle in Mark Zuckerberg’s eye and the rest of the social media channels that are dominating our conversations today as they relate to online access to patients, physicians, consumers, and other stakeholders were also still on the drawing boards in living rooms around the country. These media, which started as consumer-based vehicles have morphed into powerful mechanisms for life-sciences companies for not only delivering communications, but understanding customers’ perspectives on any number of topics. And while final guidelines for online or social media practices have yet to be officially sanctioned, not surprisingly pharma companies — for the most part — still look for solid footing from a regulatory standpoint. Despite continuing hesitation and the full embrace of these vehicles, online is not only here to stay but growing more powerful every day.

Digital is taking the industry by storm as well. Most people have in their possession more computing power than NASA had to launch the first space capsule in the 1960s, and it fits in our hands. Our cell phones, and who really uses them for talking anyway, have the capabilities that were science fiction-oriented 15 years ago.

As part of the technology revolution, only superseded in the estimation of some experts by the industrial revolution of more than 250 years ago, in terms of a far-reaching impact has been the emergence of the concept of big data and all its associated analytics, segmentation, cloud-based service bells and whistles.

Faster and Friendlier

It’s a wrap. The future of healthcare is firmly in the hands of the promise of technology to bring us quickly to solve the cost, quality, access triangle. It’s happening faster than most could have predicted, in a way that is more patient-friendly, and at a cost that most consumers are willing and able to pay.

If you have a smartphone, you’re a connected patient. Now, it’s time to look at health payers, providers and innovators to get all the rest of the pieces in place.

What piece of the healthcare tech solution fascinates you the most? The bioscience, the patient as connected consumer, the provider as cure-er and curator? What is the role of the payer? What is the proper role of government – Regulator? Arbiter? Facilitator?



 
Peggy Salvatore MBA is a healthcare writer and trainer specializing in pharmaceutical managed markets sales training and health IT. She also has authored books and training programs on leadership and working with subject matter experts. You can read her blogs at www.healthsystemed.com and www.workingwithsmes.com

Tuesday, February 2, 2016

Can Mindfulness Help Physicians?

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There are a lot of misconceptions on what mindfulness is, which are recently being debunked as it grows in popularity:
Mindfulness is paying attention or noting whatever is happening in the moment with a gentle and open mind. It involves being present in the moment, the one you’re in right now. Mindfulness doesn’t involve chanting, bowing, sitting cross-legged, or burning incense.
Universities are teaching more about mindfulness and how it can combat the stress so prevalent in the quest for a post-secondary education. Meditation and mindfulness can not only lower stress but help us to focus and interact with others - and ourselves - in more compassionate ways. It also leads to better performance and balance in all aspects of life.


Medical centers and systems across the country are researching mindfulness and its impact on various aspects of our lives, most notably the University of Wisconsin's Center for Healthy Minds.

Okay, I may be bias there as I work for the UW. Still, there's no denying that Dr. Richard Davidson is one of the biggest names in mindfulness research. He's even a friend of the Dalai Lama!

Knowing so much now about mindfulness, how can we apply it to the medical world?

There are, in fact, several medical schools that teach mindfulness as a part of their curriculum, including Brown, Duke, and Georgetown. I wish more schools did this, as getting a base for wellness early on is integral to physician and, ultimately, patient success. This is especially important when you note that 29% of young doctors are depressed.

The Association of American Medical Colleges (AAMC) points out that stress is at an all-time high for physicians. It affects everything from relationships to job satisfaction to even the will to live itself. Mindfulness can help to combat some of these stressful feelings by helping us to get more in touch with ourselves, to recognize emotions, and to cultivate calm and loving kindness.

That doesn't mean that there aren't barriers, but it's worth a try.

If you're interested, there are a ton of mobile apps out there to help us learn mindfulness and meditation. My favorite is Buddhify from Rohan Gunatillake, which has a specific section on pain and illness. I was recently featured in Rohan's new book, This is Happening, on how I use mindfulness to cope with difficult situations... namely, my chronic pain.





About the author:

Kirsten Schultz is a health activist and blogger. You can read more about her life living with multiple chronic illnesses on her blog, on Creaky Joints, or follow her on Twitter.  


She will also be joining us this year at ePharma as an official guest blogger sharing insights from the event. 

Thursday, January 28, 2016

Breaking News! Steve Case has been Confirmed as an ePharma Speaker

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Steve Case is one of the world's best-known and most accomplished entrepreneurs-a pioneer in making the internet part of everyday life, best known as the Co-Founder and former Chief Executive Officer and Chairman of America Online.

Steve Case, Former CEO of AOL; Chairman of Case Foundation and Revolution

Join Steve Case at ePharma Summit as he discusses the past, present and future of entrepreneurship. S. Case predicts that we're at the dawn of the next technological revolution unlike anything we've seen before-the Third Wave of the internet-and he offers attendees expertise, fresh perspectives, and critical advice on how to cope with these significant changes. Download the brochure to see who else is speaking at ePharma Summit here.

Register now to be there live and hear Steve Case explain the importance of partnering with fast-growing startups and how corporations-including large pharmaceuticals-can continue to succeed as significant innovations take hold.

Register for ePharma Summit with the code EPHARMA16BL and save $100.


Chronic Addict or Chronic Pain?

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"It's definitely broken, a hairline crack through the knuckle right there. You need to wear a half cast, so we will get you set up with one of those here. I can't give you any pain medication though; maybe just take Tylenol or Motrin when you get home, as needed."

That is a real-life statement, made by an Emergency Department physician after I broke my hand last weekend. Let's keep in mind that there is proof of a physical break, and I am a patient with multiple chronic diseases, including a widespread central pain disorder. So why was I denied justified pain medication?

About a year ago, new restrictions were placed on narcotic pain killers, like Norco, Vicodin, etc., as a response to "years of requests from the Drug Enforcement Administration, [or DEA], claiming the drugs were overprescribed, creating drug addictions, and too often diverted to the black market." As stated, prescription drug abuse is a huge problem in our country. The number of deaths or overdoses per year from prescription pain medications is nearing 16,000. These regulations impact the number of pills a patient can get, limit refills to zero, and require the patient to physically pick up the prescription from the physician and hand deliver it to the pharmacy, in some cases.

Let's add chronic pain into the picture, and explore the word stigma. Now, no one is arguing that these restrictions are not valid or that we don't have a prescription drug problem in this country. However, from my experience and the experiences of other patients I have spoken to, the regulations have caused real pain, real health conditions, real emergency injuries or ailments to not see relief or pain management. The stricter regulations are there for a reason, yes; however, we have not come up with a better solution or a screening process for those that need proper pain relief.

Well said by president of the U.S. Pain Foundation, Paul Gileno: "The person seeking relief from pain is not suffering from the same disease as a person who is an addict. Two separate diseases but it's hard to decipher because right away people associate pain patients with that group of addicts." In fact, the number of patients who have a real need for prescription painkillers far surpasses the number of people addicted to painkillers: over 100 million vs. 11 million, respectively.

I'm sure that I'm not alone in saying that I would rather have the ER run a urine test or toxicology screen than refuse to administer pain relief. That might not be the answer, and I don't know that I have one per se, but we have to stop refusing to open our eyes to the other population before us: the chronic disease fighters. 

How will you #StopTheStigma?





About the author: 
Kristin Coppens is a social media and digital communications professional, a health activist, an ePatient, and a multiple chronic diseases fighter and blogger. You can read more about her chronic illness journey on her blog, Chronically Kristin, or follow her on Twitter.
She will also be joining us this year at ePharma as an official guest blogger sharing insights from the event. ePharma will take place February 29 - March 2, 2016 in New York City. As a reader of this blog, when you register to join us with priority code EPHARMA16BL, you can save $100 off current rates!

Wednesday, January 27, 2016

Why a Ban on Rx DTC Advertising Makes Me Uncomfortable

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And why digital health will eventually make the ban irrelevant

By Peggy Salvatore

This is the fourth in a series of blogs for ePharma Summit 2016 to explore ways the pharmaceutical industry can maximize the promise of digital health.

I vaguely remember the last time the government imposed a controversial ban on direct-to-consumer advertising. According to my extensive academic research on the history of cigarette advertising (Wikipedia link here) cigarette ads were banned from television and radio in 1971.

The ban on cigarette television advertising meant that the handsome cigarette man wasn’t going to ride into our living room anymore, astride a beautiful horse wearing a ten-gallon hat straight out of a ‘50s Western movie, the stud-ly symbol of American manhood. Cigarette manufacturers could no longer hawk their wares directly into millions of homes to lure the next generation into the romantic world of smoking.

The ban was for the good of the masses. Smoking is bad for your health, and if the public was too stupid to make that decision for themselves, the government smackdown on television advertising would protect the innocents from the evil tobacco manufacturers. The cigarette lobby put up a symbolic fight, there were protestations from First Amendment rights advocates, but the deal was done. Cigarettes = bad. Ban on cigarette advertising = good. It worked. By 2004, half of smokers who ever smoked had given up the filthy habit.

Pharmaceuticals are…bad for your health?

Today, we are facing a television advertising ban on another widely consumed and popular product, prescription pharmaceuticals. Because…somebody help me out here…because they…ummm treat things like asthma, depression and breast cancer. Consumers might run out and buy it. No. Prospective pharmaceutical consumers have to go to their doctor, discuss their conditions and options, the doctor has to prescribe the medication after years of grueling medical study, and the prescription gets second-guessed by the patient’s insurance company regarding both cost and appropriateness.

So, a ban on pharmaceutical DTC advertising (which, by the way, is already highly regulated) protects whom from what, exactly? Those who favor the ban believe it will help protect patients and payers from the high cost of drugs.

The effect of DTC advertising is that patients ask their doctors about a branded drug made by a pharmaceutical manufacturing company that might, in turn, make a profit. And that profit might be used to promote yet more products to treat more diseases that the pharmaceutical company spent an average of $2.6 billion developing, according to the latest Tufts University study on the cost of pharmaceutical R&D.

Simply put, a ban on DTC advertising protects the pharmaceutical companies from making profits that the government perceives to be (guessing here) inappropriately gained and spent.

DTC Bans are Bad for Freedom of Choice

The rationale is that DTC advertising is a driver of drug costs. In reality, drug costs are driven by the cost to develop, produce, manufacture and promote products, and prices are regulated by the customer’s willingness and ability to pay. It’s a complex formula for another day. Let me suggest that an Rx DTC ban is a straw man.

When the ban on cigarette advertising was imposed, people accepted it because smoking is bad for your health. About that, nobody disagrees. A ban on pharmaceutical advertising would be accepted by people who believe that pharmaceutical profits are bad, not that patients are too stupid to make complex treatment decisions for themselves. Patients do not make complex treatment decisions for themselves now.

A ban on pharmaceutical advertising seals the government’s right to restrict the free flow of information. When cigarette advertising was banned, it opened the barn door on government paternalism. That horse is out of the barn, and the cigarette ban man could be riding into territory that will permanently seal the government’s right to control the free flow of information in the marketplace – not just of products – but of ideas.

Innovation is in No Immediate Danger

The rate of innovation in biotech and health technology is breathtaking. Billions of dollars in deals transacted at JP Morgan’s healthcare confab in San Francisco last week, and hundreds of entrepreneurs promoted their health gear at the Consumer Electronics Show a few days earlier.

The field of innovation and the flow of speculative dollars keep private innovation well oiled. The U.S. is still far from total government control of research, development and promotion of the results. Done well, the government has the reach and deep pockets to be a great partner in innovation, and is doing that very well today. I sense we are in no immediate danger of an Rx DTC ban stifling individual initiative or the profit motive. Quite the opposite appears to be the case. New business entities are creating technological advances that drive down cost and increase access to all kinds of healthcare solutions. A ban on pharmaceutical advertising might restrict the promotional ability of the R&D manufacturing sector that can afford mass advertising today. However, let me suggest that a new model of private biotech is emerging that will make obsolete the concerns about the effect of DTC advertising on the cost of drugs.

New, smaller and more nimble Pfizers, Mercks and Amgens are being born every minute. Whether a DTC ban passes on a strong political wind this year will ultimately be irrelevant to the development, promotion and sale of biopharmaceutical products because marketing and sales, like medicine itself, is becoming more personalized. People respond to targeted, digital messaging. And targeted medicine means more cost effective treatment.

What will not be irrelevant if a DTC ban is implemented is a further restriction on the public’s right to know and have access to information in the free marketplace of ideas.

I invite your thoughts and comments.





Peggy Salvatore MBA is a healthcare writer and trainer specializing in pharmaceutical managed markets sales training and health IT. She also has authored books and training programs on leadership and working with subject matter experts. You can read her blogs at www.healthsystemed.com and www.workingwithsmes.com

Tuesday, January 26, 2016

Are Electronic Medical Records (EMRs) Really Beneficial for Patients?

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One of the biggest contributors to the transition to EMRs was Meaningful Use. Now that this is officially kaput, one wonders where this leaves the future of EMRs.

There are problems, though, which often affect the patient disproportionately. EMR use has been linked to job dissatisfaction among health care providers who, then, provide care of a lesser quality. There are also a number of ways these systems can be breached, leading to patient privacy concerns.

These systems can make it more difficult for providers to access pertinent information and there are often issues with parental access. While this is meant to protect a growing child's privacy, this can be a headache - especially for those with chronically ill children.

Perhaps the biggest patient issues are more intuitive, though. Providers are not spending as much time interacting with patients, leading us to feel less cared for and understood. This can also lead to a deterioration of any bedside manner that may be present. For newer providers, this may not develop at all. Compassion is an incredibly important trait for providers to have, and no bedside manner can indicate a lack of this quality.

The other big issue is one that constantly plagues healthcare across the United States and abroad - the lack of patient inclusion regarding design or changes based on patient feedback after implementation.


A few weeks ago, I asked some of my friends to discuss how they felt about Electronic Medical Records (EMRs). Here's what they had to say:
I've found that via the patient portal, it is much easier to request RXs and ask any questions that I might have. I like that you can view test results and track your labs over time. The one thing I don't like is that in Michigan and New York, each of my hospitals used the same EMR system, but they couldn't combine, so one doctor didn't really have access to what my other doctors have. -Leslie Rott 
I love the patient portal from my primary and the one from my rheum[atologist]. I WISH they were on the same system, though, so it would be easier to communicate from both teams. Primary's system is easier to navigate and has my data from forever uploaded - rheum's only has the new data since they instituted the EMR. Overall, great step toward patient empowerment but still some flaws to be overcome -Lauren Elyse Kosinski 
I can certainly echo the above sentiments. I see providers in two different systems and I'm really lucky that my rheumatologist works very hard to keep up to date on everything from everywhere else - even from my dentist who is on a completely different system!

One of the things I dislike a great deal is the inability to see provider notes in our EMR. In order to get that information, we would have to request a copy of our medical records. For those of us who are chronically ill, this can result in astronomical bills. Those of us who are lucky enough to work in healthcare face fines and termination of employment if we attempt to access our own records. And yet, these records often have inaccuracies that cause differences in our care that make a world of difference.

Still, having the access to reorder medications, schedule appointments, and discuss lab results with my rheumatologist makes a world of difference - especially for those of us with anxiety, fatigue, and who lead busy lives.

I would say that Lauren is right on with her comments above. EMRs do make strides for patient engagement, but there is a lot more that can be done.





About the author:

Kirsten Schultz is a health activist and blogger. You can read more about her life living with multiple chronic illnesses on her blog, on Creaky Joints, or follow her on Twitter.  


She will also be joining us this year at ePharma as an official guest blogger sharing insights from the event. 

Saturday, January 23, 2016

Why I'm Going to a Pharma Marketing Conference

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By Danielle La Rocco, MD

Give me cat videos, or give me death. (I don’t always feel so strongly, but sometimes, in the middle of a 24-hour shift covering the hospital’s psychiatric needs, which might involve my assessing suicidal thoughts, delirium, and alcohol withdrawal, what my mind most craves to reset itself between cases is the brief, mind-numbing reprieve of some cats dancing to hip hop.) I’ll just have to get through that inevitable 15-second ad first, right?

Advertisements permeate our lives. As of 2011, one statistic from an academic journal states that “the average American television viewer watches as many as nine drug ads a day, totaling sixteen hours per year, which far exceeds the amount of time the average individual spends with a primary care physician.” Imagine the comparison to time spent with specialists; fairly frequently, psychiatric patients spend 30 minutes a month with their doctor in order to focus on their medication needs. Barring emergencies or major stressors necessitating more frequent visits, such a person would spend six hours of face-to-face time with their psychiatrist per year, or about 38% of the total time they would have spent face-to-face with pharma commercials, all from the isolated, medical-professional-free comfort of their own home.

And that’s not even counting what they might see online. NBC news points out in a 2014 web article that the average American spends 40 minutes a day on Facebook and nine hours a day interacting with digital media. The main source for that stat is, of course, Mark Zuckerberg, who has reason to know about every single one of those 3,285 hours a year that amounts to.

It seems logical that digital would be the next big frontier for pharma marketing. According to one May 2015 eMarketer blog post, “marketers in [the healthcare and pharmaceutical industries] will spend $1.64 billion on paid online and mobile advertising in 2015, up from $1.43 billion in 2014,” which they forecast will rise to $2.55 billion by 2019. That last number is significantly more than the gross domestic products of Lesotho, Liberia, or Bhutan.

In order to become a doctor, one must go through multiple years of specialized training, rife with thousand-page textbooks and hours of grand rounds covering the most cutting-edge research in neuroscience, pharmacology, and therapeutic techniques. By the end of training, one hopes as a medical professional to have a confident grasp of how to care for patients through knowledge of evidence-based treatments. There is also, though, an equally important body of knowledge that exerts an equally massive force on the practice of medicine, especially (I believe) psychiatry: pop culture, of which advertisements play a huge role. I am reminded of this constantly, from the nervous small talk a patient might make about how expensive the Super Bowl ads might be this year to the times a person unexpectedly fighting back tears might ask for one of my (non-Kleenex-branded) “Kleenex.”

An oft-cited statistic in psychiatry is that antidepressants have a 30% placebo response rate. I wonder: what percent is influenced by advertisements?

I’m excited to explore this idea in more depth preceding and during this year’s ePharma conference, where representatives of the healthcare and marketing industries will confab on the next big trends to hit our computers, phones, and even smart watches. Check back at this site, where my colleague Dr. Helena Hansen and I will be writing weekly posts as well as blogging from the event.

Now off to read about that cat who looks like Kylo Ren.



Danielle La Rocco, MD is a psychiatry resident in the class of 2013 at New York University.