Monday, March 14, 2016

We Have Granular Data on Patients and Doctors to Move the Needle on Outcomes Today

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ePharma Summit 2016 is already two weeks in the rearview mirror but the takeaways have staying power.

I keep returning to the fact that the future isn’t in front of us, but it is now. The snail’s pace of progress in the physical realm is a reflection of the snail’s pace of progress in the healthcare mindset. But that is changing. As Millennials (read: digital natives) take over the reins, this horse is going to start galloping.

Knowledge and technology are advancing exponentially. What were plans and dreams just a few years ago are now our reality. The charge is for regulatory and traditional processes to keep pace or get out of the way.

As Matthew Zachary, founder of The Stupid Cancer Show and Millennial cancer patient social network platform Instapeer, told the ePharma Summit attendees, ”We have data now that you don’t have, and we know what it means, and we want to work with you. . .Our patients, we know where they are. They want their data known.”

With just that sentence, Zachary may have dismantled HIPAA. As I discussed in my Health System Ed blog within the last year with a nudge from a former colleague and health policy advisor in the Reagan administration, our newfound social comfort with having every aspect of our personal lives online may have the effect of challenging the boundaries of personal privacy. Certainly not everyone shares that comfort, but the generation that wrote HIPAA begat the selfie generation. Matthew Zachary’s comment is a reflection of that lack of self-consciousness that digital natives bring to the party that says: Here I am. Here is who I am, and here is what I need from you.

Delivering What Patients Need

The question for digital health, then, is how to use the personal information we have to reach individual patients and do it in a way that respects personal privacy about the most private aspects of our lives even if an individual patient is willing to be all out there about their life and their condition. They want information.

Direct-to-consumer advertising blasts on television, for example, are blanket coverage of a specific solution to an unspecific audience. Today, because we know who patients are and they want us to know who they are, we can target our messages and spend those dollars more wisely. It also changes some of the messages we send about treatments and options.

Because patients don’t get to enter the treatment realm on their own, the doctors who treat them are the conduit for discussing those options. We know who they are, too. We know who their patients are and what their treatment preferences are.

Jeff Tangney is CEO of Doximity, and he spoke about the reams of valuable data he collects on physicians. Doximity averages 28 CV items per physician in its database, which is now at about 600,000 members. The site has HIPAA-grade authentication for physician members who share a back channel of secure cell and email. Doximity is growing at 10,000 members a day, Tangey said.

Market Segmentation Beyond Prescribing Data

In a panel discussion moderated by Doximity Co-Founder Nate Gross, Pfizer Director of Multichannel Marketing, Michael Rowbotham, said, “Segmentation was easier when we just looked at prescribing data.”

Easier, maybe. But with the kind of granular data available now, you can fine-tune attributes to laser focus your treatment messages exactly when and where they are most useful to patients and the physicians who treat them.

Anthony M. Antonelli, Associate Director of Professional Marketing at Bristol Myers Squibb, said, “You need the right proxy attributes. At BMS oncology, we can segment by prescribing behavior and regional view of affordability and access. We work with staff to talk about access. . .every touch (is designed) to make sure we are crafting message.”

Melina Leone, Digital and NPP Marketing for Oncology at Incyte said, “Prescribing behavior and access is very limited now. (There are) prognostic tools in the workflow, real-time or point-of-purchase points when they need our info. . .(there are) alerts when a physician is diagnosing patients and putting them on therapy. We know if doctor has a patient and (we can) increase frequency of messages so when patient gets to the stage (where treatment is needed), our product is top of mind.”

Peter Justason, Director of eMarketing at Perdue Pharmaceuticals, said, “From granularity, we need good databases to capture messages and know what will resonate with that doc. We need good IT and a lot of content. (We need to) get MLR (medical legal review) teams because they will want to approve messages, because we have multiple sequences. With the granularity we can provide now, we know when we have two different docs in same practice with different patient bases.”

Melina Leone of Incyte said,  “From Doximity, we know that 70% of physicians are on mobile. “Mobile is first, so we design for mobile apps before we design for anything else and add extra useful things for bigger screens. We used to start with big screen and squeeze it down.”

“Are we phone-first marketers? Is industry behind?” she asked.

Patients and physicians may be way out ahead of the industry that provides the treatments they need. As more than one attendee said from the stage during several days of discussions, large, lumbering pharma may go the way of the large, lumbering dinosaur unless they learn to be nimble and quick like the biotech startups they are acquiring. 
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