Publicis Health

Thought Leadership




Nadine leonard story.jpg

By Nadine Leonard, Managing Director and Hudson Plumb, SVP, Strategy, Heartbeat

The last two decades of healthcare marketing have been a wild ride, haven’t they? Whether you think back on this time as fun or frenzied, there’s no debating that the near-omnipresence of the internet is behind it all. As marketers, we’ve chased consumption from one channel to the next, swerved around “here-today-gone-tomorrow” trends, and test-drove tactical pilots to the moon and back. The learning curve was steep, but we successfully made the climb.

But our next uphill adventure is already upon us.

In order to truly understand this next excursion, we must first throw things in reverse and examine the forces that are driving it. Buckle up — this will be quick, but perhaps a bit bumpy:

FORCE #1: Baby Boomers Are Turning 65

Every 10 seconds, one of the 75 million Baby Boomers in the US blows out 65 candles on a birthday cake. And, since age tends to beget health complications, that means our Boomers are becoming an overwhelming subset of every physician’s practice.

FORCE #2: Boomers Are Sicker Than Earlier Generations

In the years after their 65th birthday, the average Baby Boomer sees a rotating group of 14 different physicians and tallies up 40 doctor visits a year. Why? Because many Boomers have at least two chronic diseases, and 25% of them have four or five (that’s not a typo!). Despite the many significant medical advances that have occurred during their lifetime, Boomers are shockingly sicker than their parents’ generation.

FORCE #3: To Compensate, Healthcare Reimbursement Is Overhauling Itself

The US government has been tracking this growing concern — crisis even — for some time. And, since Medicare will be shouldering a good portion of the cost burden for these age 65+ patients, it has made major shifts to a value-based reimbursement model — which compensates based on the effectiveness and efficiency of care instead of fee-for-service. Private insurers, armed with the same data and facing the same burden, are following suit and establishing their own value-based models. This means that physicians and health systems are feeling immense pressure, as their financials are now directly linked to the demonstration of their patients’ health improvements.

FORCE #4: Choosing the Right Treatment Is Only Half the Battle

But docs face a growing list of barriers to achieving those positive health improvements. At the top of the list: 66% of patients are not adherent to their treatment plans. And it’s a dirty little secret that most Pharma-based efforts — one-size-fits-all, one-way adherence programs — aren’t alleviating this catastrophe. This begs the question, What good is a brand’s compelling efficacy data or safety benefits when the treatment never has a chance to actually … treat? With improved outcomes now the end goal, doctors are facing a new reality: They must do more than just prescribe a promising treatment at the point of care (POC).

FORCE #5: These Effects Are Crushing HCPs and Health Systems

At a high level, health systems are operating at 3% margins, estimated to go under water by 2021 absent further changes. Meanwhile, down in the trenches, doctors have more sick patients with increasingly complex situations and numerous comorbidities. Sixty percent of physicians say that visits are too short to educate their patients and treat them effectively during their appointments. Seventy percent say that they don’t have a full picture of their patients’ health and have little visibility into their self-care and treatment adherence after the visit is over. With this lack of control, the health of their patients is at risk for not improving, leading to re-hospitalizations and other Quality Measure failures that come with government penalties. The hill is steeper, the load is heavier, the stakes are higher — and there is no relief or aid in sight.

These five forces have driven a new definition of success for pharma marketers: What happens after the prescription is written is just as important as the drug that’s prescribed. A breakthrough treatment that’s prescribed but not regularly taken — well, doesn’t break through anything. A patient who experiences disease progression and fails to report it — just leads to care regression. A pharma brand’s support program that asks the patient to do all the work — simply will never work.

Ultimately, these failures beyond the POC have the potential to collapse the healthcare experience. In other words, patient health will not improve, healthcare practitioners (HCPs) will be forced to cycle through treatment options searching for a silver bullet that doesn’t exist, and pharma brands will never see further engagement/loyalty after that initial script is written.

So, as marketers, we must continue our dedication to informing the decisions made at the POC, but we can no longer ignore what happens beyond it. In fact, we must expand our definition of what POC means; it can no longer be solely classified as “during the office visit” because we are not resolving health issues only within clinical settings. The POC must now be everywhere — and we must provide a new breed of personalized, interconnected services that will help doctors and patients stay committed to their agreed-upon treatment plans.

Yet, being everywhere sounds impossible, expensive, and exhausting. Maybe a few years ago that would have actually been the case. But something has been rapidly proliferating and it holds the power to be a Swiss Army Knife of solutions: the Electronic Health Record (EHR). To be clear, the EHR is not an answer in-and-of itself to all of these challenges. However, its pervasiveness in the healthcare ecosystem (90% HCP adoption, 4 hours of use/day), its inherent access to detailed patient info, and its growing ability to link all health audiences during and beyond the point of care, all have the potential to merge unrivaled to deliver intelligent support, solutions, and programs that HCPs and health systems so desperately need.

And the fruit is at its ripest for picking: 72% of HCPs say they have to leave their EHR because the outcome-driving services they need are not provided within the system. What are they looking for? The list is too long to print, but here’s a sampling: personalized, data-driven educational materials to pass on to patients; treatment guidelines; samples or savings programs that connect with a pharmacy home-delivery service; and services that keep doctor and patient connected between appointments.

Let’s explore a specific example of an intelligent, EHR-empowered solution: Brand X is an effective treatment for a chronic condition with a high burden of disease in the US. However, like many brands that require daily medication compliance, low adherence is a key problem. Brand X could develop a novel patient service that doctors and care teams can “order” for their patients via the EHR as part of their appointments. The program communicates regularly with patients via a conversational interface (text, voice) and prompts them to share a quick update about compliance to the daily regimen, as well as a few important health vitals. Using daily check-ins, incentives, and simple surveys, the program could smartly identify which patients are noncompliant, which patients are at risk for nonadherence, which patients need further education, and which patients need additional support, e.g. transportation to follow-up visits. On the care team side, HCPs would receive key patient information via the patient’s EHR, reducing burden on the HCP and making the patient’s next office visit more informed and more productive. This program facilitates personalized, proactive, and omnipresent care — a trifecta that physicians would love to be achieved on their own, but their reality makes it near impossible. EHR-empowered patient services make it possible.

Because the EHR is such a formidable platform for delivering the solutions and, thus, alleviating the aforementioned forces in the healthcare ecosystem, it will only be a matter of time before thoughtful and data-driven EHR programs are a crucial part of every marketing plan. There are already brands that are piloting EHR-empowered programs with great success and socializing it amongst their colleagues in other therapeutic areas — so we are sitting on the tipping point. And, as with all tipping points, when change happens, it happens fast. The consequences of waiting are the same as being second-to-market: A competitor’s solution has the chance to become a part of the physician’s treatment habits. So it’s time to show doctors and health systems that you are attuned to their needs, aligned with their goals, and ready to buckle up beside them on this next wild ride. Shift into “Drive” or you might be left in the dust.

Nadine Leonard is the Managing Director and Executive Strategy Director at Heartbeat, a marketing and communications agency within Publicis Health. Connect with her on LinkedIn.

Hudson Plumb is Senior Vice President of Strategy; EHR & Outcomes Optimization at Heartbeat, a marketing and communications agency within Publicis Health. Connect with him on LinkedIn.

Nadine Leonard