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What’s Your Digital Strategy?

December 6, 2011 by George Van Antwerp 0 Comments

Do you have a digital strategy?  Even if you don’t call it out that way, you certainly have digital as part of your overall member and physician strategy these days. 

Hopefully, you start with a few basics like:

  • What do I want to accomplish?
  • How do I measure success?
  • Who am I targeting?
  • What does my target group do online and what tools do they use (and for what)?
  • What is my competition doing?  (and what do companies outside my vertical that I want to emulate do)

Once you know those things, you can start looking at different areas of focus.  The key ones that jump to mind for me are:

  • Search engine optimization
  • Brand monitoring (e.g., Radian6)
  • Content creation (blogging, Twitter, Facebook, Google+, LinkedIn)
  • Moderation and involvement with social networking (e.g., PatientsLikeMe, DiabetesMine)
  • Tele-monitoring / telemedicine
  • Electronic prescribing / EMR / PHR
  • Digital couponing / incentives
  • Gamification
  • Mobile applications
  • SMS
  • QR codes
  • Augmented reality

But, I’m sure there are others…suggestions on what I’m missing?

Healthcare, Innovation, Leadership, Marketing / Communications, Methodology, PBM / Pharmacy, Social Media, Technology

IDC On Personalized Medicine

November 30, 2011 by George Van Antwerp 0 Comments

I was reading the IDC Health Insights newsletter this morning where they had an article by Dr. Alan S. Louie on personalized medicine.  While this was a hot topic in the PBM world 12-18 months ago, I’ve heard much less about it lately.  I thought it made sense to share one paragraph from his article here.  I hope that his predictions for delivery of this evidence-based approach to care come true and can be delivered in a cost-effective way to consumers with physician buy-in and understanding about how and when to use this information.

“I believe that the FDA is likely to be significantly marginalized as a major player in the transformation to a more personalized care scenario. While still rigorous in their role as gatekeeper to ensure that drugs are safe and effective, the ability to apply growing genomics, EMR, and CDSS data and knowledge to routine medical treatment is likely to be executed outside of FDA purview. If the FDA decides to lay down the heavy hand and demand that all testing be FDA approved, then all bets are off and medical innovation will be delayed by at least 10 years or more. With payers, clinical laboratories, and others (e.g., PBMs) all buying genomics testing capabilities, it becomes increasingly possible to deliver the latest genomics insights to the point of care and amortized over large patient populations, recognizing that what are probabilities for the individual become real outcomes for portions of patient populations. Net improvements in patient outcomes become real and avoidances of treatment with little or no likelihood of success reduce both wasted efforts and unnecessary adverse drug exposure.”

Books / Articles, Healthcare, Innovation, Methodology, PBM / Pharmacy, Research, Value Propositions

Slideshare: 2012 Digital Trends For Healthcare Marketing

November 26, 2011 by George Van Antwerp 0 Comments

Good deck that I found on Slideshare.net.

Books / Articles, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, Methodology, PBM / Pharmacy, Research, Technology

Will Pfizer Strategy On Lipitor Become The Norm?

November 23, 2011 by George Van Antwerp 0 Comments

Remember Twisted Sister’s song – We’re Not Going To Take It Anymore?

That’ seems like a good summary of the Pfizer response to the typical market dynamics around patent expiration.

Here’s a summary of what they’re doing:

  1. Pfizer is striking deals with PBMs to offer them brand Lipitor at a lower cost (net of rebate) than the generic drugs which are coming to market during the exclusivity period.
  2. Pfizer is continuing to offer their $4 coupon for brand Lipitor direct-to-consumers.
  3. Pfizer is continuing to advertise Lipitor and talking about “if Lipitor has been working for you, stay with it”.
  4. Pfizer is partnering with Diplomat Pharmacy to sell Lipitor directly to the consumer through mail order.
  5. Pfizer is offering pharmacies additional services around adherence for helping keep patients on Lipitor.

Here’s some key questions on implications:

  1. If I’m the authorized generic, how do I feel? I thought I had a deal by which I was bringing a drug to market and making some money during the exclusivity period. Will this change the way that authorized generic deals get structured?
  2. If I’m the generic manufacturer that has the 180-day exclusivity, how do I feel? I’ve just lost a lot of my opportunity. Will this change the economics of generic manufacturers? I believe most of their profit is made during the exclusivity period.
  3. Will other brand manufacturers follow suit on other patent expirations?
  4. Will the PBM response to couponing intensify with their push into couponing when there is a multi-source generic available?
  5. Will this serve as a bridge until they can get OTC Lipitor approved? And, will that ever happen?
  6. How does this affect retailers who make more money on the generics and won’t see the increased rebate dollars?
  7. For PBM clients that get rebate dollars shared with them, these deals with Pfizer are probably a win (i.e., lower cost). What about those clients that don’t? How are they being made whole? What about clients of clients (i.e., employers who contract with a TPA or MCO who gets the rebates but doesn’t share them)?
  8. How hard does it become to transition patients off Lipitor when Pfizer stops offering the increased rebates or lower cost?

This could be a game changing moment in the industry. We’ve seen lots of shifts, and I would add this as a new phase in the industry.

  • 1.0 = Traditional focus on MDs and heavy use of people to detail physicians.
  • 2.0 = Shift to DTC advertising still supported with detail reps.
  • 3.0 = Increased power of PBMs and focus on rebating and formulary positioning.
  • 4.0 = Rise of generics and shift to specialty.
  • 5.0 = DTC couponing and broader disease centric strategies.
  • 6.0 = New business models??
Healthcare, Innovation, Marketing / Communications, PBM / Pharmacy

Reprint: Getting Aligned For Consumer Engagement

November 17, 2011 by George Van Antwerp 0 Comments

(This just appeared in the publication by Frost  & Sullivan and McKesson called “Mastering the Art and Science of Patient Adherence“.  It was written by me so I’m sharing it here also for those of you that don’t get that publication.)

According to the 15th Annual NBGH/Towers Watson Health Survey, employees’ poor health habits are the number one issue for maintaining affordable benefits. Since studies have shown that 50-to-70 percent of healthcare costs are attributed to consumer choices and adherence is one of those issues, the topic of how to engage consumers isn’t going away.

The challenge is getting the healthcare industry to use analytics and technology tools when engaging the consumer in a way that works for each individual and builds on their proven success in other industries. Healthcare has an enormous amount of consumer data ranging from demographics to claims and behavior data. Consequently, there is great opportunity to use this data to engage consumers in their health to improve clinical outcomes. While on the one hand, it’s like motivating consumers to buy a good, the reality is that healthcare is both personal and local which complicates the standard segmentation models.

This is a dynamic time where people are experimenting with different strategies for engagement. For instance, in medication adherence, people are trying everything from teaming those who have chronic conditions with community pharmacists to make sure they are taking their medications correctly to technology that monitors when the pill actually enters your body. But, there are still fundamental gaps in the process which can be addressed using interactive technology to complement the pharmacist interventions.

Consumer engagement in healthcare is increasingly moving to new channels with 59 percent of adults in the U.S. looking for health information online and 9 percent using mobile health applications according to Pew Research Center. Additionally, there is more and more participation in social media or peer-to-peer healthcare applications. Modes like SMS, which companies are starting to leverage in programs like Text4Baby or the diabetes reminder program recently launched by Aetna, are gaining popularity. Companies like Walgreens have also begun exploring the use of SMS and Quick Response (QR) codes for medication refills.

At the end of the day, consumers want preference-based marketing where they can elect how to best engage them, but that doesn’t mean that’s the most likely channel to get them to take action.They want you to learn from their past responses to improve your future outreach, but they are also skeptic about how their data is used. You have to put yourself in their shoes to create the optimal consumer experience. You have to deliver the right message to the right consumer at the right time using the right sequence and combination of channels.This is not easy.

So, if you’re going to optimize your resources and build the best consumer experience, you need an approach which is dynamic and personalizes each experience. For example, we found that creating the right sequence and timing around direct mail and automated calls improved results by as much as 100 percent in a pharmacy program. Or, in another case, at Silverlink Communications, we found that using a male voice in an automated call to Latinos got an 89 percent better engagement rate around colonoscopies. We also know that using a peer pressure message does not work in motivating seniors to take action in both a retail-to-mail program and a cancer screening program, but does work for those younger than 55-years-old?

You have to make simple messaging relevant to them—why should I get a vaccination, why is medication adherence important, how can you address my barriers? Only an ongoing test and learn approach to consumer insights will suffice, and those that figure this out will become critical in the ongoing fight for mindshare and trust. But, this isn’t a stand-alone opportunity. We have to partner with providers to improve engagement, adherence, and ultimately outcomes in different forms. We have to offer them a platform for engagement that is built upon consumer insights and provides a unique consumer experience to them based on their disease, their demographic attributes, and their plan design. All of these factor into their behavior and are important in “nudging” them towards healthcare engagement and ultimately, better health.

Books / Articles, Consumerism, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, Methodology, PBM / Pharmacy, Press, Research, Silverlink, Social Media, Technology, Value Propositions

Sustained Patient Engagement Around Hypertension: Silverlink and Aetna

November 15, 2011 by George Van Antwerp 0 Comments

At Silverlink, we had a great opportunity to work with one of our clients and publicize it. This morning, Aetna released a joint press release with us about our hypertension program.

As companies continue to look at new ways to use technology to engage patients around chronic diseases, solutions like this offer companies a unique way to blend multiple channels into an overall consumer experience that improves engagement and outcomes.

From the press release:

The program also achieved high levels of engagement, with nearly 60 percent of participants continuing to actively monitor their blood pressure by using a free blood pressure monitor and submitting readings on a monthly basis. The frequency of participants’ cholesterol (low-density lipoprotein (LDL) cholesterol) screening also improved 5 percent.

“By helping our Medicare members manage their high blood pressure, we are hoping to help prevent heart disease, strokes and even deaths,” says Randall Krakauer, MD, FACP, FACR, Aetna’s national Medicare medical director. “Our nurse case managers work closely with our members and do a tremendous job providing them with the information, tools and support they need to help them control and improve various chronic conditions, including hypertension. The results of our program with Silverlink demonstrate that an automated program can further support and engage members in managing their own health conditions.”

Books / Articles, Consumerism, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, Press, Research, Silverlink, Technology, Value Propositions

Retail Pharmacy Mobile Applications

November 10, 2011 by George Van Antwerp 0 Comments

I’ve talked before about some of the mobile PBM efforts, but what about the retail pharmacies. You should expect that the chains will have different mobile strategies than the grocery stores or the big box retailers. And, it will be interesting to see how the independents might collaborate on a shared platform.

Here’s a few things already out there:
– Walmart new shopping application and Walmart’s page on mobile
– CVS retail application
– Walgreens has a mobile pharmacy app
– Target also has a mobile pharmacy application

So what should or could pharmacies offer consumers in terms of mobile applications:
– A refill application is a minimum
– Education or drug information is another basic
– There are certainly some geographic options such as a store locator or clinic locator
– There are options for location based check-in using Foursquare
– Scheduling MTM consultations or vaccinations are a reasonable option
– What about promoting saving thru 90-day retail or generics?
– As retail pharmacies are in the specialty business, there could be opportunities to promote this channel and offer support.
– Telemonitoring is another option (e.g., FaceTime)
– Use of QR code is another part as is augmenting the shopping experience with augmented reality
– Of course, couponing will be part of the solution, but what I’d like is someone who would download my shopping receipts (from multiple companies) and provide me with relevant savings.
– Should it include Rx coupons? Unlike the PBMs, retailers want traffic and if coupons increase adherence then why not.
– There are other options like photos and integration with social networks and tools.

I think one of the key “killer apps” is secure rules based messaging. Imagine using data to identify when you need a vaccination or identifying a potential drug-food issue or having age based triggers. These could be sent directly to the consumer in a secure environment. Of course, we’re only at about 10% adoption and the key question is whether these are the key consumer that everyone wants to attract. Are they the high utilizers? Do they buy other goods?

More to come here. This is a rapidly evolving space.

Consumerism, Healthcare, Innovation, Marketing / Communications, PBM / Pharmacy, Social Media, Technology, Value Propositions
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The Augmented Reality Prescription Bottle

November 9, 2011 by George Van Antwerp 0 Comments

I was watching a YouTube video on Starbucks’ augmented reality cup which got me thinking. Why not do the same with the prescription bottle?

What a great way to engage the tech savvy consumer.

Perhaps you could provide a plain language summary of information about the medication. You could give a list of side effects. Or show how to take the medication.

Perhaps it could have an embedded survey that you complete weekly.

And, it seems like an easy opportunity for someone to offer an augmented reality applications for all medications. Hold up the phone to a pill and get information on it. (maybe a little harder)

I think there is a lot more here as companies like Lamar continue to evolve.

Healthcare, Innovation, Marketing / Communications, PBM / Pharmacy, Technology
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My Eight PBM Predictions For 2012

November 3, 2011 by George Van Antwerp 0 Comments

I recently heard one of the key CEOs in the PBM industry say that his crystal ball for 2012 was fuzzy, and he wasn’t sure what was going to happen.  (Not particularly reassuring.)  That being said…it’s an exciting time, and I’m going to take my pass at predictions anyways.

  1. The proposed Express Scripts acquisition of Medco will take place although they will be required to sell off some specialty assets.  This will create a new specialty player and will also trigger further consolidation and acquisitions.  You will also see many of the Medco people go to new healthcare companies throughout the industry to drive change.
  2. The contract dispute between Express Scripts and Walgreens will get resolved shortly after 1/1/12, but it will serve as the trigger for limited networks as multiple clients will keep Walgreens out of the network since they’ve addressed most of the disruption and achieved savings.  But, you will also see several companies quickly add Walgreens back into their network.
  3. Star Ratings will trigger a bigger focus on adherence across the industry and begin to create outcomes-based performance measures that the commercial business starts to see in their PBM contracts linking payment to performance.
  4. Lipitor will be a disruptive item throughout the year with aggressive Pfizer rebating, the overhang from it potentially going OTC, and the pricing of the initial generic.
  5. Innovation will finally begin to shift to the specialty space with this being the primary area of concern from a trend management and clinical perspective.  Clients will expect innovative ways of engaging patients and improving outcomes which will push closer links between pharma and PBMs around key drugs and complex conditions.  The focus on specialty spend in medical will continue, but the increasing percentage of infusion drugs will challenge this and push specialty to look for more ways of engaging with the physician.
  6. The “retailing of healthcare” through storefronts will manifest itself in different ways in pharmacy with greater focus on specialty at retail, pharmacists as part of the ACO/PCMH concept, MTM, and ultimately through exchange based partnerships with large payers.
  7. Integration of medical, pharmacy, and lab data will be a huge focus on PBMs create targeting algorithms and databases for segmentation, targeting, and ultimately engaging consumers around specific health behaviors.
  8. Telemedicine in the form of telemonitoring will link into the retail pharmacy clinic strategy as they extend their pharmacy relationship from an event based relationship to an ongoing monitoring relationship around key conditions like diabetes.

Two things that I expect to continue to be areas of focus will be the development and execution of a mobile strategy and continued exploration in the area of personalized medicine and genomics.

The one outlier which I’m not sure of yet is Medicaid pharmacy.  It’s been a hot topic lately, but I’m still unsure of whether that will radically change in 2012 or not.

[Interested in sharing your opinions on 2012 in a formal way?  I’m going to reach out to several companies and ask their thought leaders or executives to do an “interview” with me about their predictions for 2012.  Let me know if you’d like to participate.]

[And, don’t forget that you can sign up to have these posts e-mailed to you whenever I write them by signing up for my e-mail list on the right side of the blog.  Thanks for reading.]

Healthcare, Innovation, Leadership, Marketing / Communications, PBM / Pharmacy, Research, Value Propositions

Why Don’t Physicians Use More Information Therapy

November 1, 2011 by George Van Antwerp 0 Comments

My PCP is very good about giving me information to read every time I visit him.  (Never mind that it sits in a pile on my desk.)  But, I believe this is under-utilized in today’s information rich society.

I was reading an article this morning from PharmaVOICE about physicians not using certain medications or treatments because they didn’t have the time to spend with patients explaining them.  Therefore, they default to the “easier” solution which requires less explaining.  Is this prevalent?  I don’t know.

The article talked about a survey from Sermo and Aetna Health which revealed that almost 2/3rds of the 1,000 MDs surveyed felt that “the current health care environment is detrimental to the delivery of care”.  And, less than 1/5th felt that “they could make clinical decisions based on the what was best for the patient, rather than on what the payers are willing to cover”.  Pretty scary and sad.

Imagine if the physician was using an electronic interface during the encounter.  They could pre-create several information packets around certain diseases, drugs, and/or treatments.  When the patient was diagnosed and a treatment plan agreed to, they could e-mail the package to the patient.  It might include written information, links to websites, YouTube videos, or other assets.  I would imagine this could be very powerful and address the common gaps that exist between what the physician says and the patient hears.

[The article was “Is the Business of Health Care Getting in the Way of Providing Good Health Care? by Ken Ribotsky in PharmaVOICE from October 2011.]

Books / Articles, Healthcare, Innovation, Leadership, Marketing / Communications, Methodology, PBM / Pharmacy, Technology

Will Drought Eventually Push Us To Drink Toilet Water?

October 4, 2011 by George Van Antwerp 0 Comments

Not a hot topic! But, I think we all have seen the issues in Texas and other areas of the US this year around lack of water. Water is rapidly becoming a critical resource with McKinsey estimating that by 2030, the global water supplies will meet just 60% of demand. Basically, water supplies don’t go up while demand does due to population and new uses for land.

There is an interesting article called Droughtbusters by Anita Hamilton. One of the more disgusting but yet practical solutions in there is recycling toilet water which is being done in Namibia. I won’t pull you through the technology, but if Orange County, CA can begin treating sewage water and pouring it into its underground aquifiers than it’s not that far fetched.

To read more about water scarcity, you could go to http://thewaterproject.org/.

Books / Articles, Healthcare, Innovation

Here Come The Pharmacy Co-Branded MA/PDP Plans

October 3, 2011 by George Van Antwerp 0 Comments

In the past few days, I’ve seen two new announcements:

  1. Aetna partnering with CVS to launch a co-branded Medicare plan
  2. Coventry partnering with Walmart, Walgreens, and Target

I think we’re all familiar with the success that Humana has had in their Medicare offering with Walmart.

I think one could also say that the PBMs (i.e., mail order) getting into the Medicare business was also an effort to co-brand Medicare offerings between payers and pharmacies.

I wonder if we’ll see an NCPA offering.  I would think in certain regions that that would play well.

 

Books / Articles, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, PBM / Pharmacy

Ambient Paper For Adherence

September 24, 2011 by George Van Antwerp 0 Comments

We’ve all heard of GlowCaps which is a great idea of using sound and color and communications to remind people to fill their medications.

One idea I’ve thought about for several years is the idea of “intelligent paper”.  Imagine a refrigerator magnet or prescription label or some other piece of information printed on paper that changed color with time.  As it got closer to time to refill your medication, it would turn yellow.  When it was time to refill, it would turn red.

It should be easy.  If you blend this with the QR code that Walgreens uses for refills, you have a captive reminder and reorder system that could be embedded within the label for less cost.  I haven’t totally solved the issue, but it’s one that I think is feasible to accomplish and sell as a low-cost reminder vehicle.

Healthcare, Innovation, Marketing / Communications, PBM / Pharmacy, Technology

Pharmacy Adherence (Waste) And The Need for MD-RPh Collaboration

September 22, 2011 by George Van Antwerp 0 Comments

I spent the day today at the NEHI adherence event in DC. I pulled out a few of my takeaways below, but while I was riding on the plane to get here, a few things were running thru my head:

  • The focus on budget and the estimates that adherence costs us $290B a year here in the US.  (or as one person pointed out that’s $1.2T in a presidential term)
  • The recent report estimating that chronic conditions could cost us $47T worldwide over the 20 years which is leading to the UN talking about healthcare for only the second time ever.
  • The discussion by George Paz from Express Scripts the other day about how PBMs drive value by eliminating waste (see Drug Trend Report). A large piece of waste is adherence and certainly one of the forecasted benefits of the combined Express Scipts and Medco entity is the intersection of Consumerology with the Therapeutic Resource Centers (TRCs).
  • The ongoing dialogue around motivational interviewing, commercial MTM, and blending face to face interventions with technology to “nudge” behaviors.
  • The huge opportunity which I believe exists in leveraging technologies like Surescripts to create data exchanges with physicians around MPR and barriers.
  • The exciting fact that the new STAR measures for Medicare include more adherence metrics that are weighed more heavily than some of the operational metrics.

Fortunately, these were a lot of the topics that were discussed.  Here some of the discussion topics:

  • The fact that there’s no “easy button” for adherence.
  • How adherence is a foundational building block for quality.
  • The role of HIT in sharing data bi-directionally across the care team.
  • Upcoming evidence around VBID.
  • The role of the pharmacist and need for them to collaborate more with the physician to discuss and manage adherence.
  • The fact that the adherence solution has to be multi-factorial.
  • The need to optimize the drug regiment and individualize care (aka patient-centered care).
  • The role of the caregiver.
  • Opportunities around PCMH, readmissions, MTM, and eRx.
  • The need for patient engagement.
  • The need for the patient to believe in the therapy and that it will make them better.
  • Good discussion on the role of the PCMH (patient-centered medical home) versus the pharmacy as the foundation for adherence.
  • Discussion on whether physicians could address adherence if time wasn’t an issue.  Do they have the training and skills?
  • Social media as an emerging factor.
  • Reaching the consumer when they have time and are receptive to information.
  • Helping prepare the consumer for the encounter (i.e., checklist or list of questions).
  • What happens when the patient waits in line and then is rushed themselves in the encounter.
  • The role of technology in complementing the physician and patient.
  • How to share data across team members.
  • The need for ROI data on interventions.
  • The value of having a Dx on the Rx.
  • The need to vary incentives and not keep doing the same thing.
  • If prevention is long-term and adherence is short-term, should the physician focus more on adherence and less on screening and other preventative measures.
  • The need for – sufficient accountability, information, and skills.
  • Adherence as a solution that needs to be localized.
  • Patient centered or disease centered solutions.
  • The governments role in improving adherence via policy and funding demonstration projects through CMS.
  • STAR ratings and the bonus payments as an incentive to motivate research and programs in this area.

Overall, it was a good discussion with a very engaged panel and audience.  We didn’t come to any answers, but you certainly got to think about the topic, identify some projects that should be done, and identify some research questions. 

I look forward to pulling out a few of the topics in more depth.  They align well with the communications platform and intervention strategies that Silverlink provides for our clients around adherence.

Healthcare, Innovation, Leadership, Marketing / Communications, Methodology, PBM / Pharmacy, Research, Silverlink, Value Propositions

New Walgreens Pharmacy Layout

September 19, 2011 by George Van Antwerp 2 Comments

I was in a Walgreens last week in Chicago.  Maybe it’s just a newer store than my local store in St. Louis, but I thought the pharmacy looked very different.  I captured a few shots with my camera phone.  As you can see below:

1. There is an automated check-in option for refills. 

2. There is a pharmacist in front of the counter not just behind.  (And people were actively coming in and talking with him.)  The clinic also seemed to have a person on the floor roaving around interacting rather than sitting behind a podium. 

4. There was a sitting space with what appeared to be a meeting room.

5. Overall, there was a lot more signage and videos which made it a very lively and bright place to be. 

 

This seems like a different engagement strategy.  I’m surprised no one is talking about it.  The only thing I could find was a mention of a “training store” and 40 locations and the following mention in an article about Express Scripts and Walgreens:

As part of its plan to expand its healthcare offerings and reduce costs, Walgreen is working on pilot stores with new technology and a health guide on staff to help patrons more easily fill prescriptions, speak to pharmacists and see nurse practitioners at its in-store Take Care clinics. The first such store, in the village of Oak Park, Illinois, opened in November. Walgreen plans to have 20 stores in Chicago and other nearby towns by October.  (source)

It sounds like there are just a few stores so I must have got lucky to stumble into this one.  I had heard rumors of some re-design, but I hadn’t seen anything out there on the Internet.  Interesting.  I’d love to see a study to understand satisfaction, engagement rates, retention, etc. associated with this footprint versus the older store pharmacy layout.

Consumerism, Healthcare, Innovation, Marketing / Communications, PBM / Pharmacy

Is Your Adherence Program Leveraging Segmentation?

September 19, 2011 by George Van Antwerp 0 Comments

I was just finalizing a new marketing piece with our marketing team on Silverlink’s adherence services.  I love this picture because it drives home the point of understanding the consumer.

If you don’t understand the factors that drive behavior and leverage those attributes in segmentation and personalization of your adherence program, you may be leaving opportunities on the table.

Healthcare, Innovation, Marketing / Communications, Methodology, PBM / Pharmacy, Silverlink

Primary Adherence – Technology, Kaiser Study, and EHRs

September 13, 2011 by George Van Antwerp 0 Comments

I think we all know that primary adherence is a real issue.  Depending on what you read, you see that anywhere from 20-30% (or more) of patients don’t start therapy.  They are prescribed a drug, but they never fill it.  This is due to lots of reasons:

  • They get a sample.
  • The drug costs too much leading to abandonment.
  • They don’t feel like they need the prescription.
  • They feel better.
  • The doctor tells them only to fill it if something else doesn’t work.

These issues vary based on whether it’s an acute drug or a maintenance drug.  It also varys by drug class. 

I’ve always been surprised that pharmaceutical manufacturers focus so much on ongoing refills leading to improved MPR rather than focusing on primary adherence which would grow their market significantly.  One of the big reasons for this has been visibility.  Without electronic prescriptions and mapping those to claims data, it was hard to identify who had a prescription and didn’t fill it.  You could do something with data out of the PPMS (Physician Practice Management System) or through more complicated processes to get data out of their notes, but it wasn’t easy. 

So, this new study by Kaiser caught my attention. 

If you are a diabetic, have high cholesterol, or high blood pressure and you receive medical care at an integrated healthcare system that has electronic health records (EHRs) linked to its own pharmacy, then you are more likely to collect your new prescriptions than people who receive care in a non-integrated system, a Kaiser Permanente study shows.

That’s a strong sell for an integrated model, but perhaps more realistically for the use of EHRs.  You can also see some of the data from Surescripts around this topic of electronic prescriptions and adherence. 

This creates a great opportunity for pharmacies, PBMs, payers, and pharmaceutical manufacturers to leverage technology to improve primary adherence.  By identifying people who don’t fill a prescription they receive, companies can help determine which of those are intentional and which of those should be addressed.  This should help address the overall costs attributed to non-adherence and be a business driver for all these entities. 

[Note: If you’re interested in working on primary adherence, let me know.  We have several approaches for this at Silverlink.]

Books / Articles, Healthcare, Innovation, Marketing / Communications, Methodology, PBM / Pharmacy, Research, Silverlink, Technology

$47 Per Rx Guarantee From Prime Therapeutics

September 1, 2011 by George Van Antwerp 0 Comments

I think this is a good, bold move.  Prime Therapeutics has launched four new programs.  The most aggressive is called Reliance and guarantees your net spend per Rx at $47.  The easy way to do this would be to exclude specialty drugs and basically offer a generics-only formulary.  My quick read from their drug trend report and press release is that it includes specialty drugs.  It also includes a lot of utilization management programs, suggestions on plan design, encouragement for mail order, and other features.  I’ll be interested to see the adoption of the program or whether it’s just a great program to encourage clients to consider new, more aggressive plan designs.

“Our Reliance plan keeps costs predictable for plan sponsors,” said Michael Showalter, Prime Chief Marketing Officer. “The goal is to make pharmacy benefits easy, understandable and affordable. Through Reliance, there will be no surprises, allowing organizations to better plan for and manage their pharmacy costs and reduce overall health care costs, while providing excellent benefits. We provide a single number demonstrating the true cost of care – $47. We are the only PBM to back that up with a price guarantee and complete price transparency.”

Books / Articles, Healthcare, Innovation, Leadership, Marketing / Communications, PBM / Pharmacy, Value Propositions

Increasing Preferred Pharmacy Usage (3 of 3)

August 25, 2011 by George Van Antwerp 1 Comment

This is the third of three posts on new ideas for increasing usage:
  1. Driving preferred pharmacy usage from the employer site
  2. Using social media
  3. Borrowing from other industries

The idea in all of these was to look at new ways that builds on the standard approach that we work with many clients on today.  And, if you believe that the Express Scripts / Walgreens dispute won’t get resolved, we’re going to see a lot of people using limited or preferred networks very soon.  This is also something that Adam Fein talked about in highlighting some of the progress Wal-Mart is making in this area.

So what are some examples of things we could borrow from other industries?

Referral Program:  Why not offer incentives for people who refer their friends and family into the pharmacy? Wouldn’t this play into the social network or peer-to-peer trends out there?

Satisfaction Surveys:  Why isn’t there more monitoring of the customer satisfaction to look for improvement opportunities?  [Note: I know there is some, but I think it’s under-utilized as a tool.]

Tiered Service Levels:  Frequent travelers get different levels of customer service.  Why don’t high utilizers with lots of co-morbidities and Rxs get a better level of service?

Points:  Why aren’t there more incentive systems and “points” that are used to reward consumers based on share-of-wallet or other metrics?  [I think there may be some legal issues here.]

Online Order Tracking:  Why can’t I watch my prescription being filled and track it around the system online?

Pharmacy Ratings:  Why isn’t there a consumer and business system that ranks pharmacies based on wait time, friendliness of staff, error rates, generic fill rates, overall satisfaction, or other metrics that can then be pushed to the consumers?

Incentives / Coupons: Certainly these have been tried and there are limits here especially in government funded benefits, but it’s still few and far between.

MD Programs: Physicians can certainly influence this decision.  Why isn’t there more effort to differentiate a pharmacy (mail, retail, specialty) by building relationships with high prescribers?

Check-in / Preferences: Why don’t the forms in the physician’s office (or applications) have you select a preferred pharmacy or have a pop-up with a preferred pharmacy in it to drive you there?

Credit: For some people, it’s an issue to front the money for the 90-day supply.  Why haven’t the mail order pharmacies partnered with a credit card company to allow for installment payment?

If you’re going to “win” at this game, you have to think differently.  You have to test and learn.  You have to capture insights from your customers and translate them into product offerings.  It’s not easy.

Consumerism, Healthcare, Innovation, Leadership, Marketing / Communications, Methodology, PBM / Pharmacy

Increasing Preferred Pharmacy Usage (1 of 3)

August 22, 2011 by George Van Antwerp 0 Comments

For my purposes, I’m going to define a preferred pharmacy as one of the following:

This is the first of three posts on new ideas for increasing usage:
  1. Driving preferred pharmacy usage from the employer site
  2. Using social media
  3. Borrowing from other industries
For today’s post, I’m going to focus on how a PBM (or retailer) could work with an employer to drive use of a preferred pharmacy.  There are the obvious ways:
  1. Plan design
  2. Incentives
  3. Interventions (letters, calls)
  4. Reminders on the intranet
But, let’s look at a little history of what’s been tried first outside the obvious:
  1. On-site collection boxes
  2. Kiosks
  3. On-site pharmacy
It’s my understanding that Medco used to (or maybe still does) have “drop boxes” at their large employer sites in the HR department for people to drop off prescriptions for mail order.  The employee would drop them off and then they would be FedEx’d to Medco each night.  It’s a nice convenience feature and if promoted probably serves as a good constant reminder.
Another attempt was made by Duane Reade in NY to put kiosks at employer sites and hospitals to capture new prescriptions and allow them to be couriered over to the consumer from their central fill.  It was a good idea, but it didn’t scale well and had limited upside outside NY.
I spent about a year looking at how to blend the Duane Reade model with Redbox to allow for kiosks that could leverage telemedicine and dispense the top 100 SKUs.  A few models of that concept have continued to grow (although slowly).  Instymeds now has 200 deployments (after almost a decade).  I’ve heard about a few others continuing to try also.
You then began to see a spike in on-site clinics where you could see a physician or another medical professional and get a prescription filled.  Again, this works like some of these others in high density areas where there is a population using lots of chronic medications and with the same PBM/insurer.
Now, with technology, is there an easier way?
Why not have a QR Code posted in your HR department or in the physician’s office or on the back of your ID card or some other place.  When the patient gets their new Rx, they can scan in the code and it can do any of the following:
  • Show them a message about considering mail order
  • Trigger an SMS asking someone to call them
  • Send an e-mail requesting a call back about the closest preferred pharmacy
  • Send them a map of the closest in-network pharmacy
  • Link them to a YouTube video on getting started with mail order
  • Or, in the Worker’s Compensation area, it could create a virtual card for the network
We all know that mobile apps in the pharmacy space are “all the rage” although adoption is surely in the 5-10% range (best case).  So, will this make a difference?  Perhaps not today, but it’s a low-cost way of learning about how consumers (especially those working in large, high-tech environments) might engage.  Right now, most companies are in a learning mode.
Books / Articles, Healthcare, Innovation, Marketing / Communications, Methodology, PBM / Pharmacy, Technology

Engaging The Un-Engaged

August 17, 2011 by George Van Antwerp 0 Comments

 

One of the hot topics in a lot of healthcare conversations these days is engagement.  There’s the “easy” engagement for the e-patients that are actively involved in their healthcare.  Then there’s the much harder engagement of those that aren’t engaged.  And, finally, there’s the issue of chronic engagement.  I can easily get someone to engage a few times with an incentive or some other “trick”, but how do I get them to stay engaged over time.  It’s not easy.

This is one of the topics that will be discussed at the upcoming Forum 11 in San Francisco.  If you’re coming, look me up.  I’m presenting on Friday.

Events, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, Methodology, PBM / Pharmacy, Press, Research, Silverlink, Value Propositions

How To Use A Robot For Patient Support

August 15, 2011 by George Van Antwerp 0 Comments

While it’s unlikely that we’re going to get much empathy from robots in the near future, VGo Communications is definitely making the idea of tele-presence more believable.  What intrigued me when I first saw this was the ability for remote caregivers to participate in events.  For example, I could imagine my parents going to a physician’s visit in Detroit.  If I was able to log-in and join them using a VGo robot, it would be great.  It’s unlikely I would fly from St. Louis to Detroit to join them.

Now, cost would be an issue here, but I’m guessing someone can come up with a model that allows providers or hospitals to buy multiple robots and allow a remote, web-based log-in process.  (After some training by the user on controlling the robot.)

If we look at studies like the one presented by Kaiser years ago (see below), we know that there’s a huge gap between what the physician says and should say.  For example, this shows that only 34% of the time did the physician tell the patient the duration of therapy.  This play into what I’ve talked about before which is the gap between what the physician says and the patient hears and the questions that come up after the fact versus what questions come to mind during the office encounter.  Could a tele-presence by a third-party help that?  It’s an interesting concept.

Healthcare, Innovation, Marketing / Communications, Research, Technology

Yellow Dot and HIPAA

August 9, 2011 by George Van Antwerp 0 Comments

I’m confused.  We spend so much time and money in this country worried about HIPAA and patient privacy and now people are putting all their healthcare data on a piece of paper in their glovebox and putting a sticker on their car letting people know that it’s there.  The program is called Yellow Dot.  (see USA Today article)

Don’t get me wrong…I think it’s a great, low-cost strategy to give data to rescue workers in an emergency.  (Not that there shouldn’t be a much easier strategy using technology.)  I’m just amazed that no one seems to worry about privacy here.  Maybe, privacy is only an issue when data can be stolen in mass quantities and sold not when someone can break into your car at the grocery store and take all your information.

Am I alone on this or do others find these things difficult to reconcile?

Books / Articles, Healthcare, Innovation, Marketing / Communications

Storytelling Is A Part of P2P Healthcare

August 8, 2011 by George Van Antwerp 0 Comments

P2P (or peer-to-peer) is a popular topic in healthcare today.  It builds on both the social components of behavioral modification along with the social networking trends.

About one-third of Americans who go online to research their health currently use social networks to find fellow patients and discuss their conditions, and 36 percent of social network users evaluate and leverage other consumers’ knowledge before making health care decisions. Social networks hold considerable potential value for health care organizations because they can be used to reach stakeholders, aggregate information and leverage collaboration.  (from Deloitte study)

One of the biggest researchers out there in this space is Susannah Fox from the Pew Research Center.

Peer-to-peer healthcare acknowledges that patients and caregivers know things — about themselves, about each other, about treatments — and they want to share what they know to help other people. Technology helps to surface and organize that knowledge to make it useful for as many people as possible.  (from recent presentation from NIH – “Medicine: Mind the Gap”)

With that in mind, I found this study from a few months ago about storytelling very interesting.  Imagine the power of capturing stories in some form – DVD, YouTube, written – and sharing them with newly diagnosed patients across an expanded social network.  Imagine helping patients plug into a social network (ala – PatientsLikeMe).

Conclusion:  The storytelling intervention produced substantial and significant improvements in blood pressure for patients with baseline uncontrolled hypertension.

What has really surprised me is that I haven’t seen the large institutional healthcare organizations promoting the use of the social networks.  Maybe I’ve missed it, but I would think they would partner up with a few of these to encourage consumers to use them.  I understand on the one hand that that is “handing off” a patient to a different company, but rather than trying to build their own social networking application, I think they’re better served to leverage what exists.

Books / Articles, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, PBM / Pharmacy, Research, Silverlink, Social Media

5 Indicators Of Pharmacies Crossing The Chasm

July 18, 2011 by George Van Antwerp 0 Comments

I’ve talked about this several times before in my post about The Future Of Pharmacists and in my whitepaper “Innovate Or Be Commoditized“, but I continue to believe that pharmacists can play a bigger role in healthcare (see also Pharmacists to Prescribe).

I know that people sometimes perceive my support for mail order and/or PBMs as anti-pharmacist, but they’re not. Even my criticism of independent pharmacies isn’t on the great work they do with patients but is focused on the tactics used to try to even the playing field.

But, one of the things I’ve been watching for is what are some early indicators of how pharmacists are crossing the chasm from being dispensing-focused to being core members of the care team.

I’ve seen several:

  • A more outspoken push for pharmacist involvement in ACOs.

“I really think that CMS was remiss in not explicitly including the drug benefit in the Shared Savings model. Because the industry recognizes that it’s important, what we are seeing is that the people who are planning on participating in the ACOs are already reaching out to the PBMs to lean on them to develop programs. So by default, we will end up being participants in it indirectly versus directly…. It’s the most frequently used benefit. It’s hard to imagine that you’ll be able to have a successful ACO model without considering the effects of somebody involved in health outcomes.”  Brit Pim, VP and general manager of the Medicare/Medicaid division of Express Scripts, Inc. (from Drug Benefit News)

  • MTM moving from a required program in Medicare to an optional program for commercial populations.

The Academy of Managed Care Pharmacy (AMCP) recently conducted a survey of its members to get an update on current MTM programs being offered by payers. Out of 57 respondents — which included 43 health plans, six PBMs, five integrated delivery systems and three other organizations — only six reported using MTM programs for their commercial populations alone. Another 17 said they use MTM programs for both Medicare and commercial populations. (from Drug Benefit News)

  • Continued focus on pharmacists and distribution of vaccines.

Immunizations are crucial to protecting patients from developing and dying from vaccine-preventable diseases, and in order to be successful, a team effort is required for all health care professionals to increase immunizations.29 Pharmacists are in a pivotal position to increase awareness about the importance of vaccinations and identify those patients who may benefit from specific vaccinations. By continually increasing awareness about the availability and importance of vaccinations, patients can make informed decisions to protect themselves and their family members. (Pharmacy Times article)

Up to 50 percent of chronically ill people stop taking their medication within the first year. Pharmacists understand many of the contributing factors, which range from cost and side effects to the inherent challenges of taking multiple medications, and can help address them. In fact, CVS Caremark research shows a pharmacist in a face-to-face setting is the most effective healthcare professional at encouraging patients to take medications as prescribed. (CVS Caremark press release)

Books / Articles, Healthcare, Innovation, Leadership, Marketing / Communications, PBM / Pharmacy, Politics

Silverlink eBook: 13 Common Pitfalls In Consumer Health Engagement

July 7, 2011 by George Van Antwerp 1 Comment

After working on consumer communications in healthcare for most of the  past decade, I realized that there were some common pitfalls that happen.  Many of them are pretty straightforward, but when rushed, they may get forgotten.  I worked with Dr. Jan Berger (our Chief Medical Officer) to identify a short list of them, and then the Silverlink marketing team pulled them together in a beautiful eBook. 

Each of the pitfalls is set up with a quote and a great image:

Then, there is a brief description to explain the pitfall on the page across from it:

What are some of the pitfalls:

  • Not knowing how to declare success
  • Limiting design based on company constraints
  • Forgetting about health literacy
  • Not understanding the entire process
  • Thinking you represent the customer

To get a copy of the entire eBook, you can register online.  [Alternatively, you can e-mail me at gvanantwerp at mac dot com.]

Books / Articles, Consumerism, Healthcare, Innovation, Leadership, Managed Care, Marketing / Communications, Methodology, PBM / Pharmacy, Silverlink, Value Propositions, Words Matter

mHealth, Mexico, and HIV

July 6, 2011 by George Van Antwerp 0 Comments

I can tell I’m finally getting through my pile of interesting articles when I pick up an article from February 2010 in HealthAffairs, but it’s a good case study about Mexico’s use of cell phones and mobile technology.

The focus of the story is on VidaNET which is a cell-phone based system that sends text messages and e-mail to patients reminding them to take their medications, keep their physician’s appointments, and stay up to date on their lab tests.  The VidaNET program is for HIV patients and also provides them with other related health information.

“VidaNET is a technology platform that helps you self-manage your health.”

This solution is a partnership between the leading Mexican cellular company (Telcel) and the Carso Health Institute.  It built on their initial program called CardioNET which was focused on obesity related illnesses.  CardioNet featured a risk assessment tool that then drove the consumer to health related resources and provided them with facts to lead a healthier lifestyle.

Although a few of the statistics are now a year old, they are good on the access of the mobile channel:

  • 55% of the world’s citizens have mobile phones
  • It’s projected that by 2018 that there will be one cell phone per person in the world.
  • 80% of Mexicans own a cell phone and the country has more cell phones than people.
I also learned some interesting things about the Mexican healthcare system:
  • Patients don’t have access to their medical records (by law).
  • Doctors are often too busy to explain information to patients.
It clearly is a “physician as God” type of relationship where information is handed down for the patient to follow blindly.  That makes their use of telehealth even more radical by empowering the patient.
The article references two other studies on text messaging:
  • A Vodafone study that found that text messaging appointment reminders to patients in the UK reduced missed physician appointments by 33-50 percent.
  • A review of 14 studies in the American Journal of Preventative Medicine that found that text-messaging interventions produced positive behavior change in 93% of the cases.
I thought the article also did a good job of talking about why adherence is an issue for HIV patients and its importance:
  • Multiple doses of multiple drugs
  • Unpleasant side effects
  • Work only if drugs are taken at least 95% of the time
  • If patients go off their medications, it can lead to the growth of resistant strains of HIV
To some degree, the system is essentially sending you messages based on data you input which seems like a short-coming.  It’s not looking for refill data, planned appointments, and other information which might be electronically accessible.  You input data to set up your profile which then triggers reminders.
One of the cool features is a “stoplight” which tells you quickly your MPR (medication possession ratio).  If you miss your medications twice, you get a red light with the following:
“Don’t let the virus continue replicating.  LOOK FOR SUPPORT AND VISIT YOUR DOCTOR.”
At the time of the article, they were just working on DiabeDiario which is basically a Diabetes Diary.
Books / Articles, Healthcare, Innovation, Leadership, Marketing / Communications, PBM / Pharmacy, Research, Technology

Pharma Virtual Trial (like Remote Monitoring)

July 5, 2011 by George Van Antwerp 1 Comment

I think one of the most exciting things in pharma in the past few months has been the approval that Pfizer received to allow them to do a virtual trial.  This appears to build on a lot of the momentum around remote monitoring, mobile health, telemedicine, and other trends.  The key is that this opens up a gateway for broader trials at potentially lower cost.

But, I think the key with any solution like this is the blend of active and passive monitoring.  In passive monitoring, you wait for the patient to not provide data and then intervene.  In active monitoring, you are prompting them to provide data proactively.  Different patients will respond differently, and probably, like adherence programs, you need a mix of both.

Books / Articles, Healthcare, Innovation, Leadership, Methodology, PBM / Pharmacy, Technology

What I Learned In PharmaVOICE

June 16, 2011 by George Van Antwerp 0 Comments

I’ve been reading the magazine PharmaVOICE for the past year or so. I really enjoy it. I occasionally pull a few articles out.

I was reading the March 2011 version on the plane and found a ton of interesting information. I thought I would share some of the nuggets from it:

  • In 2010, 112M people (48% of US adults) were e-pharma consumers (individuals who went online to find pharma information). (Manhattan Research)
  • Fewer than 20% of consumers who go online for pharma information mistrust pharma websites (branded and unbranded).

“We found the degree to which consumers are open to online content from manufacturers surprising, considering the common perception that consumers are generally critical of pharma generated information.” (Manhattan Research Healthcare Marketing Analyst Maureen Malloy)

  • Top Prescribing-Driving Sites (Manhattan Research):
    • Levitra
    • Chantix
    • Cialis
    • Nexium
    • Yaz
    • Lyrica
    • NuvaRing
    • Symbicort
    • Viagra
    • Lunesta
  • Talk about how research is now “peer reviewed” via social media – original article.
  • Talk about the Sanofi-Aventis blog – Discuss Diabetes – which enables two-way conversations with patients in public.
  • Talk about how Merck is helping patients engage with consumers using online videos and checklists.
  • Talk about a text messaging service focused at teens and young adults for adherence – www.ireminder.com.
  • An interesting article by Ogilvy about 8 Health Engagement Zones and 7 things to keep in mind about public and individual communications:
    • Technology is not a panacea…it has to be adopted and incorporated into everyday behavior.
    • Information must be communicated and interpreted effectively to change behavior.
    • To cut through the “clutter”, information will increasingly be communicated via story-telling and visualization.
    • Technology will allow us to create the right message with the right tone in the right place at the right time. [or already does allow for this with the Silverlink Platform]
    • Health messaging will become personalized. [already happening]
    • Highly targeted, persistent, positive messaging will be needed to help overcome fear and embarrassment.
    • Although health is a serious matter, we don’t always have to take ourselves seriously when it comes to health communications. (e.g., gaming)
  • In the year ending Oct. 2010, $4.4B was spent on DTC advertising around pharmaceuticals.
    • Pharma 3.0 success will be “based not on how many drug units are sold, but on how well pharma’s market offerings improve health outcomes, putting patients and payers at the center of the model”.
    • Pharma investments in condition support tools – smartphone apps, websites, devices, and social media – was up 78%.
  • In a recent Harris poll, only 11% of respondents perceived the pharmaceutical industry as generally honest and trustworthy.
  • According to SDI, there’s been a shift in spending from 2007-2009:
    • 30% decrease in print
    • 32% increase in online activities targeting physicians
    • 29% decrease in magazine DTC advertising
    • 300% increase in internet advertising
  • Learned about a physician “hotlink” (my name) by AstraZeneca where they can connect with the AZ medical affairs team by a feature on their iPhone – formulary status, adverse event reporting, request samples, …
  • Similarly, learned about an “Ask Pfizer” button in Sermo.
  • According to the Manhattan Research’s ePharma Consumer v10.0 study – almost 3/4th of the people visiting pharma websites take a product related action afterwards. (That’s amazing!)

“When pharma is thought of as a health-services industry, the possibilities for growth in revenue, engagement, personalization, and freedom from pipeline dependency are almost endless.” (Paul Simms, eyeforpharma)

  • A list of manufacturers and what percentage of their portfolio is at risk in the next 3 years for patent expiration:
    • #1 Pfizer with $53.6B and 68% of their portfolio
    • #2 Lilly with $20.8B and 66% of their portfolio

“The industry has to address the consumer population across multiple channels with information that is timely, easy to understand, accurate, and actionable.” (Deborah Schnell, Health Advice Networks)

  • There was an article discussing a great question about whether “brand equity” exists after patent expiration.
  • There was talk about the shifting “customer” of pharma from the physician to the consumer and the formulary committee.
  • There were some statistics from a Tufts study on REMS where 75% of people thought the program needed a major overhaul.

I shared a lot here to make a point…this is a monthly magazine packed with interesting content. If you’re in this space, you should be reading it.

Books / Articles, Consumerism, Healthcare, Innovation, Leadership, Marketing / Communications, PBM / Pharmacy, Research, Social Media, Technology

Domestic Medical Tourism and Telemedicine

June 9, 2011 by George Van Antwerp 3 Comments

The idea that local healthcare in a physical setting doesn’t work seems to be the crux of many solutions for leveraging limited resources (MDs) and addressing the geographical pricing differences which exist.  Given what we know about engagement and the value of the physical and personal relationship, there should be a better way.

BUT, without trying to solve for that…I thought I would share a few things that I recently saw.

BridgeHealth Medical is a Colorado based company that is focused on domestic medial tourism.  We’ve all heard about international medical tourism (i.e., flying someone to India for a surgery) and the savings there.  The key (and interesting) question is whether there is some middle ground within the US. 

At least according to the brief story I read in Inc. Magazine, they are getting some traction:

  • 40% savings on a total knee replacement
  • 22% savings on a spinal fusion surgery
  • 13% savings on a prostate surgery

I was amazed that the article said that Americans spend $2.1B outside the US today.  Will this replace that or will it be a new category of spend to track?

And, it will be interesting to track outcomes here and see whether savings translates to better survival rates or improved quality of life.  There will be challenges to the model as I’m sure there have been for international medical tourism.

Cisco on the other hand has rolled out their telemedicine initiative called HealthPresence which uses videoconferencing and high-tech medical equipment to share data.  Obviously, telemedicine has been a tool that’s been tried several times over the years with varying levels of success.  Can Cisco’s efforts and model finally push this from a fringe technology approach to mainstream? 

It’s certainly possible.  Timing may be right.  We’ve seen some success with AmericanWell’s efforts.  The question is how will the consumer respond.  Will they appreciate the easier access?  Will it impact the caregiver / patient relationship? 

Who knows…there is still a lot to learn especially in a country where we’ve been traditionally over-served with our access to healthcare.

Books / Articles, Consumerism, Healthcare, Innovation, Leadership, Technology
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