Biopharma Insights – June 2018
How Account Teams Can Help Ambulatory Physicians Succeed in the Era of Value-Based Care
By Brian Bamberger, Life Sciences Practice Lead
Ambulatory physicians are feeling overwhelmed these days. They must meet a variety of outcomes, quality, and other targets as health care transitions to value-based care arrangements. They are frustrated by the mismatch between their electronic health records’ (EHRs) capabilities and the needs of their practice — especially as many practices are merging or being gobbled up by integrated delivery networks. They are also stymied by their lack of proficiency in using their EHRs to improve patient care, reduce costs and address the needs of payers. Pharmaceutical account teams can make a valuable contribution by providing support and materials to help providers succeed in this new environment.
Drivers for change. Several drivers contribute to physicians’ needs for more effective use of their EHRs. These include:
- Move toward value-based care. In response to rising health care costs, stakeholders and the Medicare Access and CHIP Reauthorization Act of 2015 are requiring new delivery models and payment structures. An increasing number of payers and practices are onboard with these value-based care arrangements, which reward improved quality, outcomes and reduced costs. EHRs play a big role in this transition as the main tool for gathering clinical and cost data, analyzing those data to show compliance and transmitting reports in order to get reimbursed — or not suffer penalties.
- Complexity of the EHR market. The practice of medicine today requires use of an EHR. Currently, there are more than 500 EHR companies with varying degrees of functionality and sophistication. For example, they use different nomenclatures and ways of capturing and sharing patient data. According to a recent Surescripts report, the biggest data gap across EHRs involves medication adherence. Some 83% of physicians believe access to medication adherence information is a high priority yet only 17% can easily retrieve it electronically. Moreover, availability of advanced functionalities differs, such as clinical protocols, data analytics and clinical decision support. As a result, necessary data analysis and exchange are out of the reach of many providers.
- Practice competency gaps. Practices vary in their effective use of the tools that are available in their EHR, the sophistication of those tools and their integration within the practice. This results in competency gaps, which have implications for patient care and reimbursement. A new survey shows that 88% of small practices aren’t optimizing advanced EHR tools.
How account teams can help. By providing clinical guidelines and educational materials for various conditions, uploading them into practice EHRs and training practice staff on their use, account teams can help fill these gaps. Assistance in framing possible EHR use for practice approval is key and provide a starting point for health system or practice discussions when establishing new EHR prompts or reporting on quality. This can be a new opportunity for account teams to systematically support physician efforts for meeting value-based care metrics.
This approach enables the account team to:
- Provide a curriculum of high-quality, comprehensive content that is engaging and actionable by physicians.
- Easily provide current content and information about treatment best practices.
- Help physicians achieve the measures on which their reimbursement is based.
- Create and/or deepen relationships with physicians and office staff.
- Help physicians maximize their time spent with patients during the office visit.
- Build loyalty and trust.
- Improve sales and patient retention.
Making it work. Translating this approach into action will require some work on the pharmaceutical company’s part. First, buy-in will be needed for the practice to use and modify the company-provided materials for its own use. This should not be too challenging given that the materials can be used to meet requirements of both public and private payers. Practices do not want to leave money on the table.
Once buy-in occurs, the sales representative can work with the office’s information technology (IT) staff to configure the EHR. In small practices, the IT contact may be the office manager or practice administrator. Larger practices may have consultants or dedicated staff handling IT matters.
For patient education on the EHR, a variety of educational formats are required. For example, some EHRs aren’t optimized for outside PDFs. Inclusion of content in an HTML or RTF format allows inclusion with other patient instructions.
The company should make all materials easy to obtain and ideally have a method to update content as new guidelines and best practices are developed. To be sure, the materials need to be specialty specific and complement the needs and size of the practice.
Finally, the pharmaceutical company should make sure that providing educational content to a practice augments its resources and is not an opportunity to develop relationships with patients without physician practice involvement. Too often, an account team’s goals are centered on signing up and educating patients without physician and practice involvement. This makes practice staff wary when patients question physician choices based on what they’ve read in physician-provided but pharmaceutical company-directed content. With that in mind, note that physician practices are more likely to integrate materials when their practice’s logo appears larger than the pharmaceutical company branding.
How we can help. Point-of-Care Partners can work with your account team to effectively implement clinical guidelines and patient education efforts. We provide sales force education, reference materials and content to use with practices. For example, we can develop easy-to-use instructions for EHR prompts or patient education that are EHR specific — a necessity now that EHR feature names and capabilities vary from one system to another. Speaking the practice’s EHR ‘language’ is vital. Drop me an e-mail at email@example.com. Our knowledgeable and experienced staff are here to help.