Alternative Media: The EMR Revolution

Physicians are the anchors of new patient adherence strategies.
Dec 01, 2004

Devin Paullin
The pharma industry stands at a "tipping point" at which healthcare technology, market need, and government legislation have aligned and are poised to significantly change the adherence management model. Physicians will be the anchor of this new model, which solves the problem of their time crunch and how to fit adherence programs into their busy schedules. If pharma acts now, it can leverage this opportunity to get in on the ground floor of a new healthcare order.

Consider these dismal statistics:

  • 70 percent of all prescriptions are never consumed, according to the University of Arizona.
  • 20 percent of all new prescriptions go unfilled, according to Consumer Health Information.
  • The World Health Organization reported last year that half of all patients do not adhere to their prescribed therapies.

A large part of the problem is that physicians—the ones who are best positioned to influence patient behavior—have not been included in the adherence effort. They simply do not have the time to handle the extra workload, and they often lack the tools and incentives to make adherence programs a priority. In the meantime, health plans, employers, and the government have already spent more than $200 million, according to the Institute of Medicine, on disease management and medication adherence/compliance efforts that largely work "around" physicians rather than with them. And, as the numbers show, those efforts are failing.

Paul Foley
But there is good news on the horizon. Pharma is currently positioned to take advantage of fortuitous alignments in the healthcare arena that are moving toward adoption and widespread use of electronic medical records (EMR). That technology makes it possible for physicians to become the anchor of a new patient adherence model.

EMR Adherence Model The EMR is a wireless point-of-care technology that automates the most common physician activities, including prescribing. This technology allows doctors to send prescriptions to pharmacies electronically, eliminating many of the errors that result when pharmacists misinterpret physicians' handwritten prescriptions.

It also reduces the growing burden on physicians' time because it eliminates the need for multiple callbacks from pharmacists to clarify prescriptions and dosages. That keeps doctors on schedule and reduces healthcare costs. In fact, automated prescribing has reduced prescribing errors by 95 percent and lowered hospital costs by an amazing 13 percent, according to the Health Care Quality Modernization, Cost Reduction, and Quality Improvement Act (Healthcare Modernization Act), legislation introduced in May by Sen. Edward Kennedy (D, Massachusetts).

Build on Whats Been Successful
For pharma, the EMR technology offers one other very significant benefit—it is well suited to include online adherence program tools. It works like this: When physicians enter a prescription or modify a patient's electronic medical record, they only have to check a box in the record to automatically enroll that patient in a disease-management program at the point of care. (The application could also work in an offline mode if the physician does not use an EMR or stand-alone e-prescribing tool.) Physicians can then easily prescribe an individualized disease- or medication-management program.

The patient takes the "information prescription" home and uses a code to enroll in the program through the internet at home, the office, or anywhere with an internet connection. The programs would then allow patients, for example, to participate in three- to five-minute interactive education experiences, sign up for e-mail or direct-mail medication reminder and prescription refill alerts, or receive coupons for medication refills.

That model would finally place the nation's physicians where they belong—at the center of adherence programs. And because this solution is embedded into the care plan, it becomes an extension of the physician-patient relationship and helps foster an ongoing communication.

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