The availability of a new drug should be brought to the doctor's attention before patients learn of it from other sources, such as the Internet. Changes in overall guidelines concerning the treatment of a disease, the requirements for vaccination of pediatric patients, etc., are less time-critical.

Due to the wide variety of updates, standardizing format is generally less of a concern. Some special forms of updates, such as the discovery of new risks of a drug available on the market, have been given their own distinct, high-profile format. The "Dear Doctor" letters issued by pharmaceutical companies, for example, have a format that is unique and attention grabbing.

It is difficult to issue a blanket pronouncement about the appropriate depth and detail of updates. A notice that a drug has been withdrawn from the market, for example, provides only a statement that the drug has been pulled and information as to why. On the other hand, updates concerning the availability of a new drug—or the approval of a new indication—require, by government regulation, that manufacturers provide more information about the appropriate use, side effects, and contraindications of the medication.

The form factors—or media—employed to deliver an update vary according to the type of update being delivered. Withdrawals or new risk factors typically will require a rather formal form factor. The US mail is still employed in such cases. Updates concerning the availability of a new drug or indication typically will be delivered via a number of media. Pharmaceutical sales representatives usually provide the greatest immediacy, depth, and detail. However, such launch details typically are accompanied by seminars and direct-to-consumer advertisements. Updates in treatment guidelines typically go out in hard copy—newsletters, for instance—so that physicians can study them and file them for convenient reference in the future.

Source credibility is as important with updates as with point-of-care information. But it tends to be a more complicated topic, which can be touched on only briefly here. Doctors generally regard as credible any update that announces the withdrawal of a drug or lists new risks associated with it. Updates concerning the availability of a new drug, on the other hand, which typically are provided by the pharmaceutical manufacturer and are replete with promotional claims, tend to be regarded with skepticism. Because updates concerning changes in overall treatment guidelines are typically issued by respected medical societies, most physicians take them seriously.

A Look Ahead

To effectively communicate with increasingly sophisticated doctors, pharma must rapidly get over the idea that flinging undifferentiated information at physicians will have an impact. What has no value will be ignored. Companies must carefully study how different kinds of physicians consume and utilize information in particular situations. And they must learn to respond to those needs.

More specifically, companies must study how medical schools are training students to utilize information, and ready themselves to deal with a new wave of info-savvy doctors. The industry must face its commercial failures, such as some e-detailing efforts, and recognize that they have not become mainstream information channels, usually because they do not present data how, where, and when the doctors need it. Finally, pharma must realize that the sources of information that do succeed—such as Epocrates and UpToDate—do so because they reflect a genuine understanding of these principles, and thus provide genuine information value to physicians by telling them not only what they need to know, but by giving them the information when, where, and how they need it.

Little more than background noise

The average practicing physician reports that point-of-care data and updates meet most of their daily information needs. There are, of course, numerous other messages directed at physicians, many of which are accessed far less frequently and then only for special purposes.

CME courses, for example, are delivered through medical journals, in-person and online. Most practicing physicians report that they use such courses to gain the credits needed to retain certification, not primarily as sources of information they rely upon for daily decisions.