Look to the Future: Sharing Physician Visit Notes with Patients Improves Engagement and Adherence

More transparency and sharing of information is the way of the future in healthcare. A simple option is to allow patient’s access to their visit notes that physicians keep as a part of their medical record. Patients have a right to see their entire medical record including physician’s notes; however, this doesn’t regularly happen.

Very little is known about the impact on physicians and patients when they are allowed to read physician’s notes from their visits. There are a number of questions including…

1)  Would patients be confused or offended by the information included in physician’s notes?

2)  Would physicians feel they need to spend more time in writing their notes and would they experience increases in the number of questions they receive from patients?

To answer these questions a year-long study was launched to provide patients with electronic access to the physician’s notes from their visits. The study results were recently published on-line in the Annals of Internal Medicine.

Below are the key takeaways from this important study…

* 105 physicians and 13,564 patients participated from three sites in the US

* 11,797 patients (87%) opened at least one physician visit note

*  Of the 11,797 patients that opened at least one note, 5,391 (47%) completed a post-intervention survey

* Of the patients completing post-intervention surveys…
   - 77% to 87% of patients across the three sites reported that open notes helped them feel more in control of their care
   - 60% to 78% of those taking medications reported increased medication adherence
   - 1% to 8% reported that the notes caused confusion, worry, or offense
   - 20% to 42% of patients reported sharing notes with others

* The physicians reported...
   - The volume of electronic messages from patients did not change
   - 0% to 5% from the three study sites had longer patient visits
   - 0% to 8% from the three sites increased time spent addressing patients’ questions outside of visits
   - 3% to 36% changed documentation content
   - 0% to 21% took more time to write visit notes

This study is important because it demonstrates that increased information sharing between physicians and patients increases patient engagement. The impact of this study is…

* A significant number of patients (ie, 60% to 78%) reported increased adherence to medications. Historically, only 43% of patients that start a prescription therapy are continuing that therapy 6 months later.

* The majority of patients (77% to 87%) felt that open notes helped them to feel more in control of their care. This is incredibly meaningful and a key component to empowering patients to take control of their health.

* Overall physicians saw no more than a modest effect on their work lives by sharing their visit notes with patients. This data should help physicians overcome concerns they have in adopting this practice.

 Changes in the healthcare industry are driving the emphasis on decreasing healthcare costs and enhancing patient outcomes. Patient engagement and adherence are critical to achieving these goals, and this study supports open sharing of physician visit notes can have an impact with little additional time investment from physicians.

In the future, the industry must support initiatives that empower patients to take responsibility for managing their health. This is a very personal issue, and what motivates one individual may not work to motivate another. Innovative ideas are needed. Ultimately, many approaches will be combined to form a customized solution that is effective for an individual patient.

At Tunstall AMAC we are focused on helping build and maintain relationships with patients, caregivers, and healthcare providers to drive awareness and knowledge, support patient adherence, and empower patients to take charge of their health. We offer a wide-variety of personal emergency response and telehealth devices that can be used in the home-setting, and we provide 24/7 monitoring and click-to-chat support services to provide support, information, and educational materials to patients, providers, and payers. Our services combined with open sharing of physician’s notes can increase patient empowerment.

We recently published a white paper on how to develop successful patient and caregiver support programs, as well as emerging trends being used to deliver customized and personalized experiences for patients. If you’d like a copy of the white paper titled “Increase Patient Adherence and Do More with Less”, please click to request it.

I’d like to hear your thoughts on the open notes study. Do you think this practice is likely to be widely adopted by physicians? What other innovative solutions do you see for empowering patients to take responsibility for managing their health?

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Full-Speed Ahead: The Shift to Patient-Centric and Personalized Marketing Programs

Read a new article in PharmaVOICE magazine about segmentation advances and the value of personalizing marketing programs

Changes in the industry are shifting the goals of marketing programs to focus on the patient, and to provide meaningful outcomes. To do this, the focus must be on getting the right patient on the right treatment. Advances in technology are fueling exciting changes in how effectively marketers segment and message to their audiences. Real-time data capture empowers decision-making and increases the effectiveness of marketing programs.

The industry has used the decile model for segmentation for years, and in a world of hard-to-reach and no-see physicians this approach is no longer effective. Technological advances provide…  

     * Insights into the number of “appropriate” patients a provider has in their practice 
     * A better understanding of patient behavior so that marketers can deliver more
        compelling messages and valuable programs

As the industry continues to evolve marketing programs to be more patient-centric, delivering personalized information and messages takes on an even greater importance. The key to effective marketing programs is delivering value, and the starting point is to understand patient behavior. This understanding allows marketers to provide programs that meet their needs and helps them overcome their challenges. Valuable and relevant programs foster patient commitment and trust.

There is an article in the October 2012 issue of PharmaVOICE magazine (it’s available on-line) that shares expert insights on advances in segmenting and personalizing marketing efforts. The article provides an excellent overview of the technological changes that empower better segmentation, as well as insights into the impact personalization can have in enhancing the effectiveness of programs.

There are many options for personalized marketing programs. As a pharmaceutical call center, we provide opportunities for patients and caregivers to interact personally with our nurse educators and care counselors at their convenience.

I’d like to hear how you are personalizing your marketing activities. Also, are you using advances in technology to fine-tune your market segmentation activities? If so, what insights have you found along the way that helped you to better understand the patient journey? Did you incorporate these findings into your programs?

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Evolving Pharma Sales Models: The Customer is King

How pharmaceutical, biotechnology, and medical device products are sold is changing and it will continue to do so for the foreseeable future. There are many factors driving this change, and two of the most significant are healthcare reform changes and that healthcare providers are demanding meaningful interactions with company representatives. Life science companies are developing new sales models that aren’t solely a “sales pitch”. Rather, the interaction is “customer-centric” and based on meeting the customer’s needs and providing value.

Evolving your sales model to be focused on meeting customer needs is much more than just adapting your sales messages to address the latest concerns heard in the field. This is a fundamental mindset change, and life sciences companies have think about what it is they are offering and delivering. In the future our healthcare system will be focused on patient outcomes and cost. This environment requires the life science industry to provide programs that support treatments to improve patient outcomes, provide value, and decrease costs.

Patient adherence is an important driver in improving patient outcomes and decreasing future healthcare costs, but it is not the only one. In many disease-states and conditions there are health, wellness, and lifestyle factors that contribute to long-term improvement in outcomes and decreases in healthcare expenditures. There is an opportunity, and need, for life sciences companies to partner with patients, providers, and payers to address health, wellness, and lifestyle factors.

There are many programs that can be developed and implemented that will improve patient outcomes. To create meaningful programs patients can “stick to”, think about these areas…

* Understand the barriers patients face in remaining adherent and compliant with therapy.

* Plan programs that support patients on their treatment journey, and help them adhere to treatment.

* Develop patient support programs that are a resource and guide for patients during their treatment journey.

I encourage you to think holistically about the challenges of patients, providers, and payers and design programs to meet these broad needs. As life science companies look to evolve their sales models to meet customers’ needs and provide meaningful interactions, the need for programs that support patients, providers, and payers will increase. Provide solutions, through your product and its related services, to manage or overcome the broad healthcare challenges your customers face.

There are many options for providing programs that enhance patient outcomes. As a pharmaceutical call center, we provide as needed call-in support for patients, caregivers, and healthcare providers to answer questions about a product and its side effects, enroll patients in a support program, connect patients with healthcare providers in their local area, and connect patients with co-pay assistance resources. Our experiences show that within 6 months of implementing a patient support program patient adherence increases 10% to 15%. Patient adherence to treatment decreases future healthcare costs related to treating complications from earlier non-adherence.

There was an interesting article recently published on Pharmaceutical Executive on-line that looks at the evolving nature of pharmaceutical sales forces as they evolve to a more “customer-centric” approach. If you are interested in learning more about one model for moving in this direction you can access the article here.

I’d like to hear from you. Are you adding programs to support patients as a part of your marketing and sales efforts? If you are, what kinds of initiatives and programs are you planning? Please join the conversation and share your thoughts and challenges. We can all learn from each other. Alternatively, if you have specific needs you’d like to discuss with me you can reach me directly at louis.shapiro@tunstallamac.com.

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