healthcare communications study among physicians: medical monitor 2013

Star Life Sciences Medical Monitor™

2013 Healthcare Communications Study Among Physicians

©2013 Star Group Communications, Inc.

Healthcare Communications Study Among Patients | ©2013 Star Group Communications, Inc. 2

Star Life Sciences partnered with Plesser & Clifford,a 30-year-old market research company specializing

in medical marketing research, in designing and implementing this study.


• Background, Objectives and Research Methodology

• Executive Summary/Implications

• Detailed Findings:

Sources of Physician Information - Which communication channels have the greatest influence with physicians - Influence of the internet - Influence of pharmaceutical sales representative Keeping Patients Informed - Ways in which they share information - Beliefs on effectiveness of direct to consumer advertising and why Opinions on Topical Issues in Medicine Today - Opinion of the Patient Protection and Affordable Care Act and why - Opinion of importance of electronic health records and why

• Appendix: Screener and Questionnaire

Contents


Background, Objectives& Research Methodology


• Star Life Sciences wishes to build its learning base about where physicians are turning to keep professionally informed and in turn, what sources do they direct their patients to in order to keep them informed.

• Some of these questions asked are the same as questions asked in a similar Star Life Sciences Medical Monitor™ report conducted in 2007. Where possible, results will be compared.

• Star Life Sciences also is interested in physicians’ opinions about two topical issues in medicine today: the Patient Protection and Affordable Care Act and electronic health records, and how these issues might affect their practices.

Background & Objectives

Background & Objectives | Research Methodology


Research Methodology

• Online survey

• Physicians in the Reckner database were invited to participate in the survey via an email.

• All data collection was completed between January 18 and January 24, 2013.

The respondent quota of 100 physicians was fulfilled.

Specialists*

AllergyAnesthesiologyCardiothoracic SurgeryDermatologyGastroenterology

General SurgeryHematologyNephrologyOB/GYNUrology



Sample Characteristics

Although these were not screening criteria, the physicians represented the following groups:



Executive Summary


Physicians are significantly more influenced by peers than any other potential channel of information when trying to stay informed professionally.

Rating Communication Channels

Executive Summary: Information Sources


Specifically, physicians keep abreastof what is going on in their area ofmedicine by reading articles inprofessional journals, going toconferences, conferring with peers,consulting key opinion leaders, andmeeting in person with pharmaceuticalrepresentatives. These results havenot changed since the 2007 Star LifeSciences Medical MonitorTM Study.




When asked which 3 sources they rely on most, articles in professional journals, conferences, and in person with drug representatives are ranked in the “Top 3” most often. Websites/internet searches receive as many responses as talking to peers and are the most regularly relied upon sources of information. Some of this may be due to the fact that journals are only published periodically and conferences are often annual events, while the internet is constantly available.




In spite of the fact that computer ownership has increased since 2007 and that approximately half the physicians in this study use a smart phone and/or iPad, they do not depend on the web more heavily than in 2007. They may be going to the web more often, but they do not rate the pharmaceutical or healthcare websites more important than they did 5 years ago. Although pharmaceutical companies may be allocating more of their budgets to digital marketing, it has not made significant inroads in changing the ways physicians like to get information or in their belief that this information is useful to them.

Communication Influencers



Although pharmaceutical companies continue to decrease the size of their sales forces, according to the physicians, pharmaceutical representatives still play a vital role—especially for the physicians in smaller practices.

Importance of Pharmaceutical Representatives



Although physicians are utilizing the web via their phone and iPads to look up information, they still favor older methods to share the information they find with their patients. They are only occasionally directing their patients to websites, preferring to distribute printed material. The 2013 Medical MonitorTM study showed that both patients and physicians use the internet to look up medical information. However, physicians only occasionally direct their patients to the web, suggesting one of the following:

• A gap between what physicians want and what they find on the web that prevents them from directing their patients there.• The belief that printed materials are of more use to their patients.

Preferred Method of Sharing Information with Patients

Executive Summary: Keeping Patients Informed


The perceived effectiveness of direct-to-patient advertising is mixed. Approximately one-third believe it is effective, but the same number believe just the opposite or have no opinion. Those who believe it is ineffective feel that it is sometimes biased, confusing and can often mislead patients. Those that feel it is effective say that it raises awareness and opens lines of communication.

Effectiveness of Direct-to-Patient Advertising

Executive Summary: Keeping Patients Informed


40% say they are not happy and their concerns center around quality of care, costs and the intrusion of government into healthcare.

39% have no opinion. Of those, one-third say it is too soon to tell, one-third say they are confused about parts of it and one-third fear it might hurt their practice. This group may be made to feel better if they were educated more about the Act.

Only 21% are happy it passed citing it is for the greater societal good.

Physicians are Not Happy About Passage of the Act

Executive Summary: Patient Protection and Affordable Care Act


While a sizable portion of both groups say they are uncertain about the Act, patients currently are more optimistic than physicians.

Perceptions of the Act: Physicians vs. Patients



The majority of the physicians (61%) felt electronic health records were important. Only 19% felt they were not. There was a correlation between the size of the practice and views of electronic health records. Only 47% of the physicians in solo practice felt they were important. As the size of the practice grew, so did the importance placed on electronic health records.

Importance of Electronic Health Records to Your Practice



Although not specifically asked if they made the switch in this study, we know from the open-ended comments that comfort with electronic health records correlated with increasing familiarity and a greater degree of adoption.

• Those who felt electronic health records were not important to their practice had, for

the most part, not adopted the method yet.

• Those who were in the process of adopting electronic health records were having

adjustment issues.

• Those who had fully integrated electronic health record systems into their practice

praised the systems and felt they would never go back to paper charts.

An Image Issue

Executive Summary: Electronic Health Records


Detailed FindingsSources of Physician Information


Physicians were asked to evaluate how important each of 20 potential sources of information were in terms of keeping them informed professionally. The “Top 5” sources of influence are all peer related.

Communication Influencers Ratings

Detailed Findings: Sources of Physician Information


Physicians were also asked to indicate which 3 sources they rely on the most. The “Top 3” sources they rely on are articles in professional journals, conferences and drug representatives.




Although some new categories were added, results to this question were very similar to the 2007 Star Life Sciences Medical MonitorTM study. Peer-related sources top both years’ lists followed by direct sales.




Physicians were also asked how often they use their highest-ranked sources. Because professional journals are published only monthly and conferences tend to be held annually, the source used most often for information is general internet searches.

Communication Influencers Frequency



Although pharmaceutical companies continue to decrease the size of their sales forces, according to the physicians, pharmaceutical representatives still play a vital role especially for the physicians in smaller practices.

• Total: 76% of all physicians feel the representatives are very important or important.

• Solo/Small: 33% of the physicians in solo practice feel the representative visits are very important, 50% feel they are important. Similarly, 22% in a small group feel the representatives are very important, 54% important.

• Large/Corporation: While maybe not quite as critical, physicians in larger groups still feel the representatives are important.

Importance of Pharmaceutical Sales Representatives



• Physicians were asked, “When thinking of new digital technology, which of the following devices do you use to gather information for your patients or practice?”

• Half the physicians are using a smart phone to gather information. Almost half are using an iPad at least occasionally.

• 72% of all the physicians felt they were using technology more than they were a year ago. 28% felt they were using it the same amount as a year ago.

Usage of New Devices to Gather Information for Patients



Detailed FindingsSharing of Information with Patients


Although the physicians are utilizing the web via their phones and iPads to look up information, they still favor older methods to share the information they find.

• Physicians were asked, “Which of the following methods/vehicles do you use to share information with your patients and how often?”

• Physicians share information with their clients mostly verbally followed by giving them printed material.

• Occasionally physicians are directing their patients to websites. (Note: These numbers are consistent with the Patient Compliance Study where we found approximately half the patients say they utilize the web to get information on medications.)

Usage of New Devices to Gather Information for Patients

Detailed Findings: Sharing of Information with Patients


Physicians were asked to rate how effective they felt direct-to-consumer advertising by pharmaceutical companies was for accurate patient information.

Physician reactions to direct-to-patient advertising is mixed:

Direct-to-Consumer Advertising forAccurate Patient Education

Detailed Findings: Sharing of Information with Patients


37% of the physicians feel that direct-to-patient advertising by pharmaceutical companies is ineffective for accurate patient education.

The primary reasons why physicians believe that direct-to-patient advertising by

pharmaceutical companies is “Very Ineffective” or “Ineffective” are:

• Confusing - Patient has the potential to misunderstand

• Misleading - Ad has the potential to misinform and misdirect the public

• Biased - Presents incomplete picture

• Does not influence prescribing behavior

Rating Direct-to-Consumer Advertising Ineffective

Detailed Findings: Direct to Consumer Advertising


Confusion: Over half the physicians who feel the advertising is ineffective feel this way because they believe the advertising is confusing to patients and has the potential to be misunderstood.

• “Patients do not understand all of the information or what other medications they should consider”

• “Patients misunderstand most info”

• “Confusing to patients; implies product may be helpful for conditions patients do not have”

• “Not convinced my patients know how to interpret information”

• “The patient is frequently confused or doesn’t truly understand the information”

• “Confuses patients.They get inundated with advertisements and trust nothing”

• “Patients see and hear what they want to see and hear and I have to re-educate them about the product and the disease”

• “All of the warnings confused and scared them”

Rating Direct-to-Consumer Advertising Ineffective



Misleading: Some of the physicians feel the advertisements are misleading or inaccurate in ways that can mislead or misinform the patient.

• “Most ads don’t tell a patient why they should use the product. People come in and ask for something that doesn’t even treat what is wrong with them. Only sometimes is the information accurate. All of the side effects listed also scare them”• “Pharmaceutical company not interested in accuracy”• “Patients may not have accurate information or have unrealistic expectations by the time physician gets questions related to direct marketing”• “Usually just frightens patients due to all adverse events listed”• “Can be very misleading for patients”• “They think that the advertised medicine is the answer and that there are no alternatives”

Believe “Ineffective” Verbatims



Biased: Some of the physicians feel the ads are biased.

• “It is biased obviously”

• “I think they want to push the most expensive and profitable products”

• “It is a quick biased message to the patient. It does not take into consideration the individual patient’s issues”

• “Obviously usually biased and inappropriate for the specific patient”

Don’t Influence Behavior: Some of the physicians feel the ads just don’t work to influence behavior.

• “Patients know that they are designed for profit”

• “Don’t find it helpful”

• “Patients seem to pay little attention to the pharmacology”

• “Do not get read”

Believe “Ineffective” Verbatims



32% of the physicians feel that direct-to-patient advertising by pharmaceutical

companies is neither effective or ineffective for accurate patient education.

Reasons: Almost half the physicians who rated direct-to-patient advertising as neutral (neither effective or ineffective) questioned the effectiveness of the advertising regarding prescribing behavior. The remainder of the comments raised the same concerns as the physicians who rated it as ineffective. The reasons cited are:

• Confusing

• Misleading

• Biased

Rating Direct-to-Consumer Advertising “Neutral”



Effectiveness: The majority of these physicians just don’t see it influencing their patients behavior.

• “Occasionally effective”

• “Sometimes helpful and sometimes not helpful”

• “Patients want to talk to doctors”

• “Patients ask occasionally, but do not necessarily believe what they read”

• “It can depend on the product as well as the information being delivered”

• “The information has too many “qualifiers”

• “I feel like it leads to more questions than answers”

• “Patients most often go by their primary care recommendation, especially if it has been a long-term relationship”

• “I don’t see much in terms of patient asking for products that have directed patient advertising”

• “I do not get much feedback from my patients that they sought out information directly from pharmaceutical companies”

• “Patients do not care much about it”

Believe “Neutral” Verbatims



Confusing:

• “Because there are so many risks discussed, confuses patient”

• “Sometimes too much info for patients”

• “They usually don’t listen closely or catch the “fine print”

• “Confuses the patient”

• “Patients have a great deal of anxiety concerning the legally required, AE info”

• “Most patients do not understand what they are being told”

• “Most patients don’t understand material”

• “Often patients don’t have the ability to clearly understand/integrate information presented in such a short amount of time/space”

• “Patients may not get a clear understanding”




Misleading: There were a few comments that implied physicians felt information conveyed was misleading.

• “The information does not provide enough detail about the drug side effects”

• “It causes excess unnecessary discussion and review of a product that is not needed or very expensive on the patient’s formulary !!!”

• “I think direct to patient advertising is biased in favor of the pharmaceutical company. Then patients get preconceived ideas about what they need/want which makes it difficult for me to make good recommendations for them. On the other hand the ads often provide information to patients that they otherwise would not get”

Biased: Physicians also felt the ads can be biased.

• “I feel that patient advertising by pharmaceutical is bias”

• “Sometimes it is bias”

• “Potential for bias in promoting”

• “The information will often be in favor of the pharmaceutical company”




31% of the physicians feel that direct-to-patient advertising by pharmaceutical

companies is effective for accurate patient education.

Reasons: The primary reasons why physicians believe that direct-to-consumer advertising by pharmaceutical companies is “Very Effective” or “Effective” are:

• Effectiveness in changing patient and prescribing behavior

• Raises issues and awareness

• Opens up communication with patients

Rating Direct-to-Consumer Advertising Effective



Effective/Change Rx Behavior: Over half of the physicians in this group who commented believe the ads are effective in changing prescribing behavior.

• “They are providing truthful information which is monitored by the FDA. It is effective”

• “Provide new information clarification on meds”

• “Patients listen to them”

• “Their ads are FDA filtered and approved”

• “Many patients ask about drugs they have seen advertised”

• “Previous experience with direct-to-consumer advertising has yielded many requests for products”

• Patients do ask about the products that they see on television

• “Powerful form of media”

• “PATIENTS LEARN FROM THE EXPERIENCE”

• “I do think it helps the patient educate themselves”

• “It helps us administer Rx the patients need, making them more educated on the topics”

Believe “Effective” Verbatims



Raises Issues and Awareness: These physicians believe that exposure to the ads raises patients’ awareness to different treatment options. This awareness for the most part is viewed positively but sometimes it can have an adverse effect.

• “Makes them more aware of treatment”

• “Has raised awareness for products previously underutilized, like Mirena IUD”

• “Patients are exposed to products they might be otherwise unaware of”

• “I think it makes patients aware of medical conditions and that treatments are available, but the medications that are advertised to patients are not always the best ones for them”

• “Raises awareness of issues and options”

• “Patients often have some knowledge of new products. Sometimes that ‘knowledge’ is inaccurate”




Opens Up Communication Channels: Many of these physicians believe that the ads help to get their patients to make appointments and gives them something to discuss in the office visit.

• “Patients come in asking questions”

• “It can be a way to start a discussion about a certain disease or a certain disease process. If I mention a med and they have heard about it on TV, it reinforces the importance of that med”

• “Patients bring up the subject after seeing it on the TV”

• “Patients know more about available options and come in asking for my opinion about them”

• “They set the appointment up to ask specific questions on their disease or treatment options”




Detailed FindingsPerceptions of Passage of Patient

Protection and Affordable Care Act


Physicians were asked, “Which statement describes your reaction to the passage of the Patient Protection and Affordable Care Act: Happy it Passed, No Opinion, Need to Wait and See or Not Happy, Don’t Like It.”




21% of the physicians were happy the Act passed. The majority of those physicians who were happy it passed mentioned they believe that everyone should have insurance for the greater good of society.

• “Everyone should have health insurance”

• “It will provide insurance coverage for more people and give more attention to outcomes”

• “It will help patients who are uninsured to get the care they need”

• “Support universal coverage”

• “Healthcare is the responsibility of a civilized society. It helps me care for my patients”

A few mentioned that the Act is just the first step we need toward Universal Healthcare.

• “I want to eventually see single payer. This is the first step”

• “We need universal healthcare”

• “First step towards universal healthcare”

• “We should have universal healthcare”

“Happy Act Passed” Verbatims

Detailed Findings: Patient Protection and Affordable Care Act


Some felt it would lead to better quality of care overall or for special groups.

• “Believe people will be taken care of better”

• “More people will get insurance. Quality will be looked for”

• “We take care of so many patients with no insurance so in a way we are already paying for those patients (but not in a meaningful way which requires preventive care)”

• “Improved access to women’s healthcare”

• “There are plenty of poor people in my state and it will help them unless our governor blocks it”

• “Better for children”

• “I treat the indigent population-under insured and uninsured”

• “Improved healthcare for children”

“Happy Act Passed” Verbatims



Physicians were also asked what they saw as the implications of the Affordable Care Act on their practice. Among those who were happy it passed, half were optimistic that it would bring them more business and that it would mean better care for their patients.

• “I will be busier because more people will qualify for insurance”

• “It should be good for my patient population. Not sure of any drug co. impact”

• “More kids will have access to care; may strain our ability to provide same”

• “More business as more patients are insured. Hopefully we can work on disease prevention rather than treatment”

• “Provide means to share data and provide safer patient care”

• “Good, good and good”

• “More paperwork but better patient access and compensation”

“Happy Act Passed” Verbatims: Impact on Practice



Approximately 20% of physicians that were happy it passed were concerned about the impact it would have on their practice.

• “We will work harder for less money”

• “Will try to ratchet down costs and may prevent innovation in the pharmaceutical industry by decreasing benefits of developing new drugs”

• “Confusing initially”

• “Still will be overworked and underpaid.”

• “Not clear yet”

• “Will have more cost for insurance”

“Happy Act Passed” Verbatims: Impact on Practice



39% of physicians were reserving judgment on the Act. Of those physicians who had no opinion, about one-third basically felt it was too soon to tell and they wanted to wait and see.

• “No effects seen yet”

• “Waiting to see how effects. Like that more patients are covered”

• “Because I need to wait and see what happens”

• “Has not had an effect on me. Everyone agrees healthcare system is not good but cannot agree on what to do about it. At least Mr. Obama has made an effort to improve it. Awaiting details of full implementation”

• “As Nancy Pelosa said let us pass it and then we can read it. There is a lot of information that has not been made available to the public”

• “Prefer to decide over a bit more time”

• “This law will be reworked over the next 20 years.This is not final form”

• “TOO MANY PROS AND CONS, WE HAVE TO WAIT”

“No Opinion” on the Act Verbatims



Another third had no opinion and were confused about some aspects of the Bill in general:

• “Not sure how accepting patients will be and how it will affect the reimbursement”

• “I am in favor of healthcare for everyone, but not sure that the Act will solve our problems of how to implement the affordability of healthcare for all”

• “Too confusing to know all of the potential implications”

• “Not sure of the specifics, especially related to the indigent population which is a significant percentage of our patient population”

• “Very complex bill--not sure how much of it will actually happen. So far it has been quite good”.

• “I am still learning all of the ramifications. For instance, I still don’t know if Medicaid will be expanded in PA to cover more patients”

• “I think in theory it makes sense but the details will be very, very problematic. How does it control costs?”

• “I am not sure it is cost effective”

• “I really don’t think anyone knows how ACO’s are going to work”

• “I don’t completely understand it’s ramifications”




Others with no opinion were concerned about how it might affect their practices.

• “I’m not sure what all of the ramifications will be and how it will impact my practice”

• “Not sure what it will mean to my practice in the long run”

• “I’m not all together sure what this will mean for myself and my practice”

• “It has some good aspects and some bad, especially in relation to mandatory use of EHR. Primary care needs to be rewarded and nobody seems to realize that”

• “I believe the expanse of what is covered in the legislation is too wide and broad for me to make a determination at this time. I will see how it impacts my practice of medicine as the laws unfold”

• “I am not sure of the impact of this in my practice”

The remainder just had a basic distrust about the Act.

• “It will probably fail like every other initiative”

• “I have seen the national health in UK and other countries, which is not good for the patients”

• “I don’t trust the government”

• “There are many angles which still need to be proven”




Approximately half the physicians that had no opinion about the Act passing were also uncertain how it would affect their practice and they were going to wait and see.

• “We have no idea right now but fear the worst”

• “Do not know - wait and see”

• “I really don’t know what to expect”

• “Can’t give good opinion at this time”

• “Hard to tell at this time”.

• “Too soon to know”

“No Opinion” on the Act: Impact on Practice



About 25% feel it will have a negative impact regarding costs and reimbursements.

• “I AM CONCERNED ABOUT PATIENT LOAD AND REIMBURSEMENT”

• “Decreasing reimbursements, inability to use many vouchers for patients, less samples”

• “Unchanged and possibly increased cost of care and decreased income for practitioners”

• “I am in favor of every American having a basic level of insurance, but I suspect costs will escalate. I feel pharmaceutical reps provide a valuable service bringing information into the office setting, especially in smaller towns and rural areas”

• “I see more documentation; more time spent on paperwork; perhaps more new patients, but less compensation”

• “Less income for physicians, probably same care for patients. It will make dealing with pharmaceutical companies more difficult”




About 20% of this group feels it will have a negative effect on their patients or their practice in general.

• “I think it is going to make it more complicated and confusing for all of us”

• “It will be the end of private practice and lead to delivery of care by committee. Physicians will be less professional and more like employees. Companies will deal with companies, not physicians”

• “I believe these represent further obstacles between myself, my patients and other entities that are imposed by the government”

• “More paper, more and more people looking over my shoulder”

• “Influx of newly insured patients but not enough Drs. to go around”

• “Patient care will suffer”

• “I am concerned that the government will be reimbursing doctors less to insure more! Also, I am concerned that patients may not have access to all available specialists and procedures if the government “rations” healthcare. Our state of Illinois is not capable of administering these programs with its current deficits!!”

• “A few mention potential for good to come of it”

• “More regulations but also potential for additional patient visits”

• “Hopefully make things better for the patient”

• “Family Practice will only be more in demand”




The largest group of physicians, 41%, were not happy the Act passed. A little over one-third of the physicians who were against the Act had concerns about the effect it would have on the quality of healthcare services in this country.

• “I think it will stifle innovation and creativity in medicine”

• “Hospital and physicians will become at odds and potentially physician to physician”

• “Will cause more of my patients to lose their private insurance and increase the number with Medicaid”

• “There are too many reasons to list but I feel like this will only hurt physicians and in the long run quality patient care”

• “Will promote cookbook medicine, increase insurance premiums, mandates medical coverage that violates certain religious beliefs, will gut Medicare, and will put many on Medicaid who will find no physician to see them”

• “Increases unfunded patient roles with no providers to care for them. More regulations and government interference”

• “I think as always it looks at supply side of the equation and completely eliminates the issues regarding demand side and its associated responsibilities”

“Against” the Act Verbatims



• “Again an added expense which also reduces quality of care”

• “Will make access to docs take longer and cost more”

• “Unsustainable, very expensive and increased the deficit. I would have favored a block grant to states to manage their own Medicaid”

• “There are not enough physicians to take care of 30 more million patients and maintain quality. Rationing will occur. I witnessed this in Canada”

• “No evidence of cost-saving. Limits care. Practices cookbook medicine. More paperwork”




One-fourth the physicians who were not happy it passed mentioned the associated costs as the reason.

• “Increase cost to patient and decrease reimbursement to physician”

• “Too many hidden costs and no provision for increased providers to take care of dramatic increase of patients added to system”

• “Extra taxes. Penalizes working families”

• “It is going to raise the premium for everybody”

• “Just another tax”

• “Terrible economic impact, extra-medical community control of medical practice”

• “Used to practice in Canada. Within 3 years the country will be insolvent from debt from this alone. No chance to pay for this”

• “Too much pork tied to it. Will increase the cost of medicine”




Almost one-fourth mentioned they disliked the intrusion of government into healthcare decisions.

• “More Gov top down regulations and mandates”

• “Too much government control over healthcare. It will only lead to single payer healthcare over time and you will see a shortage of doctors. I have much more to say but there is not enough time”

• “We need health insurance reform, not mandatory coverage”

• “Personally have appreciated ability to keep my young adult children on my insurance. Professionally very concerned with amount of bureaucratic/top down control of changes without regard to differences in regions of country. Massive consolidation into larger hospital ‘systems’ including consuming of individual physicians practices”

• “Too much government control”

• “Government intrusion into the physician-patient relationship. Big Brother telling doctor and patient alike what they MUST do and can NOT do”

• “Reimbursement reductions, government intrusion between patient and Dr., bureaucracy, paperwork, sea of regulations”




A few others just had a general dislike for the passage of the Act.

• “Shoved down our throats, never proven to be of benefit, another way to screw docs”

• “Too much onerous regulation involved for my office”

• “Too complicated. Will ruin economy”

• “I think affordable healthcare should mean a limit on healthcare after a certain age and more supervision of ancillary services that seem superfluous or even abusive in their marketing”

• “More work, less pay”

• “There needs to be shared accountability with patient responsibility for their own healthcare”




Among the physicians who were against the Act, about one-third had reservations for their practices regarding expenses and reimbursements.

• “Decrease reimbursement, patient costs will go up, fewer brand name choices so less relationships with drug reps”

• “I see them paying less and wanting more. Demanding guaranteed outcomes, increasing our cost and exposure to deliver healthcare”

• “I have long been concerned with lack of awareness of the importance of ‘cost of care’ among my peers and this will now be ‘forced on us.’ That is a positive. The amount of ‘red tape’ and expansion of large organizations/cumbersome bureaucracies will do little to improve healthcare. EMR’s have been ‘forced’ on practices with little evidence that they are ready for ‘prime time’ at least in my center”

• “I think there will be less payments for me and more for the government who will spend my money telling me what and how I should practice medicine”

• “I think it will increase costs, lower efficiency and make physicians more resentful of government intervention”

• “More red tape which reduces dollars available for patient care. More expenses to my practice with no way to recover the increased overhead like all other businesses”

• “Will have to raise prices and limit access”

• “Less reimbursement, less joy in practice”

“Against” the Act Verbatims: Impact on Practice



About 20% had concerns over quality of patient care.

• “Government intrusion to patient-physician relationship, rationed care and pharmaceutical access”

• “Too much intrusive State and Federal control with poorer quality and care outcome”

• “I am retiring now. But I feel sorry for my kids and grandkids. Patient care will be unavailable in the first six months”

• “Less personal patient care”

• “More work, less personal and patient time. No reward for it”

• “Volume will increase. Quality will go down. Have to be selective which patients to accept as now I will be rated on results which means if I have a lot of high risk patients I will be low rated and less compensated”

• “Patient care will be decreased in direct contact with providers who are actual physicians, with increased waits and expense for care”




About 15% mentioned issues with the pharmaceutical companies.

• “More cost conscious, less on quality will hurt pharma”

• “More bureaucracy from Health Exchanges. More dependence on generic medications putting the squeeze on pharma. More efficient pharma reps.”

• “Hard to say but the pharmaceutical industry is getting killed. R&D going away. No reason to invent and progress”

• “We’ll limit care. Unfortunately patients will be forced to use generic medicine which has no proven benefit. Also pharmaceutical companies will limit further research”




About 10% felt it would be so bad it would restrict or make them give up their practice.

• “It will likely motivate me to leave the practice of medicine much sooner than I had intended or would like to”

• “Will probably cause me to restrict my practice in some way. Will certainly impact my personal style of medical practice. Will probably curtail interaction with drug reps”

• “Already felt and closed my private practice. Now employed by a hospital’s group practice”

• “Everything will be regulated and controlled. This will lead to major frustration and I will likely leave the field of medicine”

• “It will most likely impact my decision to stay in practice”




• Star Life Sciences asked both 100 physicians and 100 patients about the Patient Protection and Affordable Care Act as part of the 2013 Star Life Sciences Medical MonitorTM study.

• As shown in the following chart, while a significant portion of both groups were in a wait and see mode, patients were more favorable (35% Happy) toward the Act than the physicians (21% Happy).

Physicians vs. Patients



Detailed FindingsImportance of Electronic

Health Records (EHR)


• Physicians were asked, “What is your opinion of the importance of electronic health records to your practice?”

• The majority of the physicians (61%) felt electronic health records were important. Only 19% felt they were not.

Importance of Electronic Health Records

Detailed Findings: Electronic Health Records


• There is a very high correlation between size of practice and views of the importance of electronic health records.

• As the size of the practice grows, electronic health records are deemed to be more and more important.

Size of Practice



Although not specifically asked if they made the switch in this study, we know from the openended comments that comfort with electronic health records correlated with increasing familiarity and a greater degree of adoption.

• Those who felt electronic health records were not important to their practice had, for the most part, not adopted the method yet.

• Those who were in the process of adopting electronic health records were having adjustment issues.

• Those who had fully integrated electronic health record systems into their practice praised the systems and felt they would never go back to paper charts.

Electronic Health Records Face an Image Problem



19% of all physicians indicated that electronic health records were unimportant to their practice. Of this group, 90% were in solo or small private practice. None of them had adopted it into their practice so their views were based on image. They mention the following reasons for not wanting to switch to electronic health records:

• Overall image issues

• Cost of switching

• Quality of care issues

• Belief in old-school methods

“Very Unimportant / Unimportant” Verbatims



Many of the comments of those who felt EHRs are unimportant concerned overall image issues.

• “Don’t have them, everyone who does hates them”

• “I don’t use it nor trust its accuracy”

• “It would just add another headache”

• “Too slow”

• “It creates so much noise that important things are missed”

• “Takes too much time, too little benefit”

• “EHR has caused a lot of problems with follow up care. It is very good for sending out prescriptions and that’s all”

• “Has not changed the flow of data between physicians, offices and hospitals which was what was needed”

• “It’s being forced on us”




Other comments from this group mentioned costs.

• “Huge expense”

• “Solo practice, no way can afford it”

• “Will complicate things and cause massive cost increases”

• “Too expensive in dollars and time and don’t add to patient care but actually hinder care”




There were a couple of comments about the perception that quality of care for patients would be compromised.

• “Detracts from personal relationships with patients”

• “The way it is currently set up does not help patient care and is inefficient”

Lastly, a couple of these physicians mentioned that they are happy with the old-school method.

• “We have not switched to EMR. We still do paper charts and it works well for us”

• “I feel like it is still important to have a record in hand”




20% of all the physicians felt neutral about electronic health records. Half the comments in this group said they felt neutral because they didn’t have the system or were just transitioning to one.

Of the other comments many concerned quality of care.

• “Slows down patient care and frequently not reviewed for patient contacts”

• “Slows me down, less patient interaction, leans toward a bland, uninspiring patient visit note”

• “Slows down the process and does not improve patient care at all. Costly for nothing unless all EHRs communicate together regardless of which doctor the patient sees”

• “EHR vendors say improves quality of care but data do not necessarily support that statement”

• “Takes away quality time with patients”

• “Can be a help or hindrance. Can decrease the doctor-patient relationship”

There were a few other miscellaneous comments.

• “Helpful but time consuming”

• “Another potential source of med info leak and of governmental control”

• “It helps my handwriting and ordering Rxs but otherwise is a silly bother”

“Neutral” Verbatims



35% of all physicians felt they were important. The vast majority of their comments were positive using words like “easier”, “better” and “help”.

• “Wave of the future”

• “It is easy to see other specialist notes and decrease duplication of studies, provides multidisciplinary approach, much easier”

• “Aides in transferring records. Keeps up-to-date lists (meds, allergies, etc.)”

• “Simplify my life”

• “Ease of access”

• “Better documentation and tracking”

• “Help us keep accurate information on a patient and allow us to read notes”

• “Keeps things organized and readily accessible”

• “Improved record keeping. I am already on the other side of using EHR so I am accustomed to them”

• “If implemented properly, have the potential to improve speed of access to patient history/records”

“Important” Verbatims



• “It helps better co-ordinate some aspects of care and for clinical reminders!”

• “Easy to coordinate care”

• “I like having EHR although it does slow me down is some areas, like refilling Rxs. I would never go back to paper charts. EHR makes it easy to copy information from prior visits and not obtain information anew”

A few in this group view them as important, but also as a “necessary evil.”

• “We use them exclusively, but they are odious, waste time, and do not contribute to the quality of patient care. So yes, they are important in my practice, but loathsome nonetheless”

• “They have become a necessary evil. They are a tool and like any tool, can be used in a good way or in a bad way”

• “It will become more important as time goes by. Initially it is difficult to implement”

• “Hard to learn but useful for keeping and sharing information”

• “They are much more comprehensive but very time-consuming”




26% of the physicians felt electronic health records were very important to their practice. This group seems to be further along the learning curve and had integrated them into their practices. All their comments were positive with many superlatives such as “critical”, “very efficient” and “only way”. Here are some of their comments:

• “Critical to our practice”

• “Very efficient. Saves duplication of services. Legible”

• “It saves time. Patient gets a copy of her visit every time”

• “Much better for collecting patient data”

• “It is our standard and has been so for years”

• “Better coordination of care (if other physicians on EMR), less orders, can access from home”

• “More accurate. More efficient. More complete”

• “It provides a very efficient manner to follow and trend patient data”

• “Only way to keep up with all the requirements”

• “Improved access and accuracy of records”

• “Can manage patients hands on with 24/7 availability and share information easier with care partners”

• “ACCURATE, PRECISE, SAVES TIME”




Appendix:Screener and Questionnaire


1

SAMPLE SIZE : 100 Doctors • 90 Primary Care • 10 Specialists

INVITATION LETTER / SCREENER-Doctors Final SUBJECT: SURVEY TO REVIEW HEALTHCARE COMMUNICATION TRENDS AND CURRENT HEALTHCARE TOPICS We are looking for input from Physicians on their views and use of current and new healthcare communication vehicles . And your views on certain current healthcare topics. The survey is simple— a point and click through mostly closed end questions . It will take ten minutes of your time. If you wish to participate, please answer the following qualification questions.

1. How many years have you been practicing medicine? ___ 1-5 ___ 6-10 ___ 11-15 ___ 16-20 ___ Over 20

2. In which field do you practice?

Primary Care-Quota 90 Specialists- Quota 10 ___Internal Medicine ___ Cardiology ___Family Practitioner ___Pediatrician ___Obstetrics and Gynecology ___ Cardiothoracic Surgery ___ Gastroenterology ___ General Surgery ___ Orthopedics

___ Neurology ___ Plastic Surgery

2

___ Urology ___ Vascular Surgery ___ Psychiatry ___ Oncology ___ Hematology ___ Allergist 3.Which best describes your practice: ____ Solo Practice ____Private Group Practice With 2-10 Physicians ____Private Group Practice With Over 10 Physicians ____Corporate or Healthcare System Practice Thank you. You do qualify. Please click onto this link: _____, and use pass code: _____.


1

QUESTIONNAIRE –Doctors Final

ONLINE HEALTHCARE COMMUNICATION SURVEY Welcome to the Healthcare Communication and Current Topic Survey. Please answer the following questions about your views on the following

1. On an ongoing basis, how important are each of the following sources to you, in order to keep professionally informed? Rate on this 5 point scale (1= very unimportant 2=unimportant 3=neither 4=important 5=very important)

• Articles in professional journals • Advertising in professional journals • General internet searches • Healthcare information web sites • Pharmaceutical company corporate web sites • Pharmaceutical company product web sites • In person meetings with pharmaceutical sales reps • Conferences • E-mail blasts • Electronic newsletters • Personal mobile device • Newsletters • Managed care organizations • Peers • Podcasts • Social media • Societies/Associations • Direct Mail • Mobile applications • Key Opinion Leaders • Other___________

2. Please indicate below which three you rely on the most and how often

you use. Occasionally Often Always

• Articles in professional journals • Advertising in professional journals • General internet searches • Healthcare information web sites • Pharmaceutical company corporate web sites • Pharmaceutical company product web sites

2

• In person meetings with pharmaceutical sales reps • Conferences • E-mail blasts • Electronic newsletters • Personal mobile device • Newsletters • Managed care organizations • Peers • Podcasts • Social media • Societies/Associations • Direct Mail • Mobile applications • Key Opinion Leaders • Other___________

3. Which of the following methods/vehicles do you use to share information with your patients and how often?

Occasionally Often Always ___Verbally ___Printed educational material ___Direct to a pharmaceutical product web site ___Direct to a healthcare education/information web site ___Use of new technology such as a tablet/ iPad ___Product insert/prescribing information ___Other__________

4. When thinking of new digital technology which of the following devices do you use to gather information for your patients or practice?

___Smart phone ___Tablet/iPad ___Other_________ ___None skip to Q6

5. Which do you use the most to gather information for your patients or practice?


3

___Smart phone ___Tablet/iPad

___Other_________

5a How would you describe your use of new digital technology versus a year ago to gather information for your patients or practice?

___Less ___Same ___More

6. How effective on this 5 point scale is direct to patient advertising by pharmaceutical companies for accurate patient education?

(1= very ineffective 2=ineffective 3=neither 4=effective 5=very effective) 6a. Why do you say that?

7.How important is it to have interaction with the pharmaceutical sales reps that call on you?

8. What is your opinion of the importance of Electronic Health Records to

your practice? Rate on this 5 point scale (1= very unimportant 2=unimportant 3=neither 4=important 5=very important)

8a. Why do you say that ?

9. Which best describes your reaction to the passage of the Affordable Health Care Act ? ___Happy it passed and is law ___No opinion, need to wait and see ___Not happy, don’t like it 9a. You said ______ why is that?

10. In your view what do you see as the implications of the Affordable Healthcare Act on your practice in general and specifically in terms of dealing with Health Exchanges, patient care, costs, and future relationships with Pharmaceutical Companies?


Tim R. GardeManaging Partner

Star Group / Star Life SciencesSynegrated Communications

235 S. 17th StreetPhiladelphia, PA 19103215.875.4313

stargroup1.comstarlifebrands.com

For more information please contact:

healthcare communications study among physicians: medical monitor 2013

Health & Medicine