Bridging the Communication Gap Between Physicians & Patients

Contributed by:

Robin Robinson

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The Point of Care Problem At the point of care is probably the worst place for patient education: the physician is time con strained, the patient is nervous, and neither may have enough information to make good deci sions concerning the patient’s care.Filling this gap becomes the crucial factor in improving patient and physician communications. DUNCAN. AMYLIN. I believe the most critical time in the patient acceptance/learning phase is when patients find themselves at home after leaving the physician office with a new medi cation. Even if they received some inoffice education, given the demands on physicians —especially those without appropriate sup port staff — the depth of education is likely limited. If patients don’t have an avenue to be in touch with someone or have another infor mation resource to answer new questions or issues that come up at the time of administra tion, they may very well delay initiating ther apy or not start it at all. WULF. INFOMEDICS. The limited time the doc tor has in direct communication with the patient is an ageold problem, and one that continues to get worse. More than 80% of HMO doctors and more than 50% of small practice physicians have insufficient time to adequately relay all of the information that needs to be given to patients during the regu lar office visit. Studies show that onethird of the essential information that patients need when they start a new medication is not pro vided by the doctor during the visit. This is a dangerous situation that can lead to medical errors and worsening patient outcomes. EASTMAN. CATALINA. In the patient physician scenario there is only a two link chain, and maybe what is needed are more links. The physician commu nicates to the patient in an environ ment in which the patient doesn’t feel well and may be worried about his or her condition. If the physician pre scribes a medication, the patient often is not focused on what to ask or how to ask questions. What’s often missing is the information they really need to take medicine properly or to understand how it affects them. Physicians may do a good job explaining the condition, diagnosis, and prognosis, but the specifics of how to take the medication, when, what is the best time of day, pos sible adverse reactions, or whether to take it with other meds, may be lack ing. That’s the type of info the pharma cist can provide to complement the information from the physician. Almost 80% of prescriptions are filled at a retail pharmacy and maybe this new link should be added. The phar macist can provide a vehicle, such as printed information or directions of where to go to get additional informa tion, that patients can take home with them and use at a later date. PATTON. HEALTHED. There are so many time constraints during office New patient education tools and technolo gies are helping to fill the monstrous gap in patientphysician communications. But even the best tools have to address the need for simple, clear communications for BETWEEN PHYSICIANS & PATIENTS Bridging the Communication Gap both parties. PharmaVOICE taps experts from all sides of the patient education spec trum to find out what they believe make for the most effective interactions between physicians and patients. Using a visual method is much more effective than using words alone in patient education; today, a video must be part of the process to facilitate the most efficient patientphysician interaction. RAJAMIN HEALTHINATION PV0508 Issue FINAL2 4/23/08 10:36 AM Page 10 PHYSICIANPATIENT communications visits that physicians and patients automatical ly default to talking about clinical aspects of treatment. What is sacrificed are discussions about the impact of therapy or the condition on a patient’s quality of life; any assessment of the patient’s likelihood to adhere to treatment; and any support to help the patient to incorporate the medication into daily life. Those are the topics that get pushed aside. It’s really incum bent on good, solid patient education to help physicians do that part of the job. Patient edu cation can help through a solid understanding of not just the demographics and psychograph ics of the patient but also the attitudes and beliefs they have about their condition and treatment, and how it changes during the course of the condition. Then the challenge is to serve up the information in digestible amounts and not try to tell the whole story in one tactic. Instead, it is important to serve up information incrementally so the patient can hear it, under stand it, and act on it before moving on to the next step. That takes a holistic view of patients: how they consume information, where they are, how overwhelmed they might be, how they behave at point of diagnosis versus how they react after they have been on treatment, and how to keep them compliant or adherent. DEBUONO. PFIZER. The biggest gap is often in the dialogue that the patient and physician have about basic instructions regarding what the patient needs to do. The physicianpatient exchange requires the patients to absorb a lot of information, and this often occurs while the patient feels intimidated and uncomfortable. The goal of any patientphysician interaction should be that the patient walks away with an understanding of what he or she needs to do and why. There are tools that can be developed that help achieve that goal. At Pfizer, we cre ated a tool called Ask Me 3, which engages patients and physicians in a dialogue about three basic questions: what is my main prob lem, what do I need to do, and why? The aim is to get patients to feel comfortable in what can be a very intimidating setting by focusing on at least obtaining answers to these three main issues. The National Patient Safety Foundation has incorporated the tool into its activities, and results show that the Ask Me 3 program can be a way to improve adherence by achieving better patient understanding. The program also requires the physician to play an important role in assuring good com munications. PROUNIS. FLASHPOINT MEDICA. The weakest link is the lack of communication skills by both the patient and the physician. The key is that both need to do more: patients need to be more prepared and able to describe their symptoms and the impact on their life, and doctors need to draw out their patients more and ensure they’ve covered all their concerns. Patients go to their doctor’s office all of the time unprepared; they neglect to bring a list of things the doctor might need to properly assess their care. Patients are often too vague in their complaints and don’t speak in doctor language — meaning they don’t quantify symptoms by severity or frequency. Doctors need more objective info from patients so they can make good decisions and they need to learn how to get it. There are RAJ AMIN.CEO and Cofounder, HealthiNation, NewYork;HealthiNation is an independent health network that creates easytounderstand, interactive videos on specific healthcare topics. For more information, visit healthination.com. ANDREWBRANA.Senior Global Consultant,Sales Performance Optimization,TNS Healthcare, NewYork; TNS Healthcare provides globally consistent solutions and custom advisory services to support product introductions, brand, treatment,and salesperformance optimization, as well as professional and DTC promotional tracking. For more information, visit tnsglobal.com. BARBARADEBUONO,M.D.,MPH. Executive Director, Public Health and Government,External Medical Affairs, Pfizer Inc.; Pfizer is a global pharmaceutical company committed to helping people improve their health by discovering and developing medicines. For more information, visit pfizer.com. CHRIS DUNCAN.Associate Director, Symlin Marketing,Amylin Pharmaceuticals,San Diego;Amylin is a biopharmaceutical company committed to improving lives through the discovery, development,and commercialization of innovative medicines.For more information, visit amylin.com. SUZANNE EASTMAN.Executive Director, Clinical Services, Catalina Health Resource, Cincinnati, Ohio; Catalina Health Resource connects healthcare companies with patients and consumers. For more information, visit catalinahealthresource.com. KRISTIN PATTON.President,HealthEd Group,Clark,N.J.; HealthEd develops educationally based marketing programs for pharmaceutical and healthcare brands. For more information, visit healthed.com. CHARLENE PROUNIS.Copresident and Managing Partner, Flashpoint Medica,New York; Flashpoint Medica is a fullservice professional healthcare advertising agency within the Omnicom Diversified Agency Services network.For more information, visit flashpointmedica.com. STANLEYWULF,M.D.VP and Chief Medical Officer, Infomedics,Woburn,Mass.; Infomedics is a pharmaceutical services provider that delivers clear, actionable patient feedback to physicians about their treatment experience.For more information, visit infomedics.com. Thought Leaders Since we can’t buy them more time, the best we can do is to help physicians with the counseling aspect of the exam by streamlining the dialogue at the point of care. 11 PharmaVOICE M a y 20 08 KRISTIN PATTON HEALTHED PV0508 Issue Proofs 4/25/08 9:35 AM Page 11 programs available that teach doctors tech niques to create better communications skills on the doctorpatient level, such as Kaiser Per manente’s published report called The Four Habits Of Highly Effective Doctors. First, establish a rapport quickly. Second, elicit patient perspective by asking about their symp toms and feelings. Third, demonstrate empathy so patients want to talk and won’t hold back information. And fourth, provide all of the options and involve the patient in the treatment decision. This is where many doctors fall short. Instead of just giving the patient the diagnosis, now the doctor’s role is to provide the options and the risks and benefits involved, which ide ally leads to a shared decisionmaking dynamic between the two. When this happens the patient becomes committed to the care because he or she has been a partner in the decision making process with the doctor. The weak link occurs when neither performs their roles. Both physicians and patients need to be educated on what each role needs to be. Technology andTime Technology advances, time constraints, patient demands,DTC,PhRMA guidelines,managed care, andmore complicated therapies are all drivers for the push for better patient education. AMIN. HEALTHINATION. Patient education has been an increasing focus for 10 to 15 years, but now we have the technology platforms and lev els of adoption that allow us to serve a large con sumer audience. In just the past 18 months, the content on the Web has changed from being mostly text to an immersive videodriven expe rience. The YouTube generation has influenced the rest of the world and video viewing has become a common online activity. According to eMarketer, 72% of all Internet users watched at least one video a month in 2007. And as a result, visual communication has become a key part of the patienteducation process. Explain ing diabetes is very difficult, but showing someone a 30second video on how glucose and insulin interact inside the body in a simple and easytounderstand way works better than just words. Patient stories can be used to communi cate inspiration to motivate action, and also give emotional support. These are great tools to help support the educational process. DUNCAN. AMYLIN. Patient education has always been very important. But over the past number of years, time spent between the patient and the HCP in the office has become very limited, and patients are not directly receiving the education they used to from their caregiver. For this reason, as well as the wealth of general — and sometimes wrong — information available on the Web, the respon sibility of education has shifted to the industry to ensure both needed and correct educational content is provided. EASTMAN. CATALINA. When I started as a pharmacist, we didn’t tell the patient any thing. The physician provided the prescrip tion, the pharmacist administered the meds, and no questions were asked. Nobody knew what was going on and everyone accepted that. Today therapies are more complicated and more patients are taking multiple thera pies prescribed by multiple physicians, all of which can result in adverse events. Plus, the move to DTC drove drug manufacturers to put brand awareness or product information in magazines, TV, radio, billboards, and now they have an obligation to provide additional info to patients to explain why this particular medication is appropriate, and patients are demanding this information too. There is so much thirdparty intervention these days patients have a lot of questions around chang ing therapies because of formulary restrictions. Communication is necessary to prevent errors and to make sure that patients understand and take their meds properly. PATTON. HEALTHED. A pervasive opinion in the industry is that patient education became much more important right around the time the PhRMA Guidelines were implemented. While this is true from an acquisition per spective, this view does not recognize that patient education has always been critical to patient adherence and compliance. The guide lines have been implemented by the health care industry to police itself, shifting from promotional marketing to more informational marketing. And it has worked to some extent. But information is not the same as education. Information is just the first step — it does not change action but it does drive awareness. True patient education is designed to affect behavior change, so the program has to be built on a foundation of behavioral science; it has to incorporate adult learning principals and health literacy for effective writing and design. As the industry is shifting more toward compliance and adherence, we contin ue to look for the right expertise to drive patient behavior. The key is in the content, not in just sending more mail or more email or The innovation might just be in getting the message out there about what good communication is. There’s disease education and product information, but not much on learning how to communicate better. The patient should hold the physician and the system accountable to working in partnership to improve the quality of care.The real nexus is: quality, safety, adherence, and health literacy. DR.BARBARADEBUONO PFIZER CHARLENE PROUNIS FLASHPOINTMEDICA 12 M a y 20 08 PharmaVOICE PV0508 Issue FINAL2 4/23/08 10:36 AM Page 12 THE PHYSICIAN EXPERTS SM We interact with thousands of physicians every year. This, plus extensive experience, means you’ll get insights from us you wouldn’t get anywhere else. Want to align your brand with what really matters to your customers? Call Paul Dreyer at 919.544.8770 and get an unfair advantage behind your promotional efforts. www.srcomgroup . com 8090_pharmavoice.indd 1 4/11/08 9:46:43 AM 14 M a y 20 08 PharmaVOICE PHYSICIANPATIENT communications setting up a call center. If the content in those channels isn’t usable, it’s not worth spending money on. DEBUONO.PFIZER. The driving factor behind patient education is to get patients to a place where they feel much more secure and confi dent in managing their own healthcare needs, which includes everything from making the appointment with a doctor, to ordering a test, to understanding the impact of diet and exer cise, to knowing what to ask. The patient should hold the physician and the system accountable to working in partnership to improve quality of care and health outcomes. The real nexus is: quality, safety, adherence, and health literacy. Health literacy is linked to challenges with cultural communication, cul tural norms and expectations, limited physi cian time with patients, and/or not making the best use of that time to communicate effectively with patients. For one, physicians are not trained to speak in a language that is accessible to patients. Instead of the word ver tigo, they should say “dizzy” or ask if the room is spinning. Instead of sequelae, they should say “side effects” or “bad outcomes;” instead of hypertension, they might want to say “high blood pressure.” Physicians need to relearn layperson’s language to effectively communi cate with patients. It is also important that doctors and providers get rewarded for the time they spend on patient education. If there is some financial incentive for physicians to communicate better and to measure outcomes, physicians will be more likely to do so. PROUNIS. FLASHPOINT MEDICA. Research finds that patients forget half of what the doctor says as soon as they leave the office and 46% of peo ple think they don’t need the medicine that the doctor prescribed for them. Those are pretty powerful facts that prove there is not a real engagement between physician and patient. Physicians interrupt patients 18 seconds into the encounter — no wonder there is not a good connection. Physicians need to be more skilled in asking the right questions to connect with patients. Good communications lead to increased patient satisfaction, and therefore bet ter health outcomes. Responsibility Lies With Pharma,Physicians and Patients Both patients and physicians need to play amore Sound Bites from the Field PHARMAVOICEASKEDEXPERTS INTHEFIELDTO IDENTIFYWHATTHEYBELIEVETOBETHE BEST PRACTICES FOR, OR SUCCESSFUL EXAMPLES OF, PATIENT EDUCATION CAMPAIGNS THAT IMPROVETHE COMMUNICATIONBETWEEN PHYSICIAN AND PATIENT. JEFF KOZLOFF is Founder and President of Verilogue, Fort Washington,Pa.,which uses patentpending technology to capture and analyze live, inoffice physicianpatient dialogue used by the healthcare industry to further enhance its understanding of the numerous diseases that face society today.For more information, visit verilogue.com. “ One best practice is actually listening to what physicians and patients are discussing in their natural environment.There are technologies available on the market today that capture live, inoffice physicianpatient conversations.These dialogues identify critical information conveyed by physicians, key concerns presented by patients, and the absence of essential information assumed to be discussed during office visits. Effective pharmaceutical brand marketers now use the customer’s own voice — or lack of voice — to create targeted patient education materials that improve disease understanding and management. ” TOMMCDONNELL is the Product Director for Vyvanse Marketing at Shire, which is a global specialty biopharmaceutical company marketing products to defined customer groups.For more information, visit shire.com. “ The Vyvanse New Start Program has been one of the most extensive and innovative patientphysician communication tools that we have introduced into the market. The current environment presents a challenge for timestrapped physicians to hold detailed treatment discussions with their patients. Our solution was to implement a patientfeedback marketing system.This method engaged patients — and in this case, their parents — in providing treatment feedback to the children’s doctors. In return, parents received educational reports on their children’s progress. Both parents and physicians learned from the feedback process, gaining greater understanding and awareness of their ADHD condition and Vyvanse.This significantly increased the physicians’ tendencies to prescribe the brand to other eligible patients. This patientfeedback program has allowed us to ensure that patients using Vyvanse are effectively connected with their physicians while simultaneously delivering our product’s key messages — the result of a truly innovative solution. ” DEBORAH SCHNELL is President of Sales and Strategic Planning for Healthy Advice Networks, Cincinnati, which helps consumers and healthcare professionals make more informed health decisions by providing trusted, relevant, and easytounderstand health information when and where they need it. For more information, visit healthyadvicenetworks.com. “ I believe that targeting the message is the key to successful communication between a patient and a physician.This requires an in depth understanding of the `customer’ to ensure the right message is delivered. A great example of this is when the brand team for an allergy product used digital technology to customize its message down to the office level. Looking at the prescribing behaviors of the physicians helped them define the patient profile and the type of education and messaging best suited for the office.Working in collaboration with the field salesforce, they encouraged patients to ask for a starter kit. Additionally, since allergy products are seasonal, they customized their messages on a geographic basis, enabling the brand to educate patients about mold and pollen counts often before symptoms even began, getting the patients on therapy sooner and relief faster.This type of targeted communication speaks to the needs of the patients and ultimately translates into a win for the patient and a win for the brand. ” PV0508 Issue FINAL2 4/23/08 10:36 AM Page 14 The healthcare environment is filled with complex and, often, unforeseen challenges. Are your partners helping you see what’s next—or are their perspectives too narrowly focused? At inVentiv Health, we are uniquely qualified to see the big picture. With experts in all aspects of product development, launch and commercialization, we build teams with multiple perspectives to take a broader view, and robust resources to execute seamlessly. Through our five insightsdriven divisions—Clinical, Communications, Strategy & Analytics, Selling Solutions, and Patient Outcomes—you get a customized solution for every possible need. To see what you’ve been missing, contact Dan Twibell at dtwibell@inventivhealth.com. The right solution requires a broader view. accelerate your vision Your researchers just made a breakthrough. Three weeks after they did. 33869_ncihmc_pharmavc_fa.indd 1 4/11/08 4:50:53 PM 16 M a y 20 08 PharmaVOICE PHYSICIANPATIENT communications active role in their own education and it is the industry’s responsibility to make sure the informa tion needed is available. DUNCAN.AMYLIN. First, we can’t always just refer to the physician as the administrator of education. We must not forget that others often administer education in the office, for example, MAs, nurses, DEs in the case of dia betes, PAs, and others. We cannot rely on the physician as the sole dictator of necessary patient education. While they should always be a part of any educational offering, pharma must look well beyond the physician as the delivery mechanism of patient education. Obviously, it is up to the pharmaceutical com panies to provide the necessary education for their products, but the evergrowing area of education in which the industry is becoming a bigger player is nonaccredited, nonbranded disease state patient education. This both heightens the general understanding of disease conditions and also establishes a more informed patient or consumer to seek out the most appropriate treatment options. WULF. INFOMEDICS. On the physician side, the most important element for a successful pro gram is that it has to be turnkey and not absorb the physician’s time. The maximum time it can take is 30 seconds to 1 minute out of the office visit. Most of the programs involve activities outside of the doctor’s office but always close the loop back with the doctor to keep him or her informed. Not only do these programs build confidence in the brand, they can actually result in a 30% increase in new prescription writing. This results from pharma establishing a presence in a supportive role that positively influences the doctor. If a patientfeedback report is generated regarding the patient’s satisfaction and sent to the doctor as a follow up, new prescription writ ing jumps to between 50% and 60%. When programs are branded with drugspecific feed back to the prescribing doctor, the prescription writing goes up to 100%. In this way, the indus try can provide positive support to the physi cianpatient dialogue and still make money. Technology,Techniques, Training Help Bridge the Gap Technology is making it easier to close the discon nect between physician andpatient. DUNCAN. AMYLIN. Better education in terms of content is resulting from a greater under TNS Survey Shows IncreasedValue Put on Patient Education A recent TNS survey of U.S. general practitioners (GPs) investigated the types of activities and services they valued the most from pharmaceutical companies. The survey also measured the level of performance of various pharmaceutical companies in delivering these activities and services. When asked which services they would value in their relationship with a pharmaceutical company,66% of the survey participants identified patient management,education,and support programs as having value to them.This is up noticeably from a similar survey in 2007 when 55% of respondents selected patient programs as important to them.Of the GPs that selected patient programs as valuable to them in the current 2008 survey, 55% of them said it was among the top three most valuable things they would want to get from a pharmaceutical company. The survey also asked physicians if they saw an increase in the level of service from pharmaceutical companies on patient management,education,and support programs during the last 12 months;80% of physicians stated they have seen a positive change,with 29% of physicians saying it was a significant or very significant increase in service. The survey then asked the GPs to score 15 top pharmaceutical companies on their patient management,education,and support programs.The scores received ranged between average and good.No company received a score approaching the excellent range. It should be noted that the survey asked the GPs to rate the companies’ performance overall, not by individual brands or franchise areas (e.g., cardiovascular, diabetes, etc.) within the company. Key conclusions from the survey regarding patient management,education, and support programs, included: # They are seen as a valuable part of the brand services mix for two thirds of GPs. # GPs are seeing an increase in the level of service in this area from pharmaceutical companies. # GPs rate the existing patient programs of leading U.S. pharmaceutical companies between average and good, with no company standing out in the GPs’minds as having excellent or far superior patient support programs. There appears to be significant room for pharmaceutical companies to improve the patient programs that they offer to support their brands. The survey also asked about Internet based services for patients and how valuable these are to GPs; 35% of GPs find value in Internet information services for patients.While relatively low, this is a significant increase compared with 2007 when 28% of GPs rated this as important to them.As many as 69% of physicians reported some level of increase in service on Internetbased information services for patients, with 31% of physicians rating it a significant or very significant increase in service. When asked to rate individual companies on Internetbased information services, company scores ranged just slightly above the average level, noticeably lower than patient management,education and support programs overall. Source:Andrew Brana,Senior Global Consultant,Sales Performance Optimization,TNS Healthcare,New York. For more information,visit tnsglobal.com. Andrew Brana PV0508 Issue FINAL2 4/23/08 10:36 AM Page 16 P A T I E N T E D U C A T I O N P R I M A R Y & L O N G T E R M C A R E CONTEMPORARY OB/GYN MANAGED HEALTHCARE M A N A G E D M A R K E T S P H A R M A C Y S P E C I A L T Y C A R E Ophthalmology Times Ophthalmology Times F I R E W A L L F I R E W A L L F I R E W A L L F I R EWALL F I R E WALL F I R E WAL L D I G I T A L C H A N N E L S Show Dailies Web Seminars Web Sponsorship Audio Detail PodCasts ENewsletters Conferences Healthcare Internet Portal Reengineering Medical Education to Achieve Mastery in Learning… With Unsurpassed Reach to Healthcare Professionals UNIQUE LEARNING MASTERY SYSTEM Addressing measured educational gaps, cme 2 s robust, evidencebased methodology provides learners with content that is not only comprehensive, but more importantly, efficiently focused on what is most critical to the exact competencies required. To further achieve learning mastery, cme 2 interventions also apply adult learning principles as well as address key barriers to knowledge application. UNSURPASSED HIGHLYTRUSTED REACH cme 2 ‘s exclusive partnership with Advanstar’s portfolio of brands provides trusted reach to hundreds of thousands of healthcare professionals to create audiences for print, event and emedia learning programs. The cme 2 mission is to elevate medical education from a matter of pass/fail to learning mastery that significantly impacts healthcare professionals’ behavior and measurably improves patient care. To learn how cme 2 can help your CME achieve learning mastery Contact Cathy Pagano, Executive Director, at 2015712416 or cpagano@cme2.com Intensifying the Clinical Significance of Medical Education ACCME accreditation with exemplary status in three essential areas: Mission, Planning and Evaluation. cme2_ad Pharma voice.qxd 4/16/08 9:22 AM Page 2 18 M a y 20 08 PharmaVOICE PHYSICIANPATIENT communications standing of patient needs via market research, direct patient feedback, etc., and a more sophisticated approach to executing educa tional programs with the help of agencies that specialize in the area. The innovations related to delivery of the content that are making better patient education possible are also lead ing to an abundance of information, which is making for a very noisy marketplace. The Internet is an endless source of information both good and bad. But other media like spe cialty programming, localized networks of caregivers and patients, and optin programs offering individualized education have become integral parts of effective education delivery. WULF. INFOMEDICS. Technology will have to be used to educate large populations, and it must be something that is commonly available. If a handheld device has downloading capabilities that only one in a thousand people may know how to use, that’s not going to work. To reach large populations, we have to use the lowest common denominator. Therefore, the phone and the Web are the two technology avenues best suited to educate patients. Cell phones have been a great advance in patient education, giving the patient the ability to have that pri vacy they may not have on a home phone or work line. We are still in the cowboy days of Web information, however. There is an influx of independent sources of information on the Web that is not specific or tailored to the indi vidual patient. Technology solutions have to be intelligent solutions that are interactive, sup port diverse patient needs, and supply tailored information to the patient and then find out if the patient understands what he or she is read ing. The technology must be capable of robust realtime evaluations. EASTMAN. CATALINA. Many of the techniques being discussed involve delivering info to patients via electronic media or handheld devices, which might be appropriate for small populations. Most people that are using pre scription drug therapy have relationships with their retail pharmacy, so we feel print material from that source is still well received. PATTON. HEALTHED.There’s room for technol ogy to be used as long as the technology is a match for the target audience and how they consume their patient education. Web 2.0 is really starting to gain traction but I can’t say at this point it’s effectively harnessed. It’s trendy now, cutting edge. This is when we start to get into trouble because it is such a highly regulat ed environment, that we owe it to each other to execute programs with new technology plat forms credibly, honestly, and with integrity. There is change afoot and technology is help ing drive it. Podcasting and videocasting could be leveraged much more strongly as an educa tion tactic. DEBUONO. PFIZER. The Newest Vital Sign, or NVS, is a fiveminute screening tool doc tors can use to assess the health literacy of patients. The NVS tool tests patients on their comprehension of a food label. This is an easy tool for doctors to use with their patients to determine where a patient is limited in understanding health information. If 30% to 40% of a physician’s patient population is struggling with health literacy, the physician will have to address how to effectively com municate instructions and directions in his or her patient communications and interac tions. Accompanying the Newest Vital Sign is a tip sheet for effective physician commu nication and information about Ask Me 3. As a pharmaceutical company, we care about adherence to medication and the safe and proper use of medicines. Pfizer has a strong belief in clearly communicating to the patient how to use our medication, whether it is in written or verbal form. It is up to the nurses, pharmacists — in essence, everyone on the healthcare team, to make a concerted effort to communicate medication informa tion clearly to patients. PROUNIS. FLASHPOINT MEDICA. Pharmaceuti cal companies can help by synthesizing all the research done in healthcare communications and bring that to doctors and patients in edu cational venues to increase awareness of this topic. Another best practice is using interac tive workshops that help physicians direct the conversation, such as: drawing out a patient’s true concerns and identifying which ones to address first, asking what else, sitting down and communicating with patients at eye level, and not having a hand on the door while talk ing. Another innovative idea is empathy mar keting, where physicians sit in a simulator and experience what it is like to have heart disease or fatigue. After that experience, the doctor can appreciate what it’s like to have heart fail ure, for example. Kaiser Permanente mandates that all new physicians on their plan partici pate in a clinical physician communication program. The company recognizes that there is a direct link between better health outcomes and patient satisfaction, with communication being the No. 1 driver. Writing content for a thousand different patients in a way that they all find valuable is an art as opposed to the science of a patient education program. Adding the pharmacist to the patienteducation chain provides another place for the patient to get information, and certainly this connection builds relationships, and, therefore, improves adherence. SUZANNEEASTMAN CATALINA HEALTH RESOURCE DR.STANLEYWULF INFOMEDICS PV0508 Issue FINAL2 4/23/08 10:36 AM Page 18 What’s on the Horizon Physician patient communication programs are gaining traction and have no where but up to go in terms of implementation and utilization. AMIN.HEALTHINATION.We’ve seen video view ing growth of 400% in the last four months alone. Ten years from now, we’ll see video available in many more places, especially in mobile environments. There are amazing quality videos on BlackBerrys and the iPhone and iPod, and it will continue to get easier to deliver videos to these devices. Video is every where and we’ll continue to embrace these platforms as consumers do. DUNCAN. AMYLIN. I believe the methods by which the industry promotes and educates will look completely different in five years. Regulations, physician access, and patient demand will shift much of today’s profession al promotion dollars to patientbased educa tion and promotion. WULF. INFOMEDICS. Genome projects that allow the identification of genetic markers for diseases and allow greater tailoring of medica tions will increase the need to shape patient education content. For example, since we dis covered the existence of positive and negative markers in breast cancer patients, we can indi vidualize their treatments. If the patient has four out of five markers, they fall into a specif ic group, and a patient with three out of five would be in a different group. Today, those two patients are treated in the same way. In the future, those patients will be treated, and educated, differently. EASTMAN. CATALINA. For doctorpatient infor mation to continue to improve there are three things that need to take place. One, considera tion must be given to the information and rele vance of the medium used. How relevant is it to the patient to read content in a magazine or newspaper ad? Does that general information really apply to the indi vidual patient? The more relevant the info is to an individual patient, the better received it is. Two, with electronic concerns about protecting patient privacy, we need to make sure that health info is protected. And three, getting health info to patients costs money and manufac turers are in a good position to sup port patient education programs that result in positive, compliance persistent patients. Manufacturers will benefit in the long run and they will be able to realize that there is a benefit to their program. PATTON.HEALTHED.There will be an increased focus on combining the best practices from CRM and patient education. As the industry tends to focus on the importance of adherence we will begin to harness the power of Web 2.0. I expect there will be more edutainment, such as edugaming online, which will help people understand complicated disease states and therapies. There also will be an increased focus on caregivers as key stakeholders. These are the ancillary stakeholders who really will affect change at the end of the day. The role of caregiver will become much more important as marketers realize the power of the sandwich generation: people who are trying to manage the health of their children, themselves, and their parents. DEBUONO. PFIZER. The patient education movement is really under way and there is a lot of attention now being paid to electronic health records, and access to useful and current health information via the Internet and other mediums. There will be some opportunities to link health literacy, improved health commu nication, and the streamlining of information for and about patients. I believe that this is an important next step. It is amazing that when patients understand what to do, why they need to do it, and have been given clear instructions and directions — in other words, when an effort has been made to engage them in the process — their outcomes, particularly regarding self awareness, self efficacy, and chronic disease management, are

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