For the last few years, there has been a lot of talk about electronic health records (EHRs) and the promise they hold for delivering marketing solutions. As the leader of Merck Vaccine’s Innovative Partnerships, Craig Kemp has forged many successful relationships in this channel. At the JUICE Innovation Expo 2015, I had the opportunity to talk with Craig about his experiences working with EHR companies and other technology partners.
BEN PUTMAN: How did you get involved with EHRs?
CRAIG KEMP: Yeah, great question. It was about 3.5 years ago that, and it didn’t really start as EHRs, it started really as a long-standing business problem in vaccines, is that immunization rates around adult vaccination has stayed stagnant for decades. Even over the last decade, with a lot of the work put in by the Centers for Disease Control, and the manufacturers, and the healthcare environment still, the problem with vaccination is just making people aware that they need it, when they can act on it—right, so at the time of the clinical encounter.
And so, as we started to see, based mostly upon the programs that the federal government put in place, we started to see adoption of electronic healthcare records happen at a broad way across the market. And knowing that those healthcare record products had tools available within them to raise awareness of vaccination, we just started down the path to say is this something that we could pursue.
We’d looked at it before and talked to EHR companies and really, at that time they weren’t interested in collaborating across with different stakeholders. And some things had changed in the environment. Not only for them and their business model and their culture, but then also, I think just across healthcare, the idea that individual stakeholders are going to have to collaborate, and technology is becoming one of those stakeholders. And so, we started to talk to the electronic healthcare record companies and say, “Is there a way that we can work with you to raise the awareness of your client’s patients’ needs for vaccination at the time of the clinical encounter?” And those conversations ultimately, within about a year, led themselves to commercial transactions that we could do to work directly with them. So, it was just an idea of a business problem and a healthcare problem, essentially that started us down that path.
BP: What advice would you give for working with EHRs?
CK: That’s a great question, because how we started is probably not how you have to start today. You know, there’s been a lot of development. And I want to broaden a little bit beyond EHRs and maybe to say ‘health technology vendors’ because in that technology ecosystem, there are more than just the EHR companies. There are a lot of vendors of healthcare technology that are now wrapped around the ecosystem of the EHR, which are starting to deliver products that help, you know, help healthcare practitioners be more effective at medicine and more efficiently.
So, just, I think the way to get started as an organization is—probably depends upon how big your organization is. Sometimes the bigger organization, the strategy in which you get things done in the organization are different. But I would say that, first of all, I’d implore you that you’ve got to start doing something with technology vendors. You know, we’ve seen all the data that they’re here to stay. They’re becoming a significant stakeholder in healthcare and they’re looking for opportunities to work with pharmaceutical companies to try and help their products show the value they can have, you know, in medicine.
So you’ve got to start somewhere. I think in the case of, if I was to do it all over again, there are 3 or 4 different vendors of technology that have linked in with the EHR companies and are now part of their ecosystem. And those vendors are looking for commercial relationship in areas that matter, so areas such as medical education, patient adherence, patient financial assistance programs. There are now companies out there that you could actually sit down with, that give you immediate scale across many vendors, that you could start with having a conversation about, “How do we make the services and marketing solutions that we have available, available through your network?”
And you have to start down that path somewhere small, and don’t be scared at first by the scale issue because you’ve got to have all the conversations with lawyers and business people, and all those things have to happen. Because you’re going to be using patient health information to target your programs. You can do that, but a lot of times it takes time to get all of the people around you comfortable that the privacy issues are handled, that everything is taken care of.
So, I would just find a vendor that you know has a product that helps, that would help deliver your marketing solutions, and start having a conversation with them. Because there are a lot of people out there with knowledge now, that can help you. And then, just get started, because once those conversations happen within your organization, you don’t keep having to have them again. So that would just be my advice right now.
BP: What are some internal barriers to leveraging EHRs and what do you recommend to overcome them?
CK: I think the biggest barrier is probably the barrier of any organization—that it’s new, it’s not tested. You know, at the time we started, and probably the time you’re going to start, there is not a lot of good data to say whether it works or not. And so, you need to actually plan your program in a way that you can measure it, you can test it and see if it not only delivers the results for healthcare, but it delivers the business results for your organization. Do your pilot with the idea that, “I’ve got to validate that this model works.” Because our legacy models around media and channels and the legacy models around marketing are well proven. We know they work, we just all know that as time is going on their effectiveness is diminishing. And this is a new channel and so, like all new things, if you don’t have the business results, then in the long run you’re going to do yourself a disservice. You might be able to do a program because it’s cool, it’s new, it’s healthcare technology, but in the end you’re not going to get the funding you need and you’re not going to get the support of the organization unless you plan, right upfront, to test everything. The good news about this, healthcare technology such as EHR vendors, is the information to test your programs is all available. They can measure and test anything. And you just make that part of your contract.
BP: What are some external barriers and what do you recommend to overcome them?
CK: Okay, so it’s something that we’re all familiar with in our industry, there is the regulatory environment, right. And then a little bit different for us, that I think we need to start thinking about more, is that you have very little control about how these programs are put into the clinical workflow through technology. You can’t build it and plan it the way you want and have any control over that. You kind of have to say, “Okay, so here’s how the clinical encounter in my therapeutic area works, here’s how the treatment path works, here’s how technology and technology vendors are helping that, that treatment path.” And then find a place where you can leverage something that you can do as an organization to make that treatment more effective and more efficient.
But when you find that use case, you don’t have a lot of ways to change it, right. You can’t say, “Well, we’d rather do it this way or that way.” No, you’ve got to live with what’s happening because these are external factors you can’t change. You know, and it’s not
about brand promotion. It’s really about trying to figure out, that as a pharmaceutical company, when someone is using your product, it’s important for us to make sure those products are used correctly and they get the desired outcomes.
Now, the good news for us is that when that happens, we generally have a business benefit and we meet our business objectives. And so, you just need to find that transaction that works. And it might not for your area. But this is the one thing, we can no longer—this is not an area where you can build it and they will come. So I mean, that’s the hardest thing, is that you’re very constrained by the actual nature of the transaction itself but then still our rules around—our FDA regulations around promotion, the anti-kickback statutes that are there—those things are real and you have to work through them. And all of those constraints can’t be changed. It’s a lot of struggle but it’s rewarding, but you just have to find—you have to work through all of those things and find a marketing program that actually works for everybody involved.
BP: What are some quick ways to get started in EHR?
CK: I think the quickest and easiest way is, there are a couple of companies out there where you can actually do targeted, contextual messaging that shows up in the workflow that’s targeted to patients. Where, in that clinical encounter, are candidates for your drug or your therapy? And it gets you through the conversations as far as using PHI to—you can start having those conversations. But they’re available out there right now and you can start executing marketing programs, maybe not at scale, but you can start executing.
But more importantly for your team is, you’re starting to learn and understand what is now a significant stakeholder in healthcare—which is technology. And these companies, they are now helping healthcare providers provide better medicine and they’re at the table when decisions are made about how we’re going to do that. And so, you’re learning about how they work, what they need, what their clients need. And I think all of our team, if we look back on it in 3 years—even though a lot of us have been in this industry for a lot of years—we see this as probably the best learning time that we’ve ever had in our careers.