There was a time when tracking physicians through procedures, prescriptions and referrals was of primary interest to pharmaceutical companies. For medical device companies, the challenge has been how to get information about which procedures physicians are doing to better target their potential customer base.
Now both pharma and medical device companies, and more recently, hospitals want analytical data to map out and quantify that influence to better target sales and to improve efficiencies, respectively.
Jeff Klein, the chief operating officer of Health Market Science, likens the data his company provides to LinkedIn. The firm has 49 million connections that show how physicians are connected to each other based partly on referrals, procedures and the physicians’ integrated hospital networks. An integrated hospital network would not typically refer patients outside its system.
With the Rise of AI, What IP Disputes in Healthcare Are Likely to Emerge?
Munck Wilson Mandala Partner Greg Howison shared his perspective on some of the legal ramifications around AI, IP, connected devices and the data they generate, in response to emailed questions.
The King of Prussia, Pennsylvania-based company can also reveal how many times a physician has performed a particular procedure on a patient, which would interest medical device firms that are looking to introduce a particular product into that setting. Depending on the facility, the decision maker that influences the types of procedures or medication prescribed could be the physician or the hospital or the network, like Kaiser Permanente.
Pharmaceutical companies are particularly interested in off-label use. If a diagnosis pattern begins to shift — for example, if an anticoagulant begins to be prescribed for diabetes — it can spark ideas for other indications in areas they may not have considered before, Klein said.
Depending on what the client wants, physicians can be scored on an individual basis that uses criteria such as the number and type of procedures performed, the amount of research they do (journal articles), the number of referrals they make. Clients can ascribe more importance to each criteria.
The metrics for communicating a physician’s influence used to focus chiefly on volume, using a process called deciling, said Klein. For example, if two physicians did 10,000 procedures between them, they would have a higher ranking than five physicians who did the same number collectively. It’s another way of determining the 80-20 rule — that a relatively small number of people account for the bulk of procedures.
A Personalized Approach to Medication Nonadherence
At the Abarca Forward conference earlier this year, George Van Antwerp, managing director at Deloitte, discussed how social determinants of health and a personalized member experience can improve medication adherence and health outcomes.
By using medical claims, companies can mine a particular procedure to understand what is performed where on a national scale. Tracking physician influence is also an important part of data collection. By following which physicians refer the most patients for certain procedures and to whom they refer them, companies like Health Market Science can provide targeted insight to subscribers.
Looking beyond volume and providing data that shows the interconnectedness of physicians, companies helps data mining companies to charge higher premiums for their information.
Physician influence can be critical for pharmaceutical companies and drug developers to understand which physicians to contact to enlist patients in clinical trials, Klein said. But targeted data analysis that allows companies to develop a laser-focused strategy is critical to businesses working with a reduced sales and marketing team.
Klein says in the past two years, hospitals have begun using data to find key healthcare providers — for example, if a hospital wants to grow its cardiology group and recruit physicians.
Consumer groups that rate physician performance are also a growing customer base for data providers because they want to combine true statistical data with patient feedback, Klein said. “The social networking phenomenon combined with actual analytics and databases are putting power in hands of consumers.”
The shift to outcomes-based medicine where reimbursements are tied to performance and reduced readmissions are critical could lead data providers to expand the level of information they offer to a new vertical — government. The country’s largest insurer — the Centers for Medicare & Medicaid Services — probably has not taken advantage of this kind of data as much as they could and the trend, but it seems to be moving in that direction.
