MEET OUR EXPERTS:
Billie Brush Consulting
Founder and CEO
Pathfinder Business Consultants
Former VP Sales
Roche Diabetes Care
MEET OUR MODERATOR:
SVP of Quality
VP of Human Resources
Boylston Consulting Group
NOELEDGE Corner Consulting
Former Group Sr. Marketing Manager
Our thanks especially to Ben Locwin, a prominent voice in our industry who helped assemble our panel and provided much of the background for this introduction to Point of Care:
Point of Care is properly determined as the point in time that a product or service is delivered to a patient. In many cases, it can’t be infinitesimally reduced to a single timepoint, because the treatment process takes a finite duration. So, for example, it’s not the last microgram of infusion to a patient that represents the point of care, but the process of the full infusion. And, more accurately, the “process” itself is a ritual which in and of itself can promote healing.
Point of care has also been through more recent derivations, to include, of course, point of care diagnostics and point of care marketing – where new products and services can be advertised directly to the patients (potential future consumers) while they’re in situ within a healthcare facility. This can greatly increase the exposure duration of a patient to the marketing messages.
Point of care has expanded enormously from its original definition as the doctor’s office or hospital to the wider world of telemedicine, portals, wearables and more. You can be virtually anywhere today and still receive some form of care from a medical professional.
This is why point of care advertising spend is on the rise. Consulting firm ZS expects a compound annual growth rate of 15% this year, when they are projecting POC spend to reach $847 million. Approximately 10% to 20% of the brands ZS interviewed reported that they moved marketing dollars from their digital media budgets to digital POC in doctors’ offices and hospitals, which included investments in exam room tablets, interactive wallboards, sponsored apps and WiFi, and waiting room digital TV. And that’s not to ignore print, which is still an efficient platform.
Today, marketers are using EHRs (Electronic Health Records, or EMRs – Electronic Medical Records) to deliver contextually relevant messages within an HCP’s workflow, sometimes with a copay or prescription solution. The methodology for measuring success in this complex environment is still being developed. Brand teams want to see Rx lift or referral increases, so POC suppliers will need to become more sophisticated in how they weigh these efforts against traditional marketing.
But with all of the money invested, where is point of care currently? What challenges remain?
Point of care in treatment is alleged to provide benefits, such as reduction in inefficiencies, decreased probability of errors, information transfer, and encouraging care providers (MAs, nurses, PAs, physicians) to be at the bedside. This is the whole point of clinical care. But does it really do these things? It’s okay to be aspirational, but the processes and technology need to be moving in the right direction for this to actually occur. There are more who practice in medicine who are disenchanted with EMRs and EHRs rather than enchanted. This is because the prevailing thought currently is that these systems actually reduce information transfer and communication at the bedside by increasing the barriers, both physical and philosophical, rather than enhancing them.
Similarly, there are alleged benefits to point of care marketing, which by the way, has been used since the beginning of medical treatment where brochures and magazine ads were left in clinics for the patients to ‘stumble upon. But do these benefits hold up when we measure their performance? The roundtable panelists herein have some surprising answers for you.
Point of care has changed radically over the last few years. What would your definition be? And what would you consider not to fit into that definition?
JAY GRAVES: When I think of POC, I define it as a simple diagnostic test that can be done quickly and efficiently with the patient, allowing the clinician to have accurate and real-time results. This enables them to make snap decisions on treatment without having to wait for lengthy lab testing. It is also a device the patient can use on their own and in their day to day lives. And what would I consider not to fit into that definition? Testing that requires a process outside of the patient room or home.
SCOT NOEL: I think the definition of POC depends on which side of the healthcare journey you are sitting on. For the HCP it could be more transactional, i.e. symptom-solution. For the patient that HCP could just be one of many along their journey. So from a marketing perspective it’s critical that we understand for a given disease pathway we know all the touch points the patient will see along the way and what that engagement looks like from both the patient perspective and treating physician perspective. A tailored message will be needed for each stage of the journey. The brick and mortar system of POC will dwindle except for when a direct touch engagement is needed. Telemedicine will continue to expand and real time data acquisition (telemetry) will be also increasing. Where things fall through is that our healthcare system is not interconnected well. So this creates gaps in a patients continuum of care if they switch between health systems or receive care outside their own regional area. From a marketing perspective it comes down to patient education and awareness not only of their particular disease but how our particular solution tackles that for them and supplying the HCP with the materials to support that pathway to our products. When you have the patient, caregiver, and HCP all on the same page and path this will create the potential for a better outcome.
BILLIE BRUSH: Point of care definitely means more empowerment to both clinicians and patients – to clinicians because they can make quicker and more appropriate treatment decisions and better track their patients progress; and for patients because of more streamlined care with diagnostic testing and EMRs, making information available to them sooner, all while fewer steps are needed taking less of their time and many times the ability to resume daily life.
While POC is expected to affect patient outcomes more favorably and improve quality it does not mean that better quality is automatic.
POC testing near patients also present new challenges with multiple tests and new portable devices. In some areas with no regulations and the rapid availability of test results for immediate clinical intervention can result in errors. Strategic planning, leadership and management of the entire POC process are essential to prevent errors and improve quality.
BEN LOCWIN: It’s all things that transpire at the interface of the patient, and it’s not “anything that doesn’t.” It refers, of course, to marketing or treatment modalities that impinge directly on the patient, in contrast to some value chain isolated from the patient context, where they typically are only the end consumer. Here’s the nuance: not everything that’s patient facing is POC, some things are at the patient due to simple proximity, rather than smart design.
AMEE PATEL: POC has already changed patient management for the better in so many ways. Of course, there are various drawbacks, but it is a work in progress that will certainly give patients greater awareness and potentially an educated decision making process with their health care provider. It is categorically does not provide all the data a patient needs to determine whether a drug or surgery is right for them.
What are the best strategies for a point of care marketing campaign? Can you cite examples that have worked well?
NOEL: Some better strategies are where a healthcare system has narrowed their major POC marketing around a few key strength areas: women’s health, diabetes, cancer care etc. Then to have marketing campaigns around these key topics that tell a story and take the patient on a journey once they have them engaged.
BRUSH: A diversified and integrated marketing strategy is needed for point of care including multiple tactical tools to drive engagement. POC includes any time the patient and physician interact during the consultation, the doctor visit or follow-up visits and there is a need to make the most of all these intersections. Marketers must understand what their target audiences are seeking across all points of care, tailor and diversify their communications.
You are starting to see more marketing examples of how POC systems have helped with better decision making, marketing for health system to get patients or in improving patient satisfaction e.g. Swedish MyChart from Epic or Ultrasound POCUS from FujiFilm SonoSite, and others. It seems the areas I’ve seen POC marketing most active is in the Ultrasound hand-held space.
GRAVES: Pointing out the efficiency and efficacy of POC testing is key. Today, speed and accuracy in patient care is important for both the patient and the clinic. There is also an economic argument that can be made with most of these devices. A successful campaign will influence the key economic decision-makers as well as the end-user as to the benefit of POC testing.
PATEL: Any manner in which the patient is given pertinent and personalized information (that is provider-backed) to improve their health is an ideal strategy. We all need to be aware of the power POC advertising has on the patient and ensure that doctor takes a holistic view and understands the positives and negatives of any potential solution.
LOCWIN: It has to principally be memorable. Second place is actionable. If it’s not memorable, viewers won’t translate their viewing into the activity of consuming or participating. Either the novelty effect or an incentive scheme needs to be elicited in the viewer’s mind. They also need to have temporal (time-based) and spatial proximity.
How can point of care enhance the doctor-patient relationship, rather than just promote products?
PATEL: It can simply be a marketing campaign if the patient is not advocating for their own health. However, POC can give the patient information about a product that is relevant to them and in turn empowers them to have pointed conversations with their health care providers.
GRAVES: Enabling discussions and education between the doctor and patient is helpful. I was recently looking at several health systems’ value scores, and many scored low in patient-doctor interaction. If device companies provided support in this area, it could help with the interactions as well as patient engagement. These discussions can be digital, such as though an app, or paper-based, which helps solve the patient-doctor interaction as well as reinforcing the brand.
LOCWIN: We can achieve this by not pandering nor catering to every physician’s individual wishes. They provide POC care, but are not the experts in POC interactions. A good example might be some of the newer ROS monitors that continuously check and trend blood pressure, heart rate, blood glucose, pO2, etc. These data trends are astronomically better than point measurements taken in the doctor’s office, and can catalyze a discussion about treatment alternatives. About this, I always say to audiences “A better informed patient is a more empowered patient.” More empowered patients are also more aggressive with treatments, and will try more options.
NOEL: Some of it is personal – the patient’s responsibility. One big advantage when I go see my doctor is that I come with a slew of data (due to commercially available testing) to discuss with him. This is beyond the routine lab and physical test done annually. This really helps determine future follow ups, testing and creates a stronger dialogue, so my doctor can help me better to achieve my health goals and preventive care.
How has POC advertising changed the economics of marketing? What budgets are being cut back in order to ramp up POC?
LOCWIN: In most cases, it’s the same budget, being sloshed from one line item to another. With some sales decreases, POC has rejuvenated budget amounts because of the promise of greater revenue. Now we need to use the right tools and methods to actualize this promise, instead of counting on random noise to produce a revenue signal.
BRUSH: POC is changing the economics of marketing and budgets. There is more emphasis on digital marketing strategies, and you are seeing more social, video and interactive tools. While some of these digital tools are less expensive to use, e.g. social media, the content is more expensive to create, especially video and interactive content. Therefore, some of the budgets are shifting from print and tradeshows to the digital tools.
NOEL: Everyone is being asked to do more with fewer dollars and get creative. I have seen more efforts around geofencing, geotargeting and, in more competitive markets, digital beacons to try and capture and convert leads. Additionally, the efforts of ad retargeting for follow-ups and services along with journeyed emails.
GRAVES: With an increase in restrictions for device representatives to have access to physicians, I have seen advertising move more toward the patient as well as different channels to reach the clinicians. For example, you see advertising in waiting rooms, in the doctor’s office, and at check-out. EMR is also an interesting avenue to influence physicians. I have seen a shift from traditional and costly mass marketing (TV, radio, print) to targeted marketing where the devices are being used. You also tend to see smaller but specialized sales forces versus the large pharma model of the past.
PATEL: POC advertising can directly communicate with the end user – the patient rather than the middleman, the doctor. I certainly hope travel and entertainment budgets are being reduced. Let’s romance the patient with enhanced educational data rather than fancy dinners for doctors.
What is changing in the media mix within POC: video, print, wearables, patient portals, etc.?
LOCWIN: Patient profiles, quotables, and video streams. It’s refreshed some of the outward impressions of healthcare practices, but the overall value is objectively limited. There are newer directions to take it, directions I’ve been giving public talks on recently.
BRUSH: No doubt there is a real focus on digital media and the use of more web, social media, webinars, videos, targeted emails and SEO. And having more common systems and SEO tools, data and consolidated analytics is leading to more abilities for marketers to build stronger digital marketing capabilities, align customer touchpoints to deliver a unique and personalized digital engagement across the clinician/patient journey and automate the digital customer engagement to guide the decisions with minimal human interaction. However, ultimately a mix of digital, social engagement, tradeshows and still using some traditional print tools like brochures, poster/wall boards in clinical locations all still help support, engage, educate and create awareness during the patient’s journey.
Here is an example where a simple print piece at the doctor’s location helped inform my mother on some needed care. Wearables technologies are rapidly advancing, and patients need to be aware of this. My mom recently wore a type of heart monitor for a couple of weeks that was a small digital patch they could monitor in real-time and she simply could mail back into her doctor after the timeframe completion. Then there was a follow-up phone call to discuss the results. Just a couple of years ago she was wearing a huge heavy and uncomfortable device that she had to return in person and get an appointment to discuss the results. This recent experience was by far a better experience for my mom, the patient.
PATEL: Targeted POC is the future and this type of adaptability is not a feature of video or print. POC marketing needs to provide customized content and marketers need to succinctly figure out how to reach each individual patient with their unique need.
What is being done wrong or ineptly in the POC space? What can improve?
PATEL: I think the lack of integration between POC and electronic health records is an issue. When POC can help patients get the differentiated specific information necessary at each point in their care stage and be able to ask and understand the crucial questions to their doctor, then POC marketing is being done right.
GRAVES: I think some companies look at themselves as only delivering products when in fact, they could bring much more value to the customer and patients. Clinic administrators, physicians, nurses, and patients are all facing challenges that could be addressed by these companies. Understanding the challenges and figuring out what role you can play beyond the product can drive brand loyalty. Basically, be a solution in addition to your product.
LOCWIN: You see ham-fisted approaches replicated and redundant from visionless companies who are just copying in order to be represented in this space. What they’re really doing is diluting the overall impact of POC by flooding communications channels with noise. Purely valueless noise.
NOEL: I think the biggest challenge and error is interoperability with the amount of data that is being collected. Hospital IT infrastructures and SW platforms are not up to the task. Of course, IBM’s Watson is still working to that end along with up and comers like Apple, Google and Amazon to harness the data in a meaningful way along the patient care journey.
BRUSH: There are a lot of new POC technologies now available to health systems. However, there is still a lack of integration and management strategies around how to effectively integrate: e.g., diagnostic POC tools and EMRs not integrated within systems and outside of the system. There are not yet standardized formats with documentation with charts as well. Integration, standard document practices and better infrastructure can all improve, and there are still HIPAA, patient data concerns and security measures to be improved.
How is the big data revolution influencing point of care marketing?
BRUSH: Big data is key with POC technologies and driving their effectiveness so it’s influencing POC marketing. As I mentioned, an integrated marketing strategy is necessary to align touchpoints and tailor personalized messaging and engagement across the patient journey.
PATEL: Big data allows marketers to know more about the patient than patients know about themselves. While we can hope a patient investigates possible products for themselves, not all do. This is where big data and artificial intelligence can provide invaluable insights.
NOEL: Marketing engagements are becoming much more programmatic and tailored. At BTG many of our email campaigns were based on patient journeys. Depending on how they engaged with each email, which had different message, it would take them down a certain pathway for information. The advantages of this helped direct our future digital and print strategies as it’s constantly evolving as our customers became educated.
Now you have ER, hospitalists, intensivists and pulmonologists engaging in imaging diagnostics with the aid of AI. AI will accelerate POC, and this will further expand through telemedicine. The one other part that is just starting to bud in healthcare is using Blockchain. That will hopefully help fill the gap and lack of interconnectivity of EMR’s while keeping things more secure.
GRAVES: Data and measuring outcomes have become an important part of our value-based health care movement. The more data available, the better strategic decisions can be made on population health and spending for health systems. POC testing allows for rapid test results, which means an increase in datapoints to analyze.
LOCWIN: It’s pointing a lot of companies in the wrong directions. Big data, when misused (as is done so more often than not) causes marketers to chase anecdote and hyperbole. Having simple correlations about your customers buried within Big Data is not causality, nor is it smart forecasting. I’ve literally written the book on Big Data and Small Data, and how they’re improperly used every day.
What advantages are doctors – and patients – realizing from better point of care campaigns?
GRAVES: For me, I think the speed and convenience of having immediate feedback from a test is important. Doctors do not have a lot of time to spend with patients, so having the ability to do a quick test and provide feedback to the patient, or make on-the-spot therapy adjustments, can mean better patient care and outcomes.
LOCWIN: I think they provide a fleeting feeling of greater connectedness, social altruism, and trust. But these reported feelings don’t persist beyond a handful of hours after the interaction. Much of this weak connection between POC campaigns and patient-reported outcomes (PROs) I would argue is the result of the misinterpretation of Big and Small Data, as I previously mentioned.
PATEL: As Jay said, most doctors have very limited time with their patients during their appointments. This can substantially increase the doctor-patient interaction with the restricted time they have available.
BRUSH: To me it’s being able to understand there are better ways to make point of care decisions (e.g. physician with all the ultrasound POC systems) and understanding how to take charge of your healthcare with better communication and awareness (e.g. health connect apps and Mychart systems for patients).
NOEL: I agree with Billie’s statements and will add that the better the patient is educated and informed this can enhance the physician/patient engagement. It hopefully allows the patient to feel more empowered about their healthcare decisions and not feeling helpless and reliant solely on the doctors recommendations and comments.
What’s ahead? What will change, if anything, in the next five years in this realm?
LOCWIN: More trumpeting of cheap, misguided correlations, and disenchantment with lack of direct return on investment. I’ve given a lot of public talks recently on how to prevent these avoidable future pitfalls. It starts with understanding your product and consumer data better than you do currently. And make no mistake: this is not necessarily “more” data — it’s BETTER data. We are improving the methods by which we’re collecting data to make this information about the patient ultimately more useful.
NOEL: Continued evolvement to a consumer-based healthcare. As we see the advance of artificial intelligence, telemedicine, home testing kits and DNA-based testing platforms that give individual feedback, healthcare consumers are going to be more discerning but come with a wealth of information to their POC experiences. The larger challenge with all this great information is the interoperability that is largely lacking within in our healthcare infrastructure.
PATEL: The focus needs to be about the patient and nothing else. My hope is to get POC marketing to the patient BEFORE they enter the doctor’s office and ensure that doctors and patients are connected between appointments.
GRAVES: Companies will continue to become more sophisticated and efficient in the products they provide. I think many will start to provide services outside of the test, particularly as they accumulate more data from their devices. I also believe some of these companies will become more of a service and consultant to their customers in addition to providing products.
BRUSH: Hospitals will continue to do more to expand their hardware infrastructure to improve their EMRs, which will improve their POC systems. There will be more improvements with documentation practices, which will free up clinical staff to better focus on their patients. There will be more work done with cybersecurity, on protecting data and medical devices in healthcare. You will see AI tools and systems help improve point of care systems in the next 5 years by helping improve efficiency even more, reduce administrative workload, reduce errors and using evidence-based decision support.
SVP of Quality
Ben began his pharma career at Lonza, where in 11 years he was Head of Quality Risk Management, Head of Quality COE, and Global Head of Training & Development of the Quality Leadership Team. He has been Head of Global R&D Compliance L&D for Biogen, President and Managing Partner of Healthcare Science Advisors, and Head of Clinical Quality and Global Quality Operations for Karyopharm Therapeutics. Ben has also served numerous industry organizations, as Vaccine Advisor for the World Vaccine Congress, advisor to the FDA Quality Metrics Committee, chair of the 13th Pharmacovigilance Healthcare Conference, and others. He joined Lumicell in February of 2019 as the SVP of Quality. He is also the co-host of the podcast “The Science of Star Trek.”
LUMICELL investigates cancer and other diseased tissues at the molecular level, enabling physicians to take action in real-time during surgeries to improve patient outcomes. The company’s lead product, the Lumicell System, is in late-stage development for breast cancer surgery. It features an investigational onco-fluorescent agent and a handheld imaging device that enable cancer surgeons to see and remove cancer cells in real-time during operations. Lumicell is investigating the use of its therapy in patients undergoing surgery for breast cancer, ovarian cancer, prostate cancer, brain cancer, colorectal, esophageal and pancreatic cancers.
Billie Brush Consulting
Billie worked for Siemens Healthcare on Strategic and National Accounts. She then moved to Philips Healthcare, first as the Director of Strategic Business Accounts and then as the Senior Director of CT Marketing. She joined Accuray as the Senior Director of Global Marketing, Sales Account Manager, and the Senior Director of Brand Marketing. In 2017, Billie became the Vice President of Lumicell. In October 2019, she formed her independent consulting company. At Billie Brush Consulting, she provides business management and strategic marketing consulting in healthcare, medical technology and services.
Founder and CEO
Pathfinder Business Consultants
Former VP Sales
Roche Diabetes Care
Jay began his professional career in 1998 as an Intelligence Officer in the United States Army. He held multiple leadership positions and global deployments. After spending time as a sales representative at Sanofi, he joined Roche, where he held several key leadership roles within the organization, including Director of Product Marketing for North America and Head of Sales. Jay then became the Vice President of Sales for the US Roche Diabetes Care Division. He recently founded Pathfinder Business Consultants.
ROCHE DIABETES CARE With its Accu-Chek brand, Roche Diabetes care has been dedicated to enabling people with diabetes to live life as normal and active as possible, as well as empowering healthcare professionals to optimally manage their patients’ condition. Its products inclued blood glucose meters, lancing devices, insulin delivery systems, and digital solutions for data management, advice, coaching and education.
NOELEDGE Corner Consulting
Former Group Sr. Marketing Manager
Scot worked a number of years as Field Marketing Manager at Philips Healthcare before moving on to the position of Global Senior Manager for Commercial Training at Accuray. He then joined EKOS Corporation as Senior Manager for Customer Insights and ultimately Group Senior Marketing Manager for Communications. At Boston Scientific he served as Group Senior Marketing Manager for Market Development and Communications for their vascular products before establishing his own consultancy.
BOSTON SCIENTIFIC is a manufacturer of medical devices used in interventional medical specialties, including interventional radiology, interventional cardiology, peripheral interventions, neuromodulation, neurovascular intervention, electrophysiology, cardiac surgery, vascular surgery, endoscopy, oncology, urology and gynecology.
AMEE PATEL PANT
VP of Human Resources
Boylston Consulting Group
Amee Patel Pant has over 15 years of diverse human resources and management experience. She is a founder of Boylston Consulting Group and Head of Human Resources for Lumicell. Amee specializes in being a trusted advisor to CEO and Executive Management on talent management, workforce development, strategic recruitment, leadership development and effective internal communications strategies. Amee has served on the senior management team at New England Office Supply (now WB Mason), leading Human Resources strategy. She founded Boylston Consulting Group to help companies advance organizational goals, implement change and drive top and bottom line profit and revenue. She joined Lumicell 2018 and is responsible for all aspects of human resources initiatives including developing and implementing on-boarding, training, performance management, employee retention, benefits management and employee relations strategies.