Beyond the Blink: Mastering EHR and POC in Omnichannel Healthcare Marketing

Thought Leadership  |  07 March 2024

In this MM+M podcast interview, Damon Basch, VP of Strategic Partnerships at Veradigm, explores how a well-conceived omnichannel strategy can face unexpected challenges at the point-of-care (POC). He discusses the intricacies of decision-making at the POC, where seconds define success. After listening to this podcast, you’ll understand the pivotal role electronic health record (EHR) platforms play in your omnichannel strategy, the significance of understanding HCPs’ clinical workflows, and strategies to ensure that your brand not only survives but thrives in the moments that matter most.

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Full Interview Transcript

Damon Basch, Veradigm: What are they writing? Who are they treating? How are they treating, all de-identified of course, and other data points to help you understand this is what good looks like in Veradigm’s EHR, specifically based upon the patterns of our provider clients. That level of kind of bespoke Marceting support is really the secret sauce of what makes EHR so special and such a great conversion channel.

Marc Iskowitz, MM+M: Hi, this is Marc Iskowitz editor at large for MM+M, and I’m super excited to be part of this sponsored podcast with Veradigm. It’s called Beyond the Blink: Mastering EHR and POC in Omni-channel Healthcare Marceting.

In last year’s healthcare Marceting survey, MM+M saw an uptick in point of care Marceting budgets, as well as percent increase in those who said they’re using the point of care channel despite an overall 8% decrease in pharma’s overall promotional outlays. Those results suggest the durability of this channel at a time when budgets are being questioned. And while we haven’t seen a major rebound materialize in pharma Marceting spend just yet, the point of care channel’s expected to remain a budgetary staple, perhaps even gaining a bigger share of the media plan. That’s because of the pivotal role in electronic health record platforms and reaching doctors at the moment of prescribing. But as Marceters look to integrate EHR into the medium mix with TV and other channels, pitfalls can occur.

My guest Damon Basch, Veradigm’s VP of Strategic Partnerships, is going to run through strategies to ensure that your brand knows survives but thrives in the moments that matter most. Damon, how are you? And welcome back to the MM+M podcast.

Damon Basch, Veradigm: I am doing very well Marc, it is a pleasure to sit down and chat with you.

Marc Iskowitz, MM+M: Absolutely. Welcome, welcome. Okay, so let’s just get into it. Here we’re going to talk about some some ways that point of care strategies can go sideways at times. Describe some of those typical scenarios, you know, where despite having a well planned omni channel strategy, things may go amiss, or arise, I should say,

Damon Basch, Veradigm: Well, it’s a really interesting time to have this conversation Marc, because just like every other omni channel partner out there we are on the other side of RFP season. So, we’ve filled out hundreds of RFPs from all sorts of different brands. And through that process, you begin to see some of the commonalities about the ways that agencies pharma and brands are approaching omni channel and specifically POC. And obviously, a lot of it revolves around the NPI, I call it “NPeyeballs.”

And if you’re trying to normalize an omnichannel plan, you try to fill from top of funnel to bottom to reach as many of those physicians of importance as efficiently as possible. And a lot of what happens is people try and push point of care or push EHR into a kind of harmonized or normalized model, how many NPIs and how efficiently can I reach them without necessarily understanding exactly what happens in the EHR and how quickly everything accelerates to that moment of prescription.

Everything moves a little slow at the top when you’re starting with streaming or connected TV and other broad reach channels, which are meant to be efficient and broad reach. But as you start to get closer and closer to that encounter, to the prescription, things start to happen really, really fast. And so, a lot of what I want to talk about is some of the ways those things do accelerate in some of the actual clinical workflow.

Occurrences that happen in those 30 seconds to two minutes that it might take for a physician to make a prescribing decision and to actually prescribe it. Physicians can actually write a prescription in three clicks, Marc. They can select the patient, they can select the medication, they can send it to pharmacy. Now in reality, it usually takes a few more clicks, it can take as little as 10 seconds. But in reality, it sometimes takes two minutes or more. But there’s so much friction going on between the initiation of that process, and when that prescription gets sent to the pharmacy.

And so, an entire year’s worth of planning, an entire year’s worth of budgeting comes down to that crucial, let’s call it 10 seconds to two minutes. And if you don’t understand what’s occurring within that time period, everything you’ve spent all of your best planning all of those processes and work. That’s what can go sideways, super, super quick.

And so, we’re going to nerd out a little bit on EHR in this conversation. So, I hope you’re ready for that. But what I wanted to do is kind of expose what some of those workflows look alike so that omni channel people can think about that a little bit, think about EHR a little bit differently, but also get the best possible outcome at that part of the overall omni channel equation. So that was a little bit loquacious. But that’s kind of what I’m driving towards today.

Marc Iskowitz, MM+M: Yeah, that that’s really fascinating. It makes perfect sense, Damon, thanks for the setup. I was wondering, maybe we could take a step back because you mentioned that it is RFP season, how are brands in pharma kind of approaching the point of care channel? Do you see a difference in the way they’re approaching it fundamentally, for 2024?

Damon Basch, Veradigm: Well, I’m definitely seeing more programmatic out there, budgets are definitely shifting towards programmatic activation. I think that’s a good thing. I think there are more ways to in real time affect a strategy, and also get data back to tell you if what you’re doing is the right way to do things. We’re in a position where we’re offering to partners who are interested in programmatic activation, the ability to do so.

But in point of care, there’s very much a bespoke nature to it as well. And so, what I’m seeing from the best marketers is a blend. So they’re reaching in the endemic point of care category programmatically, but then when they’re really trying to get specific to a certain set of patient centric data, or a certain practice type, or a specific encounter, they’re coming to us and saying, we’re going to do our programmatic buy, but we’re also going to work directly with you for a bespoke strategy, which is really out of respect for the fact that there is so much going on within that 12 minutes, on average, that a physician is with the patient and an EHR. And again, those 10 seconds to two minutes where they’re actually making a prescribing decision and sending it.

So that’s really the trend I’m seeing is like a kind of hybridization, we’re getting asked a lot of questions about AI, which is a whole other podcast that we can talk about when the time is right. But those are the shifts that we’re seeing.

And to your point about the stats, we’re seeing an increase in the number of brands that are interested in EHR, some of that is a comfortability within MLR. And within legal and understanding point of care in general, and understanding EHR, and how best to operate in that environment. Some of it is the understanding that it truly is the conversion channel for any omni channel plan. And excluding EHR from your overall plan is feeding the top but not the bottom. And so, we’re seeing an increase in the number of brands across the board that are asking us for help. And obviously, we’re thrilled to be able to be there for that.

Marc Iskowitz, MM+M: Nice to hear that your pipeline is filling up. That’s a really good metric and an important one, right for a company like yours in this sort of environment. And we know that there’s many different EHR systems and you know, when I hear you talk about those crucial, you know, 12 seconds, you know, or the 12 minutes, you know, when a physician is where the patient, is there, a lot of variability there. And no, there’s, you know, one or two large vendors that we hear a lot and as medicine becomes increasingly institutionalized, a lot of them are, you know, seem to be standardizing on this one large vendor, which requires a lot of additional clicking through you said, you know, a provider can do it in as little as three clicks. But there’s oftentimes a lot more that has to be completed within the EHR in order to just kind of complete the encounter is there is that how does that affect things, you know, the difference in the, and the variability, the heterogeneity of the EHR systems?

Damon Basch, Veradigm: All EHRs have some fundamental clinical workflows that are the same. No matter who the software provider is, there’s a different user experience, there’s a different level of quality. And then there are different applications. Some are large health system platforms, which are really highly bespoke programs, solutions for that specific health system and all the different specialty areas within it. And some are more focused like Veradigm is on the ambulatory environment. These are clinics where patients are walking in and walking out, and they’re seeing primary care doctors and specialists who focus in a clinic based environment.

But the ePrescribing workflow, the documentation of a diagnosis, some of the clinical intervention tools, they’re all variations on a theme. One big difference for the purposes of an omni channel conversation is that these large hospital health system applications don’t accept advertising. There may be a specific instance or health system, where there’s a limited opportunity to communicate with physicians, but it’s not natively integrated into these large hospital-based systems. And so that’s a big difference, because it’s much harder to get there as a marketer than it would be for Veradigm where we built our solutions ground up with the ability to appropriately message physicians in a completely HIPAA compliant way. So, it’s challenging once you go to those top players to get any meaningful omni channel presence there.

But I also want to get back to the very first question that you asked me which is really to kind of get into the weeds to figure out where things go sideways because I don’t think we quite went as deep there as we need to understand what’s going on for physicians.

So, picture this for a minute picture Marc is going to see your primary care physician before you’ve walked in the door, most EHRs have already done a benefits investigation. So, we know who your carrier is, we know if you have government coverage or commercial coverage, we know that coverage is we know what your chief complaint is. So, you walk in with the physician, and you go through that initial presentation, you talk about your complaint, the doctors taking the free notes, the SOAP Notes, and their subjective objective assessment and plan that you see them typing away in their EHR. And they’re moving their way through differential diagnosis to diagnosis and ultimately, if required, a prescription.

So, they’ve entered that prescription process. And here’s where omnichannel marketers who don’t know EHR don’t understand exactly what’s happening. So once that prescription process starts, we’ve contacted your carrier to understand if that brand is covered or not, and that gets returned in sub seconds. And then that payer will tell us what the actual cost for that brand is. Whether or not it requires a prior authorization, and potentially therapeutic alternatives, if it’s a generic that’s available, or if it’s in the same class of drugs, but it’s less expensive. They’ll tell you what cash pricing is, they’ll tell you what pharmacy pricing is.

And so, a physician who is writing a prescription for Marc may start with one medication in mind that they think is appropriate. But between the initiation of that process, and when it gets sent to the pharmacy, their minds may be changed multiple times, they may find a drug that doesn’t require a prior authorization, or one that is same in class and just as effective, but cost less money, or one that’s approved for a 90-day supply instead of a 30 day supply. Or they may override what they’re writing. So, it’s not switched out at pharmacy by clicking something like dispense as written, or brand medically necessary.

So why do I share all of this? I just shared with you 5678 different things that happen in seconds, when a physician is writing a prescription. And if you’re marketing in that environment, you need to know how to make sure that the physician has the tools and the information to make those decisions in that moment. And that’s a conversation, it’s a little bit more of a sophisticated and targeted approach to omni-channel, as opposed to building awareness is we know what the top of the funnel building awareness and as you bring them close to that moment of care, you’re driving interest, you’re driving engagement, and then you’re driving the actual conversion. In that conversion, a lot of other things are telling you don’t convert, don’t convert, try this instead. And you can’t control those things. But you can’t control you educate the physician in support of your brand.

Marc Iskowitz, MM+M: Absolutely. You can’t control what you know, things are going to pop up, you know, prior authorization required, or as you said, a 30-day versus a 90-day supply or price. But you can control as you say what you can control. And that’s how you market and giving physicians the tools and information that they need at that moment of conversion. Right.

Damon Basch, Veradigm: Yeah, so I mean, a couple of examples. You know, tier status, we have EHR is an ideal environment to either make sure that physicians understand that for a patient they’re treating that tier status is strong, and that the pricing will be good. If it’s not, then that’s when copay and coupons start to come into the equation for cost parity. That’s one example.

I mentioned, “dispense as written” or “brand medically necessary.” That’s another one. If it’s a competitive class of drugs, it’s up to the physician to decide if the specific brand that they’re writing is the one that has to be filled. Otherwise, a pharmacist will look for something that is comparable and costs less. So those are just two examples.

But there are numerous examples where we need to think about EHR a little bit differently. Do you talk about tier status, when a physician is watching connected TV? Probably not. You’re talking about the brand, so that the name of the brand, the indication of the brand, and the happy people who are living well in the brand are all starting to generate awareness in your mind quite different than when you’re in a clinical platform. And so those differences are something that require more conversation between the partners out there who have EHR and omnichannel is trying to make sure they have the right presence there.

Marc Iskowitz, MM+M: So you’re saying like, even though point of care is fundamentally a kind of bottom of the funnel type of a tactic, you switch up you know, your messaging a little bit depending on whether you’re operating at the top or the bottom of the funnel, you know, if you’re on CTV, you’re not going to be talking about to your status or, or those kinds of minutia type things.

Damon Basch, Veradigm: I think that’s absolutely correct. Point of care in general requires a specific type of messaging that is vastly different from social media that is different from endemic journals that is different from non-endemic environments like television, and outdoor and other areas like that. There’s a reticence sometimes on the part of marketers to really focus on it that way. Because sometimes creating new assets can be a challenge. Sometimes getting new, creative assets approved through MLR can be a challenge. But if you’re going to play in the space, and you need to play in that space, then you need to think strategically about your content, your messaging, but again, what the actual clinical workflow looks like what’s going on when a physician isn’t ministering to their practice, and they’re not with a patient.

And when they’re in a clinical counter, and they’re actually looking at a patient, the more you understand that the more effective you can be with your strategy. And you can’t just necessarily look at that environment as how many “NPeyeballs” and what’s a CPM? You need to think about what’s the environment? And how can I make sure that I pull through, and I don’t get disintermediated, because of what this clinical workflow looks like.

Marc Iskowitz, MM+M: Right, preventing this from intermediation is very important. And as you mentioned earlier, you know, you’re seeing EHR get integrated more in programmatic, which is something when you and I spoke last that the MM+M trend talks last November 16. That was one of the points of discussion was that, you know, EHR is moving toward this integration more with programmatic and therefore more in the omnichannel marketing plan? Is that kind of where you know, choosing the right point of care media provider really can help, you know, make sure that the brand’s influence stays true as EHR scales up into this broader media plan?

Damon Basch, Veradigm: Yeah, I think that’s a great question. Because when you start looking at programmatic and you start looking at networks, what you tend to lose is visibility into the specific platform that your message is being delivered through. You know, there is a big difference between a connected app with a small number of users that may not have the resources for the right, privacy, or the right data protection, may not even have the data rights necessary to ensure that your message is in a safe place.

And so, you know, as you look to aggregation, and networks and programmatic, one thing you do need to be aware of is that clinical software is different than non-endemic media, or even some endemic media and the environment, the platform matters, you don’t want your brand to be presented in a platform that has a bad user experience, that doesn’t handle messaging in a way that is not disruptive to the physician and their workflow. We don’t want to see NASCAR messaging all over the clinical platform, whatever it is they’re using, there’s a lot more that goes into making sure that the messaging is complementary to the clinical errand to the physician or to their practice or to their specialty, and that everything is protected, and everything is done in the right way.

And I think as you start to step away from you know, bespoke modeling platform by platform and you look, programmatically or you look in the network fashion, you have to really uncover and ask questions about who are the underlying clinical software providers that are rendering this media? What do we know about them? Are we sure that the privacy is in place, the data rights are in place, the data security is in place, and that the messaging is delivered at an appropriate frequency, and an appropriate place in the workflow that respects the clinical experience of the provider? If that is not the case, then that will negatively reflect upon your brand. And so that’s why I talk about brand equity, and being clear on the platform that your media is being delivered on. I think it’s critically important.

Marc Iskowitz, MM+M: Yeah, it’s kind of like brand safety in the clinical environment, right, which is something we don’t necessarily hear about. It’s really fascinating, you know, sort of topic.

Damon Basch, Veradigm: Brand safety, for sure. And brand equity. Again, if a physician has an experience with the platform, where everywhere they go, they’re seeing this one brand again and again. And it has nothing to do with who they are, what they’re doing, who they’re treating, that is not a good look for your brand. And I think the specificity of working in a platform where you can use the data to make sure that you’re delivering the right message in the best possible way. You know, that’s important, you know, we cap frequencies, we make sure we’re using the data to be very specifically targeted, and frankly, you see better performance because of that as well.

But what you can’t measure, again, is that brand equity, the fact that the physician sees the brand, as one that is trying to be there for the right reasons. And that has a right to be in the room at that time. And that’s how you build brands, you know that you don’t measure that necessarily with an ROI, although we do that as well. But it’s something that needs to be thought about in point of care because there are a lot of folks jumping into point of care right now because of the stats that you use. There’s more spend, it’s more stable and growing spent is more interested awareness about point of care.

As a result, you have a lot of companies who are starting to build point of care into their networks necessarily, without understanding the clinical software, the needs of the physicians along the way. And that’s something that we, at Veradigm take with paramount importance because we are the software provider. They use our clinical tools for EHR, practice management, revenue cycle management, and so many other reasons, patient portals. And so that’s our first customer. And you want to work with platforms where the provider is the first customer, very important.

Marc Iskowitz, MM+M: Yeah, I mean, I use the term brand safety, because you were talking about, you know, you don’t you want to sort of be aware of what other brands are competing for that real estate, you know, and that your brand has been juxtaposed against, but it’s not quite the same, you know, I see, it’s more of a brand equity, sort of a discussion rather than a brand safety per se. Because in the clinical environment, you know, it’s a little different. But, you know, you talk about the need to sort of be aware of the underlying clinical software provider and making sure that all these brand equity points are in place, and as you put it, that respects the clinic’s clinicians experience, and it doesn’t negatively reflect on the brand. And that’s why it’s important, it seems to you know, have a direct relationship with it with a with a point of care media provider, you know, to sort of ensure that all that takes place. And you’re really what you’re doing is you’re making sure that the brand views the physicians not merely as an NPI target, you know, as you put it, but really understands and addresses their real world clinical experiences and needs, what are some of the other considerations there to make sure that brands don’t lose sight of that this isn’t just a number, this is a person that you’re trying to, you know, make sure you engage with?

Damon Basch, Veradigm: Well, I think, look, it’s challenging for marketers, and agencies, their agencies to kind of look at point and care, and do everything in a bespoke fashion. However, you asked about trends earlier on, you know, all major agencies that we work with now have point to care centers of excellence. And I think that’s the most important first step, you know, the agencies that are planning for point of care, the brand teams planning for point of care, they need to have centers of excellence, who can help them polish, refine their point of care and their EHR strategies, and encouragingly, I’m seeing more and more and more of that, where we get called in, to educate.

And you know, we’re not talking about work with us here, we’re saying this is EHR. This is what it looks like, this is how it’s used. And so, I think the first step is to reinforce the fact that the centers of excellence are a good thing, they’re a necessary thing, and that there’s a lot of value on the back end that comes out of using that resource the right way. And the good partners want to educate as much as they can.

So that’s really the trick here is to make sure that you don’t go end to end with a plan, using “NBeyeballs,” and cost efficiency as the end all be all the way top of funnel to the bottom, you got to take a breath, take a step. And when you’re in point of care, say how can we use this channel appropriately, and put a little bit more time a little bit more energy into understanding the physician experience, so that we can optimize the outcome for this brand and its marketing approach. And that’s it.

Marc Iskowitz, MM+M: That’s a good segue to the next question here is, you know, as they take that step, and they take that breath, and they look back, and that’s how we make sure that we’re using this channel appropriately, how can they prepare for and react to the situations where their products may be at a disadvantage due to benefits, verification outcomes, or the presence of therapeutic alternatives in the EHR system?

Damon Basch, Veradigm: Well, so a lot of this comes down to cost. Obviously, if you know you have good coverage, make sure it’s known. And if you don’t make sure that you’re offering Patient Savings Programs and other resources so that there’s either price parity, or the outcome is worth the brand medically necessary or dispense as written, there’s a specific reason why your brand is the right brand, despite any matters related to cost or anything else. And if you understand that, then the messaging can certainly support that. And we can make sure that you’re injected in the right points in that workflow so that those messages are delivered. when it matters most.

Marc Iskowitz, MM+M: I guess price really is increasingly you know, more of a factor for physicians, even though some of them probably might not want to get involved in that neck of the woods, they want to stay to what they feel is therapeutically the most appropriate treatment. They have to sort of come to grips with the fact that there’s a lot of disruptions as you put it between them and getting that prescription. So, they kind of do have to be aware of these other factors.

Damon Basch, Veradigm: Think about the fact that part of it is making it easy for them to see the pricing. If it’s not in front of them, then they’re not going to dig for it. But here’s the other part, physicians are moving towards value-based care models, period. So, we’re looking at their population of patients, and we’re looking at population level health. And so, if their patients are routinely not getting their prescriptions, not taking their medications, and not refilling their medications. And if their values are not improving, and if their outcomes are not improving at the population level, there’s a material economic impact to the physician. So that’s another trend that is really important to understand and that physicians are becoming innately more aware of cost, they have to because cost relates to adherence relates to outcomes relates to value-based care models. So, all of that is coming together, and the technology is meeting them where they live in order to make it a little bit easier for them.

Marc Iskowitz, MM+M: That’s a great point, Damon in terms of the triple aim, you know, better health care that’s more affordable and more efficient and better quality. So, they have to be innately more aware of the cost of things if they want to operate within that population based health environment, as you put it. Are you seeing, you know, kind of related question, you talked about connecting patients to coordinated care? Are you seeing that the modeling of where social determinants of health comes into greater focus where some of the systems at the EHR level are making it possible to put a plug in API’s into the EHR so that doctors or clinicians can actually prescribe support services as if they were to prescribe medications, whether it might be counseling, social services, things that heretofore had not been so easily, you know, connectable and an EHR, you think SDOH kind of become more of a presence in the EHR?

Damon Basch, Veradigm: Well, I think the sources and the scope and social determinants of health SDOH data is becoming much, much stronger. And also, data companies like Veradigm, for example, are getting much better at integrating that data into other data assets. Mortality data, claims, data, registry data, EHR data, all of that is being harmonized and used to understand patient populations and to drive better outcomes. So, we’re absolutely seeing more of that. I personally have not seen specific interventions based upon SDOH data come into play yet, but I can certainly see a world where it does. A lot of that data is unstructured and needs to be structured in a way where it can be used for that sort of outcome. But what I am seeing is frustration and progress around getting patients connected to services, hub services, for example, where everything that you described lives. So, you know, a call center is the starting point, you get a patient enrollment to get all the consents and signatures and then getting get them connected to nursing services and care coordination, financial resources or specific interventions that are related to SDOH inputs. And that’s where all that data is collected and used on the hub side. I think a natural progression would be you start to see in the EHR, more messaging of support around those sorts of things. But I think it’s a little bit early days on that, Marc.

Marc Iskowitz, MM+M: Sure. Yeah, I just remember covering a couple of years ago, one big deal with one of these providers of SDOH plugins, but I guess it has really taken off in any great way, shape or form. As we move toward, you know, wrapping up this discussion, which has been fascinating, can you kind of reiterate for us, you know, what strategies marketers can employ, Damon, to ensure that their brand remains the preferred choice, even when HCPs are making patient level decisions and they may there may be some disintermediary kind of value variables that kind of may get in the way?

Damon Basch, Veradigm: I think the it’s incumbent upon point of care providers to inform and arm omnichannel marketers with our data so that good decisions can be made. Come to me, and we’ll tell you what the clinical behaviors are of our practices and our physicians. What are they writing? Who are they treating? How are they treating, all de-identified, of course, and other data points to help you understand this is what good looks like in Veradigm’s EHR, specifically, based upon the patterns of our provider clients. That level of kind of bespoke marketing support is really the secret sauce of what makes EHR so special and such a great conversion channel, then you need to marry that with kind of the zeitgeist of the industry and moving towards programmatic, and you know, buying broad efficiently and leveraging data in real time to measure performance and look at next best action. All of that is fantastic and should be done. But it needs to be complemented by that direct, bespoke model that only comes from a conversation with a vendor partner who can give you the data necessary to be a smart marketer.

Marc Iskowitz, MM+M: Well said, well, wrapped up there, Damon, and so we hope everybody out there that you’ve enjoyed, you know, this discussion on deeper ideas of how the point of care channel can go sideways in the EHR, as well as the comments about the quality of environment, the importance of the clinical software environment, you know, there’s a lot of aggregators and networks out there. So how does a brand maintain its equity, especially as it scales up and to an omni channel environment. And so, being an EHR expert, would hope that Damon’s shining a light on this area has proven as interesting to you as it has to me. To that end, those who have any questions can email him with their EHR integration questions or contact Damon through MM+M, and you know, as point of care channel becomes more of a staple in programmatic and an omnichannel marketing Damon, I hope that we can have another one of these conversations down the road.

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