EHRs and the “Four P’s”

A survey of Patients, Physicians, Pharma, and Payers on the current use and potential of patient portals in EHRs to improve outcomes

Definitions

Electronic Medical Record (EMR)An EMR contains the standard medical and clinical data gathered in one provider’s office.

Electronic Health Record (EHR)EHRs go beyond the data collected in the provider’s office and include a more comprehensive patient history. EHRs contain and share information from all providers involved in a patient’s care.

Patient PortalA patient portal is a secure online website that gives 24-hour access to personal health information.

Source: HealthIT.gov

Acknowledgments – A Cooperative Effort

Patient Survey

HCP Survey

Payer Survey

Pharma Survey

Patient perception of patient portals

11,122 Uniqueresponses

2,0022,001

2,001

2,0011,123

3,287

Type II Diabetes

COPD

Rheumatoid Arthritis

Cancer

65+ (1,293 overlap with the 5 conditions)

MS

Patient survey statistics

Source: Google Health

175Millionhealthsearchesdaily...

But only 18% of patients surveyed

use patient portals

37%

23%8%

14%

18%

Usage of patient portals

I never heard of a patient portal before

I know it is available, but I don’t use it

My doctor doesn’toffer one

I have used a patient portal

I don’t know ifit’s available

89%

Female

11%Male

Gender Distribution across 5 conditions

2%

8%

22%25% 24%

14%

0%

5%

10%

15%

20%

25%

30%

18-24 25-34 35-44 45-54 55-64 65+

Age

Average age distribution across 5 conditions

Gender and Age distribution across the 5 conditions

Helpfulness of an online portal in engaging and communicating more with your physician

Interest in using a patient portal to track progress and provide feedback to your physician

Interest in accessing your own medical recordsthrough a patient portal

32%

30%

29%

*Interest defined as a rating of 4 or 5 on a 5 point scale

Although only 18% use a patient portal, a greater percentage have interest in accessing and using potential portal features

Engaging with the physician and tracking personal medical history...

Receiving educational materials and patient support...

*Interest defined as a rating of 4 or 5 on a 5 point scale

Value of a total health program built into a patient portal (diet, exercise, medication, education)

Value of programs to help you manage and stay on your medications

Value of eCoupons/eVouchers/Co-pay cards

Likelihood to read educational materials about a disease state within a patient portal

Likelihood to read educational materials about your medication within the patient portal

33%

30%

30%

34%

34%

Although only 18% use a patient portal, a greater percentage have interest in accessing and using potential portal features

Physician perceptions of patient portals

Patient portals—Started slow but coming on strong

0%

10%

20%

30%

40%

50%

Sending lab tests Sending patient education/disease

information

% o

f Pre

scrib

ers w

ith M

oder

ate t

o Fr

eque

nt U

se o

f Fun

ctio

nalit

y in

EH

R

Percentage of Prescribers Using Patient Portal for Key Tasks²

2013 2014

+26%

+50%

²Source: PDR Prescriber Engagement Survey 2013 (n=1,215) PDR Prescriber Engagement Survey 2014 (n = 2,977)

¹Source: Multiple PDR Quantitative and Qualitative Research with Prescribers and EMR technologists, 2013

…Since then, Active Users have Risen Significantly, often

driven by Prescriber Push

PDR estimates¹ that 3-5% of patients were active users of patient portals

as recently as 2013…

237 Prescribers (MDs, NPs, PAs) were surveyed from a variety of specialties

16%

13%

10%

8%8%8%

7%

7%

6%

8%10%

Internal Medicine

Family Practice

Allergy/Respiratory

Endocrinology

Pediatrics

Cardiology

Rheumatology

Oncology/Hematology

Ophthalmology

Osteopathic

Other

52%17%

31%of Prescribers state that they offer a patient portal

Iofferapatientportalforpatientsinmypractice

IdonotofferapatientportalbutIplan toofferoneinthenext12months

Idonotofferapatientportalanddonotplantoofferoneinthenext12months

A substantial majority of Prescribers see value in patient support delivered via patient portals

Total health program(diet, exercise,

medication, etc.)

69%

Health/medication educational materialsto help manage health

68%

Patient access to their own medical information

and records

61%

Personalized recommendations to

improve health behaviors

61%

*Percentage rating services “Moderately, Very or Highly Valuable.”

vs.Value of patient support via patient portals

74%64%

Health/medication educational materialsto help patients manage their health

74%52%

Personalized recommendations sent topatients to improve health behaviors

72%67%

Total health program (diet, exercise,medication, adherence, health education

69%57%

Patient access to their own medicalinformation and medical records

SpecialtyPrimarycare

*Percentage rating services “Moderately, Very or Highly Valuable.”

25%

65%

10%

Donotactively promotepatientportal

Activelypromotepatientportal

Activelypromotepatientportalandrequire thatPatientsuseitforaleastafewtasks

75% of Prescribers who offer portals actively promote its use

One-third of Prescribers useportals for a broad range

of clinical, financial and administrative activities

...And a majority of Prescribers surveyed want care or health management messages from the patient’s health plan provider.

Something Else

Simple Administrative

Activities

Number of AdministrativeActivities and Financial Activities

24%

31%30%

15%

Prescribers use portals for administrative, financial and clinical purposes

Payers and EHRs

Payer survey statistics

9 responses from medical directors affiliated with organizations

representing 47 million lives

National MCO

RegionalMCO

Integrated Delivery Network

3 4 2 =++

Medical Directors from those managed care organizations surveyed are not familiar with EHR/patient portal systems

Familiarity with EHR use (on a 1-5 rating):

2.8(average rating)

Familiarity with patient portal use

2.4(average rating)

1 2 43 5

*Average ratings based on a scale of 1 to 5

Although a majority of physicians surveyed say they want care or health managementmessages from health plan providers, there is mixed interest from managed care

Would the following be valuable to your members?

Access to medical records through a patient portal

Personalized health recommendations, reminders, alerts

Total health program (diet, exercise, medication, education)

Educational materials

Adherence program

eCoupons/eVouchers/Co-pay cards

1 | | | 53.9

1 | | | 53.1

1 | | | 5

1 | | | 52.81 | | | 52.51 | | | 52.1

3.1

Pharma perceptions of EHRs and Patient Portals

Are you involved in using or researching EHRs or patient portals?

Individual involvement in EHRs

Minimal

Some

Moderate

Significant

Number of responses

(investigating,planning,orimplementing)

Is your company engaged in EHRs as a marketing channel?

Company engagement

Limited

Moderate

Significant

Complex & Robust

Number of responses

Companies engaged with EHRs have dedicated staff to explore opportunities

✗✔

“Is there a dedicated role within your organization tasked with EHRs?” 7

4

75%64%

Branded Messaging

83%55%

Disease Education(unbranded)

92%55%

Adherence Messaging

25%18%

Other

Pharma respondents expect an increase in EHR use in the future

Vs.Intended future EHR use Current EHR usage

Pharma concerns and questions

“Will IDNs and ACOs allow for

such use?”

“Lack of ROI –how can we show

ROI?”

“Regulatory approval on more relevant content”

“Overwhelming number of platforms that do not

talk to each other”

“Complex subject matter with much further education needed

for most pharma marketers”

Craig Kemp, Innovative Partnerships, Merck Vaccines – one of the leading pharma EHR experts:

“HealthtechnologiessuchasEHRsnowmanagetheclinicalworkflow.Patientengagementthroughhealthtechnologysuchaspatientportalsisrapidlyincreasing.Ourindustry’sservicesandsolutionsthathelppatientsaccessappropriatetherapiesandusethemcorrectlycandramaticallyimprovehealthoutcomes.

Figuringouthowtodelivertheseservicesandsolutionsthroughhealthtechnologyisoneofthegreatchallengesourindustryfaces.”

Conclusions

Patient portals are an underutilized resource for a population hungry for health information

Physicians, payers, and pharma have similar views on much of what is valuable to patients – and patients want this information

The barriers appear to be structural – needing someone to lead the charge in creating value within patient portals

Awareness and use of patient portals is increasing, but has a long way to go. The benefits and efficiencies to prescribers are obvious

Conclusions

Thank You