Physician EHRs emerge as hot advertising venue for drugs

If physicians were to draw any conclusions from the amount of interest Jeff Meehan says his company, MD On-Line, has had in its electronic health record system from pharmaceutical companies, it’s this: If they haven’t seen them yet, there’s a good chance doctors may start seeing ads placed throughout the pages of their EHRs.

Meehan, chief commercial officer for the technology vendor, said that even though his Parsippany, N.J., company has rejected the pleas from the pharmaceutical and medical device marketers to embed ads within the pages of their EHRs, he understands why the idea is considered the “holy grail” of marketing opportunities for them. As more physicians adopt cloud-based EHR systems, interest in this type of advertising is expected to grow.

“From an advertiser perspective, the functionality of EHRs and EMRs is potentially a gold mine in that you are able to reach physicians during point of care and in a targeted capacity as well,” said Jonathon Padron, senior client service analyst for comScore, an Internet analytics company headquartered in Reston, Va.

A report by the firm analyzed the ways in which physicians use the Internet so that medical device and pharmaceutical companies will know what online activities have the largest reach among physicians. It found that physicians have the highest engagement with online EHRs in terms of total time spent using the systems compared with time spent on other online activities.

Because EHR data give marketers the ability to target messages in a more granular way to the specific physician, it’s very effective for marketers, Padron said. For example, the system can identify the condition a physician is looking at and automatically pop up a drug that can treat it. Plus, he added, in the EHR, advertisers can be assured that it’s a physician who is looking, unlike online sites that may not authenticate whether a user is a doctor.

Changes in ad strategy

Also contributing to the growth are recent challenges pharmaceutical companies have faced with traditional advertising, which was to send drug detailers to meet and woo physicians in person.

Many health care organizations have instituted bans on things like free samples and gifts from companies, said Julie Donohue, PhD, a researcher at the University of Pittsburgh Graduate School of Public Health. She has not studied EHR-based marketing in particular but said that because of the relatively low cost of placing these ads, the return on investment could be significant.

The arrangement is attractive for some EHR vendors, which have been able to make money from selling these highly desirable marketing opportunities. Because of this revenue stream, they can offer physicians use of the systems at little or no cost.

It’s not known how many cloud-based EHR vendors use this business model or how many pharmaceutical companies are using this approach to marketing. American Medical News reached out to five of the major pharmaceutical companies in the U.S. to comment for this story. Three declined, and the two others did not respond. But marketers say the physician audience is building.

In 2011, 55% of office-based physicians were using an EHR, and 41% of them were using a cloud-based system, according to a July 2012 report from the Centers for Disease Control and Prevention. A cloud-based system is necessary for EHR advertising, because a system hosted on a local server in the office doesn’t give the access advertisers would need to push ads onto the doctor’s computer.

Between the physician and patient

Getting messages to physicians at the point of care was an idea MediScripts launched in 1981 with the creation of it personalized prescription pads. It allowed pharmaceutical companies to deliver branded messages to physicians throughout the prescription pad. The concept has carried over to the electronic prescribing era, said Jim Pantaleo, executive vice president of sales and marketing for the Hasbrouck Heights, N.J., company. In addition to the prescription pad, MediScripts now delivers messages at the point of prescribing through its Rx Pad e-prescribing system.

One of the first EHR vendors to put ads in its EHR was Practice Fusion, based in San Francisco, which launched its EHR product in 2007. The ads were initially placed using Google’s AdSense program, which generates ads based on keywords in the Web-based EHR. But in the past few years, the company said, there has been such a high demand for EHR advertising that Practice Fusion hired an in-house ad sales team to work directly with the advertisers.

Zach Gursky, vice president of sales for Practice Fusion, described recent ad saturation. In the past 1½ years, the idea of EHR-placed ads went from a low level of awareness in the marketplace to a point in which more than 85% of the major pharmaceutical companies are running ads with Practice Fusion.

Even companies not offering pharmaceutical giants this level of reach with physicians are feeling the pressure from them. MD On-Line has both a cloud-based practice management/claims processing system and an EHR. It allows pharmaceutical companies to communicate directly with physicians only through its practice management system using a platform it calls Instinctive Data. But Meehan said drugmakers are clamoring to be present on the EHR as well.

Meehan, a former pharmaceutical marketer, said “the holy grail was to get in between the doctor and the patient and somehow become part of the conversation.” But it’s something MD On-Line has chosen not to do. He said that reaching physicians “near” the point of care as opposed to “at the point care” is less intrusive and something MD On-Line’s physician clients were more open to. The ads and communication they receive through the practice management system comes through a dashboard that includes in-house and sponsored educational material, clinical guidelines and industry news and announcements specific to the physician.

Gursky said there is definitely a “value exchange” when it comes to selling physicians on the idea of receiving ads at the point of care. “What the physician has to do in return for getting this really valuable software for free is give permission for us to deliver ads.” But, he said, physicians are finding value in the ads, because they are tailored to them and the kinds of patients that they treat.

Practice Fusion has an ad-free version of its EHR that physicians would pay a monthly subscription fee to use. Gursky said less than 1% of Practice Fusion’s clients use the ad-free system.