Electronic Health Records: In Pursuit of Partnership

Every brand director would love to have the ability to send a relevant message to a physician at the point of care, specifically when they are speaking with the brand’s target patient. The Electronic Health Record (EHR) is fast becoming the platform to help make this wish a reality. Some vendors are offering tactics today to accommodate messaging physicians within their platforms. These vendors are providing brands the opportunity to target their messages by ICD-9 codes, or by patients who are using competing brands. While these offerings exist, are they too good to be true? Let’s peel back the layers of the onion and see exactly how close we are to integrating EHRs in our communication planning.

A key value metric for a brand director is reach (coverage). In 2013, physicians grew their use of EHR in their offices from 50.3% to 61.0% over 2012.1 That’s 21% year-over-year growth, which is analogous to rapid adoption. At that pace, it would lead to an 80–90% adoption rate in three to four years. That's very encouraging, but let’s dig in and review some of the other variables to consider.

Geographic Targeting

Marketing in the EHR platform allows brands to target by region, state or ZIP code. This flexibility can be leveraged to communicate new coverage wins or concentrate in areas where the therapeutic class is more prevalent. If sales force territories are vacant or white space areas need to be filled, geographic targeting can cover the gaps. That said, you will need to consider where in the country we have seen the greatest EHR adoption. It may surprise you to learn that just 56.7% of HCPs in the Eastern region utilize EHR in their offices. Even when you look at the top states using EHR, it is the rural states leading the pack. At the bottom we see New York and New Jersey, which may be surprising. Regardless, adoption is trending in the right way across the US, which bodes well for further development if geo-targeting is a vital component of your strategy.

UTILIZATION OF EHR IN PHYSICIAN OFFICES

By State EHR Adoption Rate (Jan. 2014)
Top 5 States  
Utah 71.6%
South Dakota 71.2%
Wyoming 71.0%
Iowa 70.8%
North Dakota 69.2%
 
Bottom 5 States  
New York 54.6%
Louisiana 54.1%
District of Columbia 53.6%
New Jersey 53.0%
Rhode Island 52.1%

Specialty

Through Medicare and Medicaid, hospital systems are given incentives to adopt and utilize an EHR system. To this end, over 71% of hospital- or health system-owned practices have implemented EHR platforms. So it makes perfect sense that there would be less adoption among those specialties that  hospitals are slower to acquire. For example, internal medicine/pediatric practices have a 78% utilization rate, while psychiatric practices are lagging at just below a 40% adoption rate. 

By Practice Specialty EHR Adoption Rate (Jan. 2014)
Top 5 Specialties  
Dialysis 80.6%
Internal Medicine/Pediatrics 75.8%
Nephrology 70.5%
Pathology 69.4%
Radiology 69.2%
 
Bottom 5 States  
Addiction Medicine 44.0%
Bariatrician 40.6%
Psychiatric 39.7%
Holistic Medicine 37.2%
General Preventative Medicine 35.9%

Vendor

The market offering for Electronic Health Record vendors is fragmented and rapidly evolving. The top 10 vendors account for just 56% of the total market. This landscape poses a couple of brand marketing challenges to consider. Not only will you experience limited market reach with an individual vendor, a targeted message will only connect with a small portion of your target audience. While this fragmentation poses a limitation, one solution is to partner with several vendors to increase your noise level with highly targeted patients at the point of care.

Despite the apparent limitations,  piloting an EHR strategy makes good sense. As you explore your options, consider vendor metrics such as  presence in larger or smaller practices, hospital system coverage, owned practices, physician participation costs, practice participation and geopgraphic presence. These metrics will influence your reach by virtue of potentially major swings in coverage and market penetration.


  1. SK&A, A Cegedim Company, January 2014. Based on telephone surveys of 270,036 U.S. medical sites.
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