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Electronic Health Records: In Pursuit of Partnership – Part 2

In the first part of the Electronic Health Records (EHR) blog post series, we focused on physician adoption rates by geography and specialty for targeting purposes. We also began to explore the EHR vendor market, demonstrating just how vastly fragmented it is, which presents challenges in choosing the best marketing partner. Part 2 of this series will focus on some other important considerations, including reporting, messaging and how we expect this space to  evolve over time.

So just who are the top EHR vendors in physician offices:

The top 10 Electronic Health Record vendors make up just 56% of the total market.1 As you consider your options, see the table below that indicates which vendors have a stronger presence in larger practices, while others are more prevalent in smaller practices. Epic Systems is prominent in hospital systems and has reach into physician-owned group practices. However, display messaging within the Epic platform has been stymied due to brand advertising policies within the hospital sector.

EHR Vendor Market Share Chart


There are differences between vendors as to where/when you can advertise within their platforms. Some only allow advertising in the e-prescribing area while others allow advertising earlier in the workflow, such as in patient charts, messages and scheduling. It is quite possible that waiting until the e-prescribing area to advertise is too late, but that hypothesis still needs to be proven. Below is an example of how a display ad might be presented on the patient chart:

EHR advertising might not be the best place to build awareness for a launch brand, but it certainly can encourage switching once awareness has been established. For example, while with a patient, a physician is less likely to research a drug he or she has never heard of before. However, it might serve as a great reminder for a drug he or she is interested in but has not established a routine behavior for prescribing it yet.

Another proven use of advertising within the EHR is to educate physicians on proper dosing. Physicians tend to start with a low dose and titrate up so brands with multiple strengths often have strategies intended to increase dosing regimens. One internal study demonstrated a higher average last dose than during the baseline period.2

Dosing chart and the value of EHR as physician educator


In order to establish EHR as a legitimate tool in a Connected CRM (cCRM) environment, we need to get to the point of physician-level reporting. Thus far, reporting and measuring have been dependent upon the vendor, with no physician-level data being shared, and no third-party ROI verification. Ultimately, brands need and will demand physician-level (not patient) reporting to better understand behaviors and apply attribution models for future strategic planning.

Regulatory environment will force consolidation:

In 2015, the Physician Quality Reporting System (PQRS) from the Center of Medicare and Medicaid Services (CMS) will  begin adjusting physician payments to encourage reporting on specific quality measures. It is not enough just to own a certified EHR system. Providers have to demonstrate to CMS  that they are using their EHR in ways that can positively impact the care of their patients. To do this, providers must meet all of the objectives established in the PQRS for these programs. Then they will be able to demonstrate Meaningful Use of their EHRs and receive an incentive payment as part of PQRS.

Several EHR vendors will not have the capabilities to meet Meaningful Use requirements. Thus, over the next three years, we expect contraction in this space. It is at this point where an EHR vendor leader will emerge and you will be able to use their platform to address your high-value targeted physicians at scale. There is no question that marketing to physicians at the point of care will play a vital role in the promotion mix for many brands. It will also become quite a competitive space to play in. Any time you can interact with the physician while an appropriate patient is in the room, you are acting as a catalyst for physician-patient dialogue about your drug. That is a winning combination.

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