Burgess COMMENTARY

Peter Burgess

GSK and nonprofit shrink Big Data down to size

The storyline of late has been about how Big Data is going to transform pretty much everything. GlaxoSmithKline and the nonprofit Community Care of North Carolina announced an effort earlier this month that seeks to take the Big Data concept—healthcare trends and specifically adherence—and translate it into a local, quality-of-care concept. It also happens to fit squarely with the push in medicine to focus on outcomes.

In this case the goal is predictive analytics that will help the nonprofit access items such as a patient's prescription history, hospital admissions and discharge information and then use that data to predict if the patient will have a negative outcome. GlaxoSmithKline's role is a somewhat removed one—its professionals will help craft rules for processes which pharmacist-by-training and GSK's senior director of payment and delivery reform Jon Easter tells MM&M could improve care and delivery reform and “address some of the problems with medication management.” The company will not, however, be in the room with HCPs as they sketch out a treatment protocol. Easter likens it to providing the tools a mechanic may have in a garage, but with the mechanic, or in this case, HCPs, choosing which ones are appropriate.

'What I'm focused on is this marketplace, and how it is evolving from a volume-driven marketplace to a value-driven marketplace,' Easter says.

The goal of what the partners call a 'small data' project appears to be in line with a recent discussion about looking at adherence from a more holistic perspective, such as the one outlined in Medical Care's September issue which looked at factors that can predict general patient adherence trends, but in smaller, geographically defined areas. CCNC's president and CEO Allen Dobson, Jr., said in a statement that the partnership is one that can “provide a roadmap of sorts . . . to help providers treat a large number of at-risk patients in a more highly individualized way.”

This could feel like a bit of a privacy reach, with pharma in the mix, and while Easter acknowledges that there could be apprehension about industry working with patient data and having an invested party involved with medical resources, he says the divide between the company and the facility is clear. Easter says the company's participation is grounded in HIPAA. He also adds that the partnership is not a marketing ploy or a program that is being considered from a future marketing standpoint, but is rather one that will help healthcare track with emphasis on quality of care. In Accountable Care Organization speech, this roughly translates into showing the proof of concept before treatment, a point ACOs have repeatedly told the industry that it needs to provide.

Yet it was in a Tuesday end-of-day panel comprised of doctors and a Pfizer executive that zeroed in on the real issue: what doctors need as opposed to what pharma thinks they should want.

This was an almost-touched-on issue in a presentation that told the largely empty ballroom that the key to a physician's heart was the ability to provide customized details that kept reps and doctors from flipping through irrelevant slides with narratives that could be pieced together on-the-fly.

While time-saving, the late-day panel, which included cardiologist Jordan Safirstein and Kecia Gaither, Ob/Gyn and maternal fetal medicine director of Brookdale University Hospital and Medical Care in Brooklyn, highlighted why the custom tablet detail is a solid, but not on-target effort.

Safirstein said the bigger issue is that “Pharma has to find a way to insert its way into doctor's lives,” and current efforts tend to be a mix of inefficient old-school approaches and information that doesn't aid decision-making for the increasing number of doctors who do not get to choose what medications they prescribe, but are left to navigate formularies and treatments determined by group health organizations.

Safirstein said pharma needs to think outside its immediate interests -- as in brand-centric thinking -- and become a true resource beyond, say, being a source of patient co-pay cards. 'No one ever says 'Thank God you gave me that co-pay coupon, Doc,' he said, noting that these cards do trigger a reaction when they end up in a stack that have expired and are of no used to patients. His solution: integrate coupons into EHRs so there's no effort and no patient alienation. Saperstein noted that the marketing doesn't have to focus on doctors but can be tools they can provide patients, such as an iPhone heart monitor patients can use to track their heart rhythms -- as long as it doesn't lean heavily on drug promotion.

Perhaps most surprising is that Pfizer executive Wendy Mayer, the company's worldwide innovation VP, acknowledged that there is a gap between knowing what healthcare providers and organizations need and getting that messaging to filter down to the brand marketing level. Mayer said the organization is moving in that direction, but has to wend its way through several other awareness-into-action needs, such as the right channels and patient focus, and that the professional-centric messaging will follow.

The need to hit that final target is not an optional one. “Physicians really have no say anymore for drugs they want on the formulary,” Gaither said. The Brooklyn physician laid out the mindset pharma needs to adopt if it hopes a drug pitch makes it across the threshold, recalling a patient for whom she had to advocate a higher-priced medication which would help fetal lung development in a 24-hour period as opposed to the cheaper drug which would take 48 hours. She won on economics, pointing out that should the infant be born with under-developed lungs the Neonatal Intensive Care Unit coverage would cost far more than the more expensive drug.