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What Manufacturers Can Gain from Understanding the Physician Network

In a Q&A with MD+DI, Qforma's president Kelly Myers discusses how the firm is helping manufacturers understand physician networks to better target product development and marketing strategies.

MD+DI: How did the founding of Qforma come about? What were the unmet market needs?

Kelly Myers, president of Qforma

Kelly Myers: When we first started the company, we concentrated in financial services. We were doing interest rate forecasting and black-box trading. All along, we were “teaching” machines to be more right-brained to look for patterns – patterns that humans would not be aware even existed. The period we spent doing this helped me really understand the pattern recognition technologies that were out there. I was thinking about the direct applications of this technology in healthcare even though at that time, we were concentrating in financial services.

 
When 9/11 happened, the financial services industry really took a hit. Understandably, very few were interested in breakthrough technologies; they were more interested in shoring up their core businesses. A lot of what we were doing for financial services was drying up. So I went back to my old relationships within healthcare and pharmaceuticals and started looking for work. One by one we bridged into projects, first getting into traditional data analytics for pharma looking at who the most important physicians are from a volume perspective, and how you organize around them. We thought there was likely a better way to look at identifying how value is created within healthcare for pharmaceutical companies. So, instead of looking at physicians who prescribe the most, we dove into the questions: What influences them? How did they reach that decision? We then developed a hypothesis that physicians influence each other. To test that hypothesis, we started looking at data in a way that revealed the connections between physicians. Once we understood those connections, we wanted to know if we could infer how physicians may impact each other. We were successful and found some good data that showed that physicians are influencing each other. Many of the most influential physicians weren’t the busiest physicians; they weren’t seeing the most patients; they weren’t doing the most procedures, nor were they writing the most prescriptions.
 
That was interesting for a lot of reasons. Biotech, pharma, and medical device companies tended to concentrate on the high-volume physicians. We were changing how physicians could be valued, and we began to advance this idea of the network of physicians versus individual physicians from a targeting perspective.
 
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MD+DI: Talk about the technology you’re using at Qforma. What was its point of development and how has it changed?
 
Myers: We developed a hypothesis. The hypothesis was that physicians work together at a local level, and there are small networks of physicians that work with each other in the care of a patient. They help each other diagnose and treat patients. They develop areas of expertise, and they refer patients to other physicians. Medicine is becoming more specialized—that’s the fact.
 
The hypothesis was, if that’s the case, these physicians have to network together to deliver effective care. If they’re working that closely together at a local level, they’re probably impacting each other’s behavior. There’s probably an 80/20 rule at work here—20% of the physicians are probably impacting the behavior of the other 80%; but it’s probably on a topic by topic basis, or a disease by disease basis, because of this focus on specialization. That was one driver in the development of the technology.
 
The next driver was that there has to be a better way to value physicians given the fact that the value historically was just based on how busy they were. If a physician was really busy, then he or she was valuable; but, we wanted to know who influenced that physician and what influenced practice patterns. Roger Jones [co-founder and COO of Qforma] and the team pointed out that there were a number of techniques that we could use to analyze claims data to infer these relationships between physicians. If we can infer these relationships, we could get a sense for who’s leading the behavior change, who’s responding, and what is the impact at the local level of these behaviors.
 
MD+DI: How have client needs changed since the founding of Qforma?
 
Myers: When we first introduced this approach leveraging data analytics, clients that responded the most were the Davids who were fighting the Goliaths. These were the small and mid-sized pharma, biotech, and device companies that couldn’t afford to call on every physician. The idea of helping them identify the 20% of physicians that had a big impact on the other 80% was very attractive to them. It gave them a mechanism by which to compete with the large manufacturers of the world. As we were starting to build a track record, a whole sea change was occurring in healthcare—in and around pharma, biotech, and devices—including the patent cliff and more price pressures. Then, larger companies started developing an interest because they had to now transition from a “do more-with-more” culture to a culture of fewer resources, while still needing to grow their top and bottom lines (a “do more-with-less” culture). In 2008, the larger companies began taking a significant interest in what we were doing, because they too had to now take an interest in identifying the leverage points. That was a response to the market dynamic shift at that time.
 
When we first started, the world was still interested in identifying individual physicians, which we were able to deliver. We used a connection of networks between physicians to help value the individual physician. The questions we can address now include: If we’re identifying the network of physicians, why would we still act on the individual physicians? Can we start to implement against an entire network instead of just targeting individual docs? Now, clients are looking at the networks we’re identifying and acting on the entire network instead of the individual physician within the network.
 
MD+DI: How are you working with your medical device clients and meeting their needs?
 
Myers: Medical device companies were our first clients. We had this mutual “ah-ah!”moment in looking at networks. They were one of the first to realize the opportunity of identifying the network and the potential of what you can do with this information. A lot of medical device solutions have to involve a number of different physicians and a number of different relationships—primary care physicians that refer patients to specialists, etc.
 
It provides medical device manufacturers the opportunity to distribute disease awareness messaging, solution awareness, and for a subset of physicians, differentiation of their solution. Understanding network and patient flow helps device marketers identify the entire network and segment their messages for the most appropriate part of the network based on that physician’s role in the care process.
 
MD+DI: Based on market trends, where do you see Qforma headed?
 
Myers: During the last several years, we have concentrated on understanding how physicians work with each other and how decisions are made amongst physicians. We’re evolving that model now revealing that yes, physicians are involved in healthcare decisions (they’re the driver in most cases), but there are two other big drivers—payers and patients. More and more, they are all a big part of decisions. And in some decisions, payers play a bigger role in the decision than the physician does; in others, the patient will play a significant role
 
Currently, the decisions are still physician-driven. The shared-decision model is where we’re evolving, to merge all data—social media data, healthcare data, consumer demographic data, transaction data—to help reveal how each healthcare decision is made, and what each of the three stakeholder’s role is in a healthcare decision. This is where Qforma is concentrating right now.
 
We’re along the lines of a social media-meets-Moneyball-meets-healthcare data analytics. Put them together and you have a completely different perspective of how healthcare decisions are being made. This is where we are focusing our efforts going forward. It’s our belief that new and emerging datasets like social media data, connect patients to each other and potentially connect physicians to patients in a HIPAA compliant manner, and address the role of payers as well. We’re in the business of understanding and making sense of all of these interconnected relationships.
 

Maria Fontanazza is managing editor at UBM Canon. Follow her on Twitter @MariaFontanazza.

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