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In this interview, DTC Perspectives’ Chairman, Bob Ehrlich, and Phreesia’s SVP of Life Sciences, David Linetsky, discuss how the patient experience has evolved rapidly during the COVID-19 pandemic, particularly as providers leverage digital patient intake solutions to enable safer contactless workflows. They will also explore the importance of aligning with platforms that are flexible, adaptive, and meet patients where they are, given that these changes are likely here to stay.

Bob Ehrlich: As many are aware, the outbreak of the COVID-19 pandemic resulted in steep declines in office visit volumes in the Spring. Phreesia has since published multiple studies on outpatient visit volumes with Harvard University and the Commonwealth Fund, using Phreesia’s network data. Can you provide some insight into where these visit trends now stand?  

David Linetsky: Bob, I am happy to report that overall, patients have returned to seeking care. Most practices within the Phreesia network appear to have adapted to the pandemic and stabilized their operations. Visit volumes have remained relatively stable since June and in many cases have returned to pre-pandemic levels. In some cases, visit volumes have even exceeded their pre-pandemic levels, as many practices do active outreach to their patient populations to bring them in to catch up on deferred care.

Phreesia continues to publish this data in partnership with researchers from Harvard and the Commonwealth Fund. Our reports are released monthly and can be found on the Commonwealth Fund’s website.

Bob: I am glad to hear that levels are approaching normal. Phreesia has released several applications as a response to the pandemic across its provider network. As medical offices adjust to the “new normal”, how have these digital intake solutions helped practices get their visit volumes back to pre-pandemic levels?

David: Practices are implementing contactless workflows that help minimize exposure between patients and staff. Phreesia’s Zero-Contact Intake offering allows practices to set up alternative workflows, such as patients checking in from their cars or drive-through testing sites. In addition, practices are removing unnecessary shared spaces and assigning many of their non-provider staff members to remote work. Our COVID-19 Screening Module also automatically screens patients for self-reported COVID-19 risk factors before their visits and is continually updated based on evolving CDC guidance.

Telehealth visits have been proven to be an essential solution for patients, allowing those who don’t need to be seen in person to continue to receive care. Phreesia’s Intake for Telehealth workflow captures important intake information ahead of the visit and facilitates the start of the virtual session.

We recognized the urgent need for intake products that could support telehealth visits, screen for COVID-19 risks and minimize contact during in-person visits, and we shifted our efforts to help medical groups stay safe, stay open and continue to see patients.

Bob: Telemedicine seems to have been breaking new ground in providing a safe and efficient alternative for patients. How do you view this solution long-term?

David: We’ve heard from many of our practices that their priority is to adapt to COVID-19 by putting the safety of providers, medical staff and patients first. Prior to COVID-19, the telehealth market was dominated by specialty services offered through employee benefits plans. With the expansion of visit types qualifying for telehealth reimbursement and Medicare copays waived for telehealth visits, many of the barriers that have traditionally prevented practices from embracing virtual visits have been removed.

Data from our most recent Commonwealth Fund report show that while telehealth adoption varies significantly depending on the specialty, telehealth utilization has been relatively stable since June, at a level many times higher than pre-pandemic.

While the future of reimbursement changes—and therefore of telehealth—remains uncertain, many providers are looking towards telehealth as a creative, long-term solution to deliver patient care. From portable EKG machines to at-home ultrasounds to cancer screenings, physicians are looking for effective alternatives to traditional in-person services.

Bob: Do you see COVID-19 as the initial cause of these changes to the patient experience, or do you think some of these changes were already underway prior to the pandemic?

David: That’s a great question. While the COVID-19 outbreak accelerated the adoption of these tools among providers, it was not the initial catalyst. Prior to the pandemic, many healthcare providers had already begun to adopt digital engagement tools to manage operational, clinical and financial processes. This is a change that has been happening for many years in other industries, with consumers having come to expect the convenience of digital solutions broadly. So, safety concerns have greatly accelerated these changes in healthcare, but those changes were already underway and they will persist because consumers expect effective and convenient options.

Phreesia’s patient intake platform was designed to support these trends, which has allowed us to thrive in the current industry environment and to deliver valuable applications to our provider network and the broader market. As we navigate a new normal in a post-COVID-19 world, we believe digital engagement tools will become even more critical to ensuring that the POC stays relevant to Life Sciences manufacturers and healthcare marketers. 

Bob: With all these changes in the patient experience rapidly occurring, do you think Point of Care is still an effective channel to engage with patients?

David: Absolutely. Point of care remains a critical and incredibly valuable channel. However, to be successful, healthcare marketers must adapt to the long-term changes to the patient experience. They must understand that the point of care continues to become more ephemeral and less tied to physical locations; it’s now wherever patients choose to engage with their providers and seek care. In addition, one-to-one engagement tactics are increasingly more valuable as in-person visit volumes fluctuate because of COVID-19. Marketers should not have to worry about audience volume or quality. They should focus on tactics that ensure both of those important factors.

Some traditional tactics are quickly becoming obsolete due to providers’ concerns about shared surfaces. As technology enables patients to take an even more active role in their care, patients are increasingly receptive to personalized content tailored to their individual health needs, that can be accessed on their own devices.

Lastly, COVID-19 has caused a tremendous disruption to patients’ access to care, creating a greater need for support programs. The point of care has moved beyond the walls of the physician’s office, and I believe that the POC marketing industry must adapt.

Bob: Are there specific strategies you suggest for the Point of Care marketing industry to adapt to the increasingly digital environment?

David: I believe it is critical for healthcare marketers and life sciences manufacturers to have strategic insight into how the POC can become an integral part of their digital and mobile strategy. Patient utilization data demonstrate the value of mobile and how it enables providers to deliver care safely through contactless and virtual workflows. Personalized content and directed, one-to-one engagements cut through the noise and influx of health information and address patients’ specific needs and priorities.

Finally, incorporating disease education and patient support programs into digital engagement campaigns to ultimately improve health outcomes for target patient populations will be critical for long-term success in the changing healthcare landscape. As the patient experience becomes increasingly mediated by the converging forces of digital adaptation, patient centricity and pandemic response, we must find a way to align our digital engagement strategies at the point of care to every patient’s needs.

About David Linetsky
SVP, Life Sciences, Phreesia

David Linetsky is responsible for cultivating Phreesia’s partnerships with Life Sciences companies, supporting them in the development of healthcare products that deliver value and engage patients in their care. He has worked at Phreesia for more than a decade and held key leadership roles, including Vice President of Analytics and Insights, and Vice President of Finance.

Prior to joining Phreesia, David worked in academia as a researcher and instructor in the fields of biotechnology, mathematics and philosophy. David holds a BS in mathematics from the University of Alberta. He also earned a master’s degree and was a PhD candidate in mathematics and logic at the City University of New York.

To learn more about Phreesia, please click here or visit them on:

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After consistently seeing an underrepresentation of non-white patients in clinical research, Genentech decided to dig deeper as to why there is such enrollment inequity. According to an announcement from their website, the pharmaceutical manufacturer “undertook a landmark study to elevate the perspectives of these medically disenfranchised individuals and reveal how this long-standing inequity impacts their relationships with the healthcare system as a whole.”

Interviews with 2,207 patients were conducted to learn about their direct experiences with the healthcare system. Of the research participants, “1,001 [were] from the general population and 1,206 [were those] who qualified as ‘medically disenfranchised’ from four communities: Black, Latinx, LGBTQ+, and low socioeconomic status (Low SES).” Research findings unveiled a significant lack of trust, with patients often feeling that they had been treated unequally and unfairly – or worse yet, that the system was working against them.

Genentech revealed that approximately just one-quarter to one-third of medically disenfranchised patients agree that all patients are treated fairly and equally (27% Black, 27% Latinx, 34% LGBTQ+, 23% low SES). Meanwhile, nearly half (49%) of the general population agree with that statement. Furthermore, “52% of medically disenfranchised patients believe that the healthcare system is rigged against them.”

As a result of these experiences, medically disenfranchised populations often delay, interrupt, or discontinue seeking care – often “for fear that they were not understood.” Additionally, the lack of trust has also translated to as many as one-in-three medically disenfranchised patients opting to not participate in clinical trials, vaccinations, and testing for medical conditions.

Genentech plans to continue investigating this situation further and progress their program efforts to help combat this issue. The study’s announcement concluded with an inspirational message for the healthcare industry’s growth and improvement by stating:

“[T]o address healthcare disparity, we must address issues of trust in the healthcare system. We must build bridges to medically disenfranchised patients to make them feel valued, respected, and understood. We must give them reasons to believe in the healthcare system.

“We know we cannot do this alone. Only through a broad coalition of industry, government, NGO, and community stakeholders will we make the changes necessary to ensure the healthcare system works for everyone. This research is the latest step in our efforts toward that goal, and we hope it serves as a call-to-action for candid discussion, proactive collaboration, and meaningful action.”

Her current work has her continuing to lead the New York medical team, managing the EU medical strategists, and also “developing solutions to address the disparity in recruitment of people of color into clinical trials.” The medical team supports both DTC and HCP new business opportunities.

“I’m thrilled to take on this new role, as this is an opportunity to elevate our diverse, best-in-class medical talent even further,” Dr. Bazuro said in the news announcement. “I look forward to ensuring best practices are uniformly implemented across all of our offices in support of our amazing clients, as they continue to bring life-changing therapies to patients in desperate need.”

Dr. Bazuro “holds a PhD in Cell and Molecular Biology from the University of Pennsylvania Medical School, a BS-Research Intensive in Cell and Molecular Biology from Yale University, and she conducted her postdoctoral research fellowship at Memorial Sloan Kettering Cancer Center.”

A record low price increase on branded drugs and changes in health insurance benefit design are just a few of the reasons that patients in the US are experiencing improved affordability for their medications, according to a new report from The IQVIA™ Institute for Human Data Science. Their research found that 71% of branded prescriptions have a final out-of-pocket cost of below $20, while just 3.6% of branded prescriptions have a cost above $125. The report, Medicine Spending and Affordability in the U.S.: Understanding Patient Costs for Medicines, discovered that “[a] rising number of prescriptions are now dispensed with a $0 payment by the patient, and now amount to 44% of all branded prescriptions in 2019, up from 36% in 2015.”

Additionally, the data found that branded prescriptions costing more than $125 largely affects those with commercial plans (44% of high-cost claims) or Medicare coverage (35% of high-cost claims). IQVIA did also find that “abandonment is higher at higher prescription cost levels, and those prescriptions may be underrepresented as those prescriptions might have been abandoned due to cost.” Of the 9% of branded and generic prescriptions that are abandoned: 5% are for medications of no cost, but 60% are when the medicine costs more than $500.

“Lower drug price growth and improvements in affordability to patients is a testament to the positive market dynamics of the American pricing system and the fact that manufacturers, health insurers and the intermediaries, such as wholesalers and benefits managers, have taken actions to reduce the burden of drug costs to patients,” said Murray Aitken, IQVIA senior vice president and executive director of the IQVIA Institute for Human Data Science, in the news release. The report examined the complexities of our current pricing system, hoping to “contribute to more transparency and understanding of the different levels of cost,” Aitken added.

“Visits to physician offices and other health care practices, which had fallen 60 percent by early April, have now rebounded and plateaued at 10 percent below prepandemic levels,” found the latest wave of research from the Harvard University, Phreesia, and the Commonwealth Fund. In-office visits are still showing a decline, even among those states which saw a surge in cases during the June and July months. However, these declines are still smaller than that of the early days of the pandemic.

Several hot spots states – including early-opening ones such as Arizona, Florida, and Texas – recorded an increase in telemedicine visits, but only a slight decrease in overall visits. “Practices in these states appear to have maintained most of their visit volume by increasing telemedicine visits and creating new safety protocols for in-person visits.”

Telemedicine use peaked in mid-April. While it has shown a decline and its current adoption has plateaued, it is still being used at a “substantially higher rate than prior to the pandemic” the report notes.

The research continued to find a large difference in visit patterns between adults and children, with adults still outpacing children. Those aged 18-64 years old showed a -4% change in visits (the smallest percent change for the week starting 7/26/2020), while children ages 3-5 represented the largest percent change at -36%. Children ages 0-2 were tracked at -32%; ages 6-17 recorded a -17%; and those aged 65-74 and 75+ both came in with a -9% each in visits.

Initial data findings were published in April 2020, with this research partnership team providing monthly updates to track trends in outpatient office visits. Click here to view more of the findings – including what impacts insurance type has had on visit rebounds and the adoption of telemedicine by Federally Qualified Health Centers (FQHC) and non-FQHC.

In a follow up conversation with DTC Perspectives this summer, Sherry Novembre and Amy Graham shared how Ogilvy Health’s #EverydayMatters cancer awareness campaign continues to expand and reach audiences, as well as how COVID-19 has impacted the agency’s efforts.

The #EverydayMatters campaign was launched by Ogilvy Health in February of this year, kicking off a year-long campaign to “make an impact on cancer.” Their spring and summer efforts have continued, centering on colorectal cancer in March. They developed and released videos targeting all ages, not just older adults, to educate and encourage screenings. “Colorectal cancer is on the rise in those under age 50”, with 1 in 10 being diagnosed before the age of 50, stated one of their videos. An additional video included an experience view of a colonoscopy as Group Copy Supervisor, Bryan Minogue, “documented his cancer screening journey to show the ease and importance of getting checked early.” Novembre shared that the social media promotion of the #EverydayMatters campaign has made more than 50,000 impressions since its launch on World Cancer Day 2020. The team is also continuing to pursue partnerships where appropriate, such as teaming up with advocates for National Cancer Survivors Day on June 7^th. Efforts honored survivors, including a tribute video for survivors and loved ones who serve as beacons of hope, as well as providing continual support and needed information to maintain their healthy journeys.

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Amid #EverydayMatters campaign endeavors, the global COVID-19 pandemic arose. As “stay at home” and other safety orders were issued by governments, the agency team also began looking into the impacts coronavirus was having on cancer patients. Graham, citing research from the IQVIA Institute for Human Data Science shared via Medscape, stated that an estimated “80,000-plus diagnoses of five common cancers in the United States are projected to be missed or delayed during the 3-month period of early March to early June because of COVID-19 disruptions to healthcare.” Additionally, normal treatment routines may have been interrupted for patients. Already a vulnerable population group, patients now were finding themselves challenged in new ways with regards to managing their healthcare. The Ogilvy Health team knew that their mission was more important than ever and has remained steadfast in their commitment to continue creating awareness, sharing knowledge and education, and providing support to the oncology community wherever it has been needed.

To comply with government safety orders during the pandemic, the team, as with all those now working remotely, has had to make some adjustments across their practices and procedures. However, even without a studio and despite the fact that all collaborations must be done virtually, they still came together to develop content and videos to support the #EverydayMatters cause. Members of the Ogilvy Health team that were not necessarily a part of the agency’s oncology projects volunteered to participate in the efforts as so many have “a personal stake in it,” noted Sherry. Team members came together in a truly collective effort to address several serious and timely issues:

• A COVID-19 Impacts on Cancer video was created to educate and support patients.
• A unique impact survey on HCP and cancer patients as related to COVID-19 was conducted to better understand and address the challenges the groups are currently facing.
• A tribute video to acknowledge and thank those working in the oncology community during the pandemic was also produced.

According to Graham, when looking to the future of this program, based on their research and learnings they will continue to explore timely topics that enable better conversations and care for people living with cancer. Future topics may include ways to improve patient use of their Electronic Health Records, and cancer care inequality awareness. 

While some projects may launch in 2021 instead of 2020 now due to COVID-19 delays, long-term and global plans are still very much in play. One such venture is through content sharing: Ogilvy Health’s global offices are picking up content that this US-based team has created so that they may share locally how and where appropriate.

Check back with us in the fall for another update on Ogilvy Health’s #EverydayMatters cancer awareness campaign.

Eight healthcare marketing and media leaders turned over their social media channels to “eight organizations and influencers focused on health issues and disparities facing the Black community,” according to the news release about the social media effort. On July 22, #ShareTheScope allowed “new voices and perspectives from those who are tirelessly advocating for equity and justice in healthcare” to reach more than one million followers collectively. The initiative, spearheaded by Outcome Health, was “based on the highly successful #ShareTheMicNow … with the aim of amplifying Black voices working toward change in America’s embedded racist healthcare system and reaching an audience they previously hadn’t,” continued the news release about “sharing the stethoscope”.

With the African American population disproportionately affected by several health issues, including heart disease, diabetes, asthma, among others, Outcome Health “recognizes that economic instability, physical environment, inadequate education and lack of access to healthcare systems can perpetuate” such health issues. Matt McNally was quoted in the press release, saying: “#ShareTheScope is Outcome Health’s call to action to the industry to educate and advocate on the deeply embedded gaps in healthcare for Black families. Knowledge is power, so we decided to connect prominent Black organizations with our peers in healthcare who have a shared desire for justice to act together to collectively walk the walk, not just talk the talk.”

The #ShareTheScope social media turnover partnerships were:

• “Outcome Health & Suzet McKinney, DrPH, MPH, CEO/Executive Director of the Illinois Medical District, the second-largest urban medical district in the United States and home to four major hospitals.
• “Ad Council & Black Mental Wellness, which provides access to evidence-based information and resources about mental health and behavioral health to decrease mental health stigma in the Black community.
• “PatientPoint gives its platform to GEN-H, developers of a regional health plan as a community-wide response to the critical and growing health challenges facing Greater Cincinnati and North Kentucky.
• “Verywell Health & Black Women’s Health Imperative, the only national organization dedicated solely to improving the health and wellness of our nation’s 21 million Black women and girls – physically, emotionally and financially.
• “HealthiNation & Sean Peters, Ph.D., the founder of My Body, My Kitchen, an online resource to help with the development of the physical and mental health of persons of color.
• “Real Talk with Dr. Offutt & Urban Health Media Project, which is teaching diverse high school from under-resourced communities how to report multimedia stories about the health and social issues affecting their communities.
• “Shatterproof & Texas Harm Reduction Alliance, which develops and promotes practices and programs to create positive change and reduce the harmful consequences of substance use and misuse in Texas.
• “MM&M partners with BLKHLTH, which challenges racism and its impact on Black health via its platform that educates, engages and empowers the Black community.”

“Despite the fact that healthcare in America has been a topic of debate for decades, the needs of people of color have not been given equitable consideration. The opportunity to ‘Share the ‘Scope’ with Outcome Health for education and advocacy should be a catalyst to a growing recognition of the existing health disparities suffered by Black Americans, and we trust it will encourage more people to use their voices loudly to enact meaningful, lasting change,” stated Dr. McKinney in the news release.

“#ShareTheScope fits well with our mission to mobilize and engage women and organizations to pursue greater opportunities for gender and racial justice. This is a great opportunity to educate and shift public perception about the needs of Black women’s health,” noted Linda Goler Blount, MPH, President and CEO of the Black Women’s Health Imperative in the news release.

This past Friday, July 24th, President Trump signed multiple Executive Orders to lower medication prices for patients and, as he commented during the signing, to restructure the prescription drug market in terms of pricing. The three Orders, as well as a potential fourth:

1. “Enable Americans without access to affordable insulin and injectable epinephrine through commercial insurance or Federal programs, such as Medicare and Medicaid, to purchase these pharmaceuticals from an FQHC at a price that aligns with the cost at which the FQHC acquired the medication.”
2. Allow for: importation of certain, safe prescription drugs from other countries; re-importation of insulin products; facilitate use of individual importation waivers at authorized pharmacies in the US.
3. Pass along drug rebates to patients so they may save at the pharmacy counter.
4. Reduces prescription drug costs for Americans to the “lowest price available in economically comparable countries for Medicare Part B drugs.”

The fourth Order was not signed and issued; full details are still unknown. As stated in the White House’s briefings statement: “Absent successful negotiations with drug company executives this Order will be implemented on August 24.” The heads of major drug companies requested a meeting with the President, which was scheduled for Tuesday, July 28th, as noted by Trump during his Executive Order signing. That meeting was reportedly canceled.

Shortly after these Orders were issued on July 24th, PhRMA CEO Stephen J. Ubl released a statement. “The research-based biopharmaceutical industry has been working around the clock to develop therapeutics and vaccines to treat and prevent COVID-19. The administration’s proposal today is a reckless distraction that impedes our ability to respond to the current pandemic – and those we could face in the future. It jeopardizes American leadership that rewards risk-taking and innovation and threatens the hope of patients who need better treatments and cures,” said Ubl as part of his response.

According to a New York Times report: “Wall Street analysts were skeptical that the orders would have much effect on drugmakers and said they could prove difficult to implement in practice. ‘We believe they are likely geared more towards deriving campaign talking points rather than producing tangible, material effects,’ Brian Abrahams, a biotech analyst at RBC Capital Markets, said in a note.”