Trends and the Future: Physicians

1

Trends and the Future: Physicians
and Patients in a Connected World

2

Research Methodology

•
Fielded

online

in

Q
2

2012

among

1
,
819

U
.
S
.

practicing

physicians

who

are

ePharma

physicians
.

The

survey

was

released

in

Q
3

2012

•
Final

data

set

is

compared

to

the

known

universe

of

practicing

U
.
S
.

ePharma

Physicians

by

age,

gender,

region,

practice

setting,

and

specialty
;

the

research

is

accurate

and

reflective

of

the

population

of

U
.
S
.

practicing

ePharma

Physicians


ePharma Physician
®

2012

Taking the Pulse
®

U.S. 2013

•
Fielded

online

in

February

and

March

2013

among

2
,
950

U
.
S
.

practicing

physicians

across

25

specialties

•
Final

data

set

is

compared

to

known

universe

of

practicing

U
.
S
.

physicians

by

age,

gender,

region,

practice

setting,

and

specialty
;

the

research

is

accurate

and

reflective

of

the

overall

population

of

U
.
S
.

practicing

physicians

Research Overview

3

PHYSICIAN INFO SEEKING EVOLVES

4

LICENSED FOR INTERNAL USE ONLY

In 2013, Physicians have Full Digital Access

Cellular networks

Satellite networks

High
-
speed and Wi
-
Fi
at work and home

Public networks

Source:
ManhattanResearch

5

LICENSED FOR INTERNAL USE ONLY

Reach
of source (yearly)

(among all)


Influence

on
Clinical

decisions*

(among those accessing/using source)

Colleagues

(in person or

on phone)

Pharma sales
rep
(in person)

Conferences

(recorded or live)

Websites for HCP Audience Are Top Digital Source in
Reach/Influence

*% of physicians ranking source with a 4 or 5 on a 5
-
point influence scale

Offline

Online

Prof.

journals

Conferences

Prof. journals

CME

eCME

Colleagues

(message boards,

communities)

Websites for
HCP
audience

Government

websites

Pharma
websites

Source: Manhattan Research, Taking the Pulse® U.S. 2013

6

Online Textbooks Surpass Print Day
-
to
-
Day

Among all physicians

Source: Manhattan Research, Taking the Pulse® U.S. 2013

Occasional sources (yearly use)

Day
-
to
-
day sources (weekly or daily use)

References and textbooks

Professional journals

CME

Conferences

Pharma or biotech sales rep

Colleagues

Online

54%

44%

89%

71%

32%
3

Offline

50%

55%

89%

92%
4

38%

72%
2

News

55%

39%
1



(1)
Health/medical information in the newspaper or on television

(2)
In person or on phone

(3)
Online professional message boards, communities, social networks, or blogs

(4)
In person

7

Physicians are Moving Their Professional Journal Reading
Online

Online or electronic sources
Offline or print sources
Online or electronic sources
Offline or print sources
Current
percentage

Expected
percentage
in
the
next
12
months

Percentage of
time reading journals
for professional purposes:

Source: Manhattan Research,
ePharma Physician®
2011

8

Strong Growth in Frequency of Online Journal Access

72%

95%

Any use 2007

Any use 2013

74%

88%

2007

2013

2007

2013

Physician
professional journal use
online and offline
-

weekly and overall use

Source: Manhattan Research,
Taking
the Pulse®
U.S. 2007, 2013

9

Pharma Visitation Remains Relatively Low on Weekly Level

Among all physicians

Source: Manhattan Research, Taking the Pulse® U.S. 2013

Pharma

Non
-

pharma

Online resources/destinations
(weekly or daily use):

Search engines

Websites for a
HCP

audience

Wikipedia

Professional society

websites

Government

websites

Any pharma
websites

Pharma
product

websites

Pharma
customer service

websites

Pharma
corporate

websites

23% in 2012

64% in 2012

10

Non
-
print Content Sources Garner Significant Reach

Nearly 80% of physicians

About half of physicians

About a quarter

of physicians

About one in four
physicians

About one in ten
physicians

About one in four
physicians

Source: Manhattan Research,
Taking the Pulse® U.S. 2012

11

Professional App Use Common, However Adoption Remains
Concentrated among Top Apps

Source: Manhattan Research, Taking the Pulse® U.S. 2013, Medscape, Epocrates, Wikipedia, PubMed, UpToDate

Mobile

apps

Top 5

professional

apps
used on smartphone:

Epocrates Apps

(includes Epocrates or Epocrates Essentials)

WebMD Professional
Apps

(
includes Medscape Mobile or WebMD
)

UpToDate

Sermo

QuantiaMD

81%
of smartphone owners use any
1

[1] Use any specific professional mobile app (Epocrates, WebMD Professional Network, etc.) or any pharma mobile app

[2] Browse any mobile websites related to work on smartphone

Mobile

websites


67% of smartphone owners use any
2

Top

5

prof
.

websites

used

on

smartphone
:

The WebMD
Professional
Network*


Epocrates



Wikipedia



NIH
Websites**



UpToDate


* The WebMD Professional Network includes
eMedicine, Medscape or WebMD.

** NIH websites (rollup) includes Medline/NIH,
PubMed, National
Cancer
Institute (NCI), or NIH.

Among smartphone owners

12

Search Engine Ranking is Key For Attracting a Physician
Audience Online

Frequency
of using search engines for
medical info

Daily

Monthly

Weekly

Yearly

Never


Drivers of high
search engine ranking
of online destinations


Inhibitors of high
search engine ranking
of online destinations

Search engine optimization
(SEO), e.g. by …

•
coding to increase
relevance to specific
keywords

•
promoting a website to
increase the number of
backlinks

•
optimizing for general
content as well as
specific image or video
search requests

Barriers to indexing
activities, e.g. …

•
password protection

•
Firewalls

•
lack of popular inbound
links

Source: Manhattan Research,
Taking the Pulse® U.S. 2013

13

70%
of U.S. physicians watch online videos for professional purposes

Online Video Is a Key Format for Online Learning

*The WebMD Professional Network includes Medscape.com and TheHeart.org

Among all physicians

Source:
Manhattan Research, Taking the Pulse® U.S. 2013,
WebMD, YouTube, QuantiaMD, American College of Cardiology

29%

The WebMD Professional
Network*

25%

YouTube.com

16%

QuantiaMD.com

16%

A professional
association website

14

Changing Expectations for Content among Today’s Docs

15

TODAY’S MULTISCREEN PHYSICIAN

16

Dr chrono

Heart Pro III

Air
Strip

Mobile MIMs

Skeleton
System Pro III

PubMed
on Tap

Source: Drchrono, Air Strip, Mobile MIMs, drawMD, Epocrates, PubMed on Tap, Heart Pro III, Skeleton System Pro III

Both Smartphones and Tablets Serve Many Roles in 2013

Practice
Management

Remote
Patient
monitoring

Patient
Education

Quick
Reference

Professional
Education

drawMD

Epocrates

17

Three
-
device Ownership Is Now the Norm

Devices
owned or used
for professional purposes

Percentage of
physicians in
2013

72%

83%

Desktop/laptop computer

Mobile phone
(includes smartphone)

eReader

98%

91%

19%

Tablet

Smartphone*


64%

own/use a

Tablet, smartphone
and desktop/laptop

*(Includes smartphone, PDA or send email from mobile device)

Source:
Manhattan Research, Taking the Pulse® U.S. 2013

Among all physicians

18

Its Still an Apple World, but iPad Mini Not As Disruptive as
Hoped

#1

#2

Smartphone OS Ranking

Tablet OS Ranking

#1

#2

#3

19

Smartphones and Desktops Lead in Frequency, Tablets
Resemble Desktops for Overall Duration

Times per day
using each
device
to access
professional info

Minutes
using each

device
in a

typical session

Source: Manhattan Research, Taking the Pulse® U.S. 2013

Among those using their respective devices during or between patient consultations

Problem
-
solving,
quick hit

Immersion,
learning, lean
-
back

Lean
-
in, multi
-
tasking, content
creation

20

Have used this device to
access an online
professional journal

Use this device most
frequently to access online
professional journals

86%

76%

9%

36%

33%

13%

Desktop/laptop

Smartphone

Tablet

Among

those
accessing
journals
online

Device use
for online
professional journals:

Source: Manhattan Research, ePharma Physician®
2012

Mobile Devices Used to Access Journals but Larger Screens
Still Preferred

21

Source: Manhattan Research, ePharma Physician® 2012

In which of the following ways do you expect to be able to
access professional journals on mobile devices?

Ways to Access Professional Journals on Mobile Devices

22

Methods

of accessing
online professional journals

by
device
:

Among owners of these respective device

Age

Under 35: 35%

35
-
44: 23%

45
-
54: 19%

Tablet Docs Prefer Accessing Journals through a Browser,
while Smartphone Docs Have No Preference

Mobile app: 26%



Mobile website:
22%



Source: Manhattan Research, ePharma Physician® 2012

No preference:
52%



Under age 35: 33%

Age 35
-
44: 32%

Age 45
-
54: 29%

Among tablet owners

Among smartphone owners

Tablet owners:

Smartphone owners:

23

Switching devices
when reading a
journal:

Started reading a journal on a
smartphone
and switched to a
laptop/desktop:
23%

Started reading a journal on a
tablet
and
switched to a
laptop/desktop:
22%

Started reading a journal on a
smartphone
and switched to a
tablet:
13%

Among those accessing journals through multiple types of devices

Source: Manhattan Research, ePharma Physician® 2012

Multiple Device Usage while Accessing Online Journals

24

EHR Adoption Growing Steadily

Electronic health record (EHR) adoption:

*Question was asked in a different manner in 2011, 2012 and 2013

Among all physicians

Source: Manhattan Research, Taking the Pulse® U.S. 2013

Devices

used to access
EHRs:

(among physicians with an EHR)

Desktop

EHR

dedicated desktop

Tablet

Smartphone

25

Personal
devices
and
platforms

Enterprise
devices
and
platforms

?

Screenflow

in 2013

How Will Personal and Enterprise Platforms Coexist

26

Next gen EHRs

Pharma Trying to Understand How to Get Closer to EHRs &
Publishers that Partner with EHRs

27

EHR

#1

#2

Among all physicians

Source: Manhattan Research, Taking the Pulse® U.S. 2013

EHRs are a Dominant Platform, But Driving Use of Open
Digital Sources

Open Digital Sources

28

Among all physicians

Source: Manhattan Research, Taking the Pulse® U.S. 2013

Through 2015 EHRs and Open Digital Access will Run in
Parallel, with Accelerating Integration

EHRs

Open Digital Access

2013

2015

Growth in integrated content

29

Searchability
–

easy to find what
they want, when they need it

Shift toward Outcomes
-
Based Reimbursement:

What
are the new content needs?

Expectation of
truly interactive content
that
allows users to dive deeper, across screens

Physicians are accustomed to
information on demand
–

evolving learning styles
–

what are expectations of doctors
whose med school textbooks were on their
iPads
?

Considering the role of EHR
and its
effect on POC content consumption

Looking Ahead
–

Key Trends for HCPs

30

CONSUMER TRENDS

31

Consumer Devices and Technology Impacting How We
Consume and Share Information

Apple and
GoogleTV

Wi
-
Fi Cameras, 8
Mgapxl

chip in iPhone 5

Payment alternatives

Sensors:
GreenGoose

Multi
-
device access to
cable subscription

BMW Wi
-
Fi Hotspot

Smartphones, 7 inch and
larger tablets and
eReaders

32

Source:
Manhattan Research, Cybercitizen Health® U.S. 2012, Google TV Blog, gallery4gadget
, myfirst5k.wordpress.com

35%

of all online consumers access the
Internet or online content via TV sets


Avg

age: 36yrs
Avg

income: $56K

25%
of consumers watch TV or movies
streamed or downloaded online


Avg

age:
36yrs

Avg

income: $64K

Content Flows Freely across Devices

33

86%

Mobile phone*

79%

Desktop or laptop

48%

Smartphone**

20%

Tablet

Gaming console

42%

Technology owned or used

*Includes smartphone by definition

** Includes smartphone and send email from mobile device

Smartphones Becoming Mainstream, Tablets Rising

Up from 38% in 2011

Up from 10% in 2011

Up from 10% in 2011

16%

eReader

83%
of U.S. adults are
online

19%

iPod touch

Source: Manhattan
Research, Cybercitizen Health® U.S. 2011
-
2012

34

Percent of consumers in each segment who are
online for health

60% + across conditions

Source: Manhattan Research, Cybercitizen Health® U.S. 2012

Majority of Patients across Conditions Online for Health

35

Source: Manhattan Research, fitbit, mobihealthnews, tribeswell, Bits, Phoenix Business Journal, coxhealthconnection

Fitbit

Proteus’ Ingestible Electronic Pill

BodyGuardian Remote
Monitoring System

CVS Minute Clinic

American Well
remote consults

Humana workplace wellness

The Clinic at Walmart

Health360: Multiple Touch Points for Care and Services

Intel® Health Guide

36

Resources used for health info or services in the past 12 months

73%
of U.S. adults use the Internet for health info or services

Source: Manhattan Research, Cybercitizen Health® U.S.
2012

Fragmented Consumer Health Resource Mix

Pharmacist at Walgreens

Consumers ages
65+ top age cohort
to use (85%)

Black/African
American
consumers
top ethnicity to
use (67%)

Hispanic consumers
top ethnicity to use
(17%)

37

Scenarios prompting consumers to use online health resources

Age

Factors

Source: Manhattan Research, Cybercitizen Health® U.S.
2012

Among online consumers

Internet Used throughout Patient Journey

Type of
Condition

38

Scenarios prompting consumers to use online health resources

Source: Manhattan Research, Cybercitizen Health® U.S.
2012

Among online consumers

Online Patient Journey Varies by Condition and Age

RA patients:
40%

MS patients:
61%

Fibromyalgia
patients: 48%

Age a factor only early in
continuum

Condition pushes Internet use throughout continuum

Depression
patients:
29%

39

75

29

In millions of U.S. adults (ages 18+)

55%
of consumers feel
more in control of their health

as a result of using smartphones for
health or medical info
.

Among those online who are smartphone health users

Source: Manhattan Research, Cybercitizen Health® U.S. 2008
-
2012

Mobile Health Grows; Gives Consumers Sense of Control

40

Smartphone adoption includes send email from mobile device in 2011
-
2012

Tablet adoption only asked for iPad ownership in 2010

Source: Manhattan
Research, Cybercitizen Health® U.S. 2011
-
2012

Triple Screen Consumers

Consumers with smartphone +
laptop/desktop + tablet

16% of all consumers in 2012

Marketers Facing a Growing Multiscreen Reality

41

Key Insights

Key Insights

•
The digital landscape for is rapidly evolving,
especially for an information
-
hungry, technologically
advanced audience like the physician population. Digital has been a way of life for physicians for
over a decade.


•
Mobile devices
are changing physician expectations for portability and access to content
–

however at the same time the EHR will be consuming increasing time during the workday.
Considering screenflow and use cases in content delivery will be critical.


•
Digital content

is changing physicians expectations for content delivery. Searchability, ease of
access, quick reference and fitting into physician workflow are all key to attracting a viable audience
of doctors online.


•
Today’s E
-
Empowered Consumer
is engaging with online content and their physician in new ways
–

creating new needs for tools and information that will continue to evolve as more of the onus for
healthcare cost management is shifted to the consumer.


•
The world is changing
under our feet even as we talk about it
–

2010
-
2013 has seen some of the
most dramatic shifts in health and technology behavior in the past decade. In addition to technology;
the practice of healthcare
will be undergoing rapid change in the coming years, changing
physician
and

consumer needs with it.

42

THANK YOU

Meredith Ressi

mressi@manhattanresearch.com