GPs need a new care model to deal with growing demand and their own falling numbers, a new report has said.

According to the Deloitte UK Centre for Health Solutions, primary care is facing the retirement of many GPs combined with increasing numbers of elderly and chronically ill patients.

To deal with these challenges, the report argues, primary care needs to focus on community healthcare, patient self-management and new technology.

The demand challenge is well understood: the ageing population and the growing prevalence of long-term health conditions.

However, the report highlights a supply challenge: 10,000 GPs intend to retire within five years, while increasing numbers work part-time. Practice nurses, who are increasingly relied on, show a similar demographic.

The number of entrants to the primary care sector has fallen, while changes in employment regulations mean that recruiting qualified practitioners from overseas will be impossible.

The new commissioning role of GPs will increase strain on primary care, the report notes, with GPs facing unfamiliar responsibilities and performance management systems as well as severe financial constraints.

Karen Taylor, Research Director at the Deloitte Centre, commented: “GPs need to adopt new models of care, using new technology and other practice staff more effectively, working closely with patients to provide more care in the community, with an emphasis on shared decision-making and self-management.

“GPs will still need to act as gatekeepers, but also, increasingly, as care navigators.”

Is the pharmaceutical industry sometimes its own worst enemy? Blogger with attitude Maxine Vaccine looks some of the industry’s bad habits and suggests a detox programme.

In a dark time, the eye begins to see. So said the American poet Theodor Roethke. Difficult conditions focus the mind on what matters. The deepening economic crisis will achieve one positive thing: it will sort out those who take business seriously from the posers, the chancers and the egotists.

With the pharmaceutical industry under severe pressure, many companies are bucking because the ‘new’ business attitudes they developed in the 1990s are no longer valid. The yuppie is a dying breed. Business methods that maximise short-term profit are rapidly being discredited, while business methods that have stood the test of time – respect, trust, reliability and sustainable relationships – are making a comeback.

With that in mind, here are three tips for surviving pharma’s recession:

1. No to greed. As our current Pf readers’ poll shows clearly, most of you feel that pharma CEOs who award themselves supernova pay increases while staff face pay freezes and redundancies are taking the proverbial. Industry analysts have called the culture of inflated CEO bonuses an example of the ‘Lake Wobegon effect’ – after the fictitious town where “all the children are above average”. It’s the result of top executives thinking themselves a breed apart, and insisting they must have mega-rewards or their companies will lose them. So CEO rewards have to become more and more ‘competitive’ as companies become less and less so. Epic fail is hardly an adequate term for this mentality. Daylight robbery is nearer the mark.

2. No to bullies. As Pf reported online this week, Roche in the US has had to pay $1.8 million in compensation (nearly a month’s worth of CEO bonuses) to a sales rep who was 55 when a new sales manager repeatedly mocked him for being “old school” and not fitting into “the new environment”. The court ruled that Roche had unjustifiably ignored the rep’s complaints about this manager. Let’s be clear on this: it is the bullying manager who is outdated and out of touch. Companies are often happy to accept such a manager’s definition of what is ‘professional’. But bullying and discrimination are not professional. They drain energy, waste potential, sap morale and squander resources. Bullies are parasites that excrete fail.

3. Appropriate technology. In the wrong hands, a new gadget is like a Porsche or a Rolex watch: just something to flash around when you want to be noticed. The key word is appropriate. If your company is looking to purchase a new CRM or communication system, think about its purpose. Will it give you the insights, the customer access, the leverage that you need? Will it give you the edge? Half of that question is: are you ready to make the best use of the new system? There’s no point upgrading your hardware if you can’t upgrade your mind. But if you can exploit the possibilities it offers, matching its innovation with your own, appropriate technology is a key to the emerald city of win.

Maxine’s views are not necessarily those of Pharmaceutical Field.

Despite huge investments into CRM systems some pharma companies still struggle to get all of their staff to embrace and fully interact with them. Pf’s Iain Bate explores why, and what the future holds for technology in the industry.

There’s no doubt that technological developments have changed the way we live and work from year to year – maybe even from month to month in the 21st Century. But has the world of healthcare been travelling in the slow lane of the intergalactic highway?

The potential that technology offers to pharma, and the general world of healthcare, is enormous. But is the pharmaceutical industry, and its staff in particular, using it to maximise the returns of billion-dollar investments?

It would seem that technology is the ‘buzz word’ on the lips of a few of healthcare’s major players at present. The DH recently invited people to nominate their favourite health-related mobile phone ‘app’ – be it for keeping fit, to locate a hospital or chemist, or helping to manage an illness. Creative minds were also asked to design their own health app with a panel of DH judges deciding on their favourite from the most popular entries.

Health Secretary Andrew Lansley says it’s the Government’s intention to give people better access to information using modern technology and the exercise is a “unique opportunity for the NHS and those who develop apps to not only showcase their work, but to bring to life new ideas and realise true innovation in healthcare”.

As part of the DH’s technology revolution, patients may also soon be offered online consultations with their GPs using programmes such as Skype. Clearly the Government is embracing the convenience technology offers to patients, but are other sectors in healthcare as interested? It would seem there is still some way to go.

 

In two minds

Pf ’s 2010/11 annual Company Perception, Motivation and Satisfaction Survey suggests that not all respondents are completely convinced by the power of technology in the workplace. Although the Survey – which relates to 2010 and the early part of this year – found that nearly 90% of respondents have access to a CRM system, only 43% find time to use it in the field and more than a fifth of people fail to accurately record post-call reports with important clients.

Questions have to be asked as to why, despite multimillion pound investment and training by pharma companies, there remains a percentage of staff that still ignore the power and potential of the technology at their finger tips.

Results from the Survey reveal there’s no difference in uptake by key account managers, primary and secondary care representatives, those in primary care roles only, firstline sales managers and secondline sales managers and the use of CRM technology between differing age groups – although surprisingly 10% of respondents in these positions with less than two years of experience said they did not have a CRM system, compared to just 5% more experienced colleagues.

The launch of the iPad in March 2010 promised to revolutionise the way sales representatives, and those in similar roles, use CRM systems in the field. However, nearly three-quarters (70%) of respondents from the Survey are still presently sent out with laptops containing their customer-relationship systems.

When quizzed on what they’d change about the hardware which houses their system, the majority of respondents said that their CRM was too awkward to carry, with poor running systems an issue and that batteries ran out too quickly. Apple claims its second-generation iPad now enjoys ten hours of use away from a plug socket in the field.

Yet the switch to the latest convenient tablet devices may not necessarily be about high levels of investment, it may be down to maximising value for money as Paul Shawah, Vice President, Multi Channel Strategy, Veeva Systems explains. “I would say the life cycle of devices within the industry is generally about three years, sometimes a little bit longer,” he said. “When a company invests in new technology they typically depreciate that over that period, so they don’t want to replace it in the field for that time to maximise their investment.

“However, with the introduction of game changing technology like the iPad, this has changed. We see a number of our pharmaceutical customers are justifying the business case to move to the iPad even before their tablets are fully depreciated. This speaks to the business benefit that pharma expects to achieve from the iPad and the related applications only available on that device.”

A convenient shield

Despite technology eliminating mundane process in the workplace and offering the potential to assist employees and improve their efficiency at work, it has historically been used as a shield to mask poor performance and abused as a means to waste company time – a recent online survey by AOL found that nearly half of Americans (44.7%) rank surfing the web as their primary activity during the two hours they ‘waste’ each day at work.

But it would seem that a high number of respondents do value the opportunities CRM offers. Almost two-thirds (64%) said they always enter correctly the amount of customer sales they make into their CRM. But 21% admitted they fail to always report face-to-face meetings with clients. More surprisingly, over a fifth of participants said they do not always record the number of products they had sold to clients.

The lack of honest accuracy is surprising considering the amount of time spent using CRM systems each day. A third said they spend between one and two hours a day on their system with a fifth spending three hours or more on their CRM. During their time using the management system, more than half (55%) said that call reporting was the most useful feature.

Although respondents were less impressed with the KAM abilities of their software with only 19% believing it to be the most useful facility. When questioned about what they would change given the chance, 45% said they wanted an improved database, over a quarter (28%) called for their system to be overall more useful, and 18% said they would prefer their CRM to be easier to use.

 

The next level

But what of the future of CRM systems? Will they be easier to use and have improved customer databases? David Round, General Manager, UK, Cegedim Relationship Management, says the regular interaction we now have with technology means we’ve all come to expect the latest developments.

“End users are significantly more ‘technology-savvy’ than their counterparts of even five years ago,” he explained. “If anything, the challenge for companies is to ensure that they provide their end users with the types of technology that they use as consumers. It’s also important to focus on the usability of your software to ensure maximum use. Technology companies – and pharma – must work together to develop a better understanding of the interaction, to ensure it meets users’ needs in the field.”

One main reason that users have become more ‘savvy’ is down to the use and interaction with social media. Whether at home or at work, websites such as Twitter, Facebook, LinkedIn and most recently Google+ have driven an increased use of various forms of technology – especially on devices such as smartphones or tablet devices which reps are calling for in the field.

Pharma companies, both in the US and UK, have flirted with the idea of fully embracing the power social media harnesses, but at present are restricted by the PMCPA’s Code of Practice and by the FDA – who has again delayed the publication of its guidance.

The FDA says it is “difficult to provide a timeframe... due to the extensive work and review process, or ‘Good Guidance Practices’, which ensures that FDA’s stakeholders are provided well vetted guidances articulating FDA’s current thinking on a topic”.

Although the FDA may be unsure on how to direct healthcare companies, David Round believes the introduction, both professionally and personally, of social media has had an impact on staff and their expectations.

“For the modern professional person, much of their everyday life is conducted online – for example on shopping, utilities, insurance or booking a holiday – and many users then want the same level of capability from the tools they use in their job,” he added.

Dan Goldsmith, General Manager, Veeva Europe, agrees there has been a significant shift in the way we operate and interact due to our experiences online through tagged posts or hash-tagged searches. But although the 800 million users on Facebook – more than half which ‘log-on’ every day – and 175 million people on Twitter have no problem saying hello to friends, pharma finds it more difficult reaching out to people.

“Social media create a new avenue for healthcare dialogue and will only continue to pervade our lives,” said Dan. “Consequently, I believe that pharma faces two challenges. The first is to decide how to participate in the online dialogue with stakeholders and then to create those interactions through the channels we’re all familiar with, such as Facebook and Twitter.

“The second is to figure out how to leverage the model of social dialogue internally to support stronger collaboration and more focused communication among employees. Already, we see some companies taking advantage of the latest social business tools to connect employees with one another and to access and share information in real time.”

Clearly CRM solution providers understand the potential modern technology and social media platforms offer to companies. Whether pharma and its workforce get fully up to speed on the intergalactic highway sooner or later remains to be seen.

An eye-surgery robot designed to help surgeons with precision and ease during operations has been developed at Eindhoven University.

The system filters out hand tremors, which tend to occur more often with increased age.

Researcher Thijs Meenink said: “When ophthalmologists start operating they are usually already at an advanced stage in their careers. But at a later age it becomes increasingly difficult to perform these intricate procedures.”

The medical device allows the ophthalmologist to be in complete control, operating from the ‘master’ using two joysticks. Two robotic arms (the ‘slave’ developed by Meenink) then copy the master’s movements.

The surgeon’s movements are scaled down, so that each centimetre of joystick motion translates to only one millimetre of movement by the instrument “increasing the precision of the movements”, as Meenink commented.

Ophthalmologist Professor Marc de Smet, one of Meenink's PhD supervisors, said: “Robotic eye surgery is the next step in the evolution of microsurgery in ophthalmology, and will lead to the development of new and more precise procedures.”

Meenink has also designed an ‘instrument changer’, so that the robot can use different instruments during surgery. This reduces procedure time, as some eye operations can require as many as 40 instrument changes.

The first human operation using the new technology is expected within the next five years.

New 3G mobile data routers have enabled a West Midlands breast screening service to achieve more effective communication of clinical information with local hospitals.

Herefordshire data handling specialist Hicks Associates Ltd has supplied and fitted the routers to three trailers (pictured) for the Warwickshire, Solihull & Coventry breast screening service.

The mobile data ‘dongles’ previously used by the trailers to access work lists from the hospitals caused network issues and problems with weak signals inside the trailer.

The new 3G routers offer several advantages over the previous solution:

• The use of two SIM cards, from different network providers, allows automatic switchover between networks if the signal level drops below a certain point.
• The external antenna fitted to the trailer gives much higher signal strength.
• The integrated four-port 100Mbps switch allows up to four devices to share the remote connection and to communicate using normal network protocols.
• The system allows (via a secure VPN client) the equipment supplier to perform remote diagnostics on the modality.

While the new technology would not be suitable for handling images, it promises to save time and improve reliability in communication of work lists and other text information.