The ever wonderful Jane Sarasohn Kahn has written a pretty definitive piece on physician PDA use at iHealthbeat. (Yes, Jane is a co-author and long time friend, so I’m biased, but she is wonderful). It’s called PDAs Reach the Tipping Point . The point is that somewhere between 50% and 60% of doctors and plenty of other clinicians are using PDAs for reference use.
Epocrates is a big reason why. I met with Epocrates’ Michele Snyder briefly at HIMSS. Epocrates has now some 135 people and hasn’t taken any more cash since the dotcom days when it took in $35m. It still gives away its drug databases for free to any PDA user, including a scad of formularies—some 400. It’s got around 500K active subscribers (updated in 6 months) — including 200K physicians in the US alone. The struggle is of course to make money off that database.
They do that by charging for a symptom and diagnosis checker ($60 a year each or $149 for the lot) and by charging health plans and PBMs to show their formularies. In addition they have 130K physicians in a market research panel which you can ask questions of, for a fee of course! Doctors can even do CME short credit courses on the device. And one of five of their alert messages are sponsored, so there is a little advertising, but less than on a prescription pad. And apparently using the database is worth it for doctors
Let’s use one of Epocrates’ findings from the Brigham and Women’s study to calculate potential revenue savings generated by using a PDA for drug reference information alone. The study found that 35% of Epocrates physicians saved at least 30 minutes per day. Assuming the average physician generated $1.26 a minute (according to the MGMA’s 2004 physician compensation survey), using a PDA for drug reference could produce about $10,000 a year saved for a single physician. Now, consider additional applications for the PDA and what they could generate in productivity savings (and thus income enhancement). Epocrates’ recent survey on Medicare Part D offers another factoid to consider: 70% of physicians surveyed believe accessing Medicare Part D formularies via Epocrates software will help them save at least an hour per week. These time savings would be in addition to the drug reference savings already calculated.
Of course the key question is whether the PDA as a platform becomes a transaction tool rather than just a reference tool. Palm, whom I met with last week, of course hopes so, and has recently brought out a Windows mobile version of its Treo to increase its range in health care—as well as other industries. (Epocrates already ran on both systems, but some ePrescribing tools like Zix were Windows only). It’s also worth noticing that cell phone penetration amongst docs is in the 90% range, and that the integration of PDA capability into the smart phone makes it easier to get transactions into the work-flow. When everyone’s used to getting email on their smartphone, eRx will fit right in.
In fact JSK has a list in her article of PDA applications in health care. Several (like PatientKeeper) are looks into larger health care IT systems, and Allscripts’ Touchscript is probably the leading eRx application—a transactional system. So this is coming together. And as we told you in our recent piece, the infrastructure is being laid so that the eRx applications can get to the pharmacy work-flow and improve efficiency in the pharmacy and the physician’s office.
Now we just have to beat the clinicians to the point of pain to make them use it!