Product goals and lifecycle should determine venue choices.
When product managers make decisions about issuing medical grants for continuing medical education (CME), many simply replicate last year's plan. Instead, they should think strategically and consider the product's goals when determining the type of CME to be funded.
This article highlights how a sponsor's strategic vision can help guide the selection of appropriate venues and media for the most effective physician education. The examples presented are illustrative of three typical CME venues: live meetings, print, and multimedia.
New Standard of Care
When bringing new information to the medical community about a disease state and innovative treatment options (such as the introduction of the statin class), companies should use a combination of all physician education formats. This is true regardless of where the product is in its lifecycle, because it may be many years before the therapy becomes the standard of care. The educational emphasis should be on the disease state, mechanism of action, and outcomes. Affecting behavioral change across a specialty or multiple specialties requires frequent, repetitive, and consistent education in as many formats as possible.
National/regional symposia. Product managers should also work with thought leaders and medical societies to plan symposia as part of key national meetings in specific specialties. Although the approach requires good relationships with leading medical societies and thought leaders as well as long-term planning, it can generate enormous credibility and influence for the new product. Physicians' behavior is most significantly influenced when respected peers deliver the information in an academic environment or medical society meeting. To reach another level of doctors, pharma companies can also recreate national symposia on a regional level with small, specialized societies, as well as in partnership with academic medical centers and major treatment centers.
Grand rounds. In grand rounds, groups of medical professionals gather to review topics of current interest, such as new research, interesting patient cases, or major changes in medical practice. Grand rounds help physicians, residents, and other healthcare providers learn the new information from each other in a clinical, academic environment. Physicians are accustomed to learning from their peers and are very open to new data presented in this familiar setting. Follow-up evening dinner programs can help reinforce the learning experience by offering a venue for conveying more detailed information about vital disease and treatment updates.
Print opportunities. Symposia content can be adapted for journal articles and supplements to provide an enduring CME component that reaches a broad audience. A single monograph or article in a peer-reviewed journal can be delivered to thousands of clinicians.
E-venues. Research shows that multimedia formats, including teleconferences, webcasts, CDs, and the internet, are increasingly popular with physicians. In a follow-up to a 2001 American Medical Association study on physicians' use of the internet, 45.5 percent of doctors say they chose CME courses as the reason for using the internet, compared with 31 percent in 2001.
As with other formats, multimedia initiatives are far more effective if they are interactive and follow principles of good instructional design. case -based multimedia programs are particularly effective, providing physicians with practice simulations that require history taking, physical exams, diagnostic studies, and treatment selections. This type of patient scenario resonates with traditional peerto-peer clinical discussions and the physician's own experience.
Experimental Treatments
Highly targeted therapies developed with sophisticated technologies, such as Genentech's Xolair (omalizumab) for asthma and Lilly's Xigris (drotrecogin alfa) for severe sepsis sometimes have controversial issues, such as their high price. In these cases, educating physicians about its benefits, risks, costs, and appropriate use must be part of prelaunch and launch objectives. Doctors for such therapies are typically top-ranked specialists who demand a sophisticated level of medical and scientific content. Education about access to therapy, patient selection, third-party approvals, and reimbursement is also critical because these therapies are closely regulated by insurers and managed care organizations.
Patients typically need a great deal of information about dosing, administration, side effects, and efficacy. In addition, before approving reimbursement, insurance companies may require proof that other treatments have failed.
Specialty societies. Faculties should also develop highly targeted education material and present it at relevant national and regional specialty societies, choosing specific subgroups that best fit the strategic profile, such as pulmonary's American Thoracic Society, geared toward academic physicians, and the American College of Chest Physicians, geared toward practitioners.
As a new therapy evolves, planners may want to educate physicians through regional or local events with a "roundtable" or panel discussion. This format has the benefit of attracting physicians who would otherwise have remained on the sidelines, enabling them to judge the value of a new treatment for themselves.
Interact with large audiences. Educating physicians by means of an interactive format is likely to engage them, challenge their assumptions, and open their minds to modes of treatment they might not otherwise have considered. Therefore, teleconferences, webcasts, and multimedia approaches can be highly effective in this category before, during, and after the launch. Teleconferences and webcasts are excellent methods of giving a large audience access to national or regional thought leaders without the burden of site logistics or travel costs associated with a live meeting.
Challenge assumptions on many levels. Multimedia approaches such as CDs or online interactive case studies offer a similar benefit in extending the reach of the most well-known physicians, albeit not in a live format. Rather than relying on a didactic Q&A, interactive multimedia venues provide an opportunity to use a powerful learning technique, presenting the learner with an experience similar to working up and treating a patient. This venue is especially effective when standard assumptions are being challenged.
Print venue not a priority. Journal articles and supplements provide a broad reach for essential knowledge, but they are less effective in presenting the complexities of a controversy, even if they feature pro and con points of view. Real-time discussion and interactivity that highlight important nuances are missing. For experimental treatments, the print format should focus on disease state, mechanism of action, and treatment data in a straightforward presentation.
Break-In Products
For therapies that are new to an established class, live national and regional meetings held before launch are most effective in presenting new data. Conditioning physicians' mindset about an established therapeutic class is essential for the new recommendations to be taken seriously. Physicians need information about how other treatment approaches were initially developed and how the new medicine fits into that continuum of care. These events provide arenas for highly visible and open discussions. Regional meetings offer additional opportunities for primary care physician-specialist network development. Introducing specialists to PCPs often facilitates appropriate referral, speeds up the rate of referral, and creates an environment of collaboration and trust.
Print is essential. Before launch, supplements in respected peer-reviewed journals are essential for bringing an important disease state back to the forefront and raising awareness of new treatment options. Physicians will need to be convinced that the data support what their colleagues are hearing at medical conferences. This is important for establishing a clinical rationale for adopting a therapy.
Electronic backup. Teleconferences, webcasts, and online multimedia reinforce that education and support the live, enduring formats that drive the most powerful educational messages.
New Indications
The objective for older products is to keep the treatment top of mind with physicians year after year by presenting data for new indications at national meetings. Such presentations ultimately elevate the discussion level about established, effective treatments. Grand rounds are another live venue in which doctors are accustomed to hearing about new indications for treatments they use frequently.
Journal supplements and monographs on disease issues and treatments also help physicians keep up with new data and should not be ignored in this post-launch educational effort. And interactive media are additionally helpful as supplementary sources for new data. Case presentations and interactive formats serve to attract physicians' interest in treatments they are already familiar with and provide them with relevant new information that can improve their practices.
CME, like the medicine it serves, is both art and science. No single education formula works for all new treatments, but strategic planning-based on the science and supported by the treatment decision-making process-helps maximize program effectiveness.
[Sidebar]
CME is both art and science. No formula works for all treatments, but strategic planning can make any program effective.
[Sidebar]
Accounts Guilford Pharmaceuticals selects the Columbia MedCom Group as medical agency of record to educate physicians about its recently acquired cardiovascular drug Aggrastat (tirofiban hydro-chloride).
Launches Thomson acquires medical education content developer Scientific Connexions of Newtown, Pennsylvania.
People Advanced names George Davatelis director and group leader, medical affairs/editorial services. He had been medical director for Quintiies. Advanced also hires Teri Park as director, medical affairs. * PACE, a unit of Lowe Healthcare Worldwide, expands its medical education and custom solutions group by adding Margaret Borchers and Susanna Silverman. Each will have the title of vice-president of program development. * Health Learning Systems, CommonHealth's founding medical education unit, makes several personnel moves. Marie Miller is promoted to senior vice-president of professional relations, and David Winkler is made vice-president of professional relations. George Brown advances to assistant vice-president of professional relations. Maria Pollaro rises to director of meetings management. Cheryl Doto moves to program director. In addition, the following people join the firm: Jeff Kramer, PharmD, as senior medical director; Joan Alexander-Bascome as senior vice-president of program management; Eric Ratinetz as vice-president of professional relations; Sudip Biswas as senior director of program planning and development; and Carol Pierini as program director. * MedCases appoints Mike Tansey president and CEO, succeeding Deborah Hull, who is retiring. Tansey, who has vast experience in the electronic delivery of medical education and information, had been CEO of Thomson Scientific.
[Sidebar]
Research shows that multimedia formats are gaining popularity with physicians.
[Author Affiliation]
Destry J. Sulkes, MD, is managing director of Medsn. He can be reached at destry.sulkes@medsn.com.
[Author Affiliation]
Tao Le, MD, is Medsn's chief medical officer. He can be reached at tao.le@medsn.com.
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