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Best Practices, LLC Strategic Benchmarking Research

Professional Medical Education Excellence: Benchmarking Critical Program Trends Transforming the

Medical Device and Biopharmaceutical Marketplace

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Table of ContentsI. Executive Summary pp. 4-13

Research Overview pp. 4

Universe of Learning pp. 5

Transforming the Medical Education Landscape pp. 6

Key Findings pp. 7-13

II. Universe of Learning: Key Demographics of Participating Companies pp. 14-19

III. Investment Benchmarks & Trends pp. 20-36

Medical Education Spending is an Uneven Landscape Reflecting Growth, Decline and Shifts

IV. Program Benchmarks & Trends pp. 37-50

Developing and Deploying Medical Education Programs

• Educating For Better Outcomes pp. 51-60

I. Multi-disciplinary programs are on the Rise

VI. Program & Educator Impact Ratings pp. 61-75

The Programs & Professionals That Best Educate HealthCare Providers

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Table of ContentsVII. Performance Measurement pp.76-

84

• Assessing Medical Education Programs to Demonstrate Value

VIII.Technology Benchmarks & Trends pp. 85-97

New Digital Technologies Are Changing Medical Education Deployment

IX. Medical Education Program Benchmarks pp. 98-115

• Factors Shaping Medical Education Programs

X. Appendix pp. 116-119

ACCME Annual Reports – 2010-2011

XI. About Best Practices, LLC pp. 120

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Topics IncludedStudy Overview

• Funding channels utilized by Medical Education groups

• Effectiveness of different Medical Education program types and delivery channels

• Use of multi-disciplinary Medical Education programs

• Trends in grants to professional societies/associations for accredited and non-accredited education programs 

• Rating of company professionals most valued by physicians for education

• Future trends in Medical Education programs and technology

Research Objective: This benchmarking study investigates emerging Medical Education trends at medical device and pharmaceutical organizations regarding funding, program types, delivery channels, program effectiveness and value drivers.

Research findings provide industry metrics that can serve as a reference point for Medical Education leaders in future budgeting and strategic planning.

Methodology: Best Practices, LLC engaged 32 Medical Education leaders at 31 companies through a benchmarking survey instrument. In addition, research analysts conducted deep-dive executive interviews with 5 selected respondents to collect qualitative data and insights.

Research Project Objectives, Methodology & TopicsBest Practices, LLC conducted this benchmarking study to identify program and funding trends for Medical Education groups in medical device and biopharmaceutical sectors.

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31 Healthcare Companies Provide Universe of LearningThis study engaged medical education leaders from 31 leading healthcare companies. Segmentation analysis was key to examining trends and effective practices. Fourteen participants represent the Medical Device Segment and 18 participants represent the Pharma Segment . In addition, deep-dive interviews were conducted with five participating companies to gather additional insights.

(n=18)(n=14)

Benchmark Class:Medical Device Segment: Pharma Segment:

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Professional Society Utilization &

Grant Trends

In-Class & Conference Funding Trends

Multidisciplinary Education Trends

Medical Education Development & Delivery

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Key Findings: Medical Education Benchmarks Present Study Snapshot

Many observations have been harvested from the study. These are some of the key benchmarks to surface.

The device and pharma segments are at opposites in their approaches to MedEd program development and delivery. Two-thirds of the device segment develop and deliver their programs whereas two-thirds of the pharma segment utilize third-parties to develop and deliver their programs.

Both segments embrace multidisciplinary education to support better outcomes. Multidisciplinary programs make up about half of both segments’ education programs. Also, a majority of both segments think multidisciplinary programs will grow over the next 2-3 years.

Both segments utilize professional societies for roughly two-thirds of their company sponsored accredited programs and one third of their non-accredited programs. Meanwhile, a majority of both segments expect society grants for accredited and non-accredited programs to either stay flat or decrease in the next 2-3 years; a quarter of both segments expect grants to decline for both program types in the same period.

Half of the device segment expects funding to decrease in the next 2-3 years for in-class education and conferences. Half of the pharma segment expects funding to stay the same. Meanwhile, 60 percent of the MedEd programs in both segments are currently delivered in a in-class setting.

In next 2-3 years, both segments anticipate technology/Internet supported education programs will increase; however, most of pharma see it increasing 11-20+% while only 34% of device see it increasing that much.

A majority of both segments feel physicians highly value accredited programs at conferences/congresses and academic centers. A majority of both segments also feel that physicians highly value patient case studies as curricular topics and non-company affiliated physicians are highly valued presenters.

Reshaped by regulatory & political pressures, Pharma principally funds education through Medical Affairs; almost two-thirds of the Medical Device segment funds through Marketing. This is likely to change.

Medical EducationTechnology Trends

Programs, Venues that Physicians Value

Marketing Still a Major Funding Source for

Medical Device Sector

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Program Development & Regional Trends: Findings & Insights

Benchmark Finding Regarding Program Development

Education Program Development and Delivery: The medical device and pharmaceutical sectors embrace strikingly different approaches to the development and delivery of medical education programs.

• Two-thirds of medical device participants’ education programs are developed and delivered in-house while a third of programs are developed and delivered by third-party vendors.

• Pharma takes the opposite path: two-thirds of programs are developed and delivered by vendors while a third are developed and delivered in-house.

• Pharma’s different program development approach reflects regulatory and political pressures driving pharma to retreat from hands-on involvement in education development and deployment. The device sector may find itself facing the same pressures. Indeed, several device firms have stepped back to rethink their CME strategies because of compliance issues.

Benchmark Finding Regarding Regional Education Trends

Regional Education Trends: Almost 90 percent of the device segment said they will be expanding

medical education efforts into three regions: Latin America, Emerging Markets and Asia. Pharma,

meanwhile, increased its education efforts in these regions years ago. Nevertheless, almost half of the

pharma segment expects to continue expanding education in emerging markets and Latin America in the

next 2-3 years. Interestingly, about half the pharma participants expect to also expand efforts in the U.S. 7

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The following findings and insights emerged from the analysis of the Medical Education performance

benchmark and lessons learned interviews with key companies and MedEd leaders.

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MedEd Budgets Range Widely Across Both Sectors

The companies within this study’s Medical Device Segment averaged $14M whereas the companies within the Pharma averaged $13M in global Medical Education investment.

Q. Please estimate in U.S. Dollars the aggregate global investment level dedicated to all medical education functions and activities during the last fiscal year at your company/unit, to include education programs (Accredited and Non-

Accredited), grants, fellowships, MedEd staffing FTEs, training centers, and MedEd infrastructure :

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Medical Education Resource Benchmark

Aggregate Global Investment Level Dedicated to All Medical

Education & Activities

Max $50,000,000

75th Percentile $25,000,000

Mean $14,044,444

Median $5,000,000

25th Percentile $1,500,000

Min $1,000,000

Aggregate Global Investment Level Dedicated to All Medical

Education & Activities

$80,000,000

$13,000,000

$13,026,538

$5,000,000

$3,495,000

$500,000

Medical Device: Pharma:

(n=9) (n=13)

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MedEd Funding Most Often Supports Accredited GrantsGrants, specifically Accredited, are the most utilized funding distribution channel for Medical Education. Some organizations – predominately pharma companies – also utilize sponsorships. Nearly 40% of the Device segment used Accredited fellowships.

Q. Which, if any, funding distribution channels are utilized by your medical education group to support Accredited and Non-Accredited education? (Check all that apply)

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Supporting External Education Through Corporate Funding

% Responses

Medical Device: Pharma:

(n=15)(n=13)

Accredited

Non-Accredited

% Responses

Accredited

Non-Accredited

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Pharma Favor Grant Funding; Device Favor Staffing

Device companies focused more on staffing and grants whereas Pharma invested mainly in grants and vendors.

(n=13)

Q. Please estimate the percentage of your annual MedEd funding that is invested in these key areas (The sum of all sources should equal 100% of your MedEd program budget):

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Average Breakdown of MedEd Funding by AreaMedical Device: Pharma:

(n=16)

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Device Sector Typically Develops Its Own ProgramsIn contrast to the pharma sector, the device industry typically still develops a majority of its medical education programs in-house. The different approaches to program development is likely the result of regulatory issues pushing pharma to retreat from hands-on involvement in education . The device sector may find itself facing the same pressure and, indeed, a number of major device firms have stepped back from CME because of compliance issues.

(n=11)

What is the current mix of company-developed education programs versus external third-party developed programs? (Each row should add up to 100%)

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Medical Device: Development of Medical Education Programs

Max 100% 75th Percentile 97.5% Mean 60% Median 60% 25th Percentile 27.5% Min 0%

In Company:

Max 100% 75th Percentile 72.5% Mean 40% Median 40% 25th Percentile 2.5% Min 0%

Third-party:

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Pharma Pushes Program Development to Vendors

Regulatory requirements and compliance concerns have pushed most pharma to use third-party organizations to develop their medical education programs. This is certainly the case with CME programs and is becoming the trend for other types of education programs.

(n=14)

What is the current mix of company-developed education programs versus external third-party developed programs? (Each row should add up to 100%)

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Pharma: Development of Medical Education Programs

Max 90% 75th Percentile 50% Mean 30.7% Median 35% 25th Percentile 0% Min 0%

In Company:

Max 100% 75th Percentile 100% Mean 69.3% Median 65% 25th Percentile 50% Min 10%

Third-party:

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Downside of Multidisciplinary Education is losing focus on HCP with biggest impact: physician

While a majority of study participants utilize multidisciplinary education, one medical education leader noted that tailoring a program to multiple types of HCPs can cause a program to lose focus on the most important participant: the physicians.

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“It’s limiting the lens of who is going to

have the greatest impact. One thing that

we’re looking to do is to transition

some of the ancillary individuals, such

as maybe nursing or anesthesia or

scrub tech, and give them online

training and focus the hands-on event

for the physician.”

– Global Vice President, Education

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Multidisciplinary Programs Projected to GrowA majority of organizations in both the device and pharma segments expect their multi-disciplinary programs to increase in the next 2-3 years. With healthcare reform putting a greater emphasis on health outcomes, some education leaders believe the emphasis on coordination of care inherent in multi-disciplinary programs is behind the expected growth.

Q. What do expect in the next 24-36 months for multidisciplinary education programs supported by your company:

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Multidisciplinary Education Trends:Medical Device: Pharma:

(n=13)(n=12)

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Device Segment: Physicians Value Conferences, Academic Centers for Accredited Education A majority of device participants felt physicians highly value accredited education programs offered at conferences/congresses and academic centers. However, a previous slide showed that half of the device participants anticipate reducing conference program support in the coming years – a move likely associated with its high cost. Clearly, professional education leaders are going to have to balance value with cost in the coming years.

Q. Please rate the types of Professional Education that are the most valued by physicians:

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Medical Device; MedEd Types That Physicians Most Value

n =

12

12

12

12

12

11

12

12

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Pharma Segment: Accredited Programs in Variety of Settings Seen as Highly Valued by PhysiciansThe pharma segment mirrors the device perspective that physicians highly value accredited education over non-accredited programs. Likewise, physicians prefer academic centers and conferences as the venues for their programs.

Q. Please rate the types of Professional Education that are the most valued by physicians:

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Pharma; MedEd Types That Physicians Most Value

n =

16

16

16

16

16

16

16

16

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Device Segment: Roundtables, Case Studies Are Most Valuable Information Sources For PhysiciansRoundtable discussions and case studies are highly valuable product information sources for physicians, according to a majority of device participants. This perspective underscores the importance of the peer-to-peer (roundtables) and patient-focused (case studies) education formats for physicians.

Q. Please rate the sources of product/therapy information that physicians value the most:

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Medical Devices: Most Valued Information Sources:

n =12

11

13

12

12

12

12

13

12

12

12

12

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Education Presented by Peers Considered Most Reliable

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The educator often matters as much as the program content. Physicians value other professionals who have real world experience. Peer-to-peer programs are often rated highly reliable. However, the credibility of a program also depends on the event or venue where it is presented.

“Well I think it’s the peer-to-peer

relationship. So a nurse presenting to a

nurse or a cardiologist presenting to a

cardiologist or a general surgeon. I think

that has the most credibility. Having

industry present to these healthcare

professionals in accredited or a non-

accredited event is probably not the most

ideal situation.”– Global Vice President, Professional Education,

Medical Device Company

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Outcomes & Practice Adoption Rates Are Favored MedDev Metrics

Medical Device companies rate four performance metrics for assessing Medical Education value as highly effective. They include, 1) Improvement Outcomes, 2) Adoption Rates of new Practices, 3) Qualitative Feedback, and 4) Post-program Satisfaction Rates. A majority of device participants gave all these measures highly effective ratings.

Q. Please rate the effectiveness of the performance measures/metrics that you employ to show the value of your medical education group:

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Medical Device: Performance Measurement

n =

12

11

12

12

11

11

12

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Develop a Series of Metrics to Consistently Assess Programs

One medical device leader who oversees his organization’s physician training program touted the use of a rubric of performance measurement metrics as a tool for evaluating the program on a quarterly basis. Metrics could include ROI and product usage complaints.

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“I decided to develop a rubric for the

evaluation of our physician training program

and I scheduled a quarterly presentation of

the compliance committee that looks at a lot

of metrics by which we that evaluate the

relative success of our program. And my

position, and it’s supported by my corporate

compliance attorneys, is it’s OK to look at ROI

for training - it just can’t be the only thing you

look at.”

– Vice President, Clinical Affairs

Evaluating Physician Training Program

•Develop rubric for evaluating

•Use key metrics

•Present quarterly

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MedDev Funding Rising for Online, Tablet & Mobile Technology

Q. Please note whether your funding for different education delivery forms is rising, falling or staying the same in the next 24-36 months:

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Medical Device:

(n= 13 13 12 13 13 13 13 12 12 )

On average, half of the device participants expect funding to increase for online and tech-driven education formats such as online, iPad and mobile applications. In a worrisome sign, half also expect funding to decrease for in-class education, which some leaders see as the most effective format for device education and training.

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New Digital Technologies Permit Greater Flexibility & Lower Cost

In the current Medical Education environment, many healthcare facilities need to do more training of more staff with less time out of clinic and at lower cost. Consequently, new online technologies are on the rise while in-class training is on the decline.

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http://www.ama-assn.org/amednews/2012/05/14/bisc0514.htm

“If we don’t change our ways, we’re going to be left in the dust

and here’s why: One is the fact that people can’t take time out

of their days to go to these things. They have to be able to

train their entire OR and it’s cost prohibitive to send their

entire OR staff to a course. If you’re from Jersey and this

course is in LA, you’re not – you know, that’s -- a week out of

your [life]. You just can’t do it. If you look at all the data from

the medical schools right now ,they’ve all gone to iPad or

virtual learning. They still need hands-on opportunity but you

can do that at the local level. They don’t have to leave. We’re

constantly looking at technology to help us in these areas but

without the funds and the dedicated resources really

implemented, it’s a definite struggle.”

- Director, Medical Education, Medical Device

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Pharma Companies Are Increasing Technology-Enabled Funding Even More Enthusiastically Than MedDev

Q. Please note whether your funding for different education delivery forms is rising, falling or staying the same in the next 24-36 months:

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Pharma:

(n= 15 15 15 15 14 15 13 12 12 )

More than 70% of pharma participants expect funding to increase for online and tech-driven education formats such as online, iPad and mobile applications. A majority of the pharma segment expect funding to remain flat across a host of other education formats: demonstration centers, simulations, games and in-class.

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About Best Practices, LLCBest Practices, LLC is a research and consulting firm that conducts work based on the simple yet profound principle that organizations can chart a course to superior economic performance by studying the best business practices, operating tactics, and winning strategies of world-class companies.

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Link for Report: Benchmarking Critical Trends in the Medical Device Marketplace