Electronic “Dear Doctor” Network Signs Up 40,000 Physicians

The fledgling Health Care Notification Network – designed to distribute “Dear Doctor” letters form manufacturers with safety alerts via e-mail – aims to sign up about 100,000 physicians to secure a critical mass for the program’s success.

“Once the network goes live with a critical mass of docs, what choice to [other physicians] have” in terms of getting this key information, Ed Fotsch, CEO of the health information technology firm Medem told “The Pink Sheet.” He suggested that an initial milestone will be to enroll 100,000 of the approximately 500,000 physicians who are being targeted for this service, offered as an alternative to the traditionally mailed notifications.

With about 40,000 doctors already signed on, Fotsch expects the participation to reach critical mass quickly and envisions the network to be a primary means of getting safety alerts to physicians.

The service is free to physicians. Manufacturers will pay an undisclosed fee for each use.

Medem was among organizations participating in a March 25 conference call introducing HCNN. But, the not-for-profit iHealth Alliance developed the service over the last three years and will oversee it.

Mailed Alerts Often Discarded As Marketing

iHealth said it developed the program because the current system of mailing alerts is slow and mailed letters are often mistaken for company marketing material and disregarded. HCNN is being heavily promoted to physicians from a variety of sources, including medical societies and physicians’ malpractice insurance providers.

“We believe the Health Care Notification Network…has the definite potential to reduce professional liability,” David Troxel, medical director of malpractice insurer The Doctors Company, said during the conference call.

Troxel is a member of the iHealth Alliance board, which also consists of professionals from academia and medical societies, including American Medical Association chairman Edward Langston.

Fotsch said that manufacturers have needed little prodding to get involved.

“You did not have to talk them into” participation, he said, adding that HCNN has commitments from the major pharmaceutical manufacturers and is being approached by smaller companies as well. Nancy Dickey, chairwoman of the iHealth Alliance, noted during the call that Johnson & Johnson played a key role in setting up the network.

FDA also will have the ability to send alerts through the system, but HCNN is primarily a manufacturer alert system. Doctors will be targeted with specific alerts based on the drugs they prescribe, as they are now for paper alerts.

FDA’s Woodcock is Liaison Member

Janet Woodcock, director of FDA’s Center for Drug Evaluation and Research, sits on the iHealth board as a liaison member.

During the conference call, she said FDA fully “supports the transition to an interactive electronic information environment for safety information” so doctors and other prescribers “won’t be hearing of problems first from the media or from patients.” FDA proposed guidance on transition to electronic safety notifications in September 2005 (“The Pink Sheet,” Oct. 3, 2005, In Brief) and finalized the guidance later.

While not directly related, HCNN could complement FDA’s ”Safe Use” initiative, which aims to find better ways to influence physician prescribing and appropriate drug use (“The Pink Sheet,” March 3, 2008, p. 6).

HCNN will go live in the second quarter of 2008. Participating physicians will no longer receive “Dear Doctor“ letters via the U.S. mail.

Alerts Include Interactive Tools

Fotsch described the alerts during the calls as mirroring paper alerts right down to colors and fonts requested by the FDA for patient safety alerts.

Bordering the alerts on screen are new interactive tools that allow HCNN to do more than just “deliver the mail in a more timely fashion,” Fotsch said. Physicians will be able to report adverse drug reactions through links to the FDA. They can also send reports and observations back to the manufacturer, get further information on a product from both FDA and the manufacturer, or suggest how to translate information into layman’s terms for improved patient understanding.