pulling out a mobile device during a patient encounter and using Epocrates—to check on drug interactions and other prescribing information, for example—is literally part of many physicians’ muscle memory.
“At the point of care, where a physician’s got maybe 3 minutes with a patient, getting access to that information in less than a minute becomes incredibly important,” Hurd says. “We have won that space. There is nobody better than we are at that less-than-a-minute category for finding drug-drug interactions, symptoms, diagnoses.”
The opportunity now, Hurd thinks, is to make Epocrates useful for more time-consuming tasks such as brushing up on treatment guidelines, reading news reports and journal articles, networking with other clinicians, and even completing continuing medical education courses. He also says the company is working on a consumer-oriented app designed to “extend the encounter” with patients and ensure that they have ongoing access to authoritative drug information and care instructions.
Already, many doctors and nurses who use Epocrates “swivel” their phones around to show patients dosing information or pictures of the pills they’re taking, Hurd says. That’s now even easier using Epocrates’ native iPad app, released Dec. 6. But beyond that, Hurd thinks physicians would like to be able to refer patients to a consumer version of the app. “The physician would be able to say, ‘This is the knowledge base I’m using to manage your medications. If you have questions about how those interact or the side effects that might occur, I suggest you use this same knowledge base as well.’”
Hurd says a patient-oriented Epocrates app might also include detailed home-care instructions (in place of the bad photocopies that many patients take home with them after a visit to the doctor), as well as a journaling tool to help patients keep track of their symptoms. Doctors will recommend the consumer app, he predicts, as an antidote to the welter of health apps already available, each drawing on different information.
“If you are a doctor and 200 of your patients show up with [health] apps on their phones, they will probably have 196 different apps. That is when you feel clumsy and frustrated,” Hurd says. “No other business has been in the position that we’re in, to go from being in the service of the physician to being in the service of the consumer.”
At the same time, the Epocrates physician app will become more powerful as the company adds features like secure, privacy-compliant text and multimedia messaging. That’s a service other companies already provide (I’ve covered one secure medical messaging startup called Medigram), but Hurd thinks such a feature would be “in line with the capabilities Epocrates has demonstrated in terms of being streamlined, unencumbered, cool, and smart.”
He paints a hypothetical scenario in which an emergency-room physician is in need of a consult on a patient with a skin problem. “An ER doc might not be a specialty in dermatology, but would have the ability to take a picture of a rash and connect in a secure way to a dermatologist who happens to be in their network,” he says. “The communication may be no more than ‘That patient looks fine’ or ‘I can see that patient at 2:00 pm.’”
Historically, Epocrates’ revenue has come from three sources. Subscriptions to premium versions of the app account for 20 percent, and market research surveys provide another 20 percent. The last big chunk, 60 percent, comes from drug manufacturers, who pay for exposure in the form of in-app advertising and “DocAlerts” that give users the option to request sponsored reports or contact manufacturers directly by e-mail or phone.
Hurd told me in December that he wants to take that business “beyond pharma” to other potential sponsors such as
