Transitioning from AI Gee-Whiz to B2B Results

We at CarePrecise are as fascinated as anyone about the miraculous capabilities -- and astounding failures -- of the new Large Language Model Artificial Intelligence tools now battling it out in cyberspace. But we've been around too long not to reserve some skepticism about the hype cycle. The other day I was chatting with an LLM about a new medical device. It initially pointed me to the manufacturer's site and some related promo material, but when I told it I'd rather read content from actual users of the equipment it suggested some sites I generally prefer not to use. When I asked instead for Facebook Groups, it gave me a list of suggestions with very specific Group names.

None of which turned out to exist.

So, when pressed for different information than it had been providing, my chatty AI tool employed a very human tactic: MSU.

This suggests to us that perhaps the best way to effectively use AI will be to point it to data you know is good -- specifically, your own data about your customers and prospects.

This approach is already taking root in pharmaceutical marketing. Directing AI tools toward rich, highly accurate reference data will, we think, become a key component in making the new technology produce credible, and actionable, results.

Record-Linkage in Healthcare Research... and Marketing

Record-linkage is a term referring to technologies that make it possible to merge data on people and organizations from multiple, disparate sources. Early development of the technology was largely related to marketing, for instance, as a means of connecting magazine subscribers' contact information to sales records belonging to retail stores. It's still used that way (more than ever), but some very important applications have emerged since those early days in the 1950s and 1960s, when computers filled whole rooms and developing highly complex software that would use years of run time was pointless. 

CarePrecise uses record linkage to create business intelligence datasets from a broad range of information available through the U.S. Department of Health and Human Services, Department of Commerce, USPS, and other resources. For example, by merging Medicare claims data with NPI registry data and other federal data sources, we can build a 360 degree view of the U.S. healthcare system - from the health systems to the hospitals to the medical practice groups and clinics, to individual clinicians. Today, record linkage is also making significant inroads in improving patient care.

What is record linkage technology and how does it work?

Record linkage is becoming a vital tool for getting the most out of many types of data. Record linkage technology works by creating a unique identifier for each patient that is used to combine information from multiple sources. There are two general types of record linkage: Exact (deterministic) matching and statistical (probabilistic) matching. 

Disambiguation. Exact matching is, of course, ideal. Linking records based on email addresses and tax identification numbers are excellent examples. "Disambiguation" occurs when otherwise disconnected data can be "hard matched" to create an unambiguous match, for which one unique identifier - a number or other code - can be assigned.

Arriving an unambiguous match may not be as easy as comparing Social Security Numbers. That's when we turn to statistical matching. This is  trickier, and almost always less reliable. Probabilistic record linkage uses "fuzzy" matching algorithms to compare data points and make links between different records that may not have the same exact details. For example, if two records had similar birth dates or home addresses, the algorithm would recognize these as potential matches and create a statistical link between them.

Relying on one or a few non-deterministic data points to match records is, naturally, a bad idea. People tend to change home addresses several times over their lifetimes, so using a street address, or phone number or email address, for that matter, would likely miss a number of records. Also, even if these markers have remained constant, another problem, frequently referred to as "fat fingering," occurs when a name, address, phone, etc. is wrongly entered in a database. 

Deliberate ambiguation. Early techniques for reducing this kind of ambiguity between datasets included creating a data field in which all of the vowels are removed from a name or street address. This "works" because numbers and consonants are statistically far less likely to be typed incorrectly. Not a good system, but better than nothing. A "false positive," when records are matched that shouldn't be, and "false negatives," when records that should be matched aren't, abound using only this ham-handed method, but it can still be a part of the record linkage process. Where patient data is involved, and where scientists are relying on clean data to glean truth, much more must be done.

Tighter matching for critical healthcare data

Data that can be linked include sensitive medical records, hospital records, laboratory tests, insurance claims data and administrative databases. When used for research involving patient records, record linkage often involves matching information from multiple sources to create a single unified patient record identifier, sometimes called a Master Patient Identifier (MPI), that can be used to track and analyze health outcomes over time. By combining different datasets, researchers can gain insights into the effectiveness of treatments and interventions, as well as uncover patterns in disease progression or risk factors that would not be visible if looking at one dataset alone.

This allows researchers to gain insights into patient care outcomes by combining information from multiple sources and looking at patients over time. As data science developed, and much larger datasets became available, scholarly efforts to improve record matching began to emerge. Systems that compare text strings and score the difference have been among these methods. An algorithm known as Soundex compares text strings phonetically; the words "Mary" and "Merry" would have a low text-only score, but Soundex can add weight to the match because the words sound alike.

Other fuzzy-logic methods exist, and can even be bought as part of record linkage software. "Standardization" essentially means making all of the same kinds of data appear the same way across different datasets. One such technique is address standardization, based either on proprietary technologies such as the CoLoCode technique developed by CarePrecise, or other, less precise, methods such as the USPS "Pub 28" standard. Getting mail delivered properly is important, to be sure, but the post office to its advantage the benefit of mail carriers' knowledge of their routes and the human ability to disambiguate on the fly. When comparing thousands or millions of rows of data, as is not unusual in medical research applications, "eyeballing" is not an option.

Rather than get too deep in the weeds here, a fine elucidation on record linkage in medicine can be found on the National Library of Medicine website.

Benefits of record linkage technology in medicine

Data merged from many sources can provide a more comprehensive view of the patient, allowing researchers to make more accurate and reliable conclusions about healthcare outcomes. By combining multiple datasets, researchers can gain deeper insight into medical conditions and how treatments affect patients over time. It also makes it easier to compare health outcomes across different populations, as well as detect potential errors or risks in patient care. 

Additionally, record linkage technology can be used to reduce medical costs and improve efficiency in the healthcare system. By linking administrative databases with clinical data, researchers can better understand why certain treatments cost more than others and identify areas where cost savings can be made. This could lead to improved healthcare decisions, including changes in treatment protocols or resource allocations. 

Record linkage has also been used to analyze the prevalence of medical conditions in various populations, create predictive models for patient care, and identify potential drug interactions. All of these studies have helped to improve our understanding of healthcare outcomes and inform decisions about how best to provide care for different patient groups. 

Researchers at the University of California‐San Francisco used record linkage to combine patient records from different providers and examine how electronic medical records could be used to improve care coordination. 

Challenges in using record linkage technology 

Despite the many potential benefits of record linkage technology, there are still challenges that must be overcome. Lack of standardization between datasets can make it difficult for algorithms to identify matches, and data quality issues can lead to incorrect links or missing information. 

Additionally, privacy concerns arise when combining multiple datasets, as linking patient records can reveal identifying information about individuals. In order to ensure that patient data is kept secure and confidential, there must be safeguards in place to prevent unauthorized access or misuse of the information. This includes developing secure protocols for data sharing, as well as strong regulations for protecting patient privacy.

It is important to consider the ethics of combining multiple datasets in order to identify a single patient. This could lead to potential issues such as discrimination or stigmatization, and researchers must make sure that they are adhering to ethical codes when collecting and analyzing data. 

These issues must be addressed in order to ensure that record linkage technology is used responsibly and efficiently. Solutions such as secure data sharing protocols, improved standards for data quality, and rigorous processes for privacy can help researchers harness the power of record linkage technology while protecting patient privacy.

Examples of recent uses of advanced record linkage technology in medical research

Mortality in children under 5 years of age with congenital syphilis in Brazil: A nationwide cohort study

Causes of death in children with congenital Zika syndrome in Brazil, 2015 to 2018 - PLOS

Using privacy preserving record linkage to understand deaths by political affiliation during ...

Computational tool uses DNA-encoded approach to integrate and analyze different health databases Record linkage studies of drug-related deaths among adults who were released from prison to the community...

A Marketer's Guide to Using Provider Data

Quality healthcare provider data is the foundation of any marketing campaign aimed at physician and dentist offices, the practitioners themselves, and every kind of hospital and medical facility. The good data just isn't free, even though it can be downloaded in thousands of pieces from various government websites. CarePrecise simplifies and maximizes the sometimes complex and hard-to-find (or shockingly expensive) resources by providing reliable and comprehensive data on healthcare providers in the United States at truly affordable pricing.

Free Healthcare Provider Data

Free data on U.S. healthcare providers is available from the Centers for Medicare and Medicaid Services. But with a few exceptions, the data files are difficult to understand, and many are simply too large to use in ordinary office computer software. Vendors like CarePrecise, Definitive Healthcare, and OneKey sell data that has been curated and organized for much easier use. This article is a guide to using purchased data, and will spotlight CarePrecise products. That said, CarePrecise also helps its customers locate freely available data to supplement its solutions.

The Good Stuff

CarePrecise offers a number of different provider data solutions to meet specific needs. Marketers want instant access to information like practice locations, practitioner specialties based on the standard Provider Taxonomy codes, co-located colleagues, their group and hospital affiliations, and more. With these details, marketers can create compelling campaigns for audiences that are more relevant and targeted than can be achieved with blanket campaigning.

CarePrecise data resides on your own desktop or laptop computer — there's no need to learn to code for an API, and no need for a database server. These data packages are designed for easy use with the familiar programs in Microsoft Office. You can search, sort, filter, and export data in formats such as CSV or XLSX to quickly capture insights. The complete database of all 7 million+ U.S. healthcare provider records can be used instantly to create tightly targeted campaigns, with no requirement for an Internet connection.

After you purchase a data package, you'll extract it to a folder on your computer. Depending on which components you choose, you'll use Microsoft Access or Excel to view and manipulate the data. If you've chosen CarePrecise Platinum, there's a software program, CP ListMaker, that "rides on top" of these enormous data files, and makes easy work of selecting the types of providers, their specific geographic locations by zip code, city, county, state, or the entire U.S., and with additional filtering by other attributes like gender, acceptance of Medicare, years in practice, and number of practitioners in the office. This data, priced in the tens of thousands of dollars by other companies, starts at $459. You can add additional modules as needed, and CarePrecise offers an upgrade path so you can upgrade economically. If you want the whole universe of CarePrecise's provider data,* The Collection offers what others charge $30,000 and more for at just over $3,000 — an order of magnitude less expensive — and you won't have to mess with an API or dodgy web access.

We'll cover some physician marketing specifics here, but most apply to other kinds of medical offices as well.

Marketing to Physicians

Connecting with busy physicians is one of the most arduous tasks associated with physician marketing, but good data and good tools make it simpler. 

Each physician holds the power to influence millions of dollars in healthcare purchases every year — a fact that has resulted in an overwhelming amount of marketing messages vying for their attention. The COVID-19 pandemic sent billions more marketing messages through the pipeline, from sellers of everything from masks and hand sanitizer to ventilators. While that traffic has thinned out now, many of those companies got a taste of physician direct marketing, built out the capability to deploy it, and are not likely to just walk away. We're in a whole new world of selling to frontline clinicians.

Here are the top things to keep in mind...

Different Strokes

Segment your campaign into blocks of providers with different attributes. If you’re unsure which patient practice will be your best prospect, testing out different specialties can provide the answer. CarePrecise Platinum simplifies this process by splitting your list into specialties, allowing for easy comparison of responses between a product landing page or reply card. Try it today to easily identify which of your ideal prospects spending money.

Do you sell primarily to large group practices, or small, sole proprietors? CarePrecise Platinum can help you target individuals or groups, and sort them by size.

Analyze various urban and rural areas, their proximity to a city's center, state borders, etc. to identify the most budget-friendly sections for your business operations. You can even layer these elements on top of one another in order to pinpoint precisely which areas will be the best fit for your marketing campaign. Maximize campaign ROI: Reach out to all market segments by putting together an impactful message that can then be tested and spread throughout each area once you've determined which is most effective.

Gender can be important, too. We live in a time of high sensitivity to gender, in our personal relationships, speech, and writing. Knowing the gender of the person receiving your message can help you to avoid negatives, and maybe pack in some positives. There are important differences in the responses of people identifying as women, men, genderfluid, and the many shades in between. Understanding the language of gender, and being mindful of its subtlety and power, and basic. Unfortunately, the U.S. Department of Health and Human services has not seen fit to allow healthcare providers to report as anything other than M or F, but CarePrecise faithfully brings all of that information to you, along with intelligent genderization of organizations' authorizing officials, whose records do not include a field for gender.

Make it Personal

It's essential that your direct marketing campaign is as tailored to the specific doctor you are targeting as a specialist. Since what might be effective for one type of physician may not apply to another, it's important to address each individually. Your product or service can assist a wide variety of specialists, yet when speaking directly with a sports medicine doc, specifically mention how it benefits them and their specialty - this will have greater impact than using generic language.

If you want to maximize the impact of your message, consider tailoring it according to geographical location. After all, rural doctors and hospitals may have unique requirements that suburban multi-physician practices don't typically face. Similarly, small or solo practice clinicians possess a different mindset than their counterparts in large organizations - this should be kept in mind when crafting messages for them as well.

This sort of segmenting is vastly easier when you have practitioner data in a form that's easy to manipulate, and the ability to create separate lists for each angle.

Maximize the physician's time and yours

Tap into your data sources to gain insight on the physicians you are mailing or telemarketing. Learn about their specialties, gender, and if they've recently started practicing. Acquire up-to-date addresses and phone numbers so that you can establish contact efficiently. Your communications shouldn't attempt a full curriculum, but a concise call to action. Motivate the physician to visit your website for helpful information, and follow up with postal mailings, since many doctors prefer paper over electronic correspondence.

Earn loyalty

Physicians want authoritative, credible information about new products and services that may be helpful for their patients or practices. Clear, concise, high-quality information builds trust. Getting a name or credential wrong is a forgivable human error, but it doesn't engender credibility with anyone, and practitioners can be very sensitive about mistakes. CarePrecise data is updated monthly with constantly changing information reported by the healthcare providers themselves.

Educate, starting with the first sentence

Physicians are professional learners. They diagnose by observation, seeking every detail to shed light on what they see. They tend to be more attracted to factual information than the average consumer. Making sure your message stands out and provides tangible value is key to success when targeting physicians. To ensure that critical information reaches your physician, it is important to cut out irrelevant details and create a succinct message. Make sure the communication is direct and professional so that gatekeepers will be able to recognize its importance quickly. This guarantees that vital facts are transmitted directly to the doctor without wasting time or getting lost in an overload of data. Generic-looking mailers with names and addresses in all capital letters, or a salutation like "Dear Doctor:" are lame!

The SharpMail tool in CarePrecise's CP ListMaker makes your written words to physicians look smart and professional by proper-casing name and address information. SharpMail saves time by creating intelligently "attention names" (the full addressee name, like Dr. Sandra Rosenfeld, DO) and salutations (the name part of that "Dear Doctor" greeting, like Dr. Rosenfeld or Ms Rosenfeld). SharpMail is aware of whether a particular person should be addresses as Dr., Mr., Mrs., or Ms, according to their reported preference of name prefix and/or status awarded the "doctor" honorific. SharpMail is designed specifically for the medical market, and it produces beautiful names and addresses, but it's offered as open source code within CP ListMaker, and licensed customers may adapt it to their own needs.

Consider mailing information about your product that puts indicators and counter-indicators for use right up front, so that physicians and their staff know that the information is important and to the point. You should check multiple sources, to know things like whether a physician is enrolled in the PECOS system (can bill Medicare), or has been barred from billing. CarePrecise combines all of these sources in a single tool.

Relationships Count

To make sure that invoices get through to their intended recipients, establishing connections with physicians and their team members is crucial. CarePrecise Platinum can help by keeping tabs on the lists used for various communications, maintaining an opt-out list for practices which require special care, and creating separate marketing lists depending on geographical area. You'll be able to match suitable representatives with each target without relying on any external CRM software – all thanks to extensive demographic data.

Direct Mail

Although traditional postal mailings still generate considerable leads, there are alternative channels that prove to be much more effective. Direct mail is the tried and true method, while email can save on costs; however, many emails sent to physician offices fail to reach their intended audience. Postal ad campaigns fare slightly worse, but remain an important ingredient in the marketing mix.

Text messaging

A newer channel of communication has recently been gaining traction for its successful lead generating capabilities. Text messaging (SMS) is the fresh kid on the block. However, use it cautiously; text messaging has a high rate of penetration, yet it can be seen as intrusive. The "untouchable" physician isn't all that untouchable if you have a CarePrecise email list, but be sure to keep the message short and compelling, and include a shortened link to a landing page with the straight info on your product. As for telemarketing, bear in mind that the majority of your recipients will view your attempt to market something on their mobile device as unsolicited commercial messages – phone spam. That never looks good.

Sending bulk text messages may be tantalizingly easy with SMS gateway services, but they usually have an anti-spam policy that requires you to obtain the recipient's consent prior to sending any texts. CarePrecise data sets contain around 1,100,000 phone numbers for physicians, but be aware that while some of these are smartphones and some will be turned into voice mail messages by the recipient's phone carrier, a significant number will hit landlines and office phone system dead ends. Despite any technical glitches, the biggest fear should be your relationships with current physicians. Diligent list preparation is required to eliminate anyone you already connect with via more user-friendly mediums. Nonetheless, we are aware of some companies that are currently testing bulk SMS to doctors, both opt-in and cold call. It's believed that this channel will experience explosive growth over the coming years; however, it remains uncertain whether its advantages surpass the risks associated with such invasive techniques.

Email campaigns

It feels kind of thrilling to push the "Send Campaigns" button on a few tens of thousands of email messages. When I do it I even sort of push down hard on the mouse or screen so I can get all the tingly feels.

Constant Contact reports that email marketing has a return on investment of $42 for every $1 spent. There are some gotchas, of course, but email is the winner in overall ROI, while remaining perfectly legal to send unsolicited. The ideal email list is one that was collected by the practitioners' medical society, journals, conferences, and the like. Screen-scraped email addresses just, well, suck.

The problem with cheap, uncurated email lists is that even just one low-quality, high-rejection campaign can wreck your web domain, blacklist it, and send your company's regular business email messages into the junk box. Getting off of the blacklists is an expensive and slow process. A huge waste of money.

We are extremely cautious with our careprecise.com domain and would never be so sloppy. Rest assured that we carry that same care into our CarePrecise Preferred Email data stock. Our buyers develop trusting relationships with the societies, event producers, and medical journal publishers. Dirty email lists would damage that trust on all sides. Good email addresses, particularly physician emails, are expensive to acquire and maintain, especially when we try to get only the ones that the addressee has given permission to share. CarePrecise has developed a unique system for email hygiene that combines this impeccable sourcing with constant re-verification and campaign analysis. This analysis step examines the campaign reports of some of our larger customers to know, for instance, which of the three or seven email addresses we have for one physician should be the most effective.

Tips on sending email to physicians and other healthcare providers would fill pages, so instead, here's a link to our email sending best practices.

Just the good data, please

Ultimately, if you are determined to get in touch with physicians and their personnel, it's essential that you understand the protocols. Obtaining accurate data from a trustworthy source will give you the ability to communicate professionally and efficiently. With careful planning and employing innovative strategies utilizing this data, your organization can cultivate relationships of lasting trust. The ways that you use the data will make the biggest difference of all, and will be a significant driver of your competitive edge.

With CarePrecise, you can rest assured that reliable and comprehensive data will always be accessible – right there on your computer drive – so you can concentrate on what really matters: crafting compelling marketing campaigns with precision targeting to successfully reach your target audiences.

*Well, mostly the whole universe. A few packages that are designed for very specific applications, such as ScriptFax and ScribeFax, are not part of The Collection.

– Michael Christopher, Chief Analyst

Two New Beta Provider Data Releases

This summer has seen one spectacular new release of healthcare provider data from CarePrecise already, and a second is on the way. The first one, released just a week ago, is already finding its way into EMR pre-population, new web apps, OpenPayments and HIE applications.

The Extended Professional, Group & Hospital(TM) dataset extends CarePrecise's flagship master database, CarePrecise Access Complete (CPAC), with verified group practice data for physicians and other providers, their hospital affiliations, medical schools and graduation years. The EPGH's Extended Hospital table provides an unduplicated list of all U.S. acute care, VA, children's and critical access hospitals that bill Medicare (essentially all of these hospital types bill Medicare, so this list is nearly complete; link it to hospital data in the CPAC, and you've got everything -- a more complete, up-to-date and verified database of physicians than the American Medical Association's list at a small fraction of the cost... plus more than 3 million other healthcare providers not included in the AMA data.

The EPGH has only been released in beta so far, and in beta it is being distributed to all current CPAC subscribers free of charge through September 2013. The EPGH/CPAC bundle is the only commercially available merged database of NPPES, LEIE, PECOS, PhysicianCompare and HospitalCompare data, and it contains all of the "hooks" necessary to link to CMS hospital quality data and forthcoming physician quality data.

Coming next is the beta release of CP ProCase(TM), a proper-case version of the name, mailing address and practice address in CPAC, for all approximately 4 million records. Using CPAC data for marketing and other communications will be easier and more professional looking. As with the EPGH dataset, the ProCase add-on will be available bundled with CPAC, and not separately.

Planned beta release of CP ProCase will coincide with the August 2013 CPAC update release. As with EPGH, ProCase will be distributed as a free beta for evaluation to all current CPAC subscribers. (Betas are not available on single download purchasers.)

And, as if that weren't enough, our popular software, CP ListMaker, is undergoing a rebuild to add EPGH functionality. (Proper casing is already a feature of CP ListMaker.) The new version -- 4.01 -- will sport new output queries that include the new extended data linked to list outputs, completely configurable to use the new information. Release date for CP ListMaker v4.01 is scheduled to coincide with the August CPAC data release.

Questions about the new products? Call your CarePrecise sales representative at (877) 782-2294.

New data on Physicians, Groups and Hospitals

We are delighted to announce that our new Extended Physician, Group and Hospital (EPGH) dataset is in beta release, and is available for CarePrecise subscribers to download. The new data adds rich physician information, including verified hospital and group affiliations and education data, to the popular CarePrecise Access Complete database of U.S. healthcare providers.

Practice groups and hospitals, as well as physicians and other professionals are all inter-linked within the vast relational database representing nearly 4 million healthcare providers in all. But the data is made accessible by CarePrecise's unique compression and record-linkage processing, so that it can be used in popular desktop database software, such as Microsoft Access and FileMaker.

The combined CPAC/EPGH database offers a 360-degree view of U.S. healthcare providers' data, and assimilates in a single database the information contained in the federal NPI database (NPPES), the Medicare database (PECOS), the federal excluded provider database (LEIE), Hospital Compare and Physician Compare databases. It is the only comprehensive source of this data in a single database environment, and it can be used on ordinary laptop and desktop computers with ordinary office database software.

The new EPGH dataset is not available separately, but as an add-on to the CarePrecise Access Complete (CPAC) database of all HIPAA-covered U.S. healthcare providers. Currently in beta release, the EPGH add-on is now available only to current quarterly and monthly subscribers to the CPAC product, pending the full release scheduled for this fall.

To review the fields in the new dataset, see the field list table on the CarePrecise Access Complete documentation page. Standard pricing of CarePrecise data products provides a single-user license; multi-user licenses and derivative product (limited publication) licenses are also available. Contact CarePrecise Sales at (877) 782-2294.

Doctors: Will Patients Misread Sunshine Info?

The Centers for Medicare and Medicaid Services (CMS) is reassuring physicians about Physician Payment Sunshine Act reporting, saying that reporting efforts involving connections between physicians and vendors will fall largely on the shoulders of the vendors, rather than on physicians. But that's not the only issue that worries docs. Once the Sunshine data becomes public, they are concerned that it may be incorrectly interpreted by consumers and the media, leading to unwarranted witch hunts. At the AMA's House of Delegates meeting in Chicago, pediatrician Lynda Young said "The media can really sensationalize this," worrying that when information goes public, "the media jumps on it."

The Sunshine Act (Section 6002 of the Patient Protection and Affordable Care Act) is being rebranded by CMS as the "Open Payment Program," according to a June 20 article in Modern Healthcare. Quoting Dr. Shantanu Agrawal, director of the CMS data-sharing and partnership group, the agency wants to create a national transparency program for payments to physicians and teaching hospitals by drug and medical-device manufacturers and group purchasing organizations. According to Agrawal, pharmaceutical companies spent $15.7 billion in 2011 on face-to-face sales and promotional activities. But companies like Pfizer and GlaxoSmithKline have reported reductions in spending to attract doctors.

The law kicks in August 1, requiring drug and device companies to start tracking transfers of anything valued at more than $10. Physicians will be able to see what has been reported about them in the second quarter of 2014, and reports will become public on Septenver 30 of that year.

CarePrecise.com supplies accurate physician databases used by drug and device manufacturers in their Sunshine Act tracking programs.

5,000th Application Milestone

In April, 2012, CarePrecise will celebrate having built and released our 5,000th database application and version release! Actually, we will have released 5,049 (and maybe more) separate software applications, including state-by-state NPIdentify Desktop apps, CarePrecise Access sets, customized CarePrecise Select sets, CP ListMaker version upgrades, custom applications, and specialized MEDICAlistings marketing lists. In all, we will have distributed software and datasets representing nearly a terabyte of data and code since 2008. We're a privately held company and we don't release financials or our exact number of users, but we can say that it's between 500 and 1,000. And we love every single one!

Phone Messaging: New Channel to Physicians

It's wildly hit-and-miss -- much like email spam -- but marketers are increasingly using bulk text messaging to penetrate the armor cladding of physician offices. And it's a wide open opportunity; physician office phone numbers are openly published, unlike email addresses. Fax numbers are available too (CarePrecise provider data includes both phone and fax numbers, up to four numbers per record, and we know that it is widely used for marketing to physicians), but "faxpam" doesn't have the same high-tech glamor. Unlike a fax broadcast, text messaging allows marketers to embed a live link to a web landing page, as well as an instantly accessible means for recipients to opt out, making bulk SMS marketing just a little bit more respectable. (Ever tried to get a faxpammer to stop? Ha!)

So what's the difference between bulk SMS cold-calling and plain old spam? Not much, except that it's newer and less fraught with sleaze. And here's something more: It's not free, so spammers can't just set up a computer and start sending 100 million spam messages a day at essentially no cost. Text messaging to phones requires that you have an SMS gateway, or an account with a service provider who has one. These are available to bulk senders, but at a price. Okay, it's not exactly postage, but it's at least a price.

Among the numerous offerings for bulk SMS gateway and software services are Mobomix and TXTwire. Both offer essentially unlimited sending with premium accounts, but both enforce opt-in requirements. That is, you can't just upload a database of phone numbers, such as the 5 million or so in the CarePrecise database, and start texting. Instead, these services require that you are sending only to your own customers or others who have explicitly said, "Yeah, okay, text me spam."

Of course, there's always a workaround. Another company, SMScountry, offers an Excel plug in that lets you send personalized text messages. While they have a similar anti-spam policy, the way the system works would make it difficult to police. As with all bulk SMS systems, it isn't particularly easy for a recipient to contact the carrier to complain. The carrier backbone for SMS is a bit primitive compared with that of email, and there are fewer hooks for filtering messages by the carriers, should they ever want to do what ISPs are doing about email spam. It's pretty much up to the owner of the gateway.

In the war between marketers and physicians, both sides escalate as new weapons or defenses arise. A fax isn't likely to ever see a doctor's spectacles, but that same unreachable physician isn't really that unreachable if you can get his email address or phone number. Naturally, it helps to have her mobile number rather than just the office phone, for obvious reasons. But if you've got a product to sell to docs, any opening is a huge gaping hole, and, even if the text message gets converted to a computer-voiced voice mail message, and, even if only the smallest percentage reach a bona fide phyz, maybe paying $60 a month for a bulk gateway account with few limits sounds good to you. And a good many of those published numbers are cell phones, some portion of them presumably reaching right into a doctor's pocket.

Bulk SMS has its Whitehat side, of course. Services that allow you to enter your customers' account info and send text billing notices, patient appointment reminders, among a host of other applications, are opening up the commercial use of phone messaging. I opted in for a J.C. Penney's coupon texting service, and I use it.

But let's say you've got a nice big customer list, folks who freely gave you their phone numbers (long before the advent of SMSpam, but still...). Can you send em all a coupon, or a new product announcement, or an offer of a free EHR assessment? I want to say no, but we send these same customers more-or-less "unsolicited" email, at least in the sense that they never explicitely said "Send me your coupons," but something more like "Send me product update notices via your monthly newsletter." That phone number was optional, right? Houston, we have achieved opt-in.

Certain advantages of smartphones, such as the ability to blacklist messagers, are a helpful control. The barriers to entry are currently very high for an SMSpammer who wants to set up his own unrestricted gateway, so he'll be using these third party services and, perhaps, have to behave himself. But look for text marketing to grow wildly in the near future.

Check out our page on Marketing to Healthcare Providers.