Decision Management Rx: Can It Help With Compliance?
cheryl wilson 270003VHSH firstname.lastname@example.org | | Tags:  operational-decision-mana... business-rules-management business-events big-pharma decision-automation physicians-payments-sunsh... promotional-spend-complia... healthcare life-sciences decision-management sunshine-act business-rules bpm compliance
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If you’re not familiar with the U.S. Physicians Payments Sunshine Act of 2010, you’re probably not working in the life sciences industry (includes biomedical, biotechnical and “big pharma”). And even if you’re not working in life sciences, don’t stop reading. This is a compliance story for any industry that is moderately or heavily regulated.
What is the Sunshine Act? For the uninitiated, the Federal Sunshine Act imposes several recording and reporting requirements on life sciences companies to ensure transparent, unbiased, fact-based product presentation (marketing, actually) by healthcare providers. Given the importance, several state governments have followed suit with similar legislation. Basically, the Sunshine Act ensures that all money and other valuable consideration provided to a physician who promotes a life science product will be documented and reported periodically to the Federal government. In doing so, people can decide whether the compensation is consistent with objective presentation of products over time or whether it’s probably intended to influence the provider’s presentation of the product. Although these laws and their enabling regulations are specific to U.S. medical providers (typically practicing physicians and teaching hospitals) who promote life sciences products, the legislation has global implications because compliance is legally mandated for all non-U.S. companies that promote and sell life sciences product in the U.S.
The most disruptive force affecting life sciences sales and marketing today. As Eric Newmark (IDC) reported on his recent blog, “Reform at both the state and national level is quickly changing the playing field, including aggregate spend legislation, gift ban laws, and promotional sunshine regulations resulting from healthcare reform. These factors, coupled with reduced physician availability and a changing healthcare landscape, have driven [life sciences] companies to reevaluate their current sales and marketing strategy.” This reevaluation is to address several key pain points for life sciences companies and the healthcare providers that are compensated for promoting their products:
How can decision management help? To successfully comply with Sunshine Act requirements in a cost-effective manner (that the time and money required to ensure compliance doesn’t exceed the financial exposure or potential liability of non-compliance), life sciences companies are adopting IT solutions like business process management (BPM) that provide a high degree of flexibility and ease-of-use by line of business or subject matter experts rather than their IT counterparts. Important note: the BPM solution typically includes complex event processing and business rules management in a separate, but interoperable configuration referred to as decision management (DM). BPM-DM is really the only IT capability combination that can facilitate and even generate return on investment from Sunshine Act compliance by automating all or part of the “when to act” and “what to do” aspects of these compliance functions:
For example, a well-known global pharmaceutical company is using a combination of business process automation, business rules management and business analytics to accelerate promotional spend compliance. The approach has been successful for two key reasons: 1) BPM plus decision management (business rules and analytics in this case) is a proven tech-trio for coping with compliance, and 2) the initiative started with line of business experts where the impact of non-compliance for themselves as individuals and the business at large is well-understood. Only from there was the right technology matched to the desired business outcomes.
I’ll go out on a limb here and say that given how fast and furious regulations can come these days, life sciences firms that haven’t separated their compliance decisions from the processes that they drive will find themselves at a competitive disadvantage.
If you’d like to learn more ways to accelerate Promotional Spend Compliance, you can visit: http://www-01.ibm.com/software/websphere/industry/healthcare-life-sciences/physician-payments-sunshine-act/
This post comes from a new guest blogger, J. Peter Melrose, Worldwide
WebSphere Industry Marketing Manager, Healthcare & Life Sciences. Thanks, Pete!