SPECIALIST ANNOUNCEMENT:

Interview with Richard Arnhiem - AFS Health Care GM  

This week Brett Galvin caught up with Richard Arnheim - Head of the new AFS Medical Division, to find out the ins and outs of Researching this field and to understand how Richard supports Medical Researchers.

How can a data collection organisation benefit from a specialist in the Health Care field?

For the end client the most important fact is that they receive reliable data. So to ensure that the data is reliable the data collection has to be done with precision. Although this is true for all data collection it is even more critical in the area of healthcare where the samples are usually small and therefore sample error and interviewer error can have a greater impact on the data.

Therefore the idea of a specialist such as myself coming on board at AFS is to ensure that the data collection is conducted with full understanding in “healthcare terms” whether it is interacting on the sample design, questionnaire, interviewer briefing, or undertaking the debriefing of interviewers.

Additionally, I am able to offer the clients in-depth interviewing and group moderation capabilities, which AFS has not had in-house in the past.

So we are now able to offer our clients more services which should enrich the data collection process. With these additional services and increased understanding of healthcare, AFS aim to work in closer partnership with clients in order to optimize results.

It is our belief that we are one of the few data collection organizations in Australia which can now offer clients this type of knowledge base for the field administration of healthcare projects.

With your international experience in Healthcare research, what are the important and emerging areas in Healthcare Research?

Over the last 5 years there has been a large upswing in online self-completion surveys. Although there are now clients starting to cool down to this approach and are commencing to seek out other alternatives such as WATI (web assisted telephone interviewing) which is conducted by telephone but into a web based software, thereby the client is able to receive and review results in real time. Also it makes cross country consolidation of data much easier on multi-country studies. Conducting by telephone also improves compliance and participation rates of the doctors.

Like all methodologies web completion has its peculiarities which impact on its feasibility. One of the points for a small country like Australia (where the doctor population is approaching 50,000) compared to large population centres like the USA ( where there are more than 10 times the doctors) is that it is difficult to achieve a critical mass. As an example, panels in the US have over 300,000 doctors, and so it is easy to get 100 cardiologists to participate in a study (panel of around 10,000), with the typical strike rates being 2% or less this sample is relatively easy to achieve. In Australia there are about 1600 cardiologists, with a small percentage on panels, so it is almost impossible to achieve a sample of this size through e-mail mailings. As a result it becomes critical to phone recruit and than make call backs to the doctors to encourage them to participate.

It is my experience even with all this support there is a need to recruit twice as many doctors as interview completes required. This usually means that online (which was primarily indicated in consumer studies because of cost reductions and speed) has become of equal or greater cost and takes just as long as CATI (if not longer) for studies in Australia. The main advantage for online becomes that we are able to show more visual information (concepts, advertising material and get reactions to them) and the ability to consolidate data in multi-country studies.

Respondents are distinct, we know that, but I'd like to ask, what are the areas Medical professionals are most resistant to responding and are there areas they are eager to be engaged on?

Certainly when I receive a request for quote the first thing I look at is the type of health care professional to be interviewed and the screener that the client wants. I have my classification scale going from less difficult, somewhat difficult, very difficult, to almost impossible.

There are other areas which can present barriers to medical professionals, and one is suitability of the subject matter to the doctor speciality. For example, I recently conducted a study in Germany on infant formula, now the client wanted to get the opinion of gastroenterologists but the gastroenterologists refused to answer because in Germany it is very unlikely they would ever see an infant, problems related to infant feeding are taken care of by paediatricians. As a result the German doctors felt that they were not qualified to participate in the study.

OF course each project and approach has its own implications which need to be taken into account. A further example to illustrate this, if we need a doctor to recruit patients on our behalf to participate in a study, it has happened that they want to take the questionnaire before a Helsinki committee in the hospital to get approval for their patients participation. Now the important thing to remember in healthcare research, because one respondent reacts in a particular way and presents barriers, it does not mean that other doctors in a different practice will react in the same way.

Most doctors are not too favourable to surveys which check their knowledge of medicine, especially surveys to GP’s where the pharmaceutical company is trying to establish a baseline of their knowledge. I recall when ED products were first launched there was a plethora of surveys investigating what doctors are willing to ask patients, which patients they ask, if they are female doctors are they willing to confront men and so on, it was easy to hear how squeamish they were. On the same subject getting men with an ED problem along to group discussion was a bigger problem, with a decrease in sensitivities on the subject over the years it has become easier.

What are medical respondents most appreciative of when it comes to research?

There is an easy answer to that, the money, but you better make sure its sufficient otherwise that can become insulting.

However incentives are only part of the package in research physicians, because doctors are usually quite status conscience (and deservingly so) they need to be treated with respect for the position they uphold in the community. They are also very time poor and as a result require us, as the data collectors, to be willing to be flexible and interview the doctors at his most convenient time. In addition to this there is nothing worse for a doctor than an interviewer not knowing how to pronounce medical terms or drug names, it indicates to the doctor that you are not offering the respect he deserves.

Is Australia unique to the rest of the world for Medical Research? What are the implications for Researchers?

Is Australia unique, probably not, but it has its idiosyncrasies which need to be taken into account when researching and when looking at overseas results.

The PBS system has a major influence over the doctors usage of newly developed drugs, so for example you may have a DPP4 inhibitor for the treatment of diabetes which is available in Australia with strict PBS guidelines of usage, while overseas it is available without restrictions, in some countries, along with another 2 recently launched DPP4’s. So comparative results are going to be vastly different for each country given the different regulatory environments.

As previously discussed the medical universes in Australia are also smaller than many of the major markets, although this will not impact on sample size (because there is usually a minimum that needs to be achieved), it will impact on the difficulty in achieving these samples. It can also impact on the ability to achieve regional targets. Also the distances within Australia often making F-2-F overly expensive if nationally representative samples are required. As a result there is sometimes a need to make compromises on sampling which may not exist in other countries.

Who do you see a the leading Research brands in Health Care?

Over the years there have been many mergers and with each merger there is greater concentration of excellent executives within these Research houses. Irrespective of the agency whether it be TNS, GfK, IMS, Chant Link, Forethought, Millward Brown or any others, the point is that we have capabilities and the in-house knowledge to contribute to the research design and I am quite open to being used as a sounding board from the data collection point of view.

What draw you to work with the AFS Team?

I searched for a long time to find an organization which had the forward thinking attitude which I found at AFS. They are a company which appears to be thriving despite the current economic climate, while others are firing , AFS have actually gone through an expansion stage.

The company aims to become the leading data collection company in Australia , together with that we want to become a centre of excellence for healthcare related projects. Whether the target respondents be doctors, allied professionals (physiotherapists, acupuncturists, chiropractors, alternative medicine), nurses , pharmacists , veterinary surgeons (small and large animals) and patients.

I am very excited to be part of the professional team at AFS and to be part of the emerging data collection

I hear there is a Panel in the final stages of development, how do you see it?

That is correct, our intention is put together a national panel of health care professionals which will be profiled and be able to be utilized for different methodologies of research , online , CATI , F-2-F , recruitment for groups and IDI’s. The medium term objective is to have a panel of healthcare professionals with over 30,000. The healthcare professionals being recruited will include GP’s and specialists of all types, as well as, nurses, dentists, pharmacists and alternative medicine practitioners. The panel is expected to have an annual attrition of around 10% and our intention is to refresh build the panel to a greater extent.

Having our own panel will allow us to have greater efficiencies in data collection, these cost savings will than be able to be passed onto our clients, so it will become a win – win for all. Of course if you will require data collection with client supplied lists, we will be happy to accommodate that request as well. - RA

You can reach Richard at any time via:
E - Richard.Arnheim@afs-smart.com.au
P - +61 3 8789 4444
F - +61 3 8789 4400
A - 83B Hartnett Drv. Seaford 3198

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