The first part, “Set Digital Goals”, looked at the role of digital channels in achieving outcomes you can measure against your brand strategy. This second article explains how to know your digital customer so that you can engage them effectively.

Who is your digital customer?

In today’s digital era, knowing your customer means knowing how they behave online. And because digital is so measurable, it is possible to gain deep insights about customer behaviour, and to track the changes you want to make to this, in a digital setting (as long as you keep a few principles in mind – see Paul Grant’s latest article about cookies and EU law for a more in-depth discussion about tracking behaviour).

You might start by asking yourself some simple questions about the digital behaviour of stakeholders or customers who you want to engage, such as:

Why do they go online? What, for example, do they search for?

What do they share with others online? In social media, what do they talk about, what kinds of comments or opinions do they share?

Your existing investment in digital is likely to be rich in data about user journeys, search behaviour, and customer needs

You can learn the answers to these questions using various tools to carry out observational studies on digital behaviour. You can also learn from your existing digital engagement activities, and this is often the best place to start.

Your existing investment in digital is likely to be rich in data about user journeys, search behaviour, and customer needs – those needs that remain unmet as well as those that have been satisfied.

Sources of data about your digital customers

Many diverse tools and techniques may be applied to studying digital behaviour. At Creation Healthcare we broadly classify two approaches: passive listening, or observational research; and active listening, where digital users are actively engaged.

Before starting your research into customer activity, it’s a good idea to make sure you’re familiar with current industry reports on the digital environment and especially any research relating to your disease area, regions of interest, or relevant stakeholder groups.

Search behaviour analysis

A good place to start is by analysing search behaviour using tools provided by major search engines and search advertising platforms including Google. Understanding the kinds of words that are typically associated with particular themes in search will help inform your search marketing tactics; customer targeting; digital customer journeys and will also inform your further digital research.

Studying how people search on your existing digital content is also a good way to identify user needs and the language they use.

Beyond Google, advanced search keyword planning tools will provide deeper insights into customer journeys and competitor behaviour.

Social media monitoring

Passive listening techniques also include social media monitoring, where conversations, content and engagement around particular themes, topics and keywords are monitored. A range of free and commercial tools may be employed to support this research activity (for a glimpse of how much you could learn simply by using free tools, see Georgiana Murariu’s latest report, ‘Free tools you can use to study healthcare customers online’). Social media monitoring tools help by collating social media content that may be relevant to a theme, identifying trends, attitudes and related activities.

Two words of warning about social media monitoring tools: in our experience, no single social media monitoring tool will provide a comprehensive view. Typically we would use a range of tools – both commercially licensed and free to use tools – to develop a clear picture of the digital environment.

Secondly, social media monitoring tools are only tools – intelligent human analysis of the data they produce is essential. Automated ‘sentiment’ analysis reports, for example, can be misleading without some interpretation.

That said, automated listening tools are essential for processing large volumes of data to identify areas of interest for further investigation.

Analysing closed networks

While automated social media monitoring tools can provide insights into publicly-accessible parts of social media networks, blogs, and discussion forums, a wealth of additional insights exist inside closed networks that are beyond the reach of most tools.

Closed networks include some specialist social networks for healthcare professionals, as well as some patient or therapy area groups. The closed nature of these networks provides a more intimate, trusted and safe environment for dialogue to take place between like-minded people, so while the content might provide highly-targeted insights for marketing planners, the terms of the networks mean that it will simply not be possible to carry out analysis as easily as with open public networks.

Some network owners will provide access to their data to varying degrees, or will provide their own commercial analysis of conversations. In our experience at Creation Healthcare. the data that can be extracted is often limited but can provide a useful basis for further research.

Where possible, an active listening approach (see below) may provide useful further insights in some closed networks, subject to their conditions of use.

Active listening

Active listening is a term we use at Creation Healthcare to classify direct engagement of digital users, customer or stakeholders. This may take place in discussion forums, social media channels, or in closed networks; using a range of techniques including direct dialogue, comments, surveys or questionnaires.

Active listening requires a sensitive, ethical and highly controlled approach, especially in a regulated environment. In the interest of long term trust, openness about research taking place is essential, even where this limits the level of engagement that can take place. But the activity can be highly effective – qualitative, personal insights can add significant context to your digital customer insights.

Bench testing

Bench testing is where you test customer journeys and perspectives that you have identified in the research steps above. It provides a deeper understanding of your customer’s online environment, and the competitive landscape in which they engage.

Bench testing tests theories about user activity and observes the digital environment from the customer’s perspective. It asks, for example, what do customers find when they carry out the search activity you have identified? Bench testing may reveal surprising competitors, in the form of anything else that attracts the customer’s attention or engagement. Online, that could come from anywhere.

Translating data into insights

Your search analysis, passive and active listening, and bench testing activities will provide you with a wealth of data. But all your research will mean nothing unless you can apply it to understanding your customer and what this tells you about their habits and needs.

Having collected the data that exists about your customer, you will need to translate that into meaningful insights to plan your campaign, interpreting what you have discovered in the context of what you already know about your product, therapy area, and market environment.

Assuming you have started with setting digital goals (for a guide to doing this, see part 1 in this series), you should be able to identify behaviours that you can plan for. Understanding current behaviour will allow you to plan for behaviour changes, and to align these with the digital goals you have set. This is an essential step that will ultimately lead you to indicators of business outcomes.

You should also look for patterns in the data you have collected through your research. Add your existing knowledge about the environment, to put insights into context. In a Europe-wide digital behaviour study that Creation Healthcare carried out in one therapy area, for example, our research team members based in individual countries applied a local market and cultural perspective to data. This ensured that relevant channels and messages were used in a major regional campaign, with an understanding of individual market needs.

Putting it all together

By now, you will have set digital goals, and you will know your customer and their digital behaviour better. You are well equipped for the final step, selecting the right channels for your campaign. I’ll cover this next month in the third part of this series.

Meanwhile, if you would like to speak to a digital campaign planning advisor, Creation Healthcare has experts who know your market. Why not get in touch now for a confidential discussion about how Creation Healthcare could support your pharma campaign planning?

No pun intended, but ‘Target’ (a discount store chain) recently made waves in the media when it became clear that their ability to mine customer information from multiple channels had helped them to identify that a father’s daughter was pregnant before he himself knew about it.

While this instance was not necessarily about online shopping, the concept of gleaning customer relationship management data is familiar – even more so when using website technology. This may not particularly bother someone who is using Amazon to buy some books, however when it comes to health information, many people consider this to be one of the most important, personal and sensitive areas of our lives. Individuals will often choose carefully how and when they reveal detail about conditions or illnesses that they may be experiencing. The idea that a company might send an email to congratulate you on your pregnancy – even potentially before you yourself became aware of it – is either disturbing, or exciting, depending on your attitude to technology and privacy.

So with that in mind, let’s now take a closer look at ‘Cookies’ and the importance of understanding their use in relation to health information websites in Europe.

What is a ‘cookie’ and why does it matter?

I suppose a good question to start with is: Do you really know what a ‘cookie’ is and how it works?

Cookies are arguably indispensable in the operation of most modern websites. They may for instance be necessary to store personal preference information or potentially to track behavioural activity so as to build a comprehensive customer profile. From a website operation point of view, they are a fantastic solution for providing a user-friendly customer experience.

Over the past few years the variety of functions that cookies can perform has become an aspect of online data storage in general that European legislators felt needed attention, culminating in amendments to Directive 2002/58/EC. These amendments require website owners to be very clear about if and how data is being stored, even if it may be in a cookie. Here is the key extract from Article (5)3 (underline and highlight added for emphasis):

“Member States shall ensure that the use of electronic communications networks to store information or to gain access to information stored in the terminal equipment of a subscriber or user is only allowed on condition that the subscriber or user concerned is provided with clear and comprehensive information in accordance with Directive 95/46/EC, inter alia about the purposes of the processing, and is offered the right to refuse such processing by the data controller. This shall not prevent any technical storage or access for the sole purpose of carrying out or facilitating the transmission of a communication over an electronic communications network, or as strictly necessary in order to provide an information society service explicitly requested by the subscriber or user.”

Cookies and multi-channel marketing

Pharmaceutical companies are, like most digitally-enabled information providers, increasingly looking to integrate touch-points and measurement across multiple channels and campaigns. One way of achieving this is through the use of tracking cookies. It is not always an easy thing to do in practice, yet even when successful in an approach for implementation, a brand can then still face new hurdles around a person’s individual privacy preference.

Cookies in a local country implementation

As with all European Directives, member states consider the adaptation for their own legislation.

Using the United Kingdom as an example, amendments to Article (5)3 are further clarified in the Privacy and Electronic Communications (EC Directive) (Amendment) Regulations 2011. In particular, the impact for online communication is seen here:

6 (1) Subject to paragraph (4), a person shall not store or gain access to information stored, in the terminal equipment of a subscriber or user unless the requirements of paragraph (2) are met.

 (2) The requirements are that the subscriber or user of that terminal equipment—

(a) is provided with clear and comprehensive information about the purposes of the storage of, or access to, that information; and

(b) has given his or her consent.

(3) Where an electronic communications network is used by the same person to store or access information in the terminal equipment of a subscriber or user on more than one occasion, it is sufficient for the purposes of this regulation that the requirements of paragraph (2) are met in respect of the initial use.

(3A) For the purposes of paragraph (2), consent may be signified by a subscriber who amends or sets controls on the internet browser which the subscriber uses or by using another application or programme to signify consent.

(4) Paragraph (1) shall not apply to the technical storage of, or access to, information–

(a) for the sole purpose of carrying out the transmission of a communication over an electronic communications network; or

(b) where such storage or access is strictly necessary for the provision of an information society service requested by the subscriber or user.

So in this implementation of legislation, it is a requirement that no storage of information takes place without the person’s express consent – unless it is a technical transmission need, or has been specifically requested by the user. This is important; if a person requests information or a service that can only be achieved through the storing of personal information, then they have given implicit consent. Additionally, it can be argued from (3A) that if they have amended settings in their browser to accept or reject cookies, they have also given implicit consent.

That said; you will in every case want to speak with your own legal and medical colleagues to be sure that you have carefully understood the implications and definitions in respect to a particular initiative. It will largely depend on the sensitivity of the information that is being stored. The key insight is that as a Brand Manager or Project Owner it is your responsibility to ensure that the right questions are being asked of your creative agency or website developer on this matter.

The requirements and penalties of non-compliance

If we continue with the example of the United Kingdom, the officially amended legislation came into effect from the 26^th May 2011. However, businesses and organisations were given a 12 month grace period to update privacy policies and technical functionality.

It is now one year later, and from the 26^th May 2012, the UK law is in force and has penalties should a company be found in breach. The maximum penalty is £500,000 per instance – which could well be costly if the proverbial ‘house is not in order’. Now is the time, if you haven’t already, to take stock of existing and planned digital assets to ensure they remain compliant. Given the care that the pharmaceutical industry takes in developing appropriate initiatives, for the most part the so-called ‘cookie-law’ may have little impact at all!

Next steps for compliance

1. If your organisation does not already have one, commission an audit and develop a ‘living’ digital asset inventory (DAI) of all online or digital properties which have been sponsored, funded, or are managed by your company. This is the best way to keep account of what is online, whether it is compliant, and has the added benefit of enabling very quick identification of say ‘all facebook pages’ or ‘all  Twitter accounts’ should a 3^rd party technology change mean that you need to amend the functional or legal aspects of your digital assets.
2. Review all privacy policies and functional specifications together with your external agencies or internal technology experts, and of course your legal team, to ensure that you have addressed the amendments as implemented in your member state, based on how intrusive the usage is.
3. Continue to use Cookies in a thoughtful and compliant way to help integrate you visitor’s experience across multiple channels.
4. If you would like assistance in the area of implementing measurement and conversion tracking across multiple channels, talk to one of our strategic consultant team.

[Image: ©2011 BirkFoto Source: http://www.sxc.hu/photo/1358376]

More information and references:

• DIRECTIVE 2002/58/EC OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL of 12 July 2002 http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2002:201:0037:0047:EN:PDF
• The EU Cookie Law: A guide to compliance
  http://econsultancy.com/uk/reports/the-eu-cookie-law-a-guide-to-compliance
• How Target Figured Out A Teen Girl Was Pregnant Before Her Father Did http://www.forbes.com/sites/kashmirhill/2012/02/16/how-target-figured-out-a-teen-girl-was-pregnant-before-her-father-did/
• The Privacy and Electronic Communications (EC Directive) (Amendment) Regulations 2011
  http://www.legislation.gov.uk/uksi/2011/1208/contents/made

A Brief How-To Guide: Things you can try for yourself

As an example, let us look at WebMD, the well-known online resource for health and medical news, which posted its ‘Year in Health’ statistics in January 2012, revealing a high level of interest in nutrition and gastrointestinal conditions, with its most searched for term being ‘pancreatic cancer symptoms’ and its number one health story being ‘What Not To Eat’ (which also included a quiz on nutrition). It is worth mentioning that the popularity of the search term is linked to the death of Steve Jobs (Co-founder of Apple, Inc.). Other popular topics among readers included ‘diet and super foods’ and ‘weight loss’.

Whilst these topics generally reflect the website’s US-based audience, its UK counterpart reveals very similar trends: a quick search for the year’s top stories and topics uncovers stories around the 5-a-day regimen,  links between diet and bowel cancer, and, most importantly, an article that reveals that pancreatic cancer is the most fatal of all cancers within the UK, with the majority of patients being extremely dissatisfied with the health service experience they receive. Further research shows that UK survival rates for the disease lag behind US, Canada, Australia, as well as other European countries, and only 3% of patients live 5 years or more after being diagnosed. Although the article does mention the fact that Steve Jobs’ death was a significant factor in drawing attention to the condition, Google still experienced a surge in search queries on illnesses related to the gastrointestinal tract, such as pancreatitis, peptic ulcer, or Crohn’s disease. As demonstrated in the following screenshot (taken from Google Trends), the search query ‘pancreatitis’ was a very fast-rising one within the United Kingdom.

Figure 1: Search volume for 'pancreatitis' in the UK (2004-2011)

Google Trends also shows the most relevant news stories that come up when searching for the term. It is important to note that a large part of the news content that comes up is from the USA– this subject has been explored by my colleague Paul Grant in his piece about the way the Internet can affect organizational structures. Here are some prominent news stories that can be helpful in examining the kinds of messages internet users are exposed to when searching for this topic.

Figure 2: Prominent news stories on pancreatitis over the years

All this being said, by far the most interesting revelation that the Google Trends reports has produced is the fact that more searches have been carried out in Spanish than English within the UK, as shown below.

Figure 3: The number of search queries for 'pancreatitis' in Spanish is greater than that of searches carried out in English (UK)

Thus, simple keyword research such as the one shown above can be useful in highlighting areas of unmet need and raising questions such as: are there enough Spanish language support/patient communities to meet the needs of UK-based sufferers? It also provides a platform for research that can be built upon, by highlighting certain aspects of online behaviour that can then be examined more thoroughly. Furthermore, analysing the types of keywords people use can also help establish the level of regional interest in a certain area. As seen below, the term ‘peptic ulcer symptoms’ has a Search Volume Index of 86.0 in the UK, which means the number of searches for this term has increased very rapidly over time.

Figure 4: UK Search Volume Index

Of course, examining search behaviour is only the starting point of our analysis of the online landscape around digestive/gastrointestinal conditions. Patient portals also play an important role in ‘listening in’ to what people are saying about certain conditions online. On the social networking health site PatientsLikeMe, there are 258 patients with Crohn’s disease, for example.

Figure 5: Number of registered patients with Crohn's disease on PatientsLikeMe

The website also provides information on the most common treatments used by these patients, helping to complete the general picture of the online landscape surrounding the area. Other patient portals where conversations around conditions such as ulcer, pancreatitis, Crohn’s disease and IBS are taking place are DailyStrength and Inspire. The first is an online patient support group with the ability to classify patient posts about a particular disease area according to their tone and the nature of their message (some of the adjectives that have been used to describe posts are: ‘inspiring’, ‘tragic’, ‘painful’ and ‘breaking news’). These categories make it much easier to study certain aspects of the conversations that are taking place online, as opposed to sifting through numerous threads about the subject(s) in question.

As far as social media goes, BUPA’s YouTube channel is not only highly ranked by Google in generic searches on digestive/gastrointestinal conditions, but also has a selection of animations and videos with a fairly high number of views and comments. Videos from the gastrointestinal disease areas include animations on gallbladder removal surgery, and carrying out a gastroscopy. In this respect, BUPA’s videos seem to be competing with those presented by NHS Choices, which also rank fairly highly on Google when typing in the word ‘gastroscopy’. The two videos approach the subject differently, with the NHS one simulating the procedure in ‘real life’ and featuring a talking physician, whilst BUPA’s shows a colourful and detailed animation of the procedure.

On Facebook, it seems that there is a cluster of relatively small communities around diseases such as ulcer, pancreatitis, IBS, or Crohn’s disease, although they are primarily US-based. Facebook Causes, a tool that allows non-profit organisations to develop their own campaigns on the social networking site, is currently hosting a campaign called ‘Cure Crohn’s Disease’, which has attracted over 60 000 supporters so far. Several members contributed to the comments section adding their own Crohn’s-related Facebook group for viewing. The campaign is run by the Crohn’s and Colitis Foundation of America, Inc and has raised over $7000 so far.

Figure 6: 'Cure Crohn's Disease' on Facebook Causes

Lastly, another essential component of analysing the online landscape around a particular disease area is looking at physician networks and platforms aimed at this audience.  BMJ’S Doc2Doc, an international online doctor community, has an open access area that can aid in simple observational research. The forum and blog areas are quite rich in content on digestive and gastrointestinal diseases, from patient treatments to new discoveries and adverse events. Some featured articles are linked back to news tools and readers such as DocGuide, which allows healthcare professionals to stay ahead of the medical news and research as well as inviting others to contribute to the content, which consists of peer-reviewed journals, medical conference content and run-of-the-mill news stories.

Another resource aimed at physicians is Doctors.net.uk, which is not as ‘open-access’ as BMJ’s Doc2Doc, but offers the opportunity to obtain market intelligence in exchange for a fee. Other noteworthy tools include DocCheck, which offers scientific and medical information as well as a platform for colleague collaboration and information sharing.

Key Takeaways & Further Analysis  

As patients have become more internet-savvy, the online interest in conditions such as gastrointestinal and digestive disorders has increased. While some of this interest was generated by public figures suffering from such diseases as well as news stories about contaminated food, a large part of it was organic interest in topics such as pancreatitis, peptic ulcer and Crohn’s disease.   Listening in to online conversations and analysing search patterns and trends can provide useful initial insights at a high level if approached strategically, and if the right questions are asked. In order to further analyse these insights, tools such as specialist paid services offered by various social networks can be used to gain an idea of how best to engage stakeholders.   Furthermore, tools such as social media management systems can provide analysis of social media conversations. It is fair to say that a large number of companies already use some type of software suite for social media monitoring, but which social media management system provides the most ‘complete’ picture? My colleague Paul Grant, has written an article analysing a new technology that might give a better picture of meaning & causality in online conversations.

Understanding What This Means for YOUR Engagement Strategy

Naturally, none of these high-level insights are of any use if the digital research that results from them is not translated to become meaningful in the context of your own business strategy, so that they can be integrated into your healthcare campaign planning. In a recent article, Daniel Ghinn discussed the importance of setting digital goals, and how this approach can help pharmaceutical brand managers achieve outcomes they can measure.

Creation Healthcare advises pharmaceutical marketers, communicators and business leaders about improving outcomes in a rapidly changing communications environment. We work behind the scenes with pharmaceutical professionals to help them define strategies and discover insights, providing independent advice to support campaign planning. If you would like to talk with a member of our team about how we can help you to develop an effective healthcare engagement strategy, contact us now.

In this article I’ll review some lessons learned by those who are currently pioneering in this area.

Integrating online sources

According to patient recruitment company Acurian, which serves the medical research industry by recruiting suitable patients for participation in clinical trials, an increasing number of patients recruited by the company come from online sources including large health networks and social media platforms like Facebook and MySpace.

Acurian’s digital tactics include social media advertising on Facebook, and search engine marketing. The company believes that digital is currently effective for certain types of therapeutic areas – those that impact wide age ranges, rather than those that affect older adults primarily. Yet even in these areas, Acurian does not rely on digital channels alone. In a phase III trial in among patients with diabetes, for example, 46% of recruited patients were referred from digital sources, with 39% via direct mail and the remaining 15% from broadcast TV.

When comparing social media sources like Facebook with other digital marketing channels, Acurian has found that social networking sites, where users are sharing personal information, provide the most effective environment for contextual advertising based on users’ profiles. Search marketing contributes a far smaller number of patients by comparison.

Pharmaceutical companies are recruiting directly

Acurian’s experience is shared by pharmaceutical companies recruiting clinical trial patients directly using social media too. Among recent examples of pharmaceutical companies who have experimented with using social media to increase the speed of patient recruitment while lowering costs is Lilly, which has run international pilots in the areas of diabetes and head and neck cancer. The pilots made use of a range of social media channels including Facebook, Click-it-Forward, and Youtube as well as proprietary health networks, and included a thorough listening exercise to identify the most effective engagement channels. Ultimately the pilots demonstrated cost savings of over 10%, and provided insights to inform Lilly’s future social media recruitment strategies.

The most effective channels in the pilots, according to Sara James, Patient Recruitment Consultant at Lilly, were social networks – proprietary online health networks and Facebook. But as with Acurian’s experience described above, Lilly’s future patient recruitment strategy will not be exclusively digital. In future outreach programmes, says Ms James, social media tactics will be explored alongside traditional media such as print, radio and TV.

Recruiting rare disease patients

According to US hospital group Mayo Clinic, social media is especially effective at recruiting patients for its studies into rare diseases. According to Marysia Tweet, M.D, “Patients with rare diseases tend to find one another and connect because they are searching for information and support.” Mayo Clinic believes that social media and online networks could help researchers assemble large and demographically diverse patient groups more quickly and inexpensively than they can using traditional outreach methods.

PatientsLikeMe, which was established to connect together patients with rare diseases online and now has over 130,000 members covering over 1,000 conditions, has also seen the potential of its social network in supporting medical research. Its clinical trials database currently includes over 34,000 trials which may be searched by patients based on condition, gender, age and location. Last year the network established an alliance with patient recruitment company BBK to jointly offer patient recruitment and retention services to pharmaceutical companies.

Where’s this heading? The world’s first digital clinical trial

It is not only in the patient recruitment aspect of medical research that digital has potential. Last year, Pfizer launched a clinical trial programme in the US in which patient visits to a clinic were replaced by smartphone or computer interactions. The trial website provided simple information for potential trial patients to understand how they can get involved and what to expect.

Patients were invited to follow two steps to find out whether they were eligible to join the trial. The first of these was to watch a video where – presumably in an attempt to reassure patients that there were real life healthcare professionals behind the trial – the study team of healthcare professionals introduced themselves and presented their credentials before the trial process was explained in detail using a more informal, friendly animation. The second step was to answer screening questions and start the study registration process.

It’s a huge leap to attempt to replace the intimate personal engagement experience that usually takes place between a patient and their healthcare professional when a person joins a clinical trial, with a fully electronic process. The barriers that Pfizer has attempted to cross are significant.

Yet I believe in the coming years we will see the model develop, even becoming the norm. It is possible that one day in the future we will look back at this early pioneering example of digital clinical trials and consider it a little uncomfortable. But for now, I have no doubt that Pfizer’s bold and innovative move in launching the trial in this manner will prove to be a significant learning experience upon which they and others will build.

–

Daniel Ghinn is CEO at Creation Healthcare, a consultancy that partners with pharmaceutical and healthcare organizations to plan successful engagement with patients, doctors and other stakeholders. He can be reached by email at daniel.ghinn@creationhealthcare.com or on Twitter.

This article was originally written by Daniel Ghinn and published in PharmaPhorum, here.

Photo by Esthr.

We don’t know what the future holds

I’ve now been working in the area of digital and emerging channels for healthcare for over fifteen years, since I co-founded the company we now call Creation Healthcare, in the 1990′s. And one thing I’m certain of is that we cannot predict the future. We simply do not know what the future holds. Since I run a company that specialises in helping marketers to plan, coming to terms with not knowing what the future holds is important.

Let me illustrate what I mean using a mobile technology example. In the late 1990’s I was at an event organized by the Design Council in London, with various experts talking about business and technology. Tony Wilson, founder of Factory Records and the Hacienda and the man behind British band Joy Division, was there interviewing a panel of experts about design and technology. On that panel was a Director from IBM. The conversation got onto the subject of the role of mobile technology, and this particular industry expert, a director in a major technology and consulting firm, said that there’s no future in SMS texting because “it’s only used by kids”.

So we don’t know what the future holds – we don’t know what technologies will become popular or useful; or what events will take place that will shape public perception about mobile and health. But what we can do – in fact all we can do – is to start with now: what do we know so far; where do we want to get to; and what opportunities are around us that will help us to get there?

To succeed in the context of mobile in pharma, then, we need to understand how to make the most of the opportunities that mobile channels offer us today and in the future, and how to work effectively with those people who are around us, to get us where we want to be – to achieve the outcomes and results we want.

I’m sometimes asked by people in pharmaceutical companies whether I think their company should have a dedicated digital or mobile team. After years of studying this, I have come to a clear conclusion: it depends.

Just like the issue of how to put together the perfect team to make your mobile project a success – it also depends.

So let’s take a look at how you can get this right for your project, in your organization. We’ll look at what makes a good team – which roles among your colleagues will likely help you make it a success; and how to get their support; how to pre-empt any blockers, those potential barriers and instead create what we call ‘pathways’ to successful engagement.

People > technology

We have a saying at Creation Healthcare that people are greater than technology (people > technology). In other words, if the solution you’re creating is not serving a need people have, the technology is irrelevant. More importantly, it could be a waste of money and time and could lead to a negative perception within your organization of the value that new technologies can bring.

In this sense, a company like Apple is not so much a company that understands technology, it’s a company that understands people. Technology allows them to create great devices that people love to use. Technology is the enabler.

The most intimate technology channel ever?

This idea that ‘people > technology’ is more important than ever before when it comes to mobile, because mobile is a technology platform that is so personal, so intimate. It goes everywhere with us. It knows where we are. That means it’s a platform that can connect with us in context, in a highly relevant way.

In fact, we have allowed mobile technology to invade our lives like no other technology before it. Our mobile devices can wake us in the middle of the night; they can interrupt us in a meeting during the day. They’re with us everywhere.

A survey of almost 2,000 people in Britain last year revealed that around 15% of them have accidentally dropped their mobile down the toilet bowl.

Defining new social rules

Mobile devices have invaded our lives to such an extent that as societies we’ve had to define social rules about how we let our mobile devices interfere with our lives. We’re still often reminded at the start of a meeting to switch our mobiles to silent or even off. I find it fascinating to be in Tokyo and see the cultural rules around mobile phone etiquette. Japan is one of the most advanced countries in the world as far as the use of mobile devices, yet it is considered very bad manners to speak out loud on your phone in public, especially on public transport.

“Let’s build an app!”

This idea that ‘people > technology’ is an idea we would all agree with, of course. In pharma, we use technology to solve real problems that people and the business have.

Yet sometimes, perhaps because we know that channels like mobile have so much untapped potential for our industry and we don’t want to be left behind, we see situations where the technology platform seems to be the driver. “We need to do mobile”. “We need an app”. Have you ever heard that? Have you ever said it?

Be very careful not to get caught in the ‘me too’ hype trap.

Personally, I’m content with the idea that sometimes we need to push the boundary into new channels, to experiment to some extent in our regulated, controlled environment, to discover what’s out there; to explore the possibilities. If we’re up front and honest about this, then projects that are run as experiments can be just that. Measure everything; see what you learn. It helps us to plan better initiatives in the future.

So then, after we’ve experimented and learned, we can use what we’ve learned to plan great mobile tools that we are confident will meet real business needs and solve real problems for real people.

Learning from great practice in healthcare engagement

At Creation Healthcare, as part of our research into great practice in healthcare engagement, each year we run a study into the most effective initiatives that are achieving real outcomes. We call this the Healthcare Engagement Strategy Awards and we receive nominations from all around the world, and we go out and find new initiatives too. Our global team analyse and review each initiative and we develop a shortlist, interviewing the people behind the shortlisted initiatives to discover what’s really going on behind the scenes. We cover all channels but we’re currently seeing some of the most exciting innovation among new and emerging digital channels.

The winning initiatives this year, announced in February, included pharmaceutical companies, healthcare providers, public health initiatives, ranging from the USA to Asia, Europe, Africa.

One of the things we were especially interested in this year was to identify common barriers that had been overcome by these initiatives, and the ‘pathways’ that were created to overcome them. And we found that even though the initiatives were diverse, covering a wide range of social and economic environments; all sorts of channels; addressing different kinds of healthcare challenges, there was a common set of pathways we were able to identify.

We’re not going to go into the full detail of these pathways now – that’s another story – but here are the top five, in order. Here’s how the most successful pioneers among healthcare companies and organizations implement new channels:

1. Put people first
2. Demonstrate outcomes
3. Have patience
4. Get governance right
5. Invest in technology

We recently published a survey among people in the pharma industry to ask them about their experiences working in teams to deliver successful mobile initiatives. We asked them how channels like mobile have changed the way they work with their colleagues in other departments. Here are some of their comments:

“Integration with other departments is even more critical than it already was.”

“Better integration of tactics, strategy and execution.”

“Planning, communication and workflow are incredibly important.”

There was a clear sense that better collaboration is necessary, and is taking place, in order to implement new channels effectively. Is this your experience too? Do you find that you have to collaborate more effectively with colleagues from other departments to make things work?

To make this work well, you need to plan to collaborate deliberately. The first step is to recognise that if we’re going to get on those five pathways described above by the most effective pioneers of healthcare engagement, we’ll need to include people from different teams around our organization – and maybe outside of it too – in our plan.

Looking again at those pathways -  People. Outcomes. Patience. Governance. Technology – straight away you can probably identify departments who have an interest in some of these. Medical, Regulatory Affairs, and Legal, might be especially interested in Governance; Communications might be too. IT and Digital might have a special interest in Technology. Marketing might be thinking about Outcomes.

Ultimately, it all comes down to planning. Get the planning right and you’ll know whose buy-in you need to make your initiative a success. You must make the case for why this initiative is happening, so that the colleagues who will either create a pathway or a barrier understand the plan and are envisioned by it.

I recently wrote a series about how to do campaign planning in a digital world, and this applies to mobile too. I outlined three things you need to do in planning digital or mobile initiatives:

1. Set goals

What do you want people to do, that you can align with the achievement of business objectives? How will this look in terms of mobile engagement?

Be aware that you won’t necessarily have the same vision of success as your colleagues. So you first need to know what outcomes from your mobile initiative will align with business objectives, and how you will measure these, and then you also need to know what goals your colleagues in other departments have – what does success look like for them? Do you have colleagues, for example, for whom success is defined simply by the fact that nobody gets sued? I’m being ironic of course, but it is important to identify goals from different perspectives.

2. Know your customer

What channels are your customers using, and how? How will the initiative you’re planning fit into their world? How will it make their life better? What is missing from their life that your mobile initiative will deliver? Again we’re talking here about putting people first.

Now a quick word about developing insights. There’s a lot of data out there. You can measure everything – and there’s a lot that you should measure. There’s a real potential for information overload, if you’re not sure what’s useful, what you can learn from what’s useful, and how you can use that to develop a great plan or campaign. If you feel like that, ask somebody who’s independent to help you make sense of it [as an aside, Creation Healthcare can play a very useful role as an independent advisor in translating data into meaningful insights to help you plan - contact my colleague Robert Hanvik if you'd like to know more about this service].

3. Select the right channels

Even if you’ve decided on mobile, what kinds of devices will you include; how will the initiative be deployed; what platforms; will you be looking to integrate social engagement? How will the channels you deploy work together to build a cohesive experience?

You need to be clear on what the possibilities are and to understand the potential merits and risks associated with each option.

You also need to know – and here we connect back with the goals you set – what actions do you want people to take using these channels? What do we want them to learn? What does conversion look like? Fancy metrics mean nothing if you haven’t created something that results in action or change.

A tool for colleague collaboration

So you have a great plan. You know what success looks like. You know which channels and platforms you want to use and how you’ll measure success.

By now you’ll hopefully have engaged at least some of your colleagues from other departments. The key is to be proactive about this part.

The specific colleagues you need to connect with will depend on your organization structure, the way roles and responsibilities are distributed, and of course on where you fit within these roles. So you need to look around you and make sure you know who to get involved. Go wide, proactively, rather than missing out somebody who could put up a barrier later on.

Draw up a list. Let’s say for example, medical / regulatory affairs; legal; IT; Digital; Marketing; Communications.

A quick word about ‘digital’ roles: while we have seen many new roles emerging in pharma teams that are dedicated to digital or ‘e’, it is also interesting to note that these roles are not all implemented in the same way. So we see digital roles ranging from ‘Digital Communications’ to ‘eMarketing’ to other ‘New Technologies’ roles; and we also see roles like ‘MultiChannel Marketing’ which has more of an emphasis on the integration of channels.

We see these roles as roles for this current season – as businesses learn about the role of digital throughout their organization, there may be less need for subject matter experts to operate in this way.

Firstly, make sure that everybody understands the plan and that they have a vision of success for the initiative. Make sure you know what their vision of success is.

For each of these, what is their role in the success of the initiative? Make sure that both you and they have a clear picture of their role.

Now, what are their fears or concerns? Why might this initiative be something they’re not as enthusiastic as you about? There may be plenty of legitimate reasons.

Some of the typical fears we come across include: Capacity – can we handle this? Will it create more work for me? What if it’s a waste of money? I don’t understand it. What about adverse events? Fears about engaging consumers. What if we get reported for breaching the code of practice, and I’m the one who gave it the green light?

The key is this: it’s much easier to identify and address fears early on, when you have space to adapt and when your colleagues don’t feel they’re in a corner.

We’re all learning with every new idea or initiative, so give your colleagues a chance to learn too.

And finally remember, if nothing else, keep just one thing in mind: people > technology.

Get started now

This article is from a talk I have just given at Mobile Pharma World Europe 2012. If any of the issues I have raised have encouraged you to think about how you plan digital or mobile marketing initiatives, I would be very pleased to help you put these principles into practice in your own role.

Get in touch now if you would like a confidential conversation about digital or mobile planning or if you would like me to send you some additional resources to support you.

I’d love to hear your views on this. Would you take just 3 minutes to share your experience?

Your response will remain anonymous unless you choose otherwise.

Please take the brief survey here

Thank you,
Daniel Ghinn
CEO, Creation Healthcare

The new set of regulations came into effect on the 1^st of April 2012, which is also the starting date of the phase two of healthcare system reform. Newly issued laws include the Health Services Act, the Specialty and Emergency Services Act, and an amendment to the Public Health Insurance Act. These regulations will respond to an increasing requirement for more patient rights, as well as allowing them to play the role of partner to physicians and healthcare providers, rather than simply being passive consumers of healthcare services.

The healthcare system reform aims to …empower patients and enable them to make choices regarding their treatment

Reform laws are based on the concept of empowering patients, which also means enabling them to take greater responsibility regarding medical treatment. Due to concerns regarding patient adherence, many doctors have refused treatment to those who were not following treatment instructions. New regulation will ensure that patients are well looked after, even if for whatever reason, they have not followed the prescribed treatment as directed by the consultant.

The average household spend on health is also expected to increase, gradually reaching the level of financial participation seen in Western Europe, although it is crucial that the impact of this on all population groups be considered. There will, of course, always be an alternative to paid healthcare services, i.e. services fully covered by a healthcare provider with zero patient financial participation. Since 2012, people can pay extra for more costly treatments such as contact lenses, limb fractures and certain vaccines. However, the new system of payment will see money go directly to hospitals for patients, which is expected to improve the overall quality of service in healthcare facilities, as they will be more motivated to pursue customer satisfaction.

The amendment to the Public Health Insurance Act has also introduced changes in terms of drug reimbursement policy. According to this amendment, drugs are automatically excluded from the reimbursement system if it is not imperative that they be prescribed (despite being available as an option). The reimbursement system will only cover these medicines if all the major healthcare providers demand it.

The population of the Czech Republic has seen an increase in life expectancy over the last few years, especially amongst its male population, whose life expectancy has risen to 74 years from 67. Women can now expect to live to 80, compared to a life expectancy of 75 a few years ago. Senior citizens (over 60) now make up 22% of the population, and by 2030, this number is expected to increase to one third of the total population of the country.

As the number of people who contribute to the health insurance system decreases, the number of those who demand those services is on the rise, which is an issue that has to be taken into account early to prevent crises and shortages.

Savings in the healthcare system will be made by holding an eAuction to gain the lowest reimbursement of the medicine. The State Institute for Drug Control has already launched the system in 2011. The eAuction will only be open when the insurance companies demand it and with the approval of the Ministry of Health. Doctors, on the basis of these auctions, will then be required to prescribe the lowest priced medicines. The State Institute for Drug Control is currently compiling a list of drugs that will not be covered by health insurance at all from July 2012.

The next amendment to the Health Insurance Act is expected to come into effect at the beginning of 2014, bringing tougher competition and greater accountability to the health insurance market. At the moment, waiting times for procedures such as operations are not regulated, creating a situation where patients often have to wait too long for treatment. The new set of laws will insure that patients have the right to start their treatment within a certain amount of time from referral, setting maximum waiting times. Another significant aspect to the amendment is the ability to develop commercial health insurance. There will be pressure on health insurance companies to establish commercial health insurance subsidiaries.

Financial participation in healthcare is not a fundamental item for the vast majority of Czech households. It represents on average less than 3% of household expenditure, ironically slightly less than average household spend on alcohol and/or tobacco. Less than half of households’ spend on health is for treatment that is considered ‘necessary’ such as dentist treatments or drugs. Approximately 53% of the average household spend on healthcare covers various vitamins, nutrition supplements, and homeopathic drugs. The annual amount of money patients pay is over 7 billion CZK for prescription drugs, and over 8 billion CZK for OTC/non—prescription drugs.

Pharmaceutical companies that sell prescription drugs will be banned from visiting doctors’ offices directly.

As prices continue to fall, some medicines are becoming increasingly attractive for export. It is important to mention that parallel export is not illegal. Preventing the parallel export of drugs abroad and preserving their availability for Czech patients have both been taken into account and are included in the Ministry of Health Act on Pharmaceuticals, which comes into effect this August. According to the State Institute for Drug Control, the amount of drugs that end up abroad every year amounts to approximately one fifth of the total Czech drug market. For example, in 2010, the total value of medicines that ended up in other countries, making them unavailable for Czech patients, was 16 billion CZK.

Anti-corruption measures are an integral part of the healthcare reform, and as such, the financial flow from pharmaceutical companies to physicians/healthcare facilities will become more heavily regulated. Pharmaceutical companies that sell prescription drugs will be banned from visiting doctors’ offices directly. These new regulations, which will most likely come into effect starting January 2013, will consider practices such as market research and post-marketing studies (which were previously carried out in exchange for a fee) as promotional practices, which will lead to them being banned. The amendment also clarifies and significantly limits the sponsoring of congress tourism. The amendment will prohibit contests, raffles and games that affect drug sales in any way.

Medical tools that make use of emerging channels have been in use for many years now, but 2012 is the year we have started to hear more about physicians’ use of them in the Czech Republic. In general, it is fair to say that healthcare professionals in the Czech are open to incorporating digital technology into their professional resource mix, and have realised that emerging channels have ‘changed the game’, although enrolling into most eHealth initiatives remains optional.

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Creation Healthcare’s growing presence in Eastern Europe now includes the Czech Republic. To find out how we can help you plan your healthcare engagement in the region, contact us.

Photo by: 401k

This first part, “Set Digital Goals”, looks at the role of digital channels in achieving outcomes you can measure against your brand strategy.

Digital goals

Somebody once said, “if you don’t know where you’re going, any road will get you there”. Sadly, this is an approach I sometimes encounter to pharmaceutical digital campaigns. The digital medium seems so experimental that it is not uncommon to discover campaigns launched with no clear vision of outcomes.

The unfortunate result of such poor planning can be a long-term resistance to digital channels by the business, since no results can be accredited to the role of digital. The fact that no goals had been set or measured is an indication that the digital campaign was destined to fail from the start. In some cases, however, the experimentation is deliberate, with the objective to learn through customer engagement. If this is stated as a goal from the start then even this learning can be measured as an outcome.

Influence on behaviour

So what kinds of goals might you set for a digital campaign? In its early years, digital became notorious for arguably meaningless indicators such as ‘page views’, ‘open rates’, and even ‘website hits’. All of these mean nothing unless they tell you the impact on your customer’s behaviour or your business goals.

Look for activity you can measure digitally that provides an indicator of behaviour. If for example you provide a digital resource to help a healthcare professional discover the benefits of a particular drug, you might measure the level of engagement by tracking which specific content was read and to understand the professional’s ‘journey’ through your digital content.

Meanwhile, if your campaign is designed to influence the behaviour of patients, you might measure what digital actions they have taken. Give them calls to action you can measure, like printing an information guide, taking a survey, or committing to speak with their healthcare professional.

Alignment with business goals

Now, you still need to know what the impact has been on your business goals. If your behaviour changing outcomes from digital engagement have been aligned with your brand strategy, then you should expect to see the results in terms of tangible business outcomes, not just digital actions.

It’s not always easy to make the connection between digital engagement and the outcomes you see, but it is not impossible and it is facilitated by good planning. Build measures into your digital channels that are aligned with your measurement of business goals.

Integrating channels

When planning digital goals, remember that the whole engagement journey is likely to include both digital and traditional channels, since your customer or stakeholder does not operate in a purely digital environment. A consumer might be influenced by Facebook, television, and a poster campaign; a healthcare professional might be influenced by their email, doctors’ social network, medical education and a conference. Each of these channels is likely to have an impact upon the way that the customer interacts with other channels; and several channels may affect the customer simultaneously.

Getting started

Knowing what to expect when you integrate digital channels into your marketing campaign will help you to plan effectively. If this post has made you think again about digital, or you would like to consider the role of digital in your next campaign, Creation Healthcare can help you put into practice the keys outlined here. Why not talk with us?

The next part in this series will look at understanding your customer’s online behaviour.

What’s it used for?

In Johnson & Johnson’s own words, the blog claims to be “…about Johnson & Johnson — what we’re doing, how we’re doing it and why. There will be comments on the news about our company and the industry — occasionally correcting any mistakes (not that that ever happens!) or simply providing more context.  You’ll also find stories from our employees around the world, posts about programs we’re proud of, and information about some of the challenges we face.”

A simple analysis of content posted on the blog throughout last year reveals a diverse range of topics, illustrated in the ‘word cloud’ above – a summary of the most common words found on the blog, with the most frequently used words displayed at a larger size. Stakeholder groups are mentioned – we see the words ‘employees’, ‘patients’, and ‘media’ in large text, reflecting frequent use; we also see doctors (the word ‘Dr’), women, children, family, nurses, partners, and bloggers included. Health and disease topics are covered – the word ‘health’ is the most frequently used word; while other major topics include HIV, blood, medicines, treatment and wellness. And we also get a sense of some other topics that are important to Johnson & Johnson’s corporate brand: citizenship; support; sustainability; future; community; education, development, commitment, and hope.

Content on the blog reflects three main functions as I see it:

To make announcements: The blog provides a direct channel for Johnson & Johnson to make announcements to stakeholders, without being edited by journalists. In particular, these announcements support press releases – the company has not abandoned well-established channels still used by the traditional media. So while traditional press releases continue to provide a platform for connecting with the papers, Johnson & Johnson can be first to engage digital stakeholders directly via their blog.

To comment on announcements from Johnson & Johnson and outside: The blog not only provides a channel for hosting and encouraging engagement around Johnson & Johnson’s own announcements, but also a platform from which the company is able to have its voice heard in response to what others are saying. This function of successful corporate blogs – the ability to take editorial control over what is published in your response to media coverage – is something that was impossible before the days of social media.

To apologise when things go wrong: In today’s social digital environment, ignoring negative public opinion online has led some pharmaceutical companies into serious crises. JNJBTW provides an environment where Johnson & Johnson can engage, respond and if necessary apologise in public. After the arguably infamous ‘Motrin Moms’ case where outraged mothers responded online to their offence at Johnson & Johnson’s advertising, the company’s blog provided a platform for a timely response. Interestingly though, JNJBTW has not been the platform of choice for more recent apologies by the company – last December’s witty personalised apology to customers of OB Tampons after the product was discontinued is not mentioned on the blog. Perhaps this reflects the wider range of channels that the company is now comfortable using for digital engagement.

Effective corporate blogging the JNJTBW way

As a model of corporate blogging, I see five keys that make JNJBTW effective. Are these at work in your own corporate blogging strategy too?

1. Commit to creating compelling content: Social media and online credibility are not things that can simply be switched on overnight – it is earned over months and years of engagement. JNJBTW has plenty of relevant content, with almost 90 posts and 40,000 words published during 2011 and much more over the preceding years. This reflects Johnson & Johnson’s longstanding commitment to the blog and gives credibility to the platform.
2. Allow dialogue in a controlled corporate platform: Put simply, being open to comments from readers of the blog is what enables JNJBTW to perform as an engagement platform rather than a static corporate broadcast channel.
3. Make it personal: Unlike many corporate communications announcements which can seem almost clinical in their impersonal presentation of facts and opinions, with posts on JNJBTW we know who’s talking. This means that while the message is corporate and professional, readers experience something of the personality of people in Johnson & Johnson’s communications team – a factor that invites personal engagement and makes good use of a more relational style typically associated with social media.
4. Integrate with other digital and established channels: The blog is integrated with Johnson & Johnson’s other digital platforms, featuring embedded video content from the company’s Youtube channel on its home page, along with links to other social media platforms and tools to stay connected. For readers who subscribe, email alerts inform them of new content as it is published.
5. Align with commercial objectives: Although the blog is not overtly a marketing tool, it does play a role in Corporate Communications’ support for products. When the FDA approved Xarelto in the United States for the reduction of stroke risk amongst atrial fibrillation patients, a formal press release published by Janssen, a subsidiary of Johnson & Johnson, was backed up with a post on JNJBTW three days later from Johnson & Johnson’s Global Therapeutic Area Head for Cardiovascular. The blog post provided a more informal, personal message about atrial fibrillation and stroke risk and a link to the press release.

Where next?

Integrated, on-brand and engaging, JNJBTW sets a standard for corporate blogging amongst healthcare and pharmaceutical companies. In today’s environment, Johnson & Johnson will not be able to ‘rest on its laurels’ but with its proven record of finding relevant ways of connecting with changing social and digital stakeholders, I look forward to seeing how this platform continues to develop.

What difference could an effective corporate blog make to you? If Johnson & Johnson’s example has inspired you to think again about the role of blogging in your company, I encourage you to look again at the five keys above. Start by identifying the kinds of principles that should guide your blog. And remember that successful engagement might not happen overnight, but each step you take will be an opportunity to learn and demonstrate what works for your own organization.

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This article is adapted from a piece written by Daniel Ghinn for PharmaPhorum. Read the original article here.