With this post we would like to start our first interview series on H2ONLINEHU. Our aim is to discuss the idea behind pharmaceutical online communication and the recent trends of the field with experienced professionals and influential experts. And what better way to start, than to talk about the importance of social conversations in pharma with one of the founders of #hcsmeu, healthcare social media Europe, Andrew Spong.

Anyone that is involved in the field of health and social media knows you mainly from your key role in healthcare social media Europe. Could you talk about the idea behind building this particular community and having the weekly Twitter chats?

I think the story behind healthcare social media is quite well-known now, so I will just re-cap it really briefly. I was looking in the Summer of 2009 for health conversations on the social web, and I didn’t find that many at that time. What I did find however was a lady, called Silja Chouquet (@whydotpharma). We found that we were using the same key words, searching for the same sort of health-related things and, as a consequence we found each other. However, what we didn’t find at the time (although the case is very much altered now) were the sort of regular conversations about social health that we were looking for. Or rather, we didn’t find any systematically organized or regularly held contexts for those conversations to take place on the social web in Europe.

We therefore decided to launch a tweetchat. We thought we’d call it Healthcare Social Media Europe, and use the hashtag #hcsmeu following the example of #hcsm, the healthcare social media conversations started by Dana Lewis (@danamlewis) in the US. Within 10 days of our initial conversation we had the first #hcsmeu chat. We promoted it quite widely through our own networks, and were delighted when a dozen or so people turned up at 1pm CET on Friday 7^th August 2009 on the #hcsmeu hashtag. And that was in August 2009, and now of course we’ve had two real-life hcsmeu conferences, we’ve had a healthcare social media global conference, and nearly 120 weekly events now which take place every Friday as you know at 12:00 UK time, 1 o’clock European time.

To an outsider, how would you describe health conversations on the social web? Why social media, what are the advantages of this platform compared to other channels for health-related conversations?

The advantages of social media in connecting people are numerous really, but let’s just focus on a few of them. First is the instantaneous nature of the connection. To find and identify people – assuming that their bios are properly formed and feature the relevant keywords – and immediately connect with people across the world, but also with people in our own geographies around Europe who share our interest in the health conversation on the social web. So in terms of building community, social media has been I think crucial for all the healthcare stakeholder groups. What has been also very interesting is the way that social media has enabled those different stakeholder groups (patients, healthcare professionals, the industry, public health providers and so on) to find new ways to interact and new spaces to interact in, to share and to address some of the issues which we consider when we ask „What does improving the quality of care look like?”. Immediacy, speed and also availability of one-to-one connections is something new and something that social media fosters very effectively, I think.

You mentioned a couple of key words that stood out to me: interact, share, address issues. Why are these crucial? Why is it important for pharma companies especially to be involved in social media when it comes to health conversations?

While there are similarities across the different stakeholder groups, there are clearly differences as well. From pharma’s perspective, for example, the opportunities that social media offers include the rebuilding of its reputation, the building of a level of trust in its activities, and to credential itself in such a way as to offer tangible evidence of its commitments to patients and providers rather than some of the more abstracted and esoteric claims that pharma companies are prone to make on their websites along the lines of ‘wanting to make the world a healthier place’. That’s great, but really: who doesn’t want that? In short, you are far more likely to be convinced by a company’s claim to want to do that if they can actually demonstrate to you that they are doing it rather than just telling you that they’re doing it.

Thus perhaps the biggest opportunity possibly for the industry is to reach out, to credential itself, to build trust, and build credibility. However, that is also its biggest challenge, because when levels of trust in the pharmaceutical industry are as low as they currently are from an observer’s perspective, it is always going to be difficult for any given company to make that first step. It can be problematic for companies to find the most appropriate context within which they can begin to build all those adjacent benefits that we just identified. Being a heavily regulated industry as it is, pharma has not always found an easy route into this conversation. It is noteworthy that the companies that have succeeded such as Roche, Pfizer, and Boehringer have been those that have been most willing to put themselves out there. Not in an irresponsible way, but clearly, these companies understand that this is an experimental environment, and that unexpected things can and will happen. Let’s not forget that the conversation on the social web that Twitter drives has only been happening for five years. Twitter as a platform is only five years old, and whilst it is only the first generation of real-time information networks, what’s qualitatively different about the interactions that it creates and about what the industry is consequently having to learn to do in order to participate effectively is to get involved in a dialogue rather than merely making pronouncements, although at this time there is still far too much push messaging taking place.

Within European online health communication how do you see the position of pharma companies and agencies located in Eastern-Europe? Based on your past experiences what kind of advice would you give them?

I think from a Western European perspective we’ve seen evidence of interest arising across stakeholder groups including pharma, but on an individual level it hasn’t been a great deal of evidence, at least among English-speaking circles – obviously language is an issue – of affiliates within Eastern Europe coming online in a systematic way at a corporate level. So whilst individuals are beginning to mobilize, there hasn’t been a great deal of evidence of wider initiatives. Coming back to language issues, it is note-worthy that those conversations are conducted in English. However, I think that encouragement should be taken from the fact that companies like Pfizer, Boehringer and Roche are beginning to attempt to support their affiliates by supporting the bringing together and launching of local-language social media presences. And I think Pfizer is probably the leading example of this at the moment. They developed best practices from the head office in the US which have been expertly filtered out to European affiliates and they have been really supporting local colleagues in their desire to connect with the customers that matter to them in their geographies.

We know that the internet has no boundaries, so effectively everything they publish could be theoretically read by everybody. If they take it upon themselves to identify a need within their own territories, within their own geographies, in their own language then the more progressive companies are seeing that they have a responsibility to support those affiliates and help them grow those presences themselves. So, there’s not a massive amount of evidence thus far, but you get a sense that the conditions of possibility are being created to support the development, the emergence, and the blossoming of pharma social media in Eastern Europe.

And finally, how would you evaluate 2011 in terms of health conversations on the social web? What do you foresee for 2012?

I wrote a blog post about this subject recently. I believe that we are in this three-stage process of identifying trends that are slipping away, trends that are dominating, and trends that are emerging so it is interesting to watch this organic process take place. I’ve only been paying close attention to and participating in the social web since 2008, it was my third Twitter birthday in November. So I’ve personally been on Twitter for 3 of 5 years of its life, and do not possess a complete contextual framework from which I may speak to this question with any more authority than anyone else who has been using the platform. However, it is my observation in the three years that we have seen what were considered fundamental issues for the industry, when it was more focused on trying to orient itself rather than participating, we have seen these issues like listening and engagement becoming less important. That’s not to say that you don’t need to listen and you don’t need to engage, but it’s a prerequisite of maintaining an effective presence on the social web: that one listens, and listens well and continually refines one’s listening strategy. So it’s pointless to talk about that, you have to be doing that anyway. And similarly if you’re not engaging on the social web than what are you doing? So these are trends that I think are disappearing.

I’m hoping that we will talk rather less about mobile next year because it is beginning to seem  superfluous. Almost everything is mobile now and therefore to have a mobile strategy is a redundancy. You should be taking Google’s lead by looking to serve the interests of the mobile user first and allow everything else to follow on behind this. So we need to focus on mobile, but we don’t need to separate it from everything else that we do on the basis that is becoming the core focus of the consumption and therefore (ideally) the publication of content. Hopefully we’ll just take it for granted that mobile is integrated and incorporated in everything that we do.

I’m also hoping gamification and anything game-related will prove to be rather less fascinating for us next year. There was a fantastic paper by Chia Hwu (@chiah) who delivered a paper entitled ‘Three Major Trends in Healthcare: Social, Mobile and Games‘ at an Ideagoras conference recently. She made some great points about games – gamification doesn’t work, games do work, she was saying. You don’t want to be taking game elements and trying to integrate them into a user experience or user interface but if you can find a way of conveying a message through a game that’s appealing then maybe you’re on to something.

Search remains important as the way that we are searching and what we are searching for and the environments within which we are searching for the information is changing constantly. We all saw that statistic last year about effectively Facebook being the world’s biggest search engine because more searches are entered to Facebook than to Google because Facebook, although it does link out into Google it links to its own content first. People are looking for health information for example within Facebook. And the quality of information that they’re going to find more often than not at this point of time is very poor. So if we believe that the whole purpose of healthcare is to improve patient outcomes, then there are issues there regarding search. So search is critical, the question of where patients, healthcare professionals are looking, the environment in which they are searching for information, to inform their practice and to inform their shared decision-making and the co-creation of their healthcare.

The things that I think are important in 2012 are two-fold. I’m really interested in influence. By which I mean I’m not interested in whether Klout is better than PeerIndex or Kred, and that shouldn’t matter to any of us. Rather, what is important is the fact that secondary services are appearing now which are harvesting and processing social metadata, ‘Big Data’ analyses of the totality of our activity across the social web and they’re doing something with it. Now in the case of Klout they are just putting a big number on it, but if Klout for example becomes a trusted measure of influence – it has done a great job making itself untrustworthy recently – but let’s just say they managed to have done that, then it becomes an issue for the industry. People’s opinions of brands and companies will increasingly be informed in part by the way that the platforms harvesting, analyzing and discussing their social metadata present them.

The industry therefore will need to be growing importance of presenting itself consistently through the content that it publishes all across the web. This is not going to be easily achieved, but it needs to be something which senior employees or those with a global perspective begin to look upon as a pressing issue: to make sure that data and messages are consistent. A great start from the point of view of your readership and your geography is just to make sure that everything that they do within their own geographies is consistent. So they don’t have many different people tweeting things from different accounts. It’s not a complex matter, but there has to be a plan that everyone is aware of, takes ownership of, and that is coherent. Big Data is another emerging trend. Patient communities are – like CureTogether, like PatientsLikeMe – beginning to have access to relatively significant numbers of pieces of patient reported information which allow us to say interesting things about symptoms and treatment options for patients.

Finally, the industry has to be absolutely transparent about the reason why it is using social media. If it’s trying to represent itself in such a way as to simply redefine how it believes it may be able to control messages – which it cannot – then it will be found out and made to look foolish. Pharma needs to take a new approach to the way in which it represents itself within social web environments. Credibility is another trending issue in 2012. Direct messages are the last thing patients want to see. The social web is not for pushing messages, and it’s also not for selling. I’m hoping 2012 is going to be the year within which some of my fundamental questions – which underpin the financial planning and the growth of companies – around marketing are interrogated because to me it seems that an expectation endures that ideas forged in the offline world of the last century can simply by transposed onto the social web as if they had some sort of universal value, significance and bearing upon the fundamentally different dynamics of the social web. It is my opinion that they do not, and that they do not belong there, and that is why I advocate discussion about the subject via the #postmarketing hashtag. I think we are in a post-marketing era – people don’t want to be sold at on the social web, neither do they want to be tricked, or cajoled or persuaded. They want to converse, to be informed and they want to be heard. But they do not, for sure, want to be sold at. The transition from monologue to dialogue and all the expectations that inhere within it from the perspective of the way that businesses need to present themselves and think about their customers’ perceptions of their activities are key characteristics of the social turn in communication.

(Connect with Andrew Spong on Twitter or on STweM.com)