Consumer use of social media in healthcare

Social media is becoming a bigger part of the collection of health information, but it varies by health condition and treatment options how patients use social channels during their online search. The more serious the condition, the more time patients spend online researching with social media tools as part of the equation.

This is one of the findings of a recent qualitative research project designed and carried out by Rich Meyer, an experienced DTC marketer working in the pharma industry for over 10 years now. The study showed other interesting trends about how consumers are using social media for seeking healthcare information and how it influences their decisions as well.

Here are the key findings of the research:

  • Seeking health information online is often triggered by health concerns of a patient or family member. People usually do not search for health-related information proactively. The search is initiated after experiencing the symptoms.
  • There is not one online source that is the most popular when it comes to searching for health info. There is no ultimate source. People in older age groups usually start with search engines, and often mention being overwhelmed by the sheer volume of health-related information online. One of the main problems for internet users is complexity, the often feel frustrated when not finding answers to more simple questions.
  • While some people use social media sites during their search, they rarely trust the accuracy of posts. The main reason to go to social media sources is to read about others’ experiences with the same health concerns. This is trend is more dominant with more serious conditions.
  • People are concerned about personal and data privacy, so they are usually not comfortable posting their medical information on social media sites. This was even a bigger of a concern for older demographics.
  • Before making a healthcare-related decision, women usually do more research online and go to a lot more websites than men.
  • While physicians are still a very important source of medical information, the need for a more cooperative approach to healthcare is obvious. Participants stated that they would like to discuss different options with their doctors.
  • Another interesting and possibly worrying aspect of the study is that during focus groups participants didn’t mention pharma company websites as a health-related online source at all. This might be due to the fact that they questioned the trustworthiness of pharma companies all together.

(Source: Pharmaphorum.com)

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How Do We Spend Our Time Online?

A recent infographic from Go-Gulf presented striking numbers about just how much time people spend online. Social networking is the most popular activity by internet users while Google has the highest number of unique visitors monthly, followed close by Facebook. With 30 percent of the world’s population online the average time spent globally on the internet in one month only adds up to a mind-blowing 3,955,444 years.

According to the infographic below looking for health-related information online is the third most common activity among internet users. Only emailing and using search engines top its popularity. But looking for and finding valuable information can be two very different things. So do we trust online health info? Based on a new survey carried out by Wolters Kluwer Health people do trust the medical content they find on the internet. And this means a huge responsibility for every online publisher who create and distribute health-related information on the web. According the the survey:

65 percent of those seeking medical information online say they trust the information they find and 63 percent say they’ve never misdiagnosed themselves based on something they read online.

A recent post on KevinMD.com points out that Twitter can be a valuable medical resource for patients and their relatives as well. With many doctors, patient groups and health services providing help and information on the micro-blogging site, there is a pool of knowledge that could be tapped into after getting used to the idea of sharing and co-creating a knowledge base with only 140 characters at a time.

To think that only a decade ago we didn’t even have the term social networking, using Facebook, Twitter and other social media sites didn’t play any part in our everyday life. It’s safe to say that these fast paced changes in technology remodeled the way we look at medical information and diagnosing conditions entirely.

 

(Source: Mindjumpers.com, FierceHealthIT, KevinMD.com)

 

Advertising On Health Websites

Mayo Clinic’s recent decision to include paid advertisements on its website stirred up a heated debate. As the face of healthcare social media and effective patient education for a long time Mayo Clinic received a lot of criticism for its bold move to venture into the field of featuring ads next to important health-related issues.

I personally think in an economic climate like today’s no one can really argue with a financially smart decision if it is rightly done. Which means that in my opinion paid advertisements can have a place next to health information without taking away credibility and reliability. Unless they are placed poorly. And that is where Mayo Clinic made a mistake. Mark Schaefer, marketing consultant and author took to his blog to express his disbelief and disappointment about ads trying to sell children’s clothes next to an article about a condition during pregnancy that in most cases results in the death of the unborn child.

Here is a word I rarely use on my my blog: Stupid.  But I think it is an unavoidable description when an organization sells the soul of their brand for a few advertising dollars with a mindless strategy of advertising children’s clothes to women who have just lost their child.

I think the question is: was the placement of the ad intentional? I hardly think so. This is an organization that is involved in treating patients, conducting research, launching healthcare start-apps, using social media for better patient education and communication and operating a major platform for publishing reliable health-related content. I think by now they are aware of the sensitive nature of the different topics they are discussing.

I also think it is a case of not paying attention to detail and not making sure the content and the ads on the site are in sync. Placing ads can mean major funds for a website. Misplaced ads can mean angry and disappointed readers that have all the right to feel that way. And while a lot of times advertising agreements are a little loose when it comes to the content of the ads, a website specializing in healthcare content has to make sure to monitor and influence the ads appearing on the portal.

(Source: Businessgrow.com, Medcitynews.com)

The End Of Janssen’s Psoriasis 360 Facebook Page

Janssen has announced the closing of its Facebook page, called Psoriasis 360. The social campaign was known in the pharma sector as the go-to best practice example for successful and creative social media use. What the audience – and the rest of the industry for that matter – didn’t see tho, was the enormous amount of work that goes into moderating posts and comments on a platform like a Facebook page.

Janssen was the first to use “post-moderated comments”, meaning that these comments were only checked – and pulled if necessary – after they were posted. This was definitely a progressive way of handling comments on Facebook, something that became mandatory after new Facebook policies were introduced in August last year.

So does this mean that pharmaceutical companies don’t have a place on Facebook? Does this mean that monitoring is a daunting task that cannot be completed? I’m sure a lot of people in the pharma industry would say so and use the closing of Psoriasis 360 as a proof to their case. But is it fair to point fingers and use a previous best practice as a bad example, or even as an excuse to stay away from social media? Can an award-winning campaign become a “failure” overnight? I surely hope the answer is no. If anything people responsible for the campaign should be praised for not letting the situation get out of hand and for addressing difficulties on time.

The end of Psoriasis 360 should not serve as a bad example, but as a great one for the proper way to handle social media risks and still keeping the main goals of social engagement and patient education in the limelight. Janssen made its announcement available on the landing page of Psoriasis 360 where they inform their fans about the reasons behind their decision. But they go a little further too, they point the patients in the right direction to get information by mentioning the websites and Twitter accounts of the Psoriasis Association, the Psoriasis Scotland Arthritis Link Volunteers and the University of Manchester Skin Research as accurate and useful resources. The company also decided to take a little time before closing down the page entirely to make sure its message gets through to patients. If anything, this process should be a best practice example of how and when to end a social media campaign.

And before anyone accuses me of being too positive and forgiving, this event should also work as a catalyst to generate  more ideas to better manage the task of monitoring social platforms, the handling of comments coming from the audience and keeping alive successful campaigns while staying in line with regulations.

(Source: PMLiVE.com)

Strategic Change, Value Innovation and Drimpy.com – Interview with Rob Halkes

Rob Halkes has been working as a consultant in healthcare and pharmaceutical marketing for 20 years. He gained experience in the industry focusing on strategic change, professional development and innovation in pharma. He is also part of the development team of the integrated healthcare platform, Drimpy. We asked him to share his insights on the changing environment of the pharmaceutical industry and healthcare.

You have been urging strategic change in the pharmaceutical industry. Why is this issue important and what kind of specific changes do you think pharma companies should consider?

Because of the current economic situation, the trend in healthcare will be “more care for less money”. For all governments in healthcare in Europe, it is easy to cut costs on pharmaceutical products. So we see an enormous pressure in a lot of countries, not only in the Western countries, but in the Eastern countries of Europe as well. We see a lot of pressure on cutting and reducing prices and on the replacement and substitution of premium and specialty products with generic pharmaceutical products. To the pharmaceutical companies it will mean that they are trying to sell their products in the context of a commodity trap. The commodity trap is an economic phrase that implicates that prices for premium products will be inflated by upcoming generics or cheaper products. If you go along with the trend to make cheaper products or to sell your products for cheaper prices, you will find yourself in a downward spiral. The pharmaceutical companies have no tradition in trying to innovate their marketing approach other than just creating new products, submitting those to the market and introducing those at a higher price. And now premium innovative products are being replaced by generics. So although you may have made or developed very good innovative pharmaceutical products, those will tend to be replaced by generic ones. The market of specialty products merges with the market for OTC or generic products. The only solution to escape the commodity trap is to innovate your marketing approach.

That can be done if you are willing and competent to make a strategic change towards helping the doctors to treat their patients better. Helping means a two-step process: not just helping doctors to prescribe your product, but helping doctors with your product to be able to help patients better. Then you can convince the prescribers that there is more to your product than just the product itself, that you are also actively supporting the doctors to innovate their caring for the patients to support them better.  This added value could be the reason for a higher price instead of going down with the commodity trap. This is difficult for pharmaceutical companies because for 20 years now they have been on the same business model of promoting new products for higher prices – that will come to an end now. That is only one issue of all difficulties that present themselves to pharmaceutical companies.

More strict regulation of promotion, lesser access to prescribers, upcoming generics and new stakeholders – these are other issues in the pharmaceutical industry that need to be mentioned. Governments, healthcare insurance companies, payers and patients are all new stakeholders that will come to the market with a clearer voice that they want better products for a better care. Hence, strategic change is necessary when it comes to changing market conditions and the way the conditions and caring for health are changing in different countries. Adapting to the conditions in specific countries will become relevant. The European affiliates will have to design their approach according to the local conditions of care.

You also developed a new business model called “value innovation” for the pharmaceutical industry. Could you describe this concept?

The approach of value innovation that I developed in the Netherlands has very clear results. We can show graphics of the outcome and how obvious the changes and results are. Through these results the model speaks for itself. The approach of value innovation is based on two principles:

The first is that as a pharma company you have to support your healthcare providers – doctors, specialists and pharmacists – to help their patients better by improving their way of caring for the patients. There are two concepts for this kind of care: integrated care and participatory care. That’s the first principle: innovate for your healthcare providers to help them improve the way in which they are performing their care for health. It might look as though you are mingling with their business. But in our experience healthcare providers mostly don’t have time to reflect on how they are providing care. When you help them with expertise, training and other services, you will be appreciated as someone who is caring for their interests and is acting on their behalf. When you do so with integrity, you will gain a different market position: a trusted one. It will reimburse you through the attention that your product is getting from them as being your partners in the business of caring for patients. For a lot of companies this will be a change in their selling approach. They have to learn how to submit and propose those services, because it differs much from just detailing.

The second principle is based on the necessity to differentiate between your targeted doctors: between those who will readily appreciate what you are doing, and those who will not. Most of the pharmaceutical companies already segment their priority doctors as to their individual potential for business. I propose to extend this to differentiate between those who have an innovative stance to healthcare development and those who don’t. In a changing landscape of healthcare, those who do want to improve their way of caring for patients will often collaborate with colleagues to approach innovation in care cooperatively. We see examples in health care groups, like “Zorggroepen” in the Netherlands, the Policlinics or medical centers in Germany or the GP consortia in the UK. We developed a segmentation procedure with which you can target the GP centers that are the most influential and have the most potential to cooperate with as a pharmaceutical company. The benefit for those that do want to work with you will be that patients and other stakeholders in care will notice that by working together in a co-creative way, it is possible to create better outcomes of care with less cost. It will lead to a higher satisfaction for patients and for a lower cost of patient per year in specific care programs, especially for chronic care. And if you can demonstrate, that you as a pharmaceutical company are helping the healthcare system in this direction, you will get a lot of attention that will lead to a position of preference that will help your business as well.

So actually the change will be from a purely product-oriented approach toward a patient- and healthcare-oriented position. And that is an orientation that healthcare providers and doctors will recognize as a change from selling toward helping.

Last October you showcased Drimpy.com at the Health 2.0 Europe conference. Could you tell us about this project and its aims?

This particular project is two years old now. We started it with the founder and owner of Drimpy, Arnold Breukhoven in the Netherlands. He had the idea of a health platform for integrated care in which patients could communicate better and have a better relationship through the online network with healthcare providers. We did see this not only as a necessity from the patients’ point of view but also from doctors’ perspective. Data and information from the patient is relevant for the doctor to act upon. Doctors often want to get information from a patient that the patient isn’t able to generate readily. He hasn’t been tracking his health parameters before the consult, doesn’t know precisely how often he has suffered from certain conditions, is not aware of the medication he actually uses, etc. With Drimpy the patient is able to collect and monitor his health parameters like blood pressure, sugar level, daily complaints, pain sensations, etc. and record his health-related information, medications, conditions, allergies, as well as store his health related documents (documents made by the patient himself, documents received from the lab or from the hospital, for example an x-rays). So a lot of data and information can be added and tracked on the platform that will help a doctor to diagnose the patient and implement a therapy in a much more effective and satisfactory way. Furthermore, the platform not only functions as a personal health record, but also as a communication device in which the patients and caregivers can communicate and interact privately.  Naturally, Drimpy also facilitates specific applications to support the patient and his/her loved ones with adequate and reliable information to help them understand and better cope with their conditions. It supports them in compliance-related activities as well. In doing so Drimpy works as an Ehealth platform, safely and reliably.

The site is firstly based on the principle of being an integrated care platform: activities from the different caregivers like doctors, pharmacists and hospitals come together to the patient’s benefit. Secondly the platform is patient-based. The site is designed from a participatory point of view. Anyone who registers on the platform can do this. Thirdly, and that is the most interesting feature, the patient has a private network that he/she can develop for people to be a part of his/her healthcare team, and to give them access to certain personal health information. The platform is set up like a private Facebook so the patient can select people that he wants to share information with and add those who want to help him in coping with his conditions. Drimpy.com is thus an integrated healthcare platform that is managed by the patient himself being in the position to select and keep the data that he wants to track and to invite and work with those caregivers who he wants to work with. Drimpy puts the patient in the position to set up his healthcare in a participatory way.

The digital ways of setting up a network like you just described in connection with Drimpy.com seem to work for patients and doctors. How do you see the pharmaceutical companies in this mix? How do they usually react to these digital solutions in your experience?

First of all, when it comes to Drimpy we see the site as a platform with which it is possible to organize the processes of care, to organize the caring for health itself. Making it clearer for the patient what the doctor is doing during the treatment is important because the patient has to work with the doctor to set up and complete his therapy. This will result in a better understanding between both parties about what they are doing, why they are doing it and how they will proceed. So it enlightens all the processes of care and makes telemonitoring and telecare possible. That will at least reduce the time spent on unnecessary face-to-face consults. It will enable them both to be efficient with face-to-face time. As a result the doctor will have more time to attend to difficult patients rather than to routinely work through consults that are actually not needed. The doctors and patients can reserve consults for those situations where they are necessary to optimize the therapy. This makes everything more rationalistic and more efficient. The point of course, is to have doctors and patients learn about how they can do this, and to customize the platform towards the specific needs of chronic conditions like diabetes or COPD, etc. The pharmaceutical companies can offer this facility to the doctors as a service from their side. With Drimpy they have a very distinguishing service to deliver to doctors. When they do, I’m sure doctors will be surprised and thankful to get help with implementing this version of telehealth in their practice, so they can help their patients with more satisfaction.

We talked about a lot of new trends: strategic change, new business models, new platforms and ways of talking to doctors from the pharmaceutical companies’ point of view. How do you see all these trends changing in the next year?

I presume that healthcare providers – doctors, hospitals, and pharmacists – will be quicker to adopt social media for the benefit of improving care and their relationship with patients. And pharmaceutical companies will be next. That is because healthcare providers – as we see in the Western countries – will understand that social media is relevant to their practice. Social media, integrated in healthcare processes will become more and more popular. In the near future one will not be able to work without them. Social media will help doctors to distinguish their position and help them in reaching out to their patients. They will first adopt social media in a web 1.0 and then 2.0 fashion, and then in a more integrated way as we have seen it with Drimpy. Drimpy itself facilitates healthcare providers to quickly integrate social media into their practices.

Pharmaceutical companies have to cross a threshold to change their business. That is a huge task for them, and to also look at the internal condition of the pharmaceutical companies. Because it is still very tricky for them – as they perceive it – to change in ways in which they are actually delivering services to doctors to help their patients better. Providing service in this way is a way of doing business that they are not accustomed to. They will be reluctant because they see that it will be a big change. As one of our pharmaceutical affiliates in the Netherlands said: “The hard thing is not so much to change towards the local conditions of the Dutch market, it is more difficult to get an approval to do so from the European headquarters.” It seems that changing the internal conditions of a pharmaceutical company is harder than to just change into a country-based marketing approach. But luckily we are in a position to work with pharmaceutical companies to show them how they might embark on this adventure and we can also learn from examples in other countries, like the UK or Germany. We can show them how they can present themselves in difficult situations and how they can move further towards solutions that would help their business as well.

You mentioned that pharmaceutical companies are reluctant to change their ways of doing business. In your experience what are the main obstacles that they mention when it comes to implementing a new model or new marketing solutions?

Well, the main obstacle is to adopt the vision that you can do your business in a different way than you have been doing until now. The pharmaceutical industry has one of the most traditional ways of doing business in the Western world. These companies have not changed in the sense of adapting their businesses according to the market conditions for the last 10, or maybe 15 years. And the pharma rep model in which they are promoting the product in detail conversations with doctors is the most sustainable business model that we have seen. They are so accustomed to it, that it is very hard to implement any change. So this is where we provide assistance. We have a concrete and specific way in which we can guide them step by step to change their ways of marketing in order to change in a manageable way instead of changing overnight in a troublesome way. Guidance is important to change, so that the development of the business doesn’t disrupt the outcome. The most difficult steps are to learn how you should do these things differently, to try to experiment with it carefully and to build up a new company and new sales force.

Change is a very difficult thing to do, not only for pharmaceutical companies but for doctors as well. Local market conditions will show them that past performances will not sustain their business for the future automatically. You have to implement the changes that are necessary in the framework of the system of healthcare and its renewal. When these changes emerge, pharmaceutical companies either get lost in the market or they adapt to these changing conditions, partner with healthcare providers and help them to provide better care in their countries. The ones that are daring to take the first step towards the changes are the ones that learn how to change and provide this specific support. This very competence will be strategic in the years to come. The first ones to move will have this advantage over their competition. If you wait until others have changed, you can only pick up what’s left over in the market. The first ones have the benefit of choice and of learning how to proceed. Going on with following a routine is easy, making the changes, learning how to do things differently is however one of the most difficult things for people to do.

(You can connect with Rob Halkes on Twitter.)

New Trends In The Hungarian Pharmaceutical Industry

As we pointed out in our previous blog post, 2012 has several changes in store for pharmaceutical companies. The healthcare reform defined by the Semmelweis and Széll Kálmán plans mean comprehensive structural transformation for the entire field.

Changes in the pharmaceutical representative system – the increasing importance of HR

The new decisions effect pharmaceutical representatives most negatively, because the return of investment on the personal meetings with physicians is considerably lower, mainly because of the „additional taxes” that the industry has to face in Hungary. According to the new rulings that came to effect in the middle of 2011 the turnover tax rose from 12% to 20% and pharmaceutical companies have to pay a yearly 10 Million HUF amount after every representative providing product information to physicians and pharmacists. According to the data of GYEMSZI (Institute of Pharmaceutical and Healthcare Quality and Organisation Development) in the beginning of 2011 there were 2 600 pharmaceutical representatives working in Hungary. This number dropped to 2 100 by the end of the year.

In 2012 the HR support of the remaining representatives will be even more important. According to the in-depth interviews carried out by Szinapszis Ltd. among pharmaceutical representatives it has to be a priority in the future to further involve representatives in sales strategies, so they get more comprehensive insights about the entire process. When using personal representative meetings and alternative sales tools simultaneously, the initiation and training of reps are critical, so they don’t look at the new tools as rivals, but as „sales partners” – while supporting the goals of the pharmaceutical management.

The new ePatient appears

The internet plays a key role when people, patients are seeking health-related information. The patient who is constantly searching the web for information appears in the healthcare system as a (more or less) conscious customer, and these new patients or e-patients need their doctors to participate in the communication process as well – creating new challenges for healthcare professionals, since old-fashioned one-way „communication” needs to be replaced by two-sided consultations.

More informed patients have higher expectations of the quality of healthcare, which results of these patients appearing more frequently in the private sector of the healthcare system.

This group of patients create a new target for pharmaceuticals since there is a new opportunity for directed non-expert communication – and not only in the field of OTC treatments.

Improving patient non-adherence – with legislative tools

A so-called patient-compliance program is part of the restricting initiatives proposed for pharmaceuticals in 2012, this program will be introduced first among patients with vascular problems and chronic lung conditions. According to the new initiative patients who want to pay the same amount for their medications they used to need to improve their health parameters with exercise, a healthy diet and lifestyle, and with regularly taking their medications – with losing weight and quitting smoking. Therefore in 2012 the role of patient-compliance programs assumed to become more emphasized.

But when it comes to the improvement of concordance about treatment options physicians are pessimistic: almost 75% of them don’t believe that the before mentioned policies and other initiatives aimed to strengthen the co-operation will result in a better doctor-patient collaboration in the following 2 years.

The more substantial role of pharmacists

Among other things the expansion of generics and the introduction of active ingredient-based prescriptions will further strengthen the role of pharmacists in the future, even more so in sales. Observing the efficiency of pharmacy sales is going to be a crucial, which means measurement of these areas (like mystery shopping) is going to be more significant in 2012.

(Katalin Kiss)

Building A Successful Social Media Presence In Pharma – Andrew Spong Shares His Thoughts With H2onlinehu (Part 2)

In the second part of our interview with healthcare social media expert, Andrew Spong we asked him about the crucial steps toward a successful social media presence and focused on issues that pharmaceutical companies might come across when implementing digital solutions in their marketing plan.

Earlier in the interview you talked about some of the obstacles for pharma companies when it comes to social media conversation, for example the platform being so new. How can a pharma company take the first step, how to dive into healthcare-related social media?

I think they need to do a lot of things all at once which is never easy. The first thing is to get the buy-in of senior colleagues from across functions. So you need legal, you need regulatory, you need medical affairs, you need communications, marketing and more. Senior figures from all of those functions must feature in your initial task force. This is the team that will have to do the really hard work of defining and answering the „How? What? Where? Who? When? Why?” questions. Why do we want to use social media? Is it something that is going to take form in an integrated strategic plan for us or we’re just doing it because we think we should be doing it? All of those sorts of problematic but enlightening questions. The team must be able to provide compelling answers, which demonstrate to their business the critical reasons why it must participate within social media. There are many, and we already identified some of them, but they will need to be optimised in order to meet the needs of each business individually.

The next step (and ideally one which can be conducted concurrently) is to ensure that the existing corporate governance which is in place is fit for purpose, and it probably won’t be. It will need to be expanded in order to provide employees with a passport to the social web, to make them feel confident that they can express themselves on the social web. It must be made clear that they are not speaking on behalf of the company, as the communication function does that, but rather to help them understand the ways in which they can reach out to the communities of interest that they wish to communicate with in an effective and approvable way.

All of these are difficult, time-consuming, problematic issues for the industry. For the final step that we intimated before is to take all of those aspirations and those strategic objectives and incorporate them effectively into the existing strategic plan in order to make sure that social media isn’t treated as which sits outside of an integrated communications plan or marketing plan, but sits within it. This really should begin to show all the results that drive and fulfill the aspirations, that the architects of the company’s social media strategy believe they can deliver for them.

You mentioned that pharma companies need to find regulatory guidance within their companies. Is this a way to deal with or resolve the fact that there is little guidance from outside authorities?

It’s not that they’are going to reach out and find a lot of existing guidance. Firstly you need all of the people in the room at the beginning who may say ‘no’ at the end. There is no point doing all this work if you haven’t convinced people who ultimately have to sign off any plans or strategies that you want to implement. There’s no point in presenting a wonderfully crafted bundle of ideas and implementable actions that you come up with if senior colleagues are ultimately going to reject them. These colleagues’ concerns must be addressed at the beginning, and you need to get them and keep them on your side. You must keep talking about their concerns until they are resolved to everyone’s satisfaction, and all issues have been put to rest.

In order to achieve this aim, you will need to demonstrate to colleagues that there may not be a ‘Big Book of How to Use Social Media’ from you local EFPIA regulatory body or in the US from the FDA, but that doesn’t mean that existing regulation is not fit for purpose. Existing regulation – it has widely been claimed by pharma companies that are using the social web effectively – is fit for purpose. It is sufficient in as much as that it was designed to speak to all media, so in essence you make sure that you do not do anything on the social web that you would not do in any other environment and broadly speaking that means that you do not promote – it is as simple and as difficult, as that.

In your experience, what are the main concerns that pharma companies usually have when it comes to the social web?

They revolve around issues like regulatory, we just touched on one of them. But I feel like we just gave some insights on how that conversation can be managed. I’m not saying it is going to go away, because the industry always has to be aware of, and answerable to, the requirements of regulatory bodies. But it is certainly one of the issues that always comes up. Another example is adverse event reporting. „As soon as we get onto the social web we’re going to find a slew of extra adverse events that we’re going to have to report.” Well there’s a series of responses to that. Firstly, these conversations are taking place, if you believe that they are happening, those conversations are taking place anyway and it is beholden upon you if you wish to identify and respond to them. So it is a question of time management, rather than a question of maintaining your ethical responsibilities as a company. Well that’s not acceptable. Also, following Pfizer’s example of putting an AER link on their Facebook page, in terms of effective use of resources it makes a great deal of sense to provide a means of allowing reporters to convey their observations through the most successful and popular environment on the Internet which are delivered to a team of in-house experts waiting for their submissions.

A great deal of research has now been undertaken on the vast number of pieces of patient-reported information and data that are shared daily. There is a compelling body of evidence coming together that suggests that adverse events reports which meet the four standard criteria – a reporter, a reportee, a drug name, an identifiable adverse event – very seldom happen. This doesn’t mean that a company does not need an effective and functional response strategy to call upon when adverse events are identified. However, what is does mean is that the „fear” that companies are going to find tens of thousands of additional adverse events to report that they have not encountered previously is just not true. The data is suggesting this anyway. And even if they were, the industry has a duty of care to attend to them. It is in no-one’s interest to suggest that the industry would shy away from participating in the Social Web on the basis of a perceived concern that they may encounter issues that they are obligated to address. The fact is, however, that they simply won’t find them in the quantities that were feared some years ago.

The third issue is a big one, namely that „We’ve got no time to do this”, and „We haven’t got the money.” Another query that is often heard is „ what’s the return of the investment on the money we spend on the social web? Show me the cost benefit of using the social web.” Firstly, that’s the wrong question anyway because it’s not something you’re doing to drive revenues directly. It’s something that you’re doing to take care of any number of issues which are critical to your business that revolve around trust. But also going forward if we believe as many of the companies and startups have invested significant amount of time and capital in proving that patient reported information is going to change the clinical trial and drug development process and all of those issues feed back into the pressing question of why is it important for pharma to get into social media right here right now. But to loop back to the ROI question, there are two ways of looking at this. Firstly, you have to ask: „What metrics do you want me to measure? Because I can measure anything. The question is why do you want me to measure them and what are you going to do with the data that I provide you with? Are you going to implement it, and is it going to change your strategic plans in some way?” And usually the answer to that is no, which means the question isn’t worth asking in the first place. But the second response to that is „Why are we asking or probing so deeply into how much it costs to set up and maintain a Twitter account?” which frankly is not a lot. It costs nothing to set it up, and yes there are implications in terms of employee time in maintaining presences effectively but for a contemporary, progressive pharma company this is now quite simply an important part of the day-to-day work it must undertake as part of its broader strategic objectives, and should never therefore just be viewed in isolation. But more to the point that cost – as minimal as it is – is never measured against the 50 thousand, 100 thousand plus dollars, pounds, whatever currency, spent in setting up a website, for example, the benefits of which are seldom scrutinised in so exacting manner. Existing strategies that may deliver very poor ROI – like direct mail that no-one reads which just acts as a coaster for a coffee mug before being thrown in the bin  – are not similarly interrogated. Thus, a useful response strategy for pharma marketers would be „Well you show me the ROI of those iPads you bought, the BlackBerries your team uses, the memory sticks you sent out with some detailing to some GPs and tell me how many people actually got them, read them and got back to you. I’ll tell you how much it costs to make my campaign using social media.” And you can guarantee that on a cost basis, the results will be better for the virtual campaign.

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

Why Social Media? – Andrew Spong Shares His Thoughts With H2onlinehu (Part 1)

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 7th 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)

Pharmaceutical Industry In Hungary And The Challenges Of 2012

The Hungarian pharmaceutical industry had a rather hectic year, and 2012 seems to promise some new challenges as well. The different steps of healthcare reform have been summarized by the Semmelweis- and Széll Kálmán Plans. These proposals introduced and initiated numerous arrangements, that change the basis of healthcare, as well as the internal operation and marketing strategy of pharmaceutical companies. Not only have the target groups of communication changed, but even the nature of communication channels directed and applied to them are new.

The previous one-way communication directed only towards physicians is being replaced by a new strategy with more performers, including pharmacists, patients and customers, who all have an important role in the communication process.

Observing the different channels of communication, the significant growth of the role that the internet plays is obvious. In our experience the members of the market are interested, more or less open to online solutions, but at the same time uncertainty is prominent mainly because of the lack of experience in Hungary.

The new legislative regulations in Hungary are essentially strengthening the digital trends. Because of the forced axes on the number of representatives finding other, alternative sales activities to substitute the work of reps is crucial.

There are numerous tools for companies when it comes to sales and communication, but it is also very important to find the right toolkit – with the appropriate form and content – to meet the needs of the target audience. The opinions and attitudes of physicians about alternative channels are typically known, majority of them are open, or can be convinced about the advantages and possibilities provided by these new tools. In the meantime in-depth research to segment, and to observe the special needs of the target groups is going to be even more valuable.

Are you open to getting information through the following, new channels?

Multimedia presentation showed on tablet/iPad during personal visits

Source: Szinapszis MediJournalTrack 2011 (n=909)

Pharmaceutical decision makers also realize the necessity of online communication with physicians and patients, but their high level of mistrust toward this area is obvious which is typically caused by the lack of experience in Hungary. In the future agencies providing online solutions will have to try to ease the anxiety and to answer the emerging questions of decision makers.

(Katalin Kiss)

Physicians Shouldn’t Shy Away From Online Reviews

There have been reports about physicians trying to avoid a negative online reputation by getting their patients sign a contract where they give up their right to provide any information about their doctor on any internet platform. This is only a way to turn our backs to the issue and not concentrating on the main goal of a practice: to provide quality patient care where the doctor doesn’t have to be afraid of bad reviews.

Since in healthcare people are treating people, the patient experiences are not going to be black and white. But if the majority of patients are satisfied, even a few bad reviews can’t destroy one’s reputation. This is one case where prevention is not better than cure.

There is information about your practice whether you like it or not, mostly reviews provided by your patients online. Portals focusing mainly on patient experience are getting more and more recognition and attention. They are rapidly becoming the top search results on Google. Physicians have a choice to make: try to stop this trend or monitor and contribute content themselves.

Let’s be honest: stopping patients to look for and spread healthcare-related information on the internet is a task more fit for an imaginary character with unlimited time and energy than for a doctor with a busy schedule. There is no sign that suggests the decline of interest in patients-created anecdotes online. People like to search for information about a physician and usually they get what they’re looking for in patient-created content.

So instead of trying to put a stop on people turning to the internet with healthcare-related questions (obviously this is out of a physician’s power), doctors should be proactive and provide useful information about their practices. Having a user-friendly website about their practice and monitor online content about their work is not optional anymore. Whether physicians take part in it or not, whether they try to discourage patients to review them online, they can’t erase their online presence. But they can choose to have a say in what is there to be found about them on the internet.

(Source of image: Manage Your Online Reputation)