Finding your feet

Do you remember the good old days, when politicians could be trusted and newspapers told the truth, when your bank manager was a family friend and local bobbies rode bicycles two-by-two around the village green?

Of course you don't. Those halcyon days of warm beer and tea on the lawn probably never existed. But that doesn't stop the modern mood for mistrust mistily viewing the past as a golden age from which current society has suffered a miserable fall from grace.

We live in cynical times and perhaps with good reason. The MPs' expenses scandal, the banking crisis, phony phone-ins on the BBC and the Chilcott Inquiry into the government's handling of the 2003 invasion of Iraq have been big, long-running, recent news stories that have questioned the sincerity of hitherto respected institutions, organisations and government. This barrage of headlines suggesting misrepresentation at best and cover-ups at worst, at the heart of our society, perpetuates the prevailing public mood of suspicion.

A survey last year by the Royal College of Physicians found that levels of trust in society, overall, had fallen in the past decade. Doctors were still the most trusted profession, closely followed by teachers, but trust in politicians, trade union officials and business leaders had fallen significantly.

Communication in a digital age means that this suspicion can spread rapidly. Facts, half-truths, rumours and malicious gossip fly through the digital ether with little to distinguish them. Texted and twittered, this slew of digitally travelled information can fracture fragile reputations in an instant. Or can it?

Guarding reputations online
Print media was the traditional battleground on which companies fought to protect corporate reputations. This was, and still is, a form of media that is easy to monitor, and strategies to deal with adverse press coverage are well established within the pharma industry.

Print media also offered the peace of mind that if a business rival, campaign group, disgruntled employee or customer had an axe to grind against your company, their words and claims would not be printed wholesale. Newspapers that don't check their facts or, indeed, base their stories on more than the opinion of a person with an agenda, run the risk of a libel claim.

The digital age is perceived to give individuals carte blanche to use an unfettered means of criticism, fuelling negative opinion. Yet legal experts say that the internet is not quite the "untamed frontier" it may appear to be. Keith Schilling and Simon Smith from the law firm Schillings argue in an interview on the firm's Bulletproof Blog that English laws are favourable when it comes to protecting reputational damage and that, under English law, information published on the internet is deemed to be published in England and so subject to English law.

However, although there are legal steps that can be taken to counter false and damaging claims, which can be shown to ruin reputation, these lawyers argue that most threats should be ignored because to try to counter them in court does more harm than good. Schilling and Smith recommend considering the following five factors when assessing the level of risk and whether or not to take action:
1. The credibility of the maker of the allegations
2. The audience that the initial publication enjoys
3. A judgement on the likelihood of the material spreading virally online and reaching mainstream media
4. The type of information
5. The severity of the allegation.

This is an opinion echoed by digital communications expert Kai Gait. "There is a lot of concern about the potential threat to a company's corporate or brand reputation presented by digital communication platforms. However, the point is that digital communication is part of the here and now, and is the future. It is a form of communication that the pharma industry's customers use increasingly to gain information and the industry needs to accept that though it poses potential challenges, industry has limited control over the channel and, therefore, should learn to work within it."

Gait adds that the industry as a whole is still at a relatively early stage in the journey to embrace the opportunities presented by digital communication and in developing policies and technologies to respond to digital commentary.

"The web is a collaborative, sharing space and this is a concept that doesn't always sit comfortably with an industry that is highly regulated and required to be highly responsible," says Gait, but adds that the considerable soul-searching done within the pharma industry about the threat of digital communications is beginning to bear fruit.

Companies are moving beyond the provision of flat information on their websites and are starting to engage. For example, a handful of companies, such as Roche, have tackled the Sidewiki on their corporate websites by posting entries that set out their policies on this Google technology. This, according to Paul Dixey of BlueLight Partners, which specialises in providing pharma companies with compliant digital strategies, is a good sign. "Reputations are more likely to be damaged if customers and consumers are presented with only one side of the argument."

A new era
Last year was the year in which the industry really started to get to grips with the rise of social media. The open access model of much social media interaction may have sent shivers down the spine of the custodians of corporate reputation, but now many pharma companies have a presence on Twitter. For example, Boehringer Ingelheim's use of Twitter to communicate corporate messages and release results from its large stroke prevention trial, following a presentation at the European Society of Cardiology meeting, was trailblazing.

Disease-specific and corporate-focused YouTube channels from Boehringer Ingelheim and Pfizer Europe, and blogs from GSK and AstraZeneca are showing that the industry is now starting to embrace new mediums and is seeing digital communication platforms as an opportunity rather than a threat. UCB last year announced an industry–patient partnership to improve understanding of epilepsy by creating an online open epilepsy community that captures real-world experiences of people living with epilepsy in the US. It is scheduled to start this year.

But these examples do not yet represent a sea change in attitudes towards digital communications and their ability to enhance rather than damage reputation, argues Dixey. "Pharma companies are getting their heads round the potential of digital media, but many of their online activities are still very traditional. That said, a few companies are pushing the boundaries in trying new channels."

Notwithstanding the legal and regulatory constraints in communicating with consumers and healthcare customers, on the whole, experts such as Gait and Dixey believe that digital channels offer many opportunities to engage with, rather than push to, healthcare customers, and to interact with consumers in an ethical way, thus enhancing reputation.

Gait says that the digital space presents a wealth of opportunities for clinical trial investigators and researchers to share and discuss results with physicians. Dixey adds: "The age of push marketing to healthcare professionals has gone. Consumers are now expecting to engage in conversations online about your brand, whether you like it or not.

Pharma companies have to make clear decisions about whether or not they want to be part of this because if they are not part of it they can't influence it."

But as Sarah Matthew, chair of the Healthcare Communications Association (HCA), explains, the tricky thing is how to engage appropriately and be part of an enabling culture without damaging reputation by contravening European law and regulations governing best practice.

"The industry is perceived as being secretive and guarded and consumers do not understand that there are restrictions that apply to pharma companies, which do not apply to other industries. The expectation that a pharma company should be as open about its brands as non-pharma companies is a threat to the reputation of the industry in itself," says Matthew. She adds that many pharma companies are taking a cautious approach to more innovative digital strategies because they are concerned about the damage that venturing into relatively untried and untested waters may do to their reputations.

The over-riding issue, currently, seems to be how to engage in proactive digital communications while complying with the Code and, therefore, not damaging reputation through unethical or inappropriate digital forays. The industry is strictly regulated by the Code, which reflects and goes beyond extensive UK law. It is more difficult for the pharma industry to use digital media compared to other industries when the Code, UK law and European law prohibit the promotion of prescription-only medicines to the public.

Matthew predicts that this is the year that pharma will explore further how it can create compliant meaningful digital interactions.

The HCA has held workshops to discuss the opportunities afforded by digital media and has launched an online communication guide called On the Spot. Available to its members, this resource provides a consistent position relating to a number of pharma activities, including communication in the digital space. The ABPI is also holding a digital forum to help to define for members what digital communications can offer in the context of enhancing reputation and trust.

Matthew concludes: "Everyone talks about the potential of digital channels to enable the pharma industry to connect and engage with its customers and consumers but clear guidance is needed to support companies operating in a strictly regulated environment. No company wants to take the risk of damaging its reputation by taking a leap of faith."

The Author
Rhonda Siddall is a medical writer.

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