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Social revolution

The time has come to upgrade and interpret regulations to meet today's digital needs

An old fashioned rotary telephone with symbols for social networking sites replacing the numbersThe way we understand, communicate and discuss healthcare has been going through a gradual but sustained revolution in the last 20 years, reflecting  shifts in society. The general public's relationships with professionals and establishments are changing in ways never seen before. No longer must we receive all our healthcare information from doctors and nurses, just as we don't rely on mass media alone to form our opinions on many subjects.

If I am making a decision about my life, whether it's a treatment for my medical condition or where to go on holiday, I am more likely to ask Google than consult with my doctor or travel agent. If I want a second opinion, my next port of call is friends on Facebook or Twitter contacts.

Prior to 2006, neither of these options existed. If Facebook were a country, it would be among the top 40 in the world in population size, around the same size as Canada. Furthermore, the people in this community can interact with each other every day, without ever meeting face to face.

A new world
In communications and marketing we have moved from the 'information age' to the 'interaction age'. The human need for autonomy and a voice is the driving force of this change, enabled by advances in technology that have made many new digital channels available to the developed world.

For centuries, we had two channels: word of mouth and print. In 1876 the telephone was developed: over the next 50 years or so, the radio and television were born. Yet in just 20 years (since the advent of the world wide web 1989) there has been an explosion of many more channels, websites, search engines, social networks, SMS, smartphone applications, social bookmarking services, blogs, mashups, RSS feeds, wikis... with more being added every day.

What does this mean for pharmaceutical brand teams?

While finance, retail, music and media industries have embraced this new world, the pharma industry is still concentrating more than 90 per cent of its communication activity in the original two channels.

Why? At least in part it is due to structures and processes within pharma companies. Digital strategy requires a global, customer-centric, pan-brand approach. Brand teams and country affiliates that still operate largely independently of each other make this difficult.

Now, however, 20 years after the digital revolution started, pharma companies are reviewing their business models and there is a real desire to move up the digital marketing maturity curve.

Healthcare professionals have not been waiting for us. They are fully operational in this multi-channel world, picking the interactions and content most relevant to their needs, as and when it suits them.

Their main frustration is that so often the content (or discussion) is not available in the most convenient channel and format. This is the single biggest opportunity in pharmaceutical marketing today.

Picture the world healthcare professionals (HCP) now live in. Where are we going?

Med comms 2020
Assuming the channels available to us continue to develop apace, there are a few outcomes we can work towards in healthcare that will mean, by 2020, our communications environment will be very different from today. Pharma will spend 90 per cent of its marketing communications budget on digital channels and 10 per cent on face-to-face meetings.

We know from other industries that the most nimble brands, in terms of channel mix, are often the winners. It is evident that physicians spend the majority (at least 80-90 per cent) of their information-seeking time online, and time spent on face-to-face interactions continues to diminish.

Pharma brand teams are increasingly employing "channel agnostic" planning which puts the customer at the centre, prioritising the channels HCPs value and use the most. The migration of spend to online channels, matching customer behaviour, is therefore inevitable, the only question is the rate at which this happens. One thing is clear: the company and brand that does this first will be at a distinct advantage. Physicians will have, at their fingertips, the diagnostic and prescribing decision-making tools for the majority of clinical situations.

I once worked with a very talented Swedish eMarketing manager who was very good at getting colleagues across the company to adopt innovative strategies. When asked for the secret of her success, she said: "Just make it blur-dy easy". This became team lore, many of our pilots were put through the "blur-dy easy" test, and it worked.

If tools are simple to use, busy people will use them. Someone will develop a "killer app" that will serve doctors' day-to-day clinical decision-making needs, and pharma brands will sponsor it. Services like the European Prescriber's Guide ( and ePocrates are trying to do just that.

Medical education will be delivered in a multi-media format and will most often be consumed in healthcare professionals' living rooms.

Multi-media learning
A 2008 study at Vanderbilt School of Medicine showed that students responded well to rich media lecture recordings, which aided learning and reduced stress. This generation of medical students is tomorrow's clinicians. They are growing up in a multi-media learning environment and smart providers will deliver entertaining, easy-to-access learning that doctors can utilise at their leisure.

Each major disease area will have a global online community of stakeholders (HCPs, carers, providers, patients) who will drive decision making in that therapy area.

Healthcare is a networked world and the internet is a network. It is only a matter of time before the obvious happens and doctors, nurses, patients and providers can discuss developments and how to get better outcomes in a therapy area network. The platforms are there – who will be first?

It will be the norm for the industry to deliver "whole products" not just medicines. This has been happening in other industries for decades. In the software sector, the idea that you might provide a complex product without associated services to support it would be outrageous.

In an increasingly competitive and value-driven world, pharma will provide more education, support, administration, dosage and lifestyle assistance to ensure patients benefit fully from its product. The most cost-effective way to do this is via digital channels, where services are scalable and easily updated.

Sales stories will be based on patient benefit rather than product features. 

This development of marketing practice away from the core product to a "whole product" means that it becomes more compelling to sell solutions rather than features. As a result of providing good digital services in support of their products, companies will be positioned as healthcare providers, and sales messages will reflect this.

Remote access
Thought leadership in healthcare will be created online, through blogs, microblogs and social networks – and their descendents.

Twitter is a KOL-cascade. In many fields of endeavour from journalism to the law, thought leaders extol their views in 140 characters and their followers retweet them, and their followers retweet them and so on.

For more involved discussions we follow and comment on bloggers or engage in discussions in social networks. Medicine is a global field and advances in it are discussed at a global level. The most practical way to achieve this and form ongoing global relationships is using digital platforms.

More than 90 per cent of content consumption from international medical meetings will occur remotely and digitally.  

Already pharmaceutical brand teams are economising on the size of stand-alone meetings in terms of delegate numbers and dedicating more resources to pushing messages from the meeting out to a much wider audience.

The cost per doctor of this online dissemination is 10 per cent or less of the cost of the face-to-face meeting. The quality of the interaction is different, but is the face-to-face really 10 times better?

Furthermore, the online "meeting" is enduring – the content can remain available for a long time, ongoing interactions can continue (eg, a discussion forum with regular questions to consider) and rich media content such as games, elearning and viral videos can be provided to enhance engagement.

Truly integrated
Pharma companies will have a seamless, integrated relationship with each customer – from clinical to commercial, global to local, brand to brand. 

This is possible today. It is organisational structure not technology preventing this from being the case for every pharma company and healthcare professional in the world. 

The first organisation to break down these silos, develop a customer relationship strategy and, as a result, offer top quality service will be in a very strong position. The general public will see the industry in a positive light as an important player in improving human health.

To execute well in digital channels you have to listen to your customers, respond in a timely way and be completely transparent. For good reasons – mostly legal and regulatory – it has been difficult for pharma to do all of these things. For example, what if someone reports an adverse event in a social network, how do you reconcile the rules on non-promotion to consumers with the need to answer consumer questions about drugs? If doctors want to share new scientific data on public platforms, is that 'off-label promotion'?

The time has come to upgrade and interpret the regulations to fit today's world. The FDA has started to do this with its social media hearings in November 2009. There will not be a fixed rule book, however, and we need the skills, experience and confidence to interpret the guidance for evolving channels.

If we do a good job of this, then pharma will be able to engage with stakeholders in new, more transparent ways. As a result, confidence and trust in the industry will increase.

The Author
Kay Wesley is director of digital at Complete Medical Group

To comment on this article, email

23rd February 2010


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