Notes from the Back of the Book

Inciting Patient Engagement and Action: Is MY cancer different?

We are intrigued by the launch of Is My Cancer Different?  and its potential impact on both patients and the business.

Is My Cancer Different? is an unbranded educational website that promotes a movement of sharing, with the intent of prompting patient dialog with their oncologist.  The simple -but compelling- question is designed to raise awareness that each person’s cancer is different and to get patients to ask their oncologist to see if their cancer might respond to a more individualized cancer treatment.

You can click on the image below to visit the Is My Cancer Different? website and learn more from their numerous- but simple -patient and physician testimonial videos.



The site supports Clarient, a GE Health Company’s new molecular test that may help doctors identify which treatment can best target a person’s particular breast cancer.  Interestingly, Clarient chose to share the official website launch during the 2011 Social Health Summit #SXSH  that we attended, along with many other pharma/healthcare social media enthusiasts, ePatients, and Patient Opinion Leaders (POLs). [Be sure to read Shwen Gwee's recap: The 6 P's of Healthcare]

During the conference, Is MY cancer different? received twitter support; following the conference, ePatient’s wrote blogs. Here are a few examples of the word of mouth generated over the last few weeks:

Blogs: Cancer Hawk , Diabetes in Spain,  Chronic Babe, Where We Go Now, Aaron Outward, Stem Cell Transplant, Social Media Club

This campaign reflects many of the points we raised in our complementary eBook: 2011 Brand Champion Health Check.

• Are you working to deliver more personalized treatment, content and experiences? [pg. 8]
  
• Given smaller targets, how can you leverage existing social networks and dialog to online or virtual communities, to extend messaging to low incidence patient groups in a cost effective way? To create buzz? To enable 'peer-to-peer' healthcare? [pgs. 8-9]
• Are you speaking with a voice that reveals humanity—in a conversational tone, with personality, empathy and true emotions? Are your choice of words simple, using the language of your patients and caregivers? [pg. 10]
  
• Are you doing your part to stimulate patient learning and involvement; to encourage patients to be their own best advocates and health team partners? [ pg. 10]
• How can your brand help to encourage greater trust and dialog between doctors and their patients and families, to help improve patient outcomes? [pg. 15]

Brand Champion Health Check: Is Your Brand In Shape To Win?

View more presentations from Ellen Hoenig Carlson - Advance MarketWoRx

 
Is My Cancer Different? is a great example of brand champion leadership.  They have committed to a challenge of 1 million shares in 1 million minutes. What do you think? Will they make it?

Feel free to join the movement and help spread the simple question that can make a huge difference in the fight against cancer. Follow @ismycancerdiff  on twitter and/or facebook. 

You can also learn more about the ePatient movement at epatients.net and join The Society of Participatory Medicine.

Patients Beware: 1 out of 3 Subject to Hospital Error

Originally posted on e-Patients.net, click here to read post and comments

Medical errors are one of the Nation's leading causes of death and injury—the famed 1999 Institute of Medicine (IOM) study, To Err Is Human, estimated that avoidable medical errors contributed to 44,000–98,000 deaths at US hospitals annually.  Using the lower estimate,this suggests that more people die from medical errors than from fatal car crashes, breast or pancreatic cancer, or HIV/AIDS.

In November 2010, The Department of Health and Human Services (HHS) Office of Inspector General found that in  1 in 7 (13.5%) Medicare admissions experienced adverse events during their hospital stays. Further, for 1 in 70 Medicare admissions, the patient experienced an event that contributed to their deaths, which projects to 15,000 patients a month.  And that’s just Medicare!  (Sadly, Physician reviewers determined that over 40% were preventable. )

Also in November, an article in the New England Journal of Medicine NEJM reported on the first large study in a decade to analyze harm from medical care and to track it over time.  The study, conducted from 2002-2007 in 10 North Carolina hospitals, found that harm to patients was common and the number of incidents did not decrease over time.  The most common problems were complications from procedures or drugs and hospital-acquired infections.  The Harvard Medical School authors focused on North Carolina because its hospitals, compared with those in most states, have been more involved in programs to improve patient safety. [NYT Article]

So despite JAMA’s 2008 protest article suggesting that the medical error numbers were exaggerated, it appears that the situation is much worse than To Err is Human suggested. [Alternatively, an investigation by the Hearst media corporation, estimated preventable medical mistakes and infections to be responsible for about 200,000 deaths in the U.S. each year.]

The bottom line, patients have a basic expectation when they receive health care… that they will not be ‘harmed’ in the process…BUT hospitals can be dangerous.  Even good, hardworking people can        (and do) make mistakes.  E-patients must be aware and engaged in everything that happens in the hospital. .. Your second set of eyes can make quite a difference.

What is a medical error? Medical errors happen when something that was planned as a part of medical care doesn't work out, or when the wrong plan was used in the first place. Medical errors can occur anywhere in the health care system and can include errors that involve Medicines, Surgery, Diagnosis, Equipment and Lab reports.

The 1999 ‘To Err is Human’ study set off an urgent call for healthcare improvement.  In 2001, this brought an equally famed report, Crossing the Quality Chasm:  A New Health System for the 21^st Century which outlined a comprehensive strategy and action plan to foster innovation and improve the delivery of care.

However, despite the intense efforts and improvements over the last decade, a new study published in April’s Health Affairs, estimates that medical errors may be 10 times more common than previous estimates—And errors may occur in as many as one-third of all hospital inpatient admissions. A second study in April’s Health Affairs estimates that the annual cost of measurable medical errors that harm patients was $17.1 Billion in 2008. Pressure ulcers, also known as bedsores but much more serious and painful, were the most common measurable medial error, followed by postoperative infections and by postlaminectomy syndrome, a condition characterized by persistent pain following back surgery.  A total of ten types of errors account for more than two-thirds of the total cost of errors, and these errors should be the first targets of prevention efforts.  [click here for the top medical errors and largest cost]

Many of you might be thinking, “is a bed sore really worth all of this fuss”?  A few years ago, I might have thought the same thing.  But after my diabetic father scratched his foot on a piece of coral off the coast of Australia that set off a deadly infection almost costing him his life and limb, and keeping him hospitalized for close to two years, he got a terrible pressure ulcer, or bed sore.  For  the two years my Dad was hospitalized, struggling with his leg, raw with infection that had spread from his ankle to his knee, what do you think bothered him the most? He’d lie in bed in a desperate state saying that his bedsore ulcers were the most painful part of his illness…He had months and months with terrible pressure ulcers that just wouldn’t go away and left him in constant pain and despair.  So when I look at these statistics, I cringe remembering the pain and agony my father faced…It’s not a statistic I can easily gloss over.

“Without doubt, we’ve seen improvements in health care over the past decade, and even pockets of excellence, but overall progress has been agonizingly slow,” said Health Affairs Editor-in-Chief Susan Dentzer.  “It’s clear that we still have a great deal of work to do in order to achieve a healthcare system that is consistently high quality—that is safe, effective, patient-centered, efficient, timely, and devoid of disparities based on race or ethnicity.”

So where does this leave us today? ”e-Patient Dave”deBronkart says, “Any patient or family member who wants to be responsible for their care needs to have their eyes wide open about the imperfections of health care delivery.  They have to understand that the best path to quality and safety is an open, empowered team approach; both goals are served by everyone realizing the full extent of the problem.”

What can patients and caregivers do to help prevent medical errors?

The single most important way to help prevent errors is to be involved in your healthcare, to be an active member of your health care team, and to take part in every decision. Research shows that patients who are more involved with their care tend to get better results. Based on the latest scientific evidence about what works best, the AHRQ outlines 20Tips To Prevent Medical Errors.  Here are a few of their recommendations:

• Make sure that all of your doctors know about everything you are taking. This includes prescription and over-the-counter medicines, and dietary supplements.
• Make sure your doctor knows about any allergies and adverse reactions you have had to medicines.
• Ask for written information about the side effects your medicine could cause. If you know what might happen, you will be better prepared if it does—or, if something unexpected happens instead. A study found that written information about medicines can help patients recognize problem side effects and then give that information to their doctor or pharmacist.
• If you have a choice, choose a hospital at which many patients have the procedure or surgery you need. Research shows that patients tend to have better results when they are treated in hospitals that have a great deal of experience with their condition.
• If you are having surgery, make sure that you, your doctor, and your surgeon all agree and are clear on exactly what will be done. 
• Speak up if you have questions or concerns.You have a right to question anyone who is involved with your care.
• Ask a family member or friend to be there with you and to be your advocate.  I asked a nurse for her thoughts. Here is what NurseLoretta said, “The single most important way to help prevent errors is to have a family member with the patient at all times.  This is the best way to keep all the medical professionals on their toes and focused on the patient.”
• Learn about your condition and treatments by asking your doctor and nurse and by using other reliable sources. For example, treatment recommendations based on the latest scientific evidence are available from the National Guidelines Clearinghouse™ at http://www.guideline.gov. Ask your doctor if your treatment is based on the latest evidence.

Many Patients’ Bill of Rights exist to support and guide patients.  Here are two examples: the Patients’ Bill of Rights for New York State and the American Hospital Association’s.

The Lesson: e-Patients and caregivers -- get involved.  Medical Errors Are Not To Be Dismissed!

Keep Your Brand Healthy And Thriving: Complimentary eBook

With 2011 galloping along and 2012 planning just around the corner, we’re excited to share our Brand Champion Health Check  -- a complimentary eBook designed to help marketers and business leads assess their company and brand’s health, and to consider what actions will power successful growth.

While the eBook centers on the Pharma and healthcare industry, it is also highly relevant to any consumer brand.

Champions know that staying in top health is critical and that early detection is key to avoiding costly down time and poor performance - can even mean the difference for survival. However, unlike the many patient health screens available or the ease by which consumers can go for their annual physical, marketers do not have ready access to a thoughtful, comprehensive health check-up.

The Brand Champion Health Check screens three parameters:

 

 

 

 

 

 

 

The eBook includes links to helpful articles and recent books that are particularly relevant to the five risk factors.  We wish to thank each of the authors for being able to leverage their valuable content.   

We hope these pages will provoke plenty of ideas and discussion for boosting your business.  We would be delighted to hear your thoughts or comments below.

Wishing your brand "good health"!

If you are new to the blog, and you like what you read, we hope that you’ll sign up for continued articles via email or RSS feed.

 

Design credit: Laura Steur-Alvarez
Photography: iStockphoto, Getty, and Bigstock

 

Seven Life Or Death Lessons from e-Patient Dave

Reading "Laugh, Sing and Eat Like a Pig" is like having a long, wonderful chat, and even a few chuckles, with e-Patient Davehimself. 

This is Dave's story, not only of surviving stage-IV cancer, but of the birth of a cancer survivor now focused on opening the world’s eyes to what is being called “participatory medicine".  Patients who are—Empowered, Engaged, Equipped, Enabled, Educated—acting as effective partners with their clinicians.

"Participatory Medicine is a movement in which networked patients shift from being mere passengers to responsible drivers of their health, and in which providers encourage and value them as full partners."

-Society for Participatory Medicine, April 2010

Seven Life or Death Lessons from e-Patient Dave’s story:

1. Lesson 1:  It’s up to each one of us. We have a choice. It’s our responsibility to know and accept a certain measure of responsibility for our individual recovery from disease and disability…
2. Lesson 2:  When your instincts say to scram, scam.  Or if  your doctor  thinks your feelings are your problem, you might want to find someone else — Net, It’s worth traveling far to find a doctor you work well with— We are each responsible for  our choice of doctors.  Make it a conscious decision.
3. Lesson 3:  Laugh, Sing and Eat Like a Pig.  "No matter what your situation, no matter what your outcome…be fully alive for every moment you live" -- Laugh, sing and eat like a pig...for real!
4. Lesson 4:  Keep thinking and keep asking questions.   It behooves patients and their advocates to scour the web looking for new findings that haven’t made it to us yet—avoid “the lethal lag time”.  Would you do it for your child? Then do it for yourself. 
5. Lesson 5:  Hope is essential. Statistics apply to POPULATIONS, and they don't tell you a thing about YOUR outcome. While it may be helpful to understand your reality, it's wise not to let statistics self-limit, or completely shut down hope.
6. Lesson 6:  “Knowledge is symmetry”—the new reality that patients can bring legitimate information to the table that the physician might not have seen or might find useful.  Many overestimate the hazards of imperfect online health information—While there is a lot of garbage out there…in the process, we learn to find trusted resources.
7. Lesson 7:  Re: the game of life: “must be present to win.”  “No matter where you are in your journey, choose to be present in the moment, clear about your choices, and the master of your attitude.” — e-Patient Dave.

Upon reflection,three words squarely hit you over the head: personal responsibility, positive attitude, and hope.

When my first son was born, my mom came to visit only to find herself in bed on day three with a bad  case of shingles…suggesting a compromised immune system…which led to a diagnosis of a deadly  endometrial cancer that she was told meant she had virtually zero ‘percent’ of survival.  Happily, it’s fourteen years later, and she  not only escaped that cancer, but went on to escape a deadly brain tumor the size of a plum growing right behind her eye. Throughout both scares, like Dave, she showed us what it meant to never lose hope and never lose her unwavering will to live.

Implications:

To patients:  We all have a choice and the responsibility to actively manage our health.  While these seven lessons can’t guarantee success,  they sure can help produce better results. Increasingly, the evidence points to greater success for those who act decisive, consistent,and maintain hope and a positive attitude.

To doctors: these seven lessons are a view into the way patients will increasingly want  and expect to interact with their  healthcare providers/teams.  Dave’s journey provides a view into the benefits and what it means to genuinely educate, support and partner with your patients.

To hospitals: provide patients and their families with on-going support, education and compassion.  Might you provide individual test results real time with a platform for open,on-going  communication and learning between patient, physician and integrated team?

To healthcare marketers:  provide patients and their families with hope, encouragement and learning with each and every interaction, and they are sure to appreciate and reward your brand, and live longer… asking patients for their input will go a long way.

With cancer rates what they are today, this book is a strong reminder that we all have a choice and the responsibility to actively manage our health….To anyone facing cancer now, here's to your amazing grace and fortitude....and here's to  PARTICIPATORY MEDICINE to help educate and guide us all!

Thank you e-Patient Dave for sharing your story and vision!

Pick up Dave's story. And why not check out the Society for Participatory Medicine. For more insights on the e-Patient movement and an inspiring short video created by e-Patient Dave in conjunction with Kru Research, visit Eileen O'Brien's post: e-Patients: Educated. Engaged. Empowered.

Pharma Marketers: Eight Things We Might Learn From Zappos.com

Here’s my take after reading Delivering Happiness:  A Path To Profits, Passion, and Purpose by Tony Hsieh CEO, Zappos.com, Inc. While it’s true that Zappos lives in a less regulated business environment than the pharmaceutical and healthcare industry, Tony’s standards for communicating with consumers are now part of the context of our work. Patients have come to expect Zappos- level experiences.  This blog accepts that challenge:  what might a pharma company or hospital might look like if Tony were CEO…

Eight marketing insights for Pharma (or any healthcare or consumer business for that matter):

1. Are you sitting at the right table? If not, it’s never too late to change!  It’s easy to get caught up and engrossed in what you’re currently doing, and forget that you even have the option to change tables. It’s also easy to overlook that the game starts even before you sit down in a seat… Don’t let inertia win, be sure you’re playing in the right game—one that you can both win at and fulfills your goals.

 While Tony learned this lesson during a phase of heavy poker play, he switched tables quite a few times during his life, and certainly for Zappos, they switched tables when they shifted the company strategy to focus on customer service and experience as a brand differentiator. It caused a shift in their business model from one of drop-shipping to one of carrying their own inventory so that they could be in control of their customers’ experiences…What’s the game your pharma co is playing?

2. Be patient and focus on what’s best for the long term.  Poker teaches that you may win or lose individual ‘hands or games’, but it’s what happens in the long term that matters…Zappos has a track record of making decisions based on the longer term. Tony provides numerous examples of this e.g. free shipping in both directions, shipping upgrades to high potential customers,  turning down skilled new hires because they didn’t fit into the Zappos culture…Focusing on the long term and making the necessary tradeoffs is not a new concept, but one that Pharma and all companies bump up against every day.  Unfortunately, all too often, most decisions are made with a short term view and little thought for the long-term impact or consequences on the brand and/or the patient's health …

3. Never outsource your core competency.  Zappos learned that if they were going to build their brand to be about the very best customer service, that they shouldn’t outsource that department.  This meant that core competencies that they had built as an e-business, like inventory management and warehousing and/or customer service, couldn’t be outsourced. 

What are healthcare and pharma companies' core competencies? What happens when a new drug is licensed-in, but the clinical trials have not been done with the insights to optimize claims and information for physicians and patients?

4. A Brand’s critical success factor (CSF) must be the responsibility of the entire company, not just a department.  For Zappos, when they decided that they wanted to build their brand to be about the very best customer service and the very best customer experience, they believed that customer service shouldn’t be just a department, it should be the entire company. For pharma, customer service is largely not considered a true success factor let alone the responsibility of each and every person in the company.  Further, how many pharma cos like to call themselves patient –centric, yet we see inconsistent decision making, demonstrating that patient-centricity  isn’t the responsibility of each and every person in a pharma company ….it's usually the responsibility for a few members of a brand team, but is this enough to ensure consistency and success?  (What does it take to truely be patient-centric? Read Pharma: Is Your Brand Patient-Centered? 5 Critical Success Factors)

5. Culture is the best way to build a brand for the long term.  At Zappos, they believe that if you get the culture right, most of the other stuff—like great customer service, or building a great long-term brand, or passionate employees and customers—will happen naturally on its own.  It’s Zappos belief that your company’s culture and your company’s band are really just two sides of the same coin.  The brand may lag the culture at first, but eventually it will catch up.  Your culture is your brand.  Zappos takes it a step further…core values are only core values if you can commit to them—and by commit, they mean that you’re willing to hire and first based on them…

If pharma cos had strong cultures of patient- centricity, and/or transparency, would we have situations where safety or clinical data was held back?  Is your company  guided by ‘committable’ core values?

6. Deliver WOW!  At Zappos, anything worth doing is worth doing with WOW.  "To WOW, you must differentiate yourself, which means do something a little unconventional and innovative.  You must do something that’s above and beyond what’s expected.  And whatever you do must have an emotional impact on the receiver. ..Whether internally with co-workers or externally with our customers and partners, delivering WOW results in word of mouth. “

When was the last time that a doctor or patient felt a WOW and personal connection from a Pharma company?  How could Pharma achieve more WOW from more customers and patients? Every brand wants to achieve consumer buzz or to have patients advocate on their behalf…but what is the brand’s responsibility to help instigate this? Word of Mouth or WOW doesn’t just happen, it can’t be bought— it has to be earned…  Ask yourself:  What are things you (your brand or your company) can improve upon in your work or attitude to WOW more people?  Have you WOWed at least one person today?

7. Build Open and Honest Relationships with Communication. Transparency is no longer a nice to have, but an imperative in today’s world. With the internet connecting everyone together, companies are becoming more and more transparent whether they like it or not. Both the good and the ugly can spread like wildfire by e-mail or with tools like Twitter and Facebook. Zappos lives in a world of transparency…Why can’t pharma and healthcare companies act with greater transparency and openess? Really?

8. It’s not just about the money, but about happiness. Cliché but oh so true!  Tony reviews different frameworks for happiness.  All roads lead to greater happiness based on an individual world filled with more passion and purpose—being part of something bigger than yourself.  Is there a greater purpose than helping people to live healthier and happier lives? Then why aren't pharma companies and the people in them happier?

Having had positive purchase experiences at Zappos.com in the past, I decided to revisit Zappos the other day when I realized I still needed hiking boots for two of my sons for camp.  When I hit the send button for free shipping I knew that I might not get the order in time, but I decided to put my faith in the Zappos culture and hope for a 'surprise' shipping upgrade…to my ‘joy’, I received a ‘fun’ email letting me know that my order had been upgraded!  Thank you Zappos! 

Here's the email I received:

A New Reality in DTC Advertising?

The last few months, I've been deeply entrenched in "Execution" for an important client. So needless to say, I've been thinking A LOT about what it takes to move from strong strategy to superb execution, and more specifically, what it takes to achieve what I call "High Return Execution" (HRE).    Look for more thoughts on HRE in the upcoming weeks... (And my sincere apologies for the resulting lack of blogging and staying connected with many of my friends' blogs these last few months)

Today, I want to share a personal experience.  Last week my team led an advertising shoot for a prescription product's new multi-channel campaign we are intimately involved with.  There was much to feel good about - the creative idea tested very well and is strong. We also had a terrific creative and production team, a wonderful photographer who we've all worked with before, and we were shooting in a venue that turned out to be magical...not to mention the beautiful picture- perfect, dry sunny days ... [How can you  complain about spending two days on an unspoiled 200 acre ranch in northern California?]

But as I flew home from the shoot, reflecting upon the previous few days, I kept feeling there was something even more special ... something that I rarely feel after shoots ... and then I realized ...

Our work included real patients and in some cases their families as well.   We shot three different print executions using three different patients.  In one case, the mom brought her daughter who was not only proud of her Mom, but also proud to be photographed. 

You might ask, what's the big deal?  As everyone knows, so often in branded consumer and healthcare advertising -- TV, print, web etc., ads are created using models or professional talent.  Certainly, using real patients or ‘real people' adds a great deal  of complexity and tension, as these shoots require much prep and planning, and have a sizeable cost ... Using real patients means you're never quite sure until ‘it's a wrap' -- that you have captured the idea you are trying to communicate ... It also takes more time and requires special artists and production types to work with real patients...

We decided to use real patients because the idea behind our ‘first person' campaign  ‘demanded' authenticity.   Lest you dismiss this as just a current buzzword, keep listening. These are real patients who are living their lives to the fullest extent they can, and genuinely grateful for their prescription product's ‘contribution' to their improved health and QOL. Additionally, these patients were willing to step up and be photographed about a medical condition that is embarrassing to most and difficult to manage.  These patients weren't participating in these ads because they were going to get rich (hardly), they were participating in my client's campaign because they are thrilled to be living their lives in a fuller way -they had reached a milestone so to speak, and wanted to give back. They each stepped up in the hopes of leading others like themselves to try to get the right help for themselves (It may be this prescription product, or it may be another)... to help spread the word, and bring hope and attention to a medical condition that gets little attention otherwise...

Each patient joined in the production process...they were not just models that showed up for their ‘job'; they were on mission, ... tasked to rise to the challenge of being center stage and photographed...something that none of them had ever done in their lives...and in itself a huge personal risk.  There were times that you could feel the wheels in their heads spinning, "this sounded like a good idea when I was in the comfort and safety of my home, but now that I'm here, this is more than a little overwhelming and scary ..."

As a result, everyone on site joined in to support these patients to be able to do their personal best ... It was also a continual reminder to each of us why we were at the shoot ... certainly to capture DTC advertising and patient communications for our client, but it was more than that ... we were there to shoot a new campaign that would  help the many patients with this condition that are still not feeling their best ... to help spur and initiate awareness, education and dialogue so that these patients can participate in their own health decisions and have more enlightened discussions with their doctors ... The vulnerability was gripping.  I'm confident that we at the shoot will not be the only ones to respond.

It leaves me wondering what the increasing use of using real patients will mean for "direct to consumer/patient" advertising and relationship marketing in the future?  Are we witnessing the birth of a new standard that will demand real patients who are advocates for themselves and others? ... Who make a difference each day by being true participants in their health? Will consumers be touched by their 'less than perfect' delivery as actors and models?   

I suspect this trend is here to stay. The pressure is on to "come clean" when the ad suggests that it's a real patient and it isn't (See the Abilify example).  There's no faking ‘real patients' who are actively participating in their health; time will tell what impact they will have on our industry going forward--and how they potentially transcend  advertising and marketing...

My heartfelt thanks to the three patients who made a choice to join us this past week.  I learned with each conversation, and I hope they learned a little too.  I also made three new friends... :-)

See other examples of current DTC Print Ads Using Real Patients, click on image below

What Would A Pharma Marketing Champ Do? 9 Imperatives for 2010

This is the final post of a four-part series.

What Would Steve Jobs Do? 

What Would Google Do? 

What Would Jake and Rocket Do?

These are champs.

What would a 'new marketing' champ do in Pharma and Healthcare?

Here are 9 imperatives I see for Pharma Marketers as we enter 2010 and a new decade:

1. Adopt human-centered thinking across everything you do. Both Steve Jobs and Google share a relentless focus on knowing and pleasing their core customer - the consumer. No detail is ignored if it brings value. Importantly, these champs don't think of consumers sporadically or when it's convenient, but in every decision and action they take.  The customer experience is front and center from beginning to the end.
   
   Pharma and Healthcare marketers: are patients at the center of everything you do? Really? As Steve Jobs might ask, are you taking full responsibility for your patient/e-patient user experience? Are you thinking about every touch along the treatment pathway, that is no longer a straight linear line, but made of multiple touches, information and influences often hitting at once and with circular repetition? (You may also want to read: Is Your Brand Patient-Centered? 5 Critical Success Factors)
2. Get outta town. Experience and see what your patients see. What are your patients' challenges? How could you help? How can you insure that learning is turned into action back in the office? Who should 'own' a particular learning or insight and see it through? Pharma and Healthcare Marketers: is listening and learning part of your everyday doings? What are consumers and patients saying about you? your product? your service? What are they saying on twitter? Facebook? patient communities? How are patients rating your brand on sites such as iGuard? (You may also want to read Jonathan Richman's Dose of Digital blog: The Best Pharma Products According to Patients)
3. Simplify.  Challenge your product and marketing design: Is it simple enough? Simplify your products and services; simplify your customers' lives; simplify your own life...Create simple experiences.  Think about starting a search on Google...or picking up an iPod...Pharma and Healthcare Marketers: During every step of product development and marketing planning: stop and ask yourself: If Steve Jobs was the Product Manager on this, what would he do? Is the design and implementation  of your product/program flawless?
4. Embrace publicness and openness. Transform your relationship with the public in every quarter of the organization.  You may extend this new relationship in many ways from blogging, interacting with bloggers and e-Patients, participating in twitter or Facebook, customer service and sharing ideas.  Overtime, you may even truly involve customers in the real-time design process for products and/or services...But 'publicness' is much more than having a web site. It's about taking actions in public so people can see what you do and react to it, make suggestions, and tell their friends.  Living in public is a matter of enlightened self interest. You have to be public to be found. Every time you decide not to make something public, you create the risk of a customer not finding you or not trusting you because you're keeping secrets....the more public you are, the easier you can be found, the more opportunities your have...(Read Privacy (and Publicness) by Jeff Jarvis Buzz Machine)
5. Don't try to control content and distribution, and think about how you can bring your customers 'elegant organization'.  First, think in distributor ways.  Go to your consumer whenever and however you can.  This is still the opposite of many companies who continue to think centralized and want to make consumers come to them.  They spend large dollars to advertise to attract consumers.  Many try to make their home pages into destinations.  In sum, while many internet sites think of themselves as an end--Google thinks of itself as a means.  While many see the job of their home page to take you to where they want you to go, Google sees its home page as the way to get you to where you want to go.  Google distributes itself.  Google enables others to use tools as they wish. Think of your site as 'answers for every question you can imagine'.
   
   Second, it will also be helpful to think about 'elegant organization' as Jeff Jarvis outlined in What Would Google Do?--Mark Zuckerberg originally coined the phrase to stress that communities already exist... As marketers, entrepreneurs and technologists, we can benefit from these communities by providing them with elegant organization. Help them do what they are already doing better.  Pharma: how can you aggregate and curate useful and valuable content for your patients/ customers? How can you replace focus on mass market with focus on mass of niches? And how can you provide helpful content consistently?
6. Think mobile. Engage real-time with your customers 24/7. Mobile doesn't have to be just about apps; consider the value of texting, geolocators, and/or the use of quick response (QR) codes for simplification...
7. Takers may eat well, but givers sleep well. While most will wait for the FDA guidelines to be published for social media and web, some will move forward to listen, learn and to "give as well as to take." There are still opportunities for Pharma to learn, and support patients and their communities, especially if Pharma starts to see themselves not only as products, but as a service, a platform, a means to enabling others. The bottom line: help your patients (and customers) build value. One new example may be the launch of the new Patients Like Me Epilepsy Community in Partnership with UCB. (While UCB is a client, I have nothing to do with their epilepsy business.)
8. Do one thing really really well--focus on what's most important.  Each champ does one thing really, really well.  Google never loses sight of what search means to their business strategy, and in their continuous focus for improvement of search, it continually spurs other applications and new products/services. Apple never loses site of flawless and simple design for maximum consumer appeal. Jake and Rocket for Life is Good always stay close to their roots of humor and humility. What does your company or brand do really well? Where can you focus resources to continually innovate?
9. Raise Your Bar. Good isn't good enough.  If you don't think it would pass Steve Job's bar, then don't let it pass yours...Or you can think like Google: being great is a starting point, not an endpoint. But as Steve Jobs says, Stay Hungry. Stay Foolish.

Welcome to the new decade of new-marketing--any other imperatives that you'd like to add or delete from this list? Please do share!


Muhammad-Ali Image: 1976 World heavyweight boxing champion. Photo Source: Frank Tewkesbury/Evening Standard/Hulton Archive/Getty Images

2010 Outlook: 10 Ways to Win With Patients and Improve DTC Efforts

[Full article: 2010 Outlook: Doom and Gloom For DTC? 10 Points for Winning with Patients, published in DTC Perspectives, December 2009]

Despite many gloomy predictions for DTC advertising and the pharma industry overall, there's never been a better time for marketers to forward their brands and consumers' lives with new thinking about what constitutes patient marketing in the 21st Century (DTC 21).  Ten prescriptions can help improve focus and strengthen DTC efforts in 2010.  Important media and technology trends are also "musts" to actively consider for those who want to bump impact and value.

1. Adopt an updated definition for DTC that considers the full picture of how consumers will interpret and interact with a brand TODAY. This calls for attention beyond "big bang" marketing spends, and begs for identifying meaningful levers to drive education and growth. DTC is no longer just an awareness or acquisition vehicle to move "eyeballs" through a linear marketing funnel; it's every influence and touch needed to bring new information and education, help convert, instill loyalty and inspire advocacy.
2. Consider "long-tail" marketing; don't be afraid to focus on smaller targets that matter. Long tail marketing has the potential to treat consumers as individuals with unique interests and needs.
3. Go to your consumer--surround them where they get their facts, learn, and socialize.  Today's consumer is not looking for your marketing messages.  Study after study points to both the growth of the Internet, and the fact that consumers and e-patients get their information from multiple sources. (The Social Life of Health Information - PEW Internet and American Life Project) Depending on your target, this suggests a mix of relevant touches and begs for the right combination of off line and on line media and social media tactics.
   
4. Move beyond selling to engaging and providing meaningful marketing and value. Look for new ways to extend patient value, and support a more positive customer experience along each and every touch point. This also means giving consumers and e-patients what they are looking for and not just your "brand sell". Engagement requires looking at each patient as a unique human being who, by the way, would "rather not e your customer" (After all, who wants to have a chronic condition and take medication for the trust of their life, whether it be your rand or a competitors?). Think hard how you might provide relevant value real-time, every time. To improve engagement, 6 C's are crucial:  1) Content that is based on meaningful insights and provides context; 2) Customization via new ways to personalize treatment, process or support; 3) Conversation is encouraged for better service, learning and sharing: 4) Confidence is built with trust and transparency; 5) Community Connectedness - directly or indirectly- create your own, or better yet, tap into an existing one; and 6) Consistent Commitment is demonstrated to your customer base--no one shot deals here.
5. Consumer power is a fact of life requiring brands and companies to walk and talk "patient-centered" -- consumers are finely tuned to what's valuable and authentic. Ask yourself one simple question over and over:  Will this bring meaningful value to our patients?
6. Keep your brand's strategic core strong and grounded, despite the onslaught of messages and tactics, and the speed with which they require action.  A strong core requires a compelling and relevant brand promise that focuses every strategy and tactic so they're synergistic and supportive. The payoff is staying on message by protecting the brand from chasing every new, cool digital and new media tactic coming your way.
   
7. Insist on elegant solutions that do more with less. Smaller budgets don't negate innovation and may have just the opposite effect in spurring new thinking.
8. Don't overlook the details. While they may seem small and trivial, find out which are important to patients and their families.  This can help instill better ROI efficiencies.
9. Refresh brand metrics and measurement to drive current brand objectives and initiatives. Think beyond traditional reach and frequency measures and try to ensure a flow of metrics and measurement from beginning to end of the patient "buying process" for maximum learning.
   
10. Be the best listeners in you category. Listen with vigilance, and act on learning across the organization. Listening, and what you do with your learning, is the responsibility of the entire organization.  Be sure that each 'tweet" or customer learning gets mapped back to a rightful "owner' in the organization.

In 2010, important media, social platforms and technology trends can't be neglected. Below are some helpful questions to ask as media and technology continue to quickly change (yes...an understatement!):

 

Pharma: Are you ready for 2010?  Despite continued budget tightening and generic growth, and open areas such as health  reform and  FDA social media and web guidelines, it's going to be a big year for those willing to step up and experiment with new ways of marketing and 'not marketing'...What do you think?

 

Other Suggested Reading:

The Long Tail: Why the Future of Business Is Selling Less of More by Chris Anderson. Wikipedia's summary of long tail here.

Pharma: Are Current DTC Ads Meaningful? The Next Evolution of Marketing My Book review.

The Next Evolution of Marketing: Connect with your Customers by Marketing with Meaning by Bob Gilbreath, Bridge Worldwide

Susannah Fox, PEW Research Center: The Social Life off Health Information, Twitter and Status Updated, Fall 2009

Pharma: Is Your Brand Patient Centered? 5 Critical Success Factors by Ellen Hoenig, MedAd News, November, 2009

I love You More Than My Dog: 5 Decisions that Drive Extreme Customer Loyalty In Good Times and Bad  by J. Bliss

Strong Brand Core: More Core Than Ever? 

Pharma: Is Your Marketing Designed to Engage and Educate or Sell? My book review of Listen First Sell Later by Bob Poole

Pharma: Do You Elegantly Use What You Have? My book review of In Pursuit of Elegance by Matthew E May

Photo Credit:  Courtney Justice/The Cournell Group

Pharma: Is Your Brand Patient-Centered? 5 Critical Success Factors.

[As originally posted in MedAd News, November 2009]

Almost every pharma company likes to think of itself as "patient-centric," but prescription brands can become patient-centered only by putting consumers at the heart of their business model through every stage of product development and deployment and by focusing relentlessly on patient experience and outcomes. This means integrating tough consumer questions and learning into every phase of commercialization. Consumers increasingly demand direct communication and they expect the kind of standards to which they are accustomed in other industries. This is a major challenge, with substantial rewards awaiting those who find their way.

Adopting five critical success factors improves success. Marketers must put patients at the center of every decision right from the beginning; translate clinical benefits to real world health grains; encourage a more collaborative relationship between doctor and patient; improve patient and caregiver experience through the treatment pathway; and take nothing for granted, understanding that even small details can be meaningful to patients and families.

A newcomer might wonder why pharma needs reminding to center on the patient; it's a stated part of virtually every company mission. Traditionally, patients were not viewed as the primary customer—physicians were, and in some ways still are. New drugs were positioned to get maximum uptake and support of the primary gatekeepers: healthcare professionals, who were thought to know their patients. New products reaching their primary end points without safety issues were launched to physicians. While consumer companies can more easily design desired product features and benefits into the development process, drug recovery is fraught with special hurdles, plus limitations of what benefits new prescription or biologic entitles deliver in clinical use. As a result, many compounds fail before FDA approval.

Historically, development and commercialization was largely led by physicians and clinical experts. Marketing's voice carried less weight, often came late, and focused largely on physicians. Also, because physician-focused sales people were often promoted into marketing functions, they brought little consumer expertise. Increasingly, hospitals and payers have become important customers.  And with the exponential growth of generics and with healthcare reform looming, business models are morphing to accommodate hospitals and payers faster than the shift to patients and caregivers.

U.S. healthcare is encountering the Information Age and Web 2.0, slowly and painfully shifting from a physician, sales-driven approach toward "patient centered" and market-driven. This reflects a growing recognition that incorporating individuals' perspective and greater involvement in healthcare results in better outcomes and satisfaction. Patients make the ultimate decision about whether they will live healthy, fill prescriptions, and adhere to prescribed medications. Social media platforms connect consumers to each other and encourage health information sharing. Companies and brands are publicly assessed. Dialogues include patient-caregiver experience, efficacy, cost, and side effects, and will likely include one or more conversations with a physician. Consumerism was, and in many ways still is, an unpleasant surprise for pharma. Business and marketing practices, while improving, have not caught up.

So the question remains, what will it take for the industry to get current?
To win at the five critical success factors, marketers need to put the patient at the center of decisions at critical junctures along the clinical and commercialization pathway as early as Phase l and Phase ll of development. Early and more integrated cross-functional teams are more likely to succeed. Companies should establish high standards right from the start, including a focus on translating clinical benefits to real-world health gains and staying true to the Six C's: Content with context; Conversation; Customization; Community Connectedness; Confidence Creation; and Consistent Commitment.

Read/Download PDF version of patient-centered article

Pharma: Ask Not What Social Media Can Do For You, But What Your SM Can Do For Patient Health

Last week, I and a few hundred other SM-aniacs, spent  2-days in the #FDASM 'bunker'-so nick-named for its lack of windows and web/cell phone coverage. (Many more also attended via a free webcast and live twitter.)

Shortly after the program began, I heard a faint voice in the back of my mind. At first I couldn't place the voice or make out the words.  But it grew louder with each presentation. On the train home, I recognized the voice as JFK's, and the words as his inaugural speech "Ask Not What Your Country Can Do".

If you haven't read JFK's short but powerful speech, do yourself a favor and read now.  I think you may be struck by the parallels between the challenges he faced and the vision he articulated to meet them, and the challenges we must rise to as pharmaceutical and social media professionals trying to keep up with empowered e-patients in a web 2.0 world, soon to be web 3.0.   

Here are some of the challenges JFK articulated in his speech that seem particularly relevant to our challenges of engaging and educating patients and doctors using rapidly evolving technologies and strategies. I'll also do my best to link back to the many speakers and presentations from #fdasm.

"The world is very different now..."

• Fact after fact, presentation after presentation, reinforced the exponential growth of the web as a critical information source for healthcare education and community building...Some of my favorite factoids:
• Google pointed out that during just the last 3 months of 2007 there were 4.6 billion searches using healthcare terms made by 111 million people and that healthcare searches are growing exponentially. They also provided examples of how access to information on the Internet can be a public health plus (Read Senak's eyeonfda blog)
• Pew's survey reports that 61% of Americans look online for health information-these are the e-Patients of today. And 37% of adults- or 60% of e-patients- have accessed user-generated health information.
• Manhattan Research: 35% of adults use social media for medical information which equates to 80 million health 2.0 consumers. Mark Bard also presented data on physician web 2.0 use
• In addition to the sheer volume of online health activity, consumers are searching and interacting with one another in highly specific targeted ways. For example, Health Central's quick review of various social media sources last month, found: there are more than 100,000 people on Facebook diabetes groups, there were recently nearly 500 posts on ADHD in a 24- hour period on Twitter, and more than 201,000 searches on "Concerta" in September on Google, more than 40,500 searches for "Cymbalta side effects" in September on Google etc
• However, I hope this means that Pharma can now put all the 'web selling' and 'can you top this fact' finding behind us in favor of identifying and exploring solutions to more effectively engage web 2.0 platforms.
• Web 2.0 and social media platforms have engendered new consumer expectations. 'Selling' is not always welcome in the web 2.0 and 3.0 world. Patients are looking for value-added knowledge- when and howthey want it-notwhen and how the pharma co. (or FDA)wants topresentit. To many e-Patients, selling clearly comes after information and value exchange, but pharmacos should be part of the conversations. Jack Barrette of WEGO Health presented survey data from their patient advocates to this effect. (Q1,2, 3, Q5) (I also suggest reading Patient DC's blog for another e-patient perspective.) Interestingly, physicians also demand a different voice and engagement when they are using social media sites, as presented by both Sermo and Pfizer's Freda Lewis-Hall.
• New information sources, including wikipedia, blogs, chat rooms, and sites like WEGO are establishing new influencers and thought leaders that Pharma and FDA need to consider and engage. However, while Wikipedia is a vastsource of information for consumers, its contentis not 'controlled' by FDA or pharma. Nor are the many e-patient/caregiver blogs and community sites. This means that user generated content (UGC) is inconsistent at best and often incorrect or biased. Importantly, however, the patient advocates at WEGO Health reported that they expect pharma to make their ‘best effort' to monitor and correct ‘incorrect or biased' third party UGC and to monitor adverse events, despite their rational knowledge that monitoring the entire web is impossible.

"But neither can two great and powerful groups take comfort from our present course - both sides overburdened..."

• Neither Pharma/device marketers or the FDA can move forward without developing guidelines or 'guard rails' to enable faster and more effective uptake of social media platforms and tools. (Michele Sharp of Lilly) However, many speakers, including Liz Forminard and Philomena McArthurx at J&J made the case that guidelines must remain flexible. (Read Marc Monseau's blog at JNJBTW)
• Moreover, current communications are often burdened with so much technical and legal language that the average consumer cannot understand or be sufficiently motivated to make the effort to read and comprehend risk and safety information. Cadient highlighted the fact that 30 million Americans are health illiterate. Research has shown that education levels required to understand and comprehend the average ISI and PI is some college education and post-graduate education, respectively.
• This is a case where ‘more is not necessarily better'. More work is clearly needed to "radically simplify" risk language so that it's more consumer friendly, and to better educate the public for the need to report adverse events. Many speakers recommended the urgent need for new and simplified consumer risk language, and/or an easy to use ‘FDA approved' patient symbol to signal quality accurate content, and/or an easier to use and more patient-friendly MedWatch initiative to insure higher levels of AE reporting, including PhRMA, Fard Johnmar, Wendy Blackburn RxRisk icon, Jonathan Richmond, John Mack, Bill Drummy, and Dr. Diana Zuckerman of the National Research Center for Women and Families. (You may also want to read my summary and presentation from the prior FDA Patient Risk Communications Advisory Meeting earlier this year.)

"So let us begin anew - remembering on both sides that civility is not a sign of weakness, and sincerity (and transparency) is always subject to proof. Let us never negotiate out of fear. (Or worse yet, adopt a strategy of avoidance out of fear) But let us never fear to negotiate."

• Transparency and the establishment of guidelines are needed to stop pharma from avoiding social media platforms out of fear of FDA. (Lilly, Global Prairie, J&J, Pfizer)
• Many expressed that the internet is a complex and different medium than TV and Print, and likewise requires unique adequate provision policy similar to how FDA approached DTC TV advertising back in 1997. Given the many different platforms and roles that the web plays, from search to advertising to 2-way interactions and UGC, specific web 2.0 guidelines need to be created and continuously updated. While for the most part, the message must stay the course across different media, there seemed to be recognition that the web's uniqueness requires some new thought and guidelines.
• New ways of looking at benefit and risk tradeoffs are required if we are to support and educate the consumer. Digitas presented research that showed that more risk information does not always result in greater risk comprehension if less consumers read it.
• On the accountability front, Oglivy 360 Digital Influence presented their 3 C's approach to help guide responsible marketing in the web 2.0 age: creation, collaboration and compensation. If the answer is yes to any of these three C's, then the pharmaco is responsible for its content.

"Let both sides explore what problems unite us instead of belaboring those problems which divide us"...

• We need to design ways to put the patient first. Both Google, Ignite Health and Intouch Solutions presented data that showed that the drop in paid search advertising has meant a huge drop in patient searches or click-thrus to higher quality FDA approved pharma.com sites and more...So while on the surface, the 14 letters may have seemed like a prudent idea, the result may be actually something less than preferred with less scrupulous and lower quality content filling the void.
• While FDA and pharmacos may differ on how they might approach the balance of benefit and risk information, they can unite behind the need to "radically" change the way that risk/benefit information is presented to improve comprehension, to provide consumers with a way to better know that risk information they are reading is accurate (many consumers don't check the source), and to encourage consumers to report AE's-as very few are ever reported.

Let both sides seek to invoke the wonders of science instead of its terrors. Together let us explore...

• There was much recognition for the continuous exploration of how to best conquer the fast evolving technology to help educate and instill more responsibility for patient health. Many speakers recommended that on-going committees be formed...
• Great quote by Peter Pitts, Center for Medicine for the Public Interest, "Social media is too important to hide in a cave. It is communication at THE speed of life." (via Roska Digital)
• Wrapping up the two-days, Tom Abrams, Presiding officer for the FDA hearing, reinforced not only the importance of the web to current and future healthcare policy, but that its complexity requires a very thoughtful exploration by FDA. (Watch Pixel and Pills exclusive interview with Thomas Abrams at the conclusion of the advisory meeting.)
  
  
  

And so, my fellow Pharma and Healthcare Marketers:

Ask not what Social Media can do for you - ask what your Social Media can do for patients... Ask what together we can do for the improvement of patient health...     

e-Patients of the world, ask of us the same high standards of strength and sacrifice, education and responsibility, which we ask of you...

Thoughts? Comments? Feedback?  While no meeting can solve the problems of the world, all and all, I think it was an excellent start. My sincere appreciation to all the presenters.

There are also many terrific blogs and summaries on the 2-day FDA Advisory Meeting: Shwen's Live from DC extensive list of #fdasm blogs, Pixels & Pills EXCLUSIVE Interview with Thomas Abrams at the FDA Hearing and others (Rohit Bhargava of Ogilvy PR 360, Peter Pitts, Jack Barrette of WEGO Health), A Patient Perspective by DCPatient,  John Mack, Mark Senak's EyeOnFDA, Roska Digital's numerous updates, and  Chris Truelove's wrap-up which also includes some good links-Yet more blogs and speaker presentations can be found at Fabio Gratton's fdasm.com. And for a list of good blogs leading up to the meeting, read my post: Twas the night before #fdasm.