Collecting ideas and thoughts slightly too big for @digital_pharma

Subscribe via email (no, I won't spam you). You can reach me on .
Posts tagged "hcp"

Facebook is serious about getting pharma on board with social media.

You remember Facebook, right? The number one or two website in the US and the world? The place where people spend insane amounts of time playing games, posting photos, and chatting with their friends? I know you know of it, because I’m almost certain that you have a personal profile on it. 

You may have wiped it from your professional memory because for the last few years, Facebook spent a lot more telling us that it wanted our business than actually learning what it was like doing business within pharma. They were playing B2B footsie, occasionally bending their very retail-oriented rules about commenting and interaction when a brand reallyreallyreally needed them to turn off comments (read: spent a lot of money buying ads on Facebook). 

But you were probably right for writing the FB off as a place where pharma should fear to tread.

So it was surprising to see that Facebook has taken itself to the woodshed and returned a changed company. They really are serious about bring pharma into the fold, going so far as to put together a team of six full-time staffers dedicated to pharma. This team will teach any brand manager or agency willing to listen the lessons learned from the early adopters. They have regular newsletters describing new ways of targeting customers, building brand awareness and driving engagement. They will sit you down and walk you through a deck describing all the ways they can help you achieve your brand goals.

You might be interested in hearing that FB can reach hundreds of thousands of pharmacists, nurses and doctors (and based on numbers I’ve seen, assume 60-80% penetration). They can segment pretty well by specialty type, demographic-type, and geography.

They can also help you build a page that abides by your particular MLR needs. No longer is Facebook pretending all companies are the same: they are serious about getting pharma into social.

And that’s great news. Except one small detail.

While I’m all for getting pharma to embrace the twenty-first century and admit what we all already know (everyone, including your doctor, your mother, your pharmacist, your nurse, your support group, your physical therapist, your KOL, and your pharma executive are all on social media and using it quite a bit), Facebook may have a bit of problem: clicks on their ads aren’t all by people.

Someone has uncovered evidence that as much as 80% of ad clicks that businesses pay for on Facebook are by “bots.” Now, in this world of indexing spiders and other crawling bots, we expect a few clicks on any ad to be worthless because they aren’t being made by a person (good luck persuading a piece of software to ask their doctor about Humira). And it’s safe to say that this traffic is about 1% of traffic we end up paying for. But 80% is outrageous.

It would be easy to say that this is how Facebook is artificially inflating click numbers to charge you more (and if last month’s earnings report is any indicator, everyone in FB is aware of the value of charging clients money: Zuckerberg lost more than $420 million yesterday!), but there’s no real proof. It’s just as likely that bot-writers focus on their software on Facebook because that’s where people are. However, it’s not obvious what their motivation would be to fake-click on links.

As this story grows (and it will, as the “GM says FB ads aren’t effective” story is still fresh in our minds), Facebook will have it’s hands full managing the PR. They will need to prove 1) that it is not doing the fake-clicking and 2) that it is working towards eliminating the problem. Otherwise, all their hard work in building a targeting system we want to leverage will be almost worthless.

Provided it can fix both parts of the fake-click issue, Facebook will be well-positioned to become an effective pharma marketing partner. 

If you haven’t spent 60 seconds reading this article on how Google Fiber is the biggest thing BigG has done since Gmail, you probably should. Why? Because it underlines how important the next big disprupting to tech is going to be, even to (and maybe even especially to) pharma.

Tech specs: First there was dial up. Then there was DSL, which was about 10 times faster than dial-up. Then came modern cable internet (what most of us think of when we think of broadband) and that’s like ten times faster than DSL. But we’ve been stuck at eking out a few more bits per second from cable for the last ten years. Fiber (meaning fiber optics)? Well, if I said it’s going to be ten times faster than cable, I’d be lying. Because fiber is far faster than that.

In a world where we’re all very very used to downloading massive files and streaming Netflix, why do we need more speed? Well, remember when you couldn’t understand why you’d need more than a 486mHz processor to run Windows (to be fair, it was Windows 3.1)? Then came photo editing, and music downloading, and movie editing, and movie streaming.

There are new technologies on the horizon waiting for the bottle-neck of internet speed to get fixed. How will fiber everywhere change things?

Well, we’re start with wifi everywhere. No more dial-up like speeds at the Startbucks because 3 dozen people are leeching on a single connection (and one is on a video chat — who does that?!) to a computer in your pocket (who’s bottle-neck is also internet speeds via 4G). So that means any two people in America with two decent mobile devices can have a video chat pretty much anywhere with a high-res screen interface. Congrats, you just invented a way for a doctor to consult from anywhere: virtual office hours.

Or take EMR to the next level: the ability to collect patient data from anywhere. Not just from doctors, but a simple API would allow my health chart to collect data from my wifi scale, my Fitbit heartrate monitor, my ZEO sleep data, etc. Heck, just plug my Kinect and my doc can give me a pretty good physical… while i’m at home.

And pharma? As it starts to open up to being a health care partner instead of “just a pill-maker”, it can interact with all its customers in real-time. Mobile phone apps can become pill-reminders and track that data, embedding it into the EMR. 

But the real breakthrough will be in understanding Adverse Events. With so much data now being tracked and dumped into a central location, pharma will be able to see in weeks that there might be an unanticipated reaction with some real-world factor.

For example, clinical trials reveal that 0.05% of people who take your brand get nauseous. Your clinical trial won’t give you enough data to see what other factor creates that condition. But four weeks after brand launch, you see that people in the real world reporting nausea have also been diagnosed with sleep apnea. A quick study can confirm the finding and that information is now added to the label.

Fiber brings everyone closer together, and that includes HCPs, patients and pharma.

You have a great eLearning program. No, really. I can see every dollar you spent on getting that KOL on film with a killer script that nails your message. The camera work and editing is spot-on. The coding work you did to build a custom interface is delightful. The website is fast, clearly laid out behind a login, and it even remembers which videos I’ve watched and where I left off last time. Excellent stuff. Kudos to your agency partners for putting it together. I bet you get great traffic, and that everyone involved got a nice pat on the back when it came time for their annual reviews.

There’s just one problem. It might as well not exist on my phone.

This is unfortunate, because I get all my email on my phone, and you guys send me emails all the time. They practically beg me to click on the link and watch the video, but when I do, I get a big grey rectangle. Or an error message (which is funny, because I didn’t do anything wrong). I wonder how much time and money you spent on that pretty video that is completely useless to me.

Suddenly I don’t like your website anymore, mostly because it’s built around encouraging me to watch a video I can’t actually watch.

You’ve looked at your email metrics lately, right? You know that mobile devices account for anywhere from 40-60% of all email views, right*?

*[how do I know that? Because we have access to 29,000 Texas HCPs and we send them bi-monthly newsletters and that’s what our email metrics say.]

Have you looked at your web metrics? In particular, the percentage of mobile traffic to your site, and how it has grown at a near-exponential rate for the past year? That means that all those technical decisions you made only 12 months ago are kinda worthless now. Can you see how desktop traffic stays around and watches your movie, just like you want them to, but that your mobile traffic is almost all gone a minute after they show up? I bet you can (and if you can’t, I’m betting your web team can show you).

If you embrace the idea that mobile is here to stay (and if you’re reading this on a tablet or phone, I think you do), you need to understand how people use these devices.

Allow me to direct your attention to a study [] that shows that tablet and phone users are more than happy to watch a ten minute video on these portable devices. The small screen is no deterrent. In fact, sitting on a train or waiting in line might be the only time your target has a chance to watch your epic video.

The problem isn’t just the file format. It’s not too much trouble to re-render the movie into some format other than Flash, but any interactions you’ve built in need to account for the fact that on a tiny screen, buttons need to be big and easy to use. And a mobile user is more likely to need that pause button. The rule of thumb, as described here [] is that the smaller the screen, the smaller the slice of time the device works best at filling. When they start watching your movie in line at Costco, they may need to come back and finish it later. Not accommodating that behavior means that HCPs just won’t come back.

We’ve also seen that emails opened by phones tend to get opened sooner. We think it’s because most people carry their phones around with them everywhere and are happy to check their email dozens of times a day, rather than checking their email a few times a day at home on the laptop.

So are you ready to embrace mobile and walk the walk? Just don’t walk while texting.  Will you go full-mobile to get your eLearning video seen by more of your target list? Yes? That’s what I figured.

How often is too often to send an e-mail to someone? What’s the magic number of e-mails per day/week/month that defines the border between Helpful Communication and everyone’s nemesis, Spamistan?

That magic number is three.

Oh, was that not enough information for you? Oh, okay, I’ll spell it out. 

First of all, let’s all embrace the idea that one person’s spam is another person’s (um, your and my) job. Yes, there are messages that are always spam, like the ads for Canadian Viagra, Lovely Ladies Looking for Me (ladies, do you get spam about hunky guys who are new in town? Just wondering), Foreign Exchange Investing, and Re-growing Hair (huh… I just realized that a huge percentage of the spam we get is tangentially pharma related. I wonder what that means? Anyway…). 

But if these messages are spam for everyone, no one would ever make a dime from those e-mails. And if there wasn’t any money in it, no one would be spending money on sending them. Thus, there are people out there who believe that that pill is their long-lost answer to male pattern baldness. Even Viagra spam is someone’s idea of an interesting message.

So there’s no such thing as perfect spam (i.e. an e-mail message that has no value to anyone ever). That also means that there’s no such thing as a message that’s 100 percent interesting to everyone. Even e-mails I normally look forward to getting might feel like spam if I don’t have the money to spend on them today.

So everything is on a “spam spectrum,” as it were. A good marketer’s job is to position all the elements of an e-mail campaign to make the message feel relevant and useful to all the recipients (relevant and useful being the opposite of spam). This involves designing the e-mail to be readable, even if images are turned off, removing as many spam-flagging words as possible, picking a time to send when it won’t get lumped in with the rest of the early-morning or lunch-time spam waves, and doing the technical work to make sure e-mail servers don’t think it’s been mass-mailed from Russia. 

And good marketers will make sure that the content of the e-mails is actually useful to as many people as possible. 

I know it’s a given that we think that HCPs need to be sent an e-mail every X days or else they’ll forget about our brands. We think that if HCPs don’t see our logo every day, they’ll assume the brand is gone and never prescribe it again.

I’d like to challenge that assumption. I believe the if we sent an HCP five e-mails in a row, say, once a week or so, to explain the value of our brand, to show off its method of action, how it’s different, when to prescribe it, its safety record, you know, the entirety of our brand’s value proposition, we should stop and get out of our own way. Thereafter, just send news like new research, label changes, formulary changes, etc. Oh, and maybe an occasional “thanks.” And that’s it. 

As we get closer to better managed and used CRM systems we should be able to do this very easily. But instead, we take a few dozen messages and send them out every X number of days like clockwork. It doesn’t matter if there’s something useful or relevant to HCPs for us to send, we just send it because our instinct says a semi-worthless message is better than no message at all.

Which brings us back to the magic number three. No, what I’m about to say has not yet been tested. I’m basing it off my experience and some basic sociology and psychology. So here it is.

When your audience gets the third message in a row that it doesn’t see value and relevance in, they reach for the spam button. 

Of course, the issue is that what’s valuable to one person (male-pattern baldness cures) is worthless to many others. So a marketer’s goal is to build more and better high-value e-mails, ones that don’t invite spam complaints.

So you can see why I’m intrigued by the idea of short-course e-mail campaigns instead of year-long clockwork campaigns. By distilling your best content into a five-message run, you might have a more powerful campaign on your hands – one that actually costs less because you’ve stopped building and sending fluffy content that serves no purpose other than to count as a “touch” in your (okay, our) metrics. You’re able to focus on building a handful of killer messages instead of thinking up ways to spread your messages out even further. Remember, Apple built the capping to remake itself as a home-computing expert with a single ad that only ran once. Quality, not quantity, will put your message into your audience’s mind.

Even if you’ve heard the news from Facebook, you might not have seen the implications from a medical/pharma standpoint. Facebook announced a new tool called Facebook Timeline. Scrape away all the marketing copy and you get this: All that stuff you enter into Facebook (and Tumblr and Twitter and Foursquare and Flickr et al) aren’t just quips and stories and complaints and jokes and whatnot, they are the ephemeral data about your life.

If your doctor said, “I’d like you to keep track of how many cups of coffee you have, how well you sleep, when you go to the gym, and the like” you’d hear, “Do a bunch of tedious homework.” If your doctor said instead, “Hey, since you already track when you go to Starbucks and the gym on Foursquare, and complain about your lack of sleep on Facebook, can you keep doing that?” that sounds easy.

And now you can. Or rather, you already have.

Facebook, users already engage in countless acts of data entry, so it’s possible that the data [life-tracking pioneer] Felton will be visualizing will already be available. Automated data gathering through smart phones—especially location data—provides even more data to mine.
-Christopher Mims at MIT’s Technology Review

And that’s where things are about to get interesting. We’ve been sitting on the precipice of some seriously cool ideas and tools for collecting, measuring and analyzing data, but they’ve all suffered from one of two problems: Lack of broad support or lack of fun. Facebook solved both those problems.

99% of the people who are interested in, and who would benefit from, collecting and analyzing their own data are stymied by the idea that it’s a lot of work. At the end of the day, do you really want to rely on your memory? Or do you want to interrupt your life a dozen times a day and look like a dork doing it? Oh, you’re updating one of your social media services? You’re no less of a dork, but we all understand now.

And while Facebook is pitching Timeline as a way of easily keeping track of the birthday/breakup/roadtrip/concert parts of your life, people are already thinking about how to leverage all this info for medical and wellness tracking purposes.

Granted, this is Facebook we’re talking about. These are not people who have a stellar track record when it comes to privacy. Or trustworthiness. Or professionalism. And while the intent behind all this work is clearly to be able to market products and services to us in a way that may actually be something close to interesting and useful, the opportunity exists for the data to be used in more meaningful ways… assuming Facebook can be persuaded to open the door to others, something it doesn’t like to do.

So who’s going to be the first to build a Facebook App to start to collect and use people’s wellness data?

This post appeared as a guest-blog piece over at ePharmaSummitBlog. I’ll be there once a week and save a copy of the posts here.

So I’m putting some research together for a project and something hit me. Something I probably saw, read, or even thought before but I felt the need to write it down this time just so I could say that I did.

Here it is: Social and Mobile could never have become so big without each other. They aren’t so much conjoined twins as they are two separate organisms who support each other to the point of barely being able to survive without the other. 

Facebook was cool until everyone had a smart phone and could document and comment wherever they were, at which point it was like flipping the switch and suddenly everyone was on Facebook. Remember when the big feature of Twitter was that you could post to it from a text (hence the 140 character limit) from any phone? And did you see that Facebook has spent the last few months making a FB client that could work on almost any non-smart phone? You don’t spend those kind of resources unless you realize that mobile is vital to social, but that you’ve already cornered the smart-phone market.

And why else would mobile have grown so fast without social? To play more Angry Birds? We’d all have just bought GameBoys and PlayStation PSPs if it was about games. How does Apple impress you and get you to upgrade your iPhone? Twitter integration.

So from that we can ask two questions. One: why does pharma insist on separating the two? Two: Why would Google launch clients for G+ for Android and iPhones, but neglect to include iPads?

The reason pharma separates the two is obvious: Mobile is easier than social. There are so many rules (spoken and unspoken, written and unwritten) as to all the things pharma is not allowed to do in social, so it’s pretty much turned its back on it to focus on mobile. I get it, but that’s kinda like only exercising your right arm: neglecting your left arm isn’t just neglecting your left bicep and tricep, it’s really neglecting all the muscles between those arms: your chest and back which are the foundation to strong arms. It’s a short-sighted strategy and will soon result in diminishing mobile returns. 

For example, the FDA could start treating mobile a lot like it does social. Oh wait, it is! You’ve by now seen that the FDA will start looking at treating mobile apps like medical devices (which is actually not all that different from how it looks at social).  You can read Dave Ormesher’s post on it from this morning here.

Two: Why launch a Google+ iPhone app and not an iPad app? I wish I had an answer. I just know that I wasted five full minutes trying to find it in the app store to no avail (I even have a suspicion that they are blocking iPads from downloading the iPhone version).

Anyway, comment and twitter me. Tell me I’m wrong! @digital_pharma

Over at, the question was raised: Should Pharma/Biotech even bother with social media?

"…social media is about engagement and sharing; dealing with the challenges of unhappy patients complaining publicly online via social media puts Pharma in an awkward spot regarding how to handle issues that may arise" (misspelling are mine, as they disabled copying on the site). 

My response:

"So, you don’t think installing transparency via social media would increase the public’s ease with pharma and biotech?

"I would guess that the lack of transparency coupled with the fear that comes with any major medical issue is what causes the friction between the two groups. Which is terrible because pharma and biotech save lives. The public should see them as fire-fighters, not corporate behemoths."

It’s going to be very hard to break through this wall together is many of us question the need to break through at all.

So here we are, on the verge of Canadian and American holiday weekends, each celebrating independence. Can those who can’t see how such tools would benefit the industry overall speak up and explain their reticence?

Comments are open and I love to be twittered at @digital_pharma

So how do HCPs get new info on pharma? Almost half go to standard sources like books and sales reps or go to conferences and symposia (based on recent survey data). Of course, according to data presented last week at the CRM forum, 80% of HCPs carry around a smartphone for clinical use (25% carry a smart phone and an iPad: those white coats have huge pockets). 

We could just say that there is overlap. No biggie. Some people with smart phones might think that the screen is a little small for certain things, or don’t want to use it to read books. Sure. I get it.

But in the same survey at the top of the post, only a third of HCPs say they use the internet to get new info. Whatwhatwhat? 80% do clinical work on smart phones, but only 40% of them use the internet? 

Either HCPs (like so much of America) don’t really know when their device connects to the web, or that we are seeing the last vestiges of the old school v new school fight as it falls away.

Okay, speaking from a pharma marketing perspective here, there are really two kinds of HCPs. They aren’t grouped Tech vs Non-Tech. They are grouped There Is A Way To Reach Them vs No Way. It’s not “no-see” HCPs that are hard for me to deal with, it’s HCPs who aren’t interesting in anything new. They don’t want new technology to use to prescribe or learn about new treatments. They don’t need a new toy or new ideas. They know enough to do what they need to do and are done. They don’t spend 8 hours a week after office hours learning new things (on average). They don’t view eDetails, see reps, go to conferences or… anything. As a marketer, I have nothing to offer them.

So-called “no-see” docs aren’t not interested in learning, they just need pharma to be better at being there with content when *they* need it. And we are. eDetails and FaceTime and virtual rep visits and HCP-facing sites and all the other ways we leave content for HCPs to use on their time are good. If we build content that assumes all these different ways of communicating, monitoring all channels in aggregate, making adjustments to each to create a successful communication strategy, we can stop worrying about if this channel or that channel is where they all are. Here’s the answer: They’re all over. Make good content and put it everywhere.

Vacation time! Have a great long weekend everyone!

Over on, Dr. Eytan put together a quick survey of doctors on Sermo about HCP attitudes about social media. It would seem that HCPs are not interested in establishing an online presence in the social media world. In fact, as we have seen in other reported instances where HCPs attempt to stymie patients from even mentioning them on social networks, it would seem that there might be a real wall between HCPs and social media.

The first question is: are these cases outliers or are they indicative of a broader distaste for social and the web? I have no real numbers at my disposal (if you have them, share please!), but I can make some inferences. Since Dr. Eytan’s survey isn’t of HCPs overall, but of HCPs in Sermo, we can see that these people who don’t care for social media are fairly savvy internet users overall in that they are on Sermo and participating. That puts them one step ahead of most (though recent hissy fits about “sudden realizations” that Sermo was collecting data for marketing purposes may indicate that Sermo users aren’t completely internet savvy, I will assume for the sake of argument that if you are online and participating in an online community, you’re in the top quarntile of HCPs).

If these HCPs, ones who know more about social media than most have such a poor attitude towards social media, we can assume that those with even less exposure have even lower attitudes towards social media.

Any disagreements with my logic thus far? Okay.

Add the fact that HCP’s Facebook pages are better ranked than their professional pages on their practice websites and you’ve got an interesting shift building: HCPs who embrace social media will have a huge advantage against those who shun social media. Not only will Social-Savvy HCPs have better ranked pages online, when people try to make a decision about what doctor to choose, they are going to be more likely to pick the one they are the most familiar with, which would be the one that shows pics of the HCP fishing or hanging out with their dog or whatnot. Patients are going to pick Social-Savvy HCPs because they will presume that there will be a better connection with them and the HCP, if for no other reason that they can see who the HCP is and maybe (maybe!) even connect to them directly on social media sites (Can’t you see an HCP’s wall being full of posts from people who say things like “Thanks, Dr. XYZ! You made me feel so much better and that prescription really alleviated my issues! You’re the best!”? Who isn’t going to choose that HCP ten times out of ten versus the one with the single “professional in a lab coat with a stethoscope in an office” pic and a paragraph about what schools they went to?).

So let’s call this an opportunity for revolution. The Social-Savvy HCP can step in and take a lot of business from those (and they seem to be legion) who would avoid connecting to social media in any way. This is going to be the new “way things are” very soon. Non-social-savvy HCPs should stop pretending it isn’t about to happen and join the rest of teh world online.

I’m gonna stop the song and dance about social media and how pharma can use it, because we’re all struggling with a mostly unspoken issue.

As marketers, we want to be able to get our message into every channel we can: we know that it’s not the first commercial that causes people to buy, it’s the tenth (or twentieth or hundred, depending), so we know being in every channel increases the odds of hitting that magic number of impressions (yes, it’s not about sheer numbers. A clever message can cut the number of necessary exposures from a hundred to two. But that’s not the point here).

But good marketers know that in order to work, our message needs to abide by the rules of the channel. Not much value in a TV commercial without video, a billboard that’s only four inches tall, or a banner ad that doesn’t link to anything, right? These are the rules of the medium, and marketers can bend them some times, but otherwise, they have to respect them.

So what are the rules of social media? Simple: people connect to people. That’s what the Social in Social Media is referring to. You can make an emotional connection to a brand, yes, but you can’t really talk to a brand and get a response. Plenty of people have an emotional connection to the Apple or Google brand (or Lexus or Audi or Skullcandy or Twilight or Twitter or or or…) but though I love Twitter and what it stands for, I don’t expect the brand to have a conversation with me. I will never meet Twitter at a party. I will never run into Twitter walking its dog.

I can have a conversation with anyone on my friends list. I might see them at Starbucks. I can be social with them.

But since the world went social, marketers have followed, trying to bend the rules of social to work for brands. Old Spice Guy. The Most Interesting Man In The World. I, myself, once was @BuckyBadger for the University of Wisconsin. I could interact as a person pretending to be the brand, but its was very limiting.

Once, before the advent of good Twitter tools like HootSuite or TweetDeck, I accidentally porn-spammed a thousand people (porn owns every typo version of Facebook, fyi) and fixed it five minutes later. I made a joke about how hard it was to type with big fuzzy fingers. The joke was funny and no big deal, but should the brand be making jokes? Can Coke make a joke? No, the people behind it make jokes. So marketers have realized that the key to successful social media is to make it a person in charge of the brand presence. Give them the brand a persona and let it interact (FYI: Colonel Tribune is a great example of this).

Here’s where thinks get super difficult. Pharma brands can’t interact. They can’t talk about what’s off the label, they can’t put themselves in a position where someone might report an adverse effect and they don’t see it immediately. Pharma rules are very strict in this regard. They have to be, because we all know that without regulations, pharma would be involved in the process, tainting it with… something.

Here’s where I suggest a different approach. I suggest we all embrace the idea that we’re all in this together, that pharma has all the data on its product (or at least 95% of it) and it should share. In return, they get a seat at the table in talking about their product. Of course, they can’t claim it solves problems it doesn’t, but to treat them like they aren’t a player is ludicrous. We need pharma to be involved as much as pharma needs a regulatory agency to keep everyone honest. This means that pharma can brand and talk about their brand like Coke or Disney does. They can be on Facebook and be given the benefit of the doubt that they can interact with people on it without breaking rules. That a big link that says “please send adverse effects here and not on our Facebook wall” is enough. That they can misspeak so long as they fix accidents with all due diligence just like Honda or Home Depot. 

Making pharma transperant solves the social media problem, but it has other effects: it removes barriers between company and regulatory and customer. It fosters innovation. It builds smarter companies. If Google can, why can’t Pfizer (who have very similar market capitalization)? 

Lets focus less on building more walls and build more transparency in pharma.