Collecting ideas and thoughts slightly too big for @digital_pharma

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If you’re reading this post, there’s a good chance it’s because someone mentioned it on Twitter, Tumblr, Quora, Facebook, on another blog. And if you are aware of these kinds of social tools, you’re probably already aware of measurement tools like Klout and Kred (I assume Kwality and Kwant are just around the korner). Even if you don’t check your Klout score, you’re aware that someone who has a high score is indicated to have a larger and more robust network than someone with a low score.

Yay! So what? Well, what if there was a tool that measured not just the value of a network, but that also determined the value of content depending on the scores of those who wrote it or read it? For example, when someone with a low-scoring network (a “nobody,” to use more earthy language) writes a post, it would sink to the bottom of the rankings, unknown and unloved, because that person hasn’t built a robust network for themselves. However, when a higher-ranking person (a “mover and shaker”) writes something, many people comment on it and share it., Why? Because being a part of such a high-profile post confers some status on the commenters and sharers. Perhaps even enough to nudge their scores higher.

This new measurement tool concept isn’t fantasy, this is something that is about to happen. And it represents a serious shift in the marketing landscape for pharma.

Part of what Google Plus is doing is allowing all authors, bloggers, commenters, posters, commentators and social-network “talking heads” to collect their total body of work in one spot. This spot, called a G+ profile, allows Google to figure out who’s writing the best content and give that person a score (much like how PageRank scores web pages based on their connectivity to other pages).

Very soon, Google will start adding a person’s G+ score to its complicated search algorithm as a means to weigh the value of that person’s page. Thus, the page by a “nobody” will move way down in the search rankings compared to one by a “power networker.” In fact, Google’s intention is to place a higher value on pages written by authors it can find on G+.

Can you see where this is going? Can you see how someone who has a solid network of fans and friends, who writes a lot and engages in a lot of online conversation, has more clout with Google than a faceless, authorless corporate page? Suddenly, Google has opened the door to someone who doesn’t work for your brand to rank very highly in a Google search on your brand. Your brand’s top search results are no longer guaranteed to be your page, wikipedia and the NIH. Someone who’s very motivated and connected will have a very good shot at making the top ten (or five!) of your Google search results. And there’s no guarantee the content they’ll be generating about your brand will be positive, or even accurate.

This search-scoring approach is called Google Authorship. It aligns with how Google sees the web. It wants an internet filled with hand-written content, built by people, not corporations. It wants more personal perspectives and fewer “talking points,” because it believes that’s how we create more authentic content for the world.

How serious is Google about all of this? Well, if it knows that you wrote a post, it will attach your name and picture to that post within its search rankings. That kind of visibility shows where Google is trying to take its idea of authorship. However, if you attach authorship to a company, Google will reject it. For example, if you try to attach authorship to your corporate page, where the avatar is a logo, it won’t show up. Google is using facial recognition software to verify that a “person” is being attributed as author.

Right or wrong, Google is a serious part of your marketing plan, and any change it makes is something you need to consider.

But how? In an industry where comma placements involve protracted Medical, Regulatory and Legal discussions, how can we let “regular people” talk about our brand? The fear of AE reporting alone is enough to make a mortal pharma marketer quiver in terror.

Well, one idea is to personalize your brand. Much in the same way Steve Jobs was the face of Apple and Howard Schultz is the face of Starbucks, you can designate someone in your company to be the “face” of the brand. Sadly, the second that person leaves, you’re in trouble.

Another idea is to build a G+ page for your brand, and select the caretaker of that page to be the face of the brand. Should they leave, someone else can simply take over the account.

You can ignore Google authorship at your peril, or you can see this development as the sea-change that motivates your brand to get serious about social communication. After all, what’s more social than having a “brand face” that people can engage with?  The time of playing ostrich is over, folks. The time to finally figure out how to get our brands engaging socially is now.

Thanks to Andy Crestodina of Orbit Media for doing the legwork on Google Authorship.

So yesterday, after having poked at Pharma Guy’s stance on gamification, I got called out pretty severely by John Mack. Reading between the lines, I feel like he called me out as some sort of gold-digging digital con artist, so that was fun. Maybe it’s a case of, “You’re nobody in this town until Pharmaguy makes fun of you.” Perhaps I should take it all as a weird compliment.

Ignoring the ad hominem attacks, I’d like to dive deeper into Mr. Mack’s argument against the likelihood of the FDA ever approving a game as a proper treatment, the likelihood of a doctor prescribing a game, and the likelihood of an insurer paying for any of it.

The truth is, there is no proven science that games can, in any way, treat a patient’s condition better than a drug. Mr. Mack drills that point home pretty hard, which is fine because it isn’t the point I’m making.

The point I was making is that just because something doesn’t work now, it doesn’t mean that it can’t work in the future. In fact, the entire pharmaceutical industry is predicated on the idea that this particular clump of atoms form an unusual molecule, which when applied to certain people, cause certain outcomes. At one point, penicillin was just mold that grew on bread. It didn’t cure anything until we applied some science to it and learned what it could do.

And, like games, the first time we tried penicillin, it didn’t work. We learned, through trial and error, applied via the scientific method, the best way to use it to stop infections. I wonder if there was a Mr. Mack in 1928, claiming that no one would ever eat the mold off of bread because no one had ever been cured by it before. Or that no one would pay for moldy bread bits.

This all gets even more interesting in light of Mr. Mack’s post today in which he is supportive of the idea that people play games in order to stave off the onset of Alzheimer’s disease. You’ll excuse me for being confused by his position. Regardless of what the FDA will or won’t do tomorrow (as my crystal ball is in the shop), pharma’s reason for being is to discover find whatever solutions to people’s health care issues they can, no matter how unlikely or unusual the source. They were skeptical of tree frog venom, once. Video games seem obvious in comparison.

Frankly, the day pharma can build a game that treats a disease (in a scientifically-provable manner) nearly as well as a brand, is the day pharma finally realizes how much money can be made from this. That’s when pharma takes gamification seriously and issues about the FDA will be figured out.

Also, since games probably won’t have much in the way of side effects, does the FDA really need to be called in to do anything more than verify that the game does what it says it does? Indeed, proving one’s claim hasn’t stopped, say, magnetic jewelry makers and vitamin salespeople from edging in on what should be solely pharma’s domain.

The real issue is that pharma, by playing ostrich, is letting tech get a huge head start. Kodak used to believe that no one would want digital pictures to much the same effect. Acting outside the traditional pharma section puts tech in a position to be a true disruptive agent. Ten years ago, no one thought a guy with a list named Craig would be able to put thousands of journalists out of work. So let’s not assume the protective force-field of the FDA will stop tech companies from trying to do to pharma what Craigslist did to classified ads.   

So, in an honest attempt to learn where Mr. Mack stands on the issue of gamification, I will ask that he define his stance free of argumentative distraction like the FDA, insurance providers, and things not necessarily germane to the issue at hand. I think that would be very enlightening.

It’s hard to remember, but there was a time when the idea that disease came from unseen microscopic organism that moved from person to person (or from water well to person) was something akin to “magic.” Disease was a function of luck, karma, the god’s displeasure, or some secret failing of one’s own soul.

You know what changed all that? Science.

So, if I told you that there was a tool whose regular use lowered (and even eliminated) a patient’s symptoms, and I could back it up with a set of clinical studies, you’d have to assume that I had a viable product on my hands, right? That’s the rule that pharma follows for the pills, topical treatments and injectables right? 

But last week, Pharma Guy decided to stomp all over the idea of gamification like it was irritating pest. A game that helps kids with ADHD train their brain to not need Ritalin? Laughable!

Now, I’m not picking a fight with John Mack (oh, wait. Yes I am), but he seemed to take actual joy in pointing at it and calling it names.

I’m not calling for pie-in-the-sky (mmm… pie) thinking that leads to rose-colored glasses (so hot this year), but in science. If I can prove that a divining rod is far more likely to predict water than a placebo, it may seem like mysticism, but science proves that there’s something there (not that I have any proof that divining rods are any more than drought-based snake oil). And it’s the same with all sorts of things that aren’t pills and topical treatments and injectables and whatnot. I can’t see how penicillin works, but science proves it does, so that’s that.

Why can’t we apply the same rational thinking to games?

It seems like Mr. Mack is focusing on the politics of funding, testing and reviewing a game like a drug, and I agree that it’s a long road to follow, but pharma follows the path where science leads. What if playing a game every day really lower or eliminate the need for taking Ritalin?

Let’s not forget that games probably won’t have a lot of side-effects like nausea, heart palpitations and addictions (like Ritalin does). And what kind of adverse events would a game cause? Yeah, that doesn’t seem like a path worth following, does it?

The best part is that pharma can and should be making money marketing these new kinds of treatments. If pharma doesn’t get on ball and start playing with these ideas, the tech world is going to beat us to it and shut us out of the market completely. We’ll be busy playing an outdated game while tech moves the playing field out from under our feet.

Now, I’m not saying that we shouldn’t apply a critical eye to games like we do any other brand, but declaring them dead before they’ve had a chance to prove themselves like any other brand is short-sighted and closed-minded.

Or maybe Pharma Guy thinks washing one’s hands before an operation is lunacy.

Just wondering.

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.

Three years ago, someone was able to estimate that most people in America saw about five thousand ads in a given day. Before most people were on Twitter and Facebook, you could anticipate that your audience was subjected to more ads in a day than your parents saw in a month. Objectively speaking, that a whole lot of ads.

Let’s do some very simple math. How many HCPs are on your target list? Even if you filter out your low-performing deciles, what are we talking about? Ten thousand people? Is that a safe number? That means that in a day, your targets are seeing… Carry the two… Fifty million ads. In a day. Times 365 days, that’s 18.2 billion ads.

And somewhere, your friendly neighborhood brand manager is hoping that they can catch their target’s eye. In fact, some might be hoping that they can buy up lots of ad space to try and blunt a competitor’s message upon launch.

What the numbers tell me is that there is a nearly infinite space in which to advertise (remember, the 5,000 number predates Facebook’s growth, which now accounts for one in every five page views in America. Let that idea sink in a little bit) which means that the job of ”simply” increasing brand awareness in so much space is a full-time job. You are, in essence, trying to get someone to see your particular star in a milky way of stars. And in a world of Pepsi and Coke, Disney and McDonald’s – the stars that can spend big cash to look as obvious as Orion’s belt – how can a non-blockbuster brand even register?

Well, the answer comes down to message and placement (though I’ll save a discussion of messaging strategies for another day). At its most basic, it’s about delivering what you want to say to someone who’s inclined to listen to it.

You can target “old-school-style” by buying placements on HCP-centered websites and networks (like WebMD and eHealthcare Solutions) or electronic medical records sites (like PracticeFusion or Precision Health). These kinds of sites allow you to filter even farther, focusing on specialty, condition, and sometimes even to specific people on your target list. Some companies, like PracticeFusion, can even tell you how well your ad buy is doing to increase prescription-writing (by holding back a sample of the target group and comparing the two groups at the end of the test period, they can see if seeing the ad changed the HCP’s behavior).*

Or you can “kick it new-school” and focus on behavior-based placements (like when a target hits your branded site, gets cookie-ized and suddenly sees your ads on USAToday or their Google Reader). This placement process lets you filter to a very specific group of people in places that fall far from the usual HCP-centered sites. The question remains whether unusual placements like this are useful, as your target probably isn’t thinking about their patients when they are searching for a tee time or researching vacation destinations.

These same placement strategies can also be applied in a competitor-blunting process without going broke in an attempt to completely ad-block them.

For example, if you have a competitor launching in May, you can use old-school placement strategies to target placements during the month before and after May (they won’t be able to counter before their launch and they may leave buying placements until the last minute to avoid the possibility of having to push the date back and wasting money). This is your opportunity to seize as much brand space as possible.  

You can combine that with an email push which embeds a tracking cookie on their system. A re-marketing (sometimes called a re-targeting) campaign, done just before the competitor’s launch, can push a lot of placements on a variety of non-HCP locations. Best of all, re-marketing costs are a small fraction of those on HCP-centered sites.

In the last year, we’ve seen a huge upswing in the places and ways in which you can target your users. Are you up-to-date on all of them, or are you trying to negotiate banner ads on

*full disclosure: I have placed Insertion Orders (the industry term for buying ad space) with PracticeFusion and EHS, and have had conversations with many reps from the companies mentioned in this post. I am not attempting to recommend any of them, just trying to show you that there are a lot of options out there.

It wasn’t that long ago that my mother got all of her email on paper. Once a week, she would check her email, by which she meant she would have my dad log in, delete the junk mail and print out anything that was relevant, interesting, or useful. Then, she would call people back. She was proud to tell people that she was up on new technology like email and would give out her address to anyone who seemed interested.

Since most people didn’t get a response for almost a week via a completely different medium, eventually everyone learned to just call.

This begs the question: was my mother really on email? (is “on” the right preposition? Whatever.) She had an email address, and she got information through it, but wouldn’t you say that she was just bending the medium against its inherent… “emailness?” You might cover yourself in feathers, but that doesn’t make you a bird, does it?

I have a similar (mostly internal) conversation about pharma and social media. We all know that social media is mainstream. Does anyone reading this not have their own personal Facebook/Twitter/LinkedIn accounts? I didn’t think so. We’re social, and the numbers tell us that pretty much everyone else is, too. When you post to Facebook, have you ever thought about turning off comments? No, of course not. You might think about blocking your brother-in-law because he’s obnoxious and won’t stop posting political rants, but you would love it if everyone you knew commented on that photo of yourself, especially if they comment how good you look.

In return for comments, you’re more likely to comment on other people’s posts, maybe even share videos of babies giggling or helicopters made of stuffed animals. The funny thing is that you might have done stuff like that even before Facebook. You might have had a blog of great links, a LiveJournal, or maybe you just passed emails around with your friends and family. You were “social” online long before you were on Facebook.

We can’t mistake the platform from the intention. Facebook the “social” platform merely facilitates your intention, which means that simply being on Facebook doesn’t mean you are being social – you’re just leveraging a social platform. Being on a social platform doesn’t mean you’re social. To return t the bird analogy, it just means you’re covered in feathers.

So many pharma brands are patting themselves on the back by claiming to be social, when they are really just on Facebook, furiously fighting to turn off all the functions and features that make Facebook social. To pharma, Facebook is just a blogging platform with a lot of unnecessary (and risky) opportunities for people to talk back. However, it is the conversational features that make Facebook social, and what made it popular in the first place.

No one wants to get messages from Pepsi and Doritos and the new Batman movie. What they really want is to be social, either with other fans, or to the brand itself. For example, if you “friend” the TV show Archer (it’s a cartoon for adults) on Facebook, you will get posts from the character Archer himself. You can reply. You can be social.

Now, I appreciate that there are rules and guidelines and all sorts of medical, legal and regulatory concerns that keep you from making your brand more social. Maybe that means you shouldn’t be spending all this time and money trying to pretend to be social. The same resources, if dedicated to smart emailing and texting (tech that’s more than 30 years old, now) would reap far more benefits without having to pretend that your Facebook page’s seventy friends (almost all of whom work for the brand in some form or another) are worth the money it takes to post.

It’s very possible that pharma brands’ trying to be social is as valuable as attempting to email people without a computer. Sure, you could create email accounts for all of them, allowing you to claim some great innovation, but since your targets can’t actually access them, what’ the point?

I’m not anti-social. I love social media (my twitter accounts attest to that). But we need to use it right, or else use it not at all. Pretending to be social in the pharma sector is just a great way to spend money.

And get covered in feathers.

I am a hoarder. Not the “I’ll be appearing on an A&E series next month, buried in my belongings” type of hoarder. I’m more the “Oooo, that book looks interesting! I’ll buy it and probably never actually read it” type of hoarder. I used to have shelves and shelves of books, but then I started paring them down to the point where I bet there aren’t 50 books in my house. However, I have hundreds of electronic books that I hoard like an old lady with cats.

I hoard them because they make me feel as if I have access to new things. Every new book is the opportunity to learn something new and amazing (though, in reality, it’s really like there’s a 4.7% chance the book will be worth getting past the first few pages). I collect them in some vain hope that having them on my iPad will make me more likely to be smarter by some sort of mental osmosis.

Alas, it doesn’t work for college kids who buy their textbooks but never crack them open, and it doesn’t work for me, either.

I’m guessing you have collected a lot of data lately. A lot of sales numbers. Geographic distribution data. Attitudinal data. Behavior data. Data about how many and who opened that last email, and the one before that, and the one before that. You know who is registered on your site, who watched the last eLearning, requested a rep, requested samples and requested patient sales cards. You know their specialty, probably where they practice, probably how old they are, where they went to school and if they ate lunch you paid for.

That’s a lot of data. What good is it doing you?

Ostensibly, you’re going to use that data one day. You’re going to hire a bunch of geeks who did their own math homework and probably majored in mathematical modeling. They are going to unlock that data and turn it into something called “usable insights.” You are going to apply those insights, increase brand awareness by 17% per annum without spending any more money, and get that promotion and corner office you always wanted.

That’s a great story, but are you really ever going to use that data?

How much did you spend on your data in the last month? The last year? The last five years? How much do you spend to maintain all that data every month? What could you spend that same amount of money on to make the needle move right now?

Let’s explore a simple “what if” scenario. If I told you right now that female PCPs over the age of 45 are prescribing your brand 20% more than the average (a fairly interesting and important finding), what could you do with that information? How long would it take you to design a campaign that focused on that segment and got it approved and launched? Three months? Six? Would the insight I just gave you still be useful in six months?

To that point, how hard would it be for you to turn off existing messaging to that audience? Could you do it in a week? A month?

The ability to respond to data insights is as important as the data itself. Just as the ability to leverage the knowledge in your books is predicated on reading and digesting them, getting value out of your data is a function of being able to change course. The CRM that holds all of that data is worthless without the system in place to leverage it.

Now, I’m a known fan of CRM strategies. But if you can’t commit to one – if you can’t commit to building a system that can respond to new information –  stop what you’re doing right now. Those nice reports they give you are pretty and interesting, but if you haven’t used one to make a business decision in the last couple of months, or if you simply can’t change anything based on the data, you should stop looking at them. They will only stress you out.

Stop being a data hoarder. Data is only as good as its ability to influence your decisions. Keeping it around in the hopes that magic springs out of it is as silly as sleeping on your textbook.