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Posts tagged "social media"

Last night, Clint Eastwood spoke at the GOP convention, mostly by pretending to talk to an invisible President Obama, sitting in an empty chair next to him.

If you got a good night’s sleep last night and missed it, let me assure you that this happened and that every single word I write here is true.

Regardless of your political beliefs or like/dislike of Romney or Obama, this is something that will be remembered for a long time. Why? Well, let’s see what happened next.

Well, like with almost everything these days, things turned online. As the place where anyone can say anything and reach everyone in the blink of an eye for almost no money, this shouldn’t be a surprise.

First, we got “Eastwooding,” a meme where Eastwood pointed at different types of chairs (those of you about to celebrate your 40th birthday might agree that the choice of Pee Wee Herman’s chair Chairy was pretty funny). People added funny captions to pictures of Eastwood and the soon-to-be-famous chair. Maybe you saw the picture of a fake newspaper clipping of Abe Simpson was entitled “Old Man Yells At Chair.”

People made ever increasingly interesting/funny/pathetic attempts at humor inside the meme and it kept shifting, growing, morphing and evolving.

Then that shifted to old people pointing at chairs. And then anyone pointing to almost anything was “Eastwooding.” 

Then, because this isn’t weird enough, you got President Obama, who tweeted a picture of the back of his head in a seat marked President and wrote “This seat’s taken.”

And then, we we introduced to @InvisibleObama, because in this world, you’re nothing until someone makes a fake Twitter account about you or your idea.

This all happened while you were asleep last night.

To recap: An idea to get some press, to change the news cycle from “Paul Ryan seems to know what he’s talking about though even FOX News thinks he’s lying" and "Romney’s list of things he doesn’t want to talk about keeps growing” is now “Hey! Everyone loves Clint! And Clint loves America and the GOP! Yay!”

But that event shifted the course of conversation not one, not twice, but three times overnight. Overnight.

Now, I’d suggest that a meme like Eastwooding won’t much legs and will probably be a “hey, remember this meme” two months from now. But think how these two memes will affect the presidential coverage and thus the election. Memes. Helping us determine who the next American President is.

So if you don’t think the internet is serious business, doesn’t have the power to change minds, start and destroy careers and businesses, you are wrong. If you think your business’s 12-month plan for how to manage social media is adequate, in a world in which the tech changes weekly and the ways to use it changes minute-to-minute, you’re in trouble.

And it’s only going to get worse/better (depending on how you look at it). What happens if your brand, in an effort to generate awareness or change the news cycle ends up in a similar meme-hole? What can you do about it?

Are you ready for the future? Because it’s already here. Just ask the holographic head of Ronald Reagan the GOP was planning on using this year.

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. 

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.

If you haven’t heard of Pinterest yet, you are probably purposely avoiding it. It has become the fastest-growing social media site in the US (#3 behind Facebook and Twitter, ahead of #4 LinkedIn) and it has a fairly rabid fanbase. But what is Pinterest? How is it different from the other social networking sites we’ve grown comfortable with lately?

To understand Pinterest, you need to think about the internet not as a bunch of ones and zeros (bytes), but as a collection of things (photos, articles, posts, videos, graphics, infographics, PDFs, etc).

Typically, you might spend a lot of time crafting an article that includes a bunch of text, a few images, an infographic, and maybe some links. You think of the article as the unit of transfer – the product produced and distributed. This is a holdover from the previous generation of media (magazines and journals).

But what if the pieces were as valuable as the entire article? For example, let’s say you have a set of instructions on how to make something interesting. A headboard, for example. You will write the instructions out and annotate it with a series of instructive photos describing each step. To you, the information, as defined by this collection of text and images, is the thing. Except, the final image is really pretty. It allows people to see the outcome and mentally project it on to their lives (or, in this case, in their bedroom). To them, the final picture is the thing, with a bunch of semi-interesting text and explanatory images along for the ride. The picture of the dessert is far more important that the recipe. The picture of the dress is more important that who makes it (but not who sells it, as many retail brands are finding that Pinterest is a more effective channel for sales that Twitter or Facebook). 

Think about it. The information needed to create something isn’t as important as the marketing tool wrapped around it. That is the thing that Pinterest trades on. So people see the image and pin it to their board (it’s like “Liking” something on Facebook, but allowing the user and their fans to see all the related likes in one place). Beyond that, other users (via searching or via networking) see the image and may choose to like the image as well.

This is Pinterest: A very visual array of ideas grouped by a user to collect inspirations on given topics. 

If you’re confused by my examples (headboards, desserts, dresses), then you don’t know the audience for Pinterest (whether it was the intended audience or not). Depending on the source of information, Pinterest’s users are 68-97% female. What is successful on Pinterest is very pretty, very cute, very clever, or very funny. The marketing piece (the final product, the lavishly-designed graphic, the snarky line) trumps the supporting content. If you want your material pinned, you had better have a gorgeous photo or killer infographic.

So what does all this mean to pharma? Based on the meager existing pharma usage of Pinterest, it’s very hard to say. Like all social media, the tool is designed to facilitate conversations between people, a conversation that might sound like “I like this thing, and you might, too.” Despite the value that pharma brings to people’s lives, there isn’t much activity on the boards. For example, a search for the enormously popular Viagra leads to seeing three pins: one bottle image, one ad, and one picture of red pills forming a heart. A search for Paxil shows roughly 20 pins, where Paxil is as likely to be used as code for “chill out” as in a professional frame. And searching for Nexium shows far more pins for “natural alternatives” and online pharmacies than anything the industry might consider useful or productive.

From the other side of the fence, Bayer US’s Pinterest page (53 pins currently) is filled with advertisements for its business, sustainability, innovation and education initiatives. The only brand shown is for pet med Advantix.

We can see that Pinterest may not be an obvious channel for pharma. It is open (people can comment freely and re-purpose a pharma pin onto a board of any name they choose), it is conversational, and it is very visual. These are traits that do not lend themselves to pharma.

That said, there is a massive community here (mostly younger and female). If we look at the example of NuvaRing (female contraceptive), there aren’t many pins, but almost all of them are serious or informational in tone. Clearly, the audience here understands the value of this product to both themselves and their peers. The question is: will Pinterest become the way women talk to each other about this brand? That remains to be seen.

Yesterday, my boss’s boss’s boss (hi, @ormshr) asked me to talk more about this idea I have about how certain sites/tools/companies have DNA that they simply can’t escape.

For example, the DNA of IBM means that it will always embrace structure, hierarchy, and rules, no matter what the rest of the world does. It may have taught elephants to dance when it moved from PC powerhouse to enterprise services, but it did so through structure, hierarchy and rules.  When it finds a new challenge, it will fall back to that view of the world and itself to meet that challenge. That’s what  mean by corporate DNA.


Let’s start with the DNA of Microsoft. You know what I hate? Microsoft commercials. All of them. It doesn’t matter what marketing team they hire, they will always be bad. Why? Because all of Microsoft’s marketing is based on its DNA, that all of our problems can be solved with the rigorous application of office tasks. Currently, there are two commercials which show a family hanging around the house, creating powerpoint slides (and no, Microsoft Word, I refuse to capitalize “powerpoint,” no matter how angrily you add red squiggly underlines). Now, I have to assume this is some sort of alternate dimension, because I’ve never been in a house where creating a slide deck was considered something fun a family did. Nor have I ever heard of a family deciding to buy a dog because of persuasive powerpoint deck. In the Microsoft world, the only reason you have a computer at all is to write memos, work on spreadsheets and craft slideshows. The web? Angry Birds? Facebook? These are distractions to the true purpose of computing: get a promotion. And helping you get that promotion is the nature of Microsoft’s DNA.

No matter what product Microsoft puts out, it will be in service of the office task. Whatever fun veneer they apply to it (the only reason the Xbox succeeded is because it was treated as an almost separate company from the start), the root DNA is all about the “TPS Report” or “Billable Hours” or “Corporate Memorandum.” What do you mean they can’t come up with an iPod competitor?! I’m shocked!


The mirror image of that Microsoft is Apple, who’s entire DNA is about how much you want to get out of the office. Every product they release is designed to make you forget about the office, that you should pick up your tools and work in a park or coffee shop, that the end of the workday is almost here and you can go play. If you have to be at work, at least the tools are designed around the idea of exploration, curiosity and play. I mean, what percentage of Apple commercials involve people dancing?

Even tools used in a professional setting (like current Siri commercials) don’t seem like “work.” It seems like a friendly, fun process to figure out what your next meeting is about, or what that last text said. From the smiley-face Mac that shows up on boot, to the magic mouse that is really a big touchpad, everything Apple produces is imbued with that feeling of discovery.

The reverse example: What was Apple’s biggest corporate failure in the modern Steve Jobs era? The Xserve server. No one wants to “play” with servers; it just didn’t fit with the DNA.


Then there’s Google’s DNA. Google started as a search engine, and that’s significant. Google believes that there is no problem that can’t be solved or any situation that can’t be improved when you are given the right piece of information from the right place at the right time. It doesn’t matter if what you need is a photo or book, web page or blog post, it wants to give it to you. Remember that email you needed? Or that document? Or that calendar event? Or that song? Or that movie? Google wants nothing more than to be the obedient puppy butler that gleefully retrieves it for you and waits, tail wagging, for your next request.

Google+ is a great example of what happens when you try to break out of your DNA. Google doesn’t understand social, it understands finding and delivering useful information. Google could be good at retrieving something on some other social network, but building its own doesn’t make any sense. When it tries to be truly social, it’s like watching Shaq trying to be a jockey: its DNA keeps it from succeeding. (G+ should be seen as a way to collect, store and share all your personal online information, not at a place to display your “status”.)


And then there’s Facebook. As the youngest company on this list, its DNA might be the easiest to see. Facebook’s DNA is a 17-year-old punk-ass, snot-nosed kid who wants to find a lot of people it can call friends without ever having to be too close, who respond to their whining and rants with cheers for more. Facebook’s DNA is our collective Id, responding with dopamine bursts at our righteous indignation and joyful squeals. Facebook wants to be your social secretary and best friend gossip, not talk about logic or complex issues. It’s is pure lizard brain, connected to 800 million other lizard brains.

Is it surprising that the idea of a meme, while fairly old, didn’t really explode on the internet until Facebook made it easy to share these ideas with our friends? David at the Dentist ( and only 107 million views) and that surprised kitty ( and 60 million views) wouldn’t have existed if they didn’t cause some sort of protean emotional reaction in our reptile brain. And Facebook is the delivery mechanism.

Think about what additions and partnerships have succeeded on Facebook: Zynga games are all about distraction. Newsfeed tickles that “I need to know what’s going on RIGHT THIS SECOND” fear in the Id. And the Timeline is pure nostalgia trigger. Facebook will not be publishing a treatise on Plato or helping you navigate the complex waters of making important life decisions. There is no financial planning app in the works. Facebook’s communal Id is what makes Facebook so successful.

Pharma likes to put itself in a very specific frame: They are makers of our “Brussels sprouts.” No one wants to take their meds, or go to the doctor, or track their progress. These are chores we all simply have to do. And while Pharma is fully engaged in finding and designing new Brussels sprouts to make us healthy, they throw a sidelong glance at the idea of adherence. You can almost hear pharma say, “It’s good for you, so just take your meds while we get back to making new ones.” They leave it to the prescribers and pharmacists to scare patients into adherence. But adherence is key to pharma’s success in the long run. Low adherence reduces the likelihood or curing or treating the disease, which lowers patient’s interest in taking more meds. If we instantly hit 100% adherence, pharma sales would be way up and we’d hear less doom and gloom at industry conferences.

So let’s look at someone who’s gotten the idea of adherence right and see what we can learn. Fitocracyis a site designed to get people to take a different kind of medicine: Exercise. Excluding those handful of crazy people who consider exercise fun, most Americans look at time at the gym or on the treadmill as a chore even more dreadful than swallowing some pills. Yet somehow, Fitocracy has levered a number of different psychological and sociological tricks to get people to commit to getting more fit, and then doing the work required to get there. How successful is Fitocracy? In a world where startups are desperate for people’s attention, Fitocracy’s site is invite-only, and it took a little effort for me to get in. In a nutshell, Fitocracy gives you points for being physical. You get points when you work out, but you also get points when you shovel snow, or take the stairs instead of the elevator (granted, you get a lot more points for deadlifting half your body weight than you do taking the stairs, but it all adds up). There are pre-assigned quests and achievements you can complete (like when you log 10 items in a week, or try a barbell squat). And as you add workout data, you can level-up, like in a video game. And like a video game, each level gets a little harder to achieve, but by the time you’re working towards level 10, you’ve got weeks of workouts under your belt and you have the confidence you can complete the level without it being too easy. Aside from the game tricks, Fitocracy leverages the power of each person’s personal network. Just as you will gain weight when you hang out with over-eaters, and get funnier when you hang out with clever people, hanging out with people who work out encourages you to work out. Hanging out with people trying to lose weight helps you look at your choices in a new light. On the site, your social network gives you props for good workouts or when you’ve had a couple of good workouts in a row. Or when you lose a few pounds. Or when you set a record on the treadmill or barbell. You get positive reinforcement, right there on your screen every time you work out, along with points for giving your friends props, encouraging you to give as well as you get. No friends? Join one of the existing groups, like the Chicago group or the weight loss group to achieve your goals. You are collaborating together, and that induces even more adherence. This is social proofing: you don’t want to let your friends down, and they don’t want to let you down.

 How can pharma steal some tricks? Well, if pharma wants to start using the ideas of persuasion, gamification and social proofing to increase adherence levels, it needs to start by getting out of its own way. Especially in terms of privacy. Yes, pharma succeeds because of federally mandated privacy laws, but as you can see from the thousands of patient forums, people are willing and interested in talking about their disease state so long as they get the choice to do it on their own. Pharma can play a part, and even encourage people to talk amongst each other without coming anywhere near violating privacy rules. They can build a site like Fitocracy devoted to diabetes or gastric distress or gout or depression, where patients get points for doing things that make them healthier (like taking their meds), or talking to other people with the same disease, or helping other people with their problems. Beyond the obvious health benefits to the patient and adherence benefits to Pharma, this community could serve as an active focus group, one that can help you understand patients and even leverage should you need to communicate with patients or the public at large. Pharma needs to become partners with their patients to solve a lot of each other’s nagging problems, and it seems Fitocracy has developed a pretty interesting template on which to model that solution. If you’re looking for Fitocracy invites to check it out, ask me on Twitter: @digital_pharma!

You’ve read the FDA’s new partial guidelines for pharma in social media titled “Responding to Unsolicited Requests for Off-Label Information About Prescription Drugs and Medical Devices,” right? (If you haven’t, go now. We’re all waiting. Try Dose of Digital or Fierce Pharma.) 

Okay, so in a nutshell, if I’m reading this right, it says that pharma companies are allowed to respond to people who post in private and public internet spaces about off-label uses of their drug. But have to respond privately. Specifically, these are unsolicited requests, so you can’t coordinate with your marketing company to seed the idea that Brand XYZ cured baldness. There are some other considerations, but that’s the gist. (Those of you waiting for complete guidelines from the FDA should get comfortable, because if this is what we got in a year or two of discussion, you’re in for a long wait.)

So, here’s what is interesting:

1) The words “liability,” “expectation,” or “anticipate” are nowhere in this document. The FDA is not yet ready to place the burden of having to listen to every online channel on pharma. Yet. So pharma can hang back and choose not to get involved in social if they don’t want to because the FDA is not forcing them to.

2) The rules for what pharma is allowed to say seem to differ depending on whether or not the request came in public or private, despite the fact that the answer must be private. (Private requests will answer scientific questions with scientific information, public requests will pretty must stick to the label and ask the requestor talk to a healthcare professional.) Thus, the same questions asked in two different medium might get two different responses.

3) The FDA is saying while pharma can respond to all unsolicited requests about their own brands, they have to respond privately. But we all know in social media nothing stays private for very long. 

Let’s walk through a scenario to see how these new rules are applied.

So I write Brand XYZ and ask them a question. The brand is now allowed to respond privately, but they, as good corporate pharma citizens, must be “truthful, non-misleading, accurate and balanced,” and include standard response information. Then, I go on Twitter and ask the same question and get a different response via DM or email. This isn’t much on the surface, except that the FDA has done everything to keep pharma from ever saying anything anywhere that hasn’t been reviewed seven ways to Sunday. The review process is the FDA’s way of getting everyone to stick to the script (because it’s far cheaper to stick to the script than to try something new, and gamble on whether it survives medical, regulatory and legal reviews). To allow two different responses from pharma on the same question is new. 

But since the FDA is quite clear on keeping those responses private, maybe it thinks it can control the message in the world’s most porous communication environment. Which would be silly.

So either A) the FDA is asking pharma to do nothing new (i.e. “stick to the script, kids”) or the FDA is anticipating (or worse, not realizing) that every private response will quickly be copied and pasted into public forums all over the internet, thus negating the FDA’s own intent of keeping off-label information private.

On one hand, the new guidelines seem to focus on solving a very narrow problem in social media. On the other, the FDA may be trying to learn how quickly these “private” messages will become public, indicating that the FDA is serious about understanding the social media environment–not just in theory, but in practice.

There has been a lot of speculation since it was announced this summer as to why Twitter was embedded so deeply into the new iOS5. Actually, the speculation hasn’t been about why Twitter was embedded. That’s easy: Twitter is a super-simple message system used by more than 300 million people. The real speculation isn’t why Twitter, but why not Facebook.

There shouldn’t be any surprise that the world’s number two mobile operating system is trying to integrate more social media. Social and mobile is <a href=””>the beast with two heads</a>. There is a reason the two have grown so fast side-by-side: they support and augment each other. So clearly, a mobile operating system would be smart to embrace this idea and partner up with a major social media platform. 

On the face of it (hahaha! I hate puns) Facebook would seem to be the obvious choice. It has more than 800 million users world-wide, half of whom visit the site in some capacity daily and tend to stay for extended periods of time. It has integrated games and numerous time-wasting, distracting engagement-based tools from third parties (one of whom IPO-ed last week). While its growth is slowing, it’s not because people aren’t using it anymore, but because it might be reaching market saturation. Every day, new kids turn 13 (or say they turned 13) and log in for the first time, but who isn’t using Facebook today who might consider it tomorrow?

So why Twitter? By all measures, Twitter is the runner-up. Fewer users, less time spent on the site (by a huge factor, because most people use Twitter via a client), etc. Between the two, who wouldn’t choose Facebook?

But Apple didn’t, and there are some very good reasons.

1) Facebook is a site, Twitter is a service. By many different measures, Facebook is trying to re-build the web inside itself. When you add links and videos to Facebook, Facebook tries to show them to your friends inside of Facebook. Its games work inside Facebook. The only ways to access Facebook is at or one of the mobile clients it built (there are a handful of third-party clients, but they existed only because Facebook was slow to launch fully-featured mobile clients). 

Twitter, on the other hand, would be perfectly happy if you never went to its site. It wants you to use a client, on your desktop, on your cellphone, your smartphone, your tablet, your TV–whatever. Twitter works because it’s simply creating connections between two people, not trying to get you to stick around its site and play WordsWithFarmWars.

2) Facebook is closed, Twitter is open. Look at the above point and see all the ways Facebook wants you to enter its garden and never ever leave. It doesn’t like to even admit that you might update your status on Twitter or Tumblr or Postulous. Facebook wants you to think about the internet as a function of Facebook. An example: Ask anyone who has tried to connect their Tumblr to Facebook so that posts to Tumblr get mirrored in Facebook. It’s a pain. It doesn’t tell you when it works. It breaks frequently without telling you. These apps are outside Facebook and Facebook treats them like third-cousins it dislikes.

Twitter connects to… everything. You can have Twitter updates sent to your phone from 1999! Twitter lets any client connect to its API, and has been raising the number of API calls per hour (so you can use it more and more). I can send any 140 characters through Twitter. Services will shrink URLs so I can actually send a lot more than just 140. And when people click on that link, they don’t stay in Twitter, they go to the link.

3) Facebook is a competitor, Twitter is agnostic.  While we don’t ever have the thought: Should I buy an iPhone or should I join Facebook, Apple and Facebook see each other as competitors for your attention. And as we enter the attention marketplace, your attention becomes a very valuable commodity. 

Twitter is like the electric company: it’s a service. It doesn’t care what you plug into the wall, so long as it abides by some basic technical standards. 

The best example highlighting the real difference between the two services is that this year, the Arab Spring movement embraced Twitter, not Facebook. And now, Apple has embraced Twitter, as well.

This serves to underline the difference between these two tools to marketers. I’ve heard too many people look at the two tools and treat them as if they were the same. They couldn’t be more different. Putting them under the same “social media” umbrella is like treating a Bugatti Veyron and Nissan Leaf the same because they’re both “cars.”

So consider them two very different things when plotting your social media strategy for the coming year. Otherwise, you won’t be getting real value out of either of them.

It is tempting to look at CRM and say “we now have collected a lot of structured data about many/most HCPs… So I wonder what other interesting data we can stuff into it,” and cast a glance towards social media, the land of unrestricted opinions and attitudes. Tempting, but untenable. And here’s why:

One, data issues. Even if you were able to hack into Sermo or Facebook or some other huge social media site and drain it of it’s content to stuff into the CRM, the data will be almost useless. The reason why CRM works is because it’s been optimized to a high glossy sheen. The data has been structured and standardized and cleaned and properly tabled in ways to allow meaningful (read: complicated) queries to extract useful information.

The reason social media is interesting is because it is the unfettered thoughts in digital form, like an endless stream of focus groups already transcribed. That “data” (if we can even call it that) is a mess. It would take a million monkeys at a million terminals to evaluate, code and input attitudes and opinions into the database to give it any use. For example, if you wanted to ask the question “what are the TV shows that Brand X-prescribing HCPs watch?” you need to query the CRM for a list of high-prescribers, query social media for the likes or interests of those HCPs and then run some data analysis to determine which shows correlate to high-prescribing HCPs (Hogan’s Heroes? Really?). But the data would already have to know what’s a tv show and what’s a book or website or hobby. And that does even take into account the most basic standardization (so that American Idol was the same as american idol). So there’s the data issue, but Google proved that these kinds of issues can be solved with enough money.

Two, personal and professional social media is different. The fact that some people include UpToDate as “social media” is indicative of how hard it is to define social media itself. Is anything interactive and vaguely personal social media? If so, let’s lump Amazon and email into the social media realm and muddy the waters further. But the real issue is one that Google has highlighted with Circles: we treat personal and professional social media differently. My personal twitter and Facebook is where I say personal stuff, make jokes (not all of them completely funny or tasteful), talk to my friends and generally am “off-the-clock” (assuming that any of us are truly off the clock much anymore).

My work twitter, blog, and linkedin account are professional. My opinions there are far more guarded (if you can believe that) and rarely stray far out of professional bounds. I don’t talk about my interests here. I don’t give much away. I start conversations, espouse opinions I may not agree with in the attempts to generate counter-arguments (too much debate training in high school, I guess), and generally talk about things I might not in my personal life. What good is any of that info to the CRM?

Social media is an amazing barometer of attitude in the aggregate, but worthless in the specific. People lie, or are silent, or pass along things they disagree with for no other reason than it was funny or worth mocking. Log into Klout with your personal Twitter account and discover what it thinks you think about. It’s a party game for the nerdy marketer. Laughable.

Three, most companies have not proven that they understand and respect social media enough to let me open up to them. Let’s say I’m a huge fan of the movie “Miller’s Crossing” (and I am, actually. It’s the Coen Brothers’ best work for my money). Maybe I told Facebook that it’s my favorite movie. Why would I do that? Maybe to attract other fans or give people an excuse to start a conversation about it. What did I get? Two things: targeted marketing about mob movies I might like because I like Miller’s Crossing (I don’t like it because it’s a mob movie, I like it because it’s an excellently produced movie) and spam from Fox, the movie’s distributor. The movie is more than 20 years old. I don’t need to to be marketed to about it. So I removed it from my Facebook interests.

The same is true about bands I like, TV shows I watch, books I cherish, etc. I love these things, but companies just use them as a hook to try and sell me something. It’s like no one’s read The Cluetrain Manifesto. (Please, please PLEASE tell you have read it. No? Go Google it and read it online for free. You’ll be doing the world a favor, believe me.)

Most companies simply let me be social with the intent to push a “targeted” product at me. The fact that the targeting is juvenile is beside the point. They are using social media like most people used CRM in the beginning, to put “Dear Mr. Ellis” at the top of the form letter. What a waste. So much data about me and that’s as far as you go…

You know what I want? It’s what I imagine HCPs will respond to, as well? Taking all that data and using it to build relationships (hey, you know that the R in CRM stands for Relationship, right?) is what gets you in the door. Take what you know about me and use it to begin to understand me and my needs so that you can begin to slowly offer me ideas and products that make my life better (that’s not quite the same as trying to sell me something, btw).

Please note that Facebook, the most social of all social medias, is the worst at trying to build relationships. They just want to sell me off to the highest bidder. And that’s why I try and hide everything from Facebook while still using Facebook everyday.

But maybe there’s a solution here. So, if I’m not totally off base here, maybe I can suggest an incremental and achievable solution: reps. Reps solve all these issues very easily. They have met the HCPs, have talked to them, seen their offices and practices, can code the data into your CRM, are focused on the professional side without being blind to the personal side (Dr. ABC has a picture of fishing with his friends, so he must be into fishing. Maybe that can be useful later, like an honorarium he would be hard-pressed to refuse). And a good rep will have begun to form relationships with the HCPs, learning what they want and need to make their life and practice better.

So instead of trying to take a shortcut and “just leverage” social media (as if it’s that easy), maybe pharma should be looking to leverage it’s own internal social network.


This is a slightly expanded comment I made on the Center for Healthcare Innovation’s LinkedIn Group. But feel free to tell me I’m full of it on Twitter. I love that!

While doing some work for a client, I ended up putting together a rough outline of what kinds of technological platform shifts we can expect to see in the next 18-24 months. Then I shopped it around the office and got a bunch more opinions, so this is closerlook’s current understanding of what that pharma/tech world will look like in the near future.

Before you jump to the list, I wanted to point out that I built it in, which is a very cool list-building productivity tool. I’m going to link to the live list, in case you want to see the current version, but I really liked working with the tool. 

Enjoy! Comments and twitters always responded to and appreciated.

  • Hardware: The “Big to Small” shift continues
    • Yesterday’s desktops are now laptops
      • Sales data show that desktops are more likely bought by companies for their employees than people for their homes.
      • People buy laptops
        • Computer technology is improving laptops, but we’ve off-loaded more and more work to the cloud
          • If everyone has about 20GB of music (that seems like a safe number, though I have no data to back it up except to say that I have about 80GB, and I’m probably in the highest decile) and no one has to keep it on their computer anymore, that’s a lot of hard drive space saved.
          • Google Docs, Amazon Music Locker, cloud storage and more will free up additional storage space
        • Laptops are evolving and getting closer to netbooks (e.g. Macbook Air) because unless you’re doing a lot of video/music/graphic production, what do you need all that power for?
    • Laptops are now tablets and smartphones
      • Do you know anyone without a smartphone? I do, but she’s 12. Even my parents (62 and 63 years old) have them.
      • Almost everything you’d want a computer to do, a smartphone can do
      • And it can do it wherever you are
    • Cellphones are dead… in the West.
      • Dead. In the next 2-3 years, seeing one will be akin to seeing a checkbook or pager.
    • Phones are and will be a huge deal everywhere else
      • Not to denigrate one or the other, but outside of westernized nations, the cell phone is a computer in the BRIC and other countries.
      • In India, they bank by text. This trend because of the relative affordability of the devices.
      • Mobile health means an app (or mobile web) in the west, but it means SMS everywhere else
    • Faster, yes. Lighter, yes. Smaller, no.
      • We’re pretty close to as small as things will get (if keyboards get any smaller, none of us will be able to use them) so expect to see more power and functionality within the same footprint.
        • Until someone figures out a way of doing virtual keyboards right
      • The tech I’m looking forward to in the next 2-3 years is a flexible, bendable, foldable screen.
        • Imagine an iPad 40% smaller with a screen that opens up to be 40% bigger
    • Near Field Communications (NFC) is almost ready for prime time NFC will require some standardization that is currently lacking. One of my best friends is an architect for Discover and has been working to make this happen for nearly a decade now. Last time we talked about it, he said the tech has been set to go for years but they can’t get device manufacturers in the same boat.
      • NFC is a way for 2 devices to talk to each other very easily and securely. It’s how you’ll be able to pay for parking meters, vending machines and friends without opening up your wallet: wave your phone at the device, get confirmation, walk away.
      • HCPs can pass data to patients without getting their email. And patients can collect their Quantified Self materials and have it formatted and inserted into their medical records.
      • If iPhone 5 comes out with it, expect it to be common in 2 years.
        • If not, 3 years.
  • Mobile World
    • It’s not about the the size of computers but their portability (and the personal connection that portability creates). They are small enough to be carry-everwhere-able and now there’s a decent internet connection just about everywhere.
      • And just wait to see what happens in the 18 months when real 4G internet is everywhere.
    • That kind of shift is changing the way we think about computers and computing
      • We are within a few years of every aspect of our lives being enhanced by phone-based personal technology. It helps us buy wine, choose a restaurant, compare prices, read reviews, make itinerary changes at the drop of a hat in a way we’ve never seen before.
        • Phone-based technology will answer this question: I wonder if we can get a deal on an empty room in this very nice hotel tonight
        • In 2 -3 years, the assumption will be that everyone’s hours/calendar will publicly available and accessible.
          • On the day of my appointment, I shift the start time from 1:30 to 4:45 without having to call anyone and waiting to see if there’s an opening available later today.
        • Here’s a killer: how we make friends is changing. How we meet new people is changing. Our interests are becoming more granular and now we can find people interested in the very very specific thing we are interested in.
          • For example, GrubWithUs lets you join a party of people you don’t know at a restaurant to sample new dishes with new friends.
      • We will expect to be able to make publicly-accessible (and publicly indexed and searchable) comments to the world about what we are doing as we’re doing it.
        • Not like Facebook, where we feel like we have control of our own little castle, but in a publicly open way
        • We will have a period of chaos where the least little bit of waiting or bad service will result in a crazy public letter may feel like the death of a business. That will shift as we get to a point of saturation where no one review/comment is killer. An aggregated opinion will accurately describe the business/practice
    • The world, especially the HCP world, is about to be an iPad world
      • Statistically speaking, its as if there are no other tablets being made or marketed.
        • None. The “existing use” and “intent to buy” numbers are stunning.
        • When Epocrates cancelled it’s webOS version, webOS was dead weeks later
          • So few HCPs were on webOS that Epocrates didn’t find it worthwhile spending resources on it
          • Those few HCPs, (tiny to Epocrates), were enough of an audience share to break HP.
        • Everyone who isn’t Apple is in a very tenuous position
      • Major current uses in the HCP world
        • Clinical information
          • PDR, look-up tables, conversion tools, things that make it easier for an HCP to do their job
        • Patient education
          • Look at this video to explain your condition, here is material you need to understand, etc
        • Off-line education
          • HCP takes 20 minutes to watch an eDetail, read a paper, practice using a diagnostic tool, etc
      • Major emerging uses in the HCP world
        • Camera
          • “Face-to-face” communications with reps, staff, patients
          • Virtual Detailing
          • Virtual consult
          • iPad “office hours” where patients can call in and ask a question and get 5 minutes of time
        • Augmented reality
          • Education opportunities are pretty intense
        • Clinical practice
          • If phones did a great job slicing tasks into 2-minute slices, the iPad in clinical use will mean that the HCP will get, in a glance, a patient’s history, HCP notes, and pertinent material updates.
            • You’ve diagnosed someone with diabetes. On your way to the exam room, you remember where they were on the progression/continuum, what you prescribed, what factors you suggested that the patient change and what news there was on that type of diabetes.
            • Download and read the charts the patient kept themselves (see next section) to get a sense what’s been happening.
      • Just because they use iPads, doesn’t mean they will need to be marketed to via iPads.
        • Technology is a gimmick to attract attention. What you do with that attention is more important.
        • iPads do not necessarily increase retention or awareness. The content determines the value.
  • Quantified, World, Quantified Self
    • We are 1-2 years away from the point where a smartphone and $150 of accessories will be able to measure what’s going on in people’s bodies better than most private practices have access to now.
      • This includes:
      • Real time vitals like blood pressure, heart rate, blood sugars, white blood cell count, etc.
      • Food intake, weight, etc
      • When did the user take their medicine? (and what did it do to their vitals all day long?)
      • What minute did that person take that drug relative to their last meal and last drink (or exercise, or sleep, or vitamins or whatever)? What was the outcome?
      • We are moving quickly to a world where you won’t hear “it’s 80% effective…” but you will hear “after three days, we can see that this *is* effective in you and can prescribe the following course of action…”
      • Location log (were you at your gym for 45 minutes? It will track that)
      • Food recognition (take a pic of every meal and it will estimate and keep track of calories, fat, protein, etc)
      • Sleeping (a huge market just starting to appear, assuming device makers can convince peole how a device can help them sleep)
      • Prescribe/Administer/Validate feedback loops will be hours and days instead of weeks.
      • Exercise tracking (estimate steps walked, calories burned, heart rate, etc)
      • The list goes on and on.
  • Software Shifts
    • Within 12 months, HTML5 and CSS3 (eventually CSS4) will be the de facto standard for all “modern” browsers
      • Flash is doomed.
      • But until it’s actually dead, Flash developers will shout its relevance to anyone who will listen.
    • Apps vs. Mobile Web
      • Clearly, apps are winning the war, but the war isn’t over. We aren’t sure when or if to expect a winner either way.
      • Apps
        • Are device-specific, giving them access to hardware features (camera, compass, tilt-sensors, etc) that the mobile browser can’t see yet
        • Apps feel like something you own.
          • When you buy an app, it feels like it’s all in your pocket, even when it isn’t (that’s why the Wikipedia app doesn’t take an hour to download: all the data is accessed through the web)
            • Apps usually need access to the web to work properly
      • Mobile Web
        • Aren’t device-specific
          • Can’t access hardware
          • Yet
            • We expect that hardware interfaces will standardize enough so that the web browser will be able to access the phone’s hardware.
            • No expectation as to when, though
          • While you can bookmark a web page to your phone, and even make an icon on your home screen so it looks like an app, most people feel like that the content is “out there” in the cloud where they don’t own it.
          • This creates tension and users opt for less tension.
          • However, it is possible for a mobile web page to cache materials like databases on the phone so that the web page can have just as much of the content stored on the device.
            • So which will be more “owned?” It’s all about the user’s perception
      • Developers vs. Users
        • Developers like mobile web because they can design and build for one ecosystem, not 2 or 3.
        • Users like apps because they “just work.” No fiddling or experimenting and adjusting to make it do what the user expected it to do.
        • We don’t have an expectation as to who will win this war or what will be the deciding factor. We assume as the major platforms develop, things will get even more complicated before a victor emerges.
    • Browsers
      • Soon, all browsers will demand auto-updating a la Chrome to keep everyone up-to-date on tech standards
      • Microsoft will still suck at keeping up with standards and will lose market share.
        • 2-3 years from now they will control 40% of the market (down from 50% worldwide), but they will control the less-advanced/savvy audience’s browser. IE9 will not slow this slide.
    • More and more software will be cloud-based. We’re still years from having a majority of people be comfortable having all their stuff be cloud-able and be comfortable renting software online as necessary.