Category Archives: General

Too much to do too little time

I have been a tad behind at writing this blog post and responding to comments, which saddens me given the glowing responses I have got in some of my comments. In an ideal world I would like to write a post weekly, rather than the current monthly timing. I should also be responding to comments ideally within 24 hours which I am also failing to do. This blog is hobby which allows to me to share my thoughts on one of my passions – digital and social media in the pharma industry – and I do enjoy writing it. Career wise I am sure the blog helps too. Sadly working as a full time consultant, trying to support my charity, spending time with my cats, and dealing with an Auto-immune disorder which often leaves me very tired and requires me to sleep 8-10 hours a night, leaves me with very little spare time to do anything else (including blogging for my charity www.hopeforstrays.com). I occasionally also blog for my employer ZS around social media but I find that far less rewarding (for one I never get many comments glowing orotherwise!). It is the age old dilemma of too much to do and too little time.

This is of course a similar dilemma that many companies face with their social media and digital efforts. A number of companies I have advised on social media where taken aback when I told them how much content and resources would be needed if they wanted to truly engage via this channel. One local brand team, for example, were adamant that they had more than enough content to set up their own Twitter feed, which warranted them going against the Corporate guidance of using the local country Twitter account. When I joined the discussion my first questions was how much content exactly? How often would they be Tweeting and what were their monitoring plans? It turned out they planned to Tweet once per week – a far cry than the recommended multiple times per day! Realising how much effort and resources (tine and financial) would be required they ended up towing the line and using the country account and appropriate #. Whilst Twitter is a particularly active social media channel that requires high levels of content and monitoring, other channels also benefit from a steady stream of new content, which takes time and money to develop.

The other side of social media is of course the monitoring element. As I have already confessed I am far from following the best practice in terms of responding to comments, but I am not a large company with products and services and a reputation to defend.   Whilst as an individual I can get away with taking a few days to respond, a company is expected to respond within 24 hours, 48 max. This again takes resources, as well as a clear process, to respond appropriately. This is the scary part for many pharma companies and is also the part that has led to automated responses (and there are some classic examples where automated responses go horribly wrong). It need not be scary however if you have the appropriate level of resources involved in this activity and process in place to be able to respond rapidly. Technology can do a large amount of the leg work (for example sending an alert that a response is required) and having a team of people who can respond then facilitates responding within the time-frame required.

Many companies I know have 1 or at most 2 people dedicated to social media. In my opinion this is not enough. In fact for most tasks you should never be solely dependent on just one person because when that person is sick, on holiday or decides to quit, the company is left vulnerable (and given that you are probably requiring them work through holidays and sick days they are more likely to be sick, and eventually quit). That does not mean that you need to employ another dedicated resource but it does mean you have to have other employees appropriately trained so that they can step in if required.

For companies looking for resources in social media but struggling with restricted headcount and resources, there is one resource that few are totally optimising – their own internal network. Looking at social media there are now many employees who are active with social media in their personal life who, with appropriate training, could be called upon to help out. It is a useful skill for many people’s career and there are many ways of rewarding or incentivising people to provide that additional support. As resources within the industry become more restricted, but the demand for digital and social content and engagement rises, the industry will need to start thinking a bit more out of the box to find solutions such as this.

Sadly this is not a resource I have access to. Much as my cats take an interest in my laptop (sitting on it, walking over it, etc.) I have not yet managed to train them to write blog posts or respond to comments for me. All I can do is keep trying to find time and when I don’t, keep apologising. And perhaps posting more kitteh photos because everyone love a good kitteh photo right?

 

The Don helping out

The Don helping out

 

Advertisements

A patient’s point of view

I was recently involved in a workshop for a pharmaceutical product and one element we talked about was the emotional journey a patient goes on, and how digital tools played a role in that journey.  This really resonated with me as a patient.

We are of course all patients at some stage or other, but some of us are patients with chronic or long term illness which require on-going treatment.  In my case I have Hashimoto’s, which causes hypothyroidism, and I will need to take thyroid hormones the rest of my life.  My journey as a patient with a thyroid condition has been highly emotional, distressing and sometimes extremely difficult.

A patient will experience a whole array of emotions as they go through their own journey.  Mine started with joy when I was told I had hypothyroidism – I finally had a reason to my sudden and excessive weight gain.  Unlike in some other conditions I never really felt isolated, in part because I was very open on Facebook about my hypothyroidism, and this resulted in a surprising number of other friends also identifying that they had the condition. I also initially did not have many problems, it was only in the last year or so that things got worse and it was at this point that I would have been in danger of feeling very alone with my condition had it not been for Facebook.

As my condition and health deteriorated, the journey became more emotional and more distressing.  I put on weight again, felt lethargic and was constantly tired, and I felt depressed and low.  I was very miserable.  I also got increasingly desperate.  As an educated woman, working in the healthcare industry, I knew that something was not right with my health – something was wrong.  As per my previous post I received absolutely no support (informational or emotional) from my then doctor.

In the days of old I would have been totally alone at this point in my journey.  I would not have known that it was not right that I was feeling this ill. I would have been totally dependent on my doctor’s response (good or bad). I have no idea how I would have coped with the despair, the depression and the fear (and believe me thinking that you may spend the rest of your life feeling exhausted and listless is very frightening).

Fortunately today we have the internet and social media.  It really was a game changer for me and my disease. I already knew that my symptoms were common for hypothyroidism but what confused me was that I was already on a very high dose and should have felt fine and full of energy.  I was terrified of lowering my dose and feeling even worse (and putting on yet more weight) and yet this is what my blood results indicated I needed to do.  I was also scared that it was just me – that other patients coped fine and it was just my body not working properly.

Through a support group on Facebook I very quickly found out I was not alone.  In fact far from it.  It turns out there are many patients on treatment but having issues with their health, their symptoms and their doctor’s response to their concerns.  It was such a huge relief to find out I was not alone and to have fellow patients to share my story with and to be able to connect with people who felt exactly like me.  The emotional support that this virtual engagement provided was immeasurable.  I no longer felt alone and the feeling of despair went down as I felt there were answers and there was hope.

It was through this support that I found the strength to question my previous doctors’ response and seek further treatment.  I paid, out of pocket, to see an endocrinologist in the UK and I armed myself for that appointment with as much knowledge as I could, from the internet, in order to ensure I received the optimal treatment for me.

My appointment with Dr Morris was like chalk and cheese compared to the Spanish endocrinologist.   He was supportive, listened to me and provided some solid advice, which included bringing my dose down.  The way he advised me took some of the fear out of lowering my dose.

The rest of the fear was taken away because, through my online searches, I had found out that in a very small minority of patients being on too high a dose can cause the same symptoms as hypo even though they are hyper.  Turns out I was one of this small minority.

The other thing Dr Morris did was confirm what I had suspected – my hypothyroidism was caused by Hashimoto’s disease.  Following the Spanish endocrinologist’s failure to tell me what was causing my hypothyroidism I had gone online and done my own research using my blood results.  Through this research I had self-diagnosed Hashimoto’s but it was also great to get it confirmed by a physician.

Armed with this confirmed diagnosis I did more research.  Through support groups and blogs I found out that most Hashimoto patients have some form of gluten intolerance and that eliminating gluten could help improve health outcomes.  Not one of the doctors I had spoken to over the last couple of years ever talked to me about my diet and the impact lifestyle changes could have on my disease.  It was only through interacting with other patients online and doing my own research that I found out about the changes I needed to make to my diet and lifestyle.

As a result of my online research, I now no longer eat gluten and I have reduced the amount of goitrogenic food such as cabbage.   I am also very careful about getting enough sleep and staying healthy.  The impact this has had has been huge.  I feel relatively normal again now, and whilst I still get tired easily I no longer feel depressed or listless.

My emotional journey has now come to a point where I feel confident and hopeful.  Some fear still remains, for example how my need for ten hours sleep will impact my work and the fear that I may feel ill again in the future.  But for now, thanks to resources and information I found online, my main emotions are relief, happiness and hope.   I do not know where my patient journey will take me to next but I am certain I will find the support and resources I will need online.

Sunrise after a dark night

New hope after the despair – just like sunrise after a dark night

Turning KOL into KOI

As I mentioned in my previous post most Pharma companies have a great idea of who their offline, traditional KOLs are but very little idea of who the Key Online Influencers (KOI) are.  They also rarely have any real idea of how many of their offline KOL are active online and using social media.  Pharmaceutical companies should have a far better understanding of the online activity of all their key stakeholders, including KOI but also KOL.

The reality is that most top KOL, who tend to be older, are not that active on social media, but they also would see little value in spending their time with social media.  They are extremely busy and have already reached the top of their game – for them social media may be a waste of time.

Younger, up and coming KOL however are another matter.  Whilst they may not be digital natives they are more adept at using digital resources and some may also already be using social media.  This group is also trying to reach the top and expand their name within their field and the healthcare industry.  To this group, social media can be a valuable tool, enabling them to extend their reach and influence, and giving them a leg-up to top tier KOL status.

This is a huge opportunity for pharma.  KOL have always played a key role within the industry and building relationships with KOL is standard practice.  One of the core elements to relationships of this nature is being able to bring value.  Helping up and coming KOL building their “brand” online and helping them turn themselves into KOI could be a hugely valuable resource that pharma could offer this group.

So could a pharma company go about working with up and coming KOL around their use of social media?  Absolutely! The first thing to do, as with all initiatives, is to do some research.  Identify who the up and coming KOLs are (the chances are this has already been done by Medical) and then find out if they are active online, and if so how and where.  Also find out whether their name already has digital klout, even if they are not themselves online.

 

kol

 

The next step is then to reach out to them and find out if they would be interested in social media training.  The key element here is to communicate the value to them and ensure they understand that this would be a totally neutral training, with no expectations of them to start tweeting information about the company.

At this point I often get asked about how to set this up internally, process-wise.  The reality is that this process generally already exists.  Companies often do media training with KOL and social media is a form of media so the same process, with a few amendments, could be used.  It should be relatively simple to offer KOL social media training, either as part of their media training, or as a stand alone training.  In fact given time pressures, and some potential reticence on the part of the KOL to participate, it is probably more effective to do a quick intro to social media as part of the media training, and then offer an additional social media specific training as a follow on.  This initial session can be used to demonstrate the value of social media to the KOL personally.  A follow up session can then delve into more details and provide more hands on practice.

The final element to remember is to be realistic regarding timing and ROI.  Do not expect every KOL trained to become a KOI – start with conservative KPIs (for example 1 in 10 trained per year will become active on social media).  Also remember to be realistic with timing – becoming active on social media does not happen overnight – allow at least one year for the KOL to fully master social media and to start seeing some impact from the training.

This training could however have a great positive impact, for the KOL, the pharma company but also for other stakeholders such a patients.  As the KOL becomes more fluent and adept at using social media they will move towards becoming a KOI, ensuring good quality information becomes prominent in their field.  From the pharma company’s point of view if the digital information they produce and share is of good quality and of value  to the KOL, and their followers, the result will be more impactful digital assets with a greater reach.

Finally of course is the fact that this whole process can act as a great way to build, and strengthen, the relationship with that up and coming KOL, so that when they do reach the top the company has played a pivotal role in supporting them and being there, as a partner.  And of course let us not forget that eventually all KOL will be KOI anyway, it is just a matter of time – this opportunity exists now but will not exist in a few years time!

 

Thank you to KOL / KOI Dr James Underberg aka @Lipiddoc for his insights into this post.

Building relationships with Key Online Influencers

Last week I was at the GLC social media & emarketing forum in Frankfurt listening to an interesting presentation by about HCP relationships.  One of the slides presented showed a KOL map, showing who the KOLs are, who the upcoming KOLs are, and where they are based.  This map is developed based on an analysis of presentations at congress and publication – but it is all offline inputs.  I am however happy to hear that they are also looking into doing a KOL digital map.

Personally this rings a bell a with me as one of my recommendations in the past has been to do precisely this.  Pharma companies generally have a great idea of who their traditional KOLs are, but they have no idea about how active they are online (if at all) and they often have no real idea of who KOI (Key Online Influencers) are.  This is a big gap in a key knowledge area.  As more and more HCPs turn to digital the impact of KOI will become increasingly important.  Pharma companies need to start finding out which KOL are active online, and who the KOI are that they should be building relationships with them, just as they have traditionally built relationships with KOLs.  This is essentially just a new group of KOL and the process for KOL relationship development offline already exist – they  just need to be adapted for online.

From experience I know however that at this point alarm bells go off with legal and compliance as this is a new area.  A second issue though is that unlike KOLs who are always HCP KOI may be HCPs, but they may also be journalists, bloggers, patient advocates, etc.  This raises a whole area of problems.  For the HCP KOI it is relatively simple to deal with – they fit into the existing framework and the Medical teams can build the relationships here, using a different process but still essentially following the same principles and guidelines.  The problem however is how to deal with the other KOI – who owns the relationship?  How to deal with the various regulatory issues that then arise?  So, for example, for a non-HCP KOI there is the danger of being seen to be doing promotion.  How can a pharma company deal with these issues?

The answer is to be totally transparent and never, ever look at relationship building from a promotional point of view.  Building relationships needs to be based on providing value, whether it be for an HCP or a patient KOI.  With that thinking as a starting point you then do some research.  What are the KOI interested in?  What content and assets would be of value to them?  Do they have a blogger outreach policy or do they give any indication of how they feel about partnering with organisations? Build up a good level of knowledge about each individual KOI, just as one would do with a traditional KOL.

 

KOI needs

 

You then need to identify where the relationship will sit.  As mentioned Medical KOI relationships sit comfortably with medical, journalists sit well with the comms team, and patient advocates sit well with advocacy teams.  Very rarely do these relationships sit in marketing – even though very often this is where the desire to have these relationships starts.  The other issue is of course also that digital and social media often sits either with marketing or comms – not with Medical, and yet Medical is the area that could really provide the most value and also get some real benefits from social media.  Given the lack of digital expertise in Medical there is a strong argument, in some cases, for some relationships to live with the digital or social media team, who (hopefully) understand the dynamics of digital relationships.

Once you have identified who owns the relationship you then need to start relationship building.  Like any relationship it will depend on the individuals involved, what channels they use, what value you can provide etc.  However in general your first step will be to start building the relationship digitally – retweet their content, comment on their blog posts, etc.  Offline however also plays a pivotal role in this relationship building – just because this is a digitally focused relationship does not mean it has to only stay in the digital arena.  If you know the KOI is going to be attending the same conference as you then get in touch and arrange a meeting.  Or perhaps you see that the KOI is going to be in the same town as you – arrange to meet for a coffee.  Alternatively invite them to a specific event you are organising.

A good example of this comes from Roche Diagnostics blogger summits which are annual events they organise with key diabetes bloggers specifically to build relationships.  Roche has been very successful – partly because they were realistic in their approach and accepted that this would need to be a long term initiative and it would take time for the summits and relationships to work (in fact it took 3 years).  Another reason Roche was so successful was also because they went in with a “what can we do for you” mentality – rather than a promotional “what can you do for me mentality” – they asked attendees what they needed from the organisation and what value Roche could bring to the community. The response Roche got was very positive and they now have a good relationship with the community, who blog and tweet about Roche’s initiatives and help improve the Roche name within the community.

Follow Roche’s lead then when you look at building your own KOI relationships – allow time, and focus on their needs first and not your own.  As the relationship develops and builds it will turn into a win win relationship, with the KOI spreading the reach of your content and providing a more credible way of reaching your target audience.  Put aside internal squabbling and politics to focus on the relationship and share knowledge and process internally.  Building KOI relationships will increasingly become a key part of the “KOL” process in the future so learn how to do it today – and do it well.

 

 

Why digital? Because everyone loves a rainbow!

A few years ago it was totally normal to have to convince people that digital was a valid, and important, channel.  That fact is now a given – and yet there are still people who need to be convinced.  One issue is that traditional marketing is a safe option and it has worked in the past.  During this tough economic times people are more wary of trying something “new” (even if strictly speaking digital is no longer new) and this is why they need convincing that they should shift some of their budget from their “safe” traditional channels to this “new” and “dangerous” channel.

The trouble is that this traditional way of splitting budgets no longer matches users needs and behaviours.  How come some pharmaceutical companies are spending less than 5% of marketing and sales budgets on digital when physicians, for example, would like to receive over 60% of their product information online?  This seems like a huge disconnect with reality and customer needs and cannot be sustainable.

HCP information preference

HCP information preference

It also seems rather ludicrous given clear direction from customers, physicians as well as patients, that they want more information and resources digitally, that we still need to stand up and argue the need for more digital to be included in the marketing and communications mix.  We should no longer need to be trying to persuade senior managers on the need for digital – rather we should be working with them to look at how best to integrate on- and off-line resources and how to get a more balanced marketing mix.

There will always be a need off-line materials but they should work in harmony with online elements and all marketing and communication elements should be integrated and optimise each other.  There is no battle between digital and traditional – one is not better than the other on its own.  Rather they tell a far more powerful story when combined in an integrated and strategic way based around customer, and organisation, needs.  Just like a the colours of the rainbow are truly impactful when joined together in a smooth combination, communications should be joined together to provide an impactful and memorable experience for the end audience.

Right now the pharmaceutical audience is just getting a huge sway of reds and oranges but there are hardly any blues coming through which is not impactful at all.  We need to stop defending why we even need digital, and and stop fighting to get more digital budget, but instead we need to start working on getting the mix and colour combination as perfect as a rainbow.

Rainbow in Sri Lanka

Rainbow in Sri Lanka

Strategy – more than a list of tactics

I am a strategist by nature and have spent most of my career in strategy.  I believe that you can learn about strategy but to be a great strategist takes more than just studying it in a book.  A great strategist has vision and passion and is a forward thinker.  A great strategist also knows that strategy is a living thing that needs to be based on insights and understanding and needs to be adapted.  A great strategist also knows that strategy is not a list of tactics.

Unfortunately strategy is a word that gets bandied around a fair amount without it always being understood.  Every Tom, Dick and Harry now has to have a strategy – but that does not mean that every Tom, Dick and Harry has the required skills or expertise to put together a strategy.  The result tends to be a “strategy” that is little more than a list of tactics. The result is disjointed, inconsistent and ineffectual marketing and business.

A strategy should be the cornerstone of any business venture – be it a product launch or a new Twitter campaign.  The strategy should be based on knowledge and insights – not on what the team leader thinks and knows or what tactics the agency happens to suggest.  The strategy should be a road map which provides the team with the directions to success and how to get there.  Tactics are then the vehicles used on this road – but they are not the road themselves.

A strategy is also a multifaceted document. Like any good roadmap it features more than just a line where the road is.  It also gives you distances, key points on the map, alternative routes, etc.  McKinsey’s 7 S model provides a good overview of the various key elements for the Strategy roadmap.

7S

Most important is the shared values.  If doing a digital strategy, for example, at its centre should be the corporate strategy and values, and if appropriate the brand strategy and values, as well as the values and needs of the target audience.  A strategy should not be a stand alone document but should link to other relevant documents and should be founded on the corporate strategy.  I have however rarely seen a brand team approach the corporate strategy team to ask for the latest corporate strategy on which to base the brand strategy.  Unfortunately I have also come across brand digital strategies that were not even based on the brand strategy.

A further important element in the strategy is the structure and systems.  It is all well and good developing a brilliant, innovative strategy, if the infrastructure or internal systems required to implement it do not exist.  In the case of marketing the strategy should also include the structure of the ecosystem (so for example how will the various channels be interlinked).  Given the changes in marketing today the strategy should also include the process and systems that need to be put in place to be truly successful, for example cross-functional workgroups.  Whilst the industry may be highly siloed the outside world is not.  A strategy should suggest how to tackle this issue in order to follow the road successfully without getting diverted onto a side street – what systems need to be in place in order to overcome these obstacles?

Style is also worth mentioning.  As one progresses down the road will the style remain the same or will it evolve?  Should the style be a mirror image of the corporate style or is there a need for different style in order to achieve the objectives.  Having a clear idea of style before going to an agency is worthwhile as it gives the agency a clearer direction and ensures that everyone has the same idea in mind.

Last but not least are skills and staff.  If there is a need for more headcount this needs to be flagged in the strategy – and if that headcount cannot be met then the strategy should also provide an alternative route.  When it comes to implementation these elements are also very important.  A great strategy will fail if there are not the right people with the right skills to implement it.  Education is a key element to many successful strategies.  In particular when looking at “new” areas, such as digital, education is critical to success.  If you come up with a great strategy but people just do not understand it or the required steps, then it will fail.  Providing clear directions around the education needed for the strategy to succeed is very useful.

Finally when looking at skills and staff there also needs to be the acceptance that not everyone has the required skills to develop a strategy.  This is why consultancies like McKinsey do so well – they are strategy experts. However too often strategy is left to the team and very few will have the sort of expertise that McKinsey does.  Many of these strategies consist of no more than a mission statement and a list of tactics.  There is minimal research behind this, little analysis and very little direction.  The result is a document called “strategy” that is however nothing close to being a real strategy.

This is a huge flaw as the strategy is the most vital element to any business.  It is worth investing in doing a strategy well up front and providing sufficient resourcing for this – including for market research and external expertise.  Managers should accept that they may not have the required skills – or indeed time – to develop a great strategy – and should reach for support (internally or externally). Strategy is the foundation stone and as such it needs to be robust and taken seriously – and any manager handed a list of tactics called “strategy” should be very concerned.

The strategy is after all your roadmap and if you have the wrong map you may take a disastrous wrong turn.  Invest in the map first – then you can judge what type of car you need.

 

road

I have the power . . .

One wonderful thing about social media and new technologies is the power it places in individuals hands.  Where previously as an individual you either had to have actual power – e.g. be the Prime Minister, or be in a powerful role such as a journalist for a leading newspaper, today technology has placed power within reach of individuals and small groups.

This is particularly valuable when it comes to worthy causes and raising awareness.  Social media has enabled some very positive changes in healthcare – for example raising the awareness around the need for women to get screened for cervical cancer.  Often the awareness is driven by an organisation or charity, but at other times it can come from a dedicated individual who knows how to make full use of the channel.  Kelly Young, aka @Rawarrior, and author of the http://rawarrior.com/ blog, springs to mind as a great example of an individual who does a great job in raising awareness and providing resources around a disease.

Now the reason I was inspired to write about this is actually not related to healthcare.  Rather my inspiration for this post comes from a very small and brand new charity called Hope for Romanian Strays set up by Aniela Ghita.  To me Aniela is a wonderful example, like Kelly Young, of the difference that one person can make – and how social media can then amplify that difference.

I first came across Aniela via my cat’s facebook page (https://www.facebook.com/TheDonCat).  I saw a rather desperate post asking for help with a paralysed dog that had been rescued from the street.  Emily was a one year old terrier and along with her friend Aira – another rescue dog – had been found a forever home in the UK.  Emily and Aira’s new mum was going to pay for the medial expenses – including Emily’s expensive wheels – and a transport option had been found for them.  However the cost for the transport was around €1000 and Aniela had four days to raise the funds – the new mum could not afford to pay medical expenses and transport costs.

Paralysed Emily rescued from the streets and rehomed with a loving family in the UK

Years ago this would probably have been an impossible ask – but Aniela posted an event on Facebook and shared it with her network.  This was how I came across this heart-wrenching story.   My first concern was that this was one of the many scams but I decided to risk it anyway and donated – I felt that if this was genuine then I had to act to help get these two dogs both with horrific stories to a new loving home.  It was no scam and Aniela managed to raise the funds in time thanks to Facebook and Emily and Aira are now both very happy in their new home in the UK.  Had it not been for Facebook both these dogs would probably still be in a desperate condition in Romania but social media gave one woman the power to make a small change for the good and rescue these dogs.

For me this is truly inspiring to see passion and dedication like this becoming really effective, and making bigger changes thanks to a technology and channel that gives the individual the power to reach out to like minded people around the world and ask for help for such a worthy cause.  I salute all you individuals out there making these changes and doing good – and on behalf of all the dogs and cats you rescue I thank you Aniela!

As an addendum:  I am now working with Aniela to help further extend her work.  She has formally set up a charity called Help for Romanian Strays and you can find out more information via Facebook https://www.facebook.com/pages/Hope-for-Romanian-Strays/310177669061280 ,  Twitter @hopeforstrays and via the blog http://hopeforstrays.com If you can help with your skills or wish to donate (or even better adopt) then please contact Aniela at hopeforstrays@yahoo.com.  And of course please share!

The ages of digital

We are now part of a world that is full of digital natives.  But what about those who are new to digital – or what about back in the day when you and I were new to digital?  How did we behave?  What steps and feelings did we go through as this brave new world opened up to us?

A colleague recently described his mother’s reaction to her new iPad.  She sounded like a young child with a new toy – describing every new action and move.  And this made me think about the “ages” we go through in our digital journey.

First contact with digital technology – be it a new device like a iPad or platform like Skype – generates a child like glee and excitement.  Everything is new and full of discovery and brings further exploration and a verbalisation of the joy of discovery.  Those of us who have recently experienced parents going through this process can testify to the simple pleasure the joy of new technology can bring.

But what happens as the relationship progresses and the person reaches “school age”?  Here there are lots of questions, lots of learning needed and unfortunately a need to do some homework.  The excitement and glee has all but worn off – however a glimmer still remains and it is this that carries the person through the “school years”.  Frustrations however do start to appear – the lack of understanding and despair at not getting it, despite having done ones homework.  Encouragement by the “teacher” (generally a younger relative or more tech savvy friend) pulls them through.

School age moves into the difficult teenage years.  Not all teenagers are alike – some pass through their teenage years with no rebellion, no problems whilst others have a very troublesome time.  These problem years can mean a move away from the newly learnt technology and skills, a disregard for the joys but also the stress the technology brings.  The “teenage” rebellion can mean a return to the old ways, turning away from Skype or the computer.  Like all of our ages however the “teenage” years will invariably come to an end for most.  A few may remain forever in their teenage years but most will mature and move into their 20s, 30s etc.

The next decades bring increasing confidence and a comfort in the technology.  They will be familiar and happy with the basics and will be open to new platforms and technologies – depending on their age mind you.  As the person matures they find a comfort level they are happy with and find the technology meets their needs.  Their youthful curiosity may give way to routine but generally contentment, mixed with a bit of frustration that life invariably brings.  They now use technology as part of their everyday life.  If something new comes along that will really make a monumental change, then they may consider it, but if not they will do very nicely with the skills and technologies they have.

And so we come to old age.  This is where we hand the reins over to the next generations – it is up to them to lead the change and bring in the new technologies.  It is up to them to teach their “grandparents” how to use the latest of the latest.  The “elderly” user however can look back and reminisce on their early days with the technology and all they learnt – and how quickly things have changed again.  Some will be forever youthful and keep learning and evolving but many will stay at a happy status quo with their technology.

Augemented Reality use in healthcare

The recent launch of SapientNitro’s augmented reality (AR) lungs on Channel Four’s Embarrassing Bodies (http://bit.ly/qprBo2 ) made me ask why there is so little use of these new technology within the health arena.

AR has been around for quite a few years now, and the term itself was coined over twenty years ago.  The use of this technology has been very limited but is finally starting to take off – particularly in the advertising and fashion industries (for one of my favourite examples watch this video: http://www.youtube.com/watch?v=uDTdHG_FytM). Like many new technologies this has partially been as a result of reductions in cost as well as the growth in smart phone ownership.

The opportunities for AR in healthcare are potentially huge and just as for other industries the barriers to use are dropping. Currently it is still relatively new, providing a window of opportunity to grab attention but even without this “shiny new toy” appeal it has the potential to provide real value.

SapientNitro’s lungs show one very impactful use of the technology – education. As the Channel Four video shows, the impression on teenagers of seeing “their” lungs is huge.  Whereas all teenagers know that smoking damages the lungs, and many may have seen images of damaged lungs, to actually witness 3D lungs on their own body deteriorate as they input smoking usage figures is extremely impactful.   AR allows for this additional personalisation that an image or video can not achieve.

Given the issues that still exist with poor patient compliance and adherence any tool that could potentially improve patient education must be taken seriously.  Patient education can be a key element in strengthening compliance for certain patients and patient recall of information given in a doctors surgery is notoriously low.  Improving patient comprehension of the disease issue but also improving recall of the key health message can be extremely beneficial – to the patient and in turn to the healthcare system and even a country’s economy.

Education also plays a key role in prevention. Again the AR lungs video is a good example – hopefully the teenagers that took part in this video will be less likely to smoke as a result and thereby improve their health outcomes in the future. Prevention is an increasingly important national health concern – particularly given rising obesity and preventable disease rate.

There are other educational opportunities for AR but for HCPs.  Using AR as part of training for HCPs – e.g. Medical students – again it provides a very visual and real life way of learning.  Outside of education AR has all sorts of other opportunities too – for example in novel minimally invasive surgery techniques (for more information: http://www.ariser.info/).

From a marketing point of view AR could help sales reps explain how novel products function or help with disease awareness campaigns targeted at patients, and being still a relatively novel technology could potentially even help a disease awareness campaign go viral.

Despite all the opportunities however there are still very few examples of actual use of AR within the healthcare arena – why?  Part of the reason has until recently been due to typical barriers of entry such as cost and technological barriers – however these are now disappearing. Another reason is the unfortunate reality that the healthcare and pharmaceutical sectors are not exactly at the forefront when it comes to making the most of new digital technology.    No doubt this is a technology that we will start to see a great deal more of in the consumer goods and media industries and once they become common place then the healthcare industry  may start to venture into using the technology.  By this time of course it will have lost its novelty factor – but that’s life!

GPs: can you communicate please?

Yesterday I had the dubious pleasure of having to visit my GP for a prescription. After the usual brief discussion he then was about to give me my prescription when I pointed out that he was prescribing a medication to which I had previously had an adverse reaction. I was obviously a bit perturbed that I was the one telling him this and that he had not spotted it on my medical record. I was then even more perturbed when he duly informed me that there was no mention on my record that I had ever taken the said medication!

 

The reason for this disturbing mishap however is very clear. My current London GP has not communicated with my ex-GP in Suffolk (where my parents live and who I still use when in Suffolk). I have moved around a considerable amount – including abroad – but in the UK have only ever had two GPs – the London one and the Suffolk one. I am fortunate to have the same London GP now as I did many years ago when I first lived in London but I never actually checked whether they still had my old records (but presumed they did).

 

I also never checked that when I registered with them and gave them my Suffolk GPs address that they would get copies of my medical records from the Suffolk GP. I thought this would be an obvious thing to do to ensure that they had a full set of records and had no major information missing (such as adverse reactions and allergies). It now appears my assumption was wrong.

 

Even five years ago I would not have made this presumption but given the ease of transferring digital information securely I thought that this communication would be a simple, standard thing to do for a new patient. Given that patients generally do not yet carry their own electronic medical records around with them the onus is still on the GP to own an up-to-date medical record for the patient.

 

Taking this thinking further though it struck me that when I had the unlucky misfortune of having to visit A&E a while back that they also had minimal information about me and I had to inform them of my medical allergies. What if I had been unconscious and/or unable to communicate? I presume at some stage they would have contacted my London GP to ascertain my allergies but given the above situation that would not have been 100% successful. My parents may also have forgotten my obscure allergy so may not have been much help.

 

I am fortunate to live in a country with essentially a single healthcare provider and payor – the NHS. Is it really so inconceivable that a patient has access to their medical records throughout the system – whether it be with a London GP, an A&E department or a specialist in a different part of the country? Granted I am aware this is a mammoth ask and a huge task but it also makes me question the vast sums of money that has been ploughed into IT in the NHS. Where exactly did all this money go?

 

Actually I know there is quite a lot of evidence of where it went – some of it has been used successfully and some has been plain wasted. But given the rapid changes in technology and the ever decreasing costs as well as the ease of communicating cheaply surely there could be some sort of a basic system in place by now? How hard could it be to have a basic patient register with basic medical information such as any chronic diseases, allergies etc? And if patients are worried then they can opt out of the system – but for patients like me it would be great.

 

I appreciate that a massive organisation like the NHS, with all its fiefdoms and political issues will take time to change and implement new systems. However it strikes me that at a time when money is a huge concern there should be more focus at looking at new technology to reduce costs, including medical errors (such as administering a medication to which someone is allergic) and streamlining services. In the meantime I will make sure that next time I am in Suffolk I see if the GP can give me a copy of my medical record to hand deliver to my London GP.