Category Archives: General

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.

Why so many Diabetes Dosie award-winning initiatives?

This year’s Dosie awards are now out ( http://www.doseofdigital.com/2011/06/meet-2011-dosie-award-winners/) and I was struck by the high number of diabetes resources that won awards.  This led me to ask the question at this week’s HCSMEU tweet-up (Friday’s at 12GMT in case you did not know)  as to why this was – why is there such a plethora of diabetes award-winning resources but not for other TAs?  There are a number of factors that feed into the answer to this question.

 

Pharmaceutical company investment

Diabetes is a highly prevalent disease but it is also growing rapidly. It is a disease that has a large population pool, with still high unmet needs but which is also growing in importance globally.  This has led to an increase in investment by pharmaceutical companies in the disease area and it is seen as a strategically important disease area by many of the big players.

 

This impacts digital resources in two ways.  Firstly it means that diabetes teams will have access to more resources for marketing purposes.  It also means there is more investment in R&D and there are a number of recent new diabetes products and more in the pipeline.  New products get more resources for marketing – and new products tend to be including digital resources in their marketing.  As a high profile, but highly competitive, disease area there may also be pressure on marketing teams to come up with innovative marketing ideas – e.g. digital solutions. 

 

Active and vocal patient communities

The diabetes community is well established – both online and offline.  Diabetics have been at the forefront of some of the early digital communities and they have been very visible and vocal.  This effects today’s digital resources in two ways.  Firstly it means that there are some tried and tested approaches (so investors can see the ROI) which makes it easier to develop a new initiative based on lessons learnt.  It also means that as a community they are more active online and therefore initiatives have higher usage numbers (which impacts both ROI and award winning). 

 

As a chronic disease digital resources are also particularly effective for diabetes patients.  Digital tools make it easier to control and track the disease and there are plenty of ways in which digital resources provide real value to diabetes patients (my favourite is still  the Go Meals app from Sanofi http://www.gomeals.com/ ).  At the end of the day for a resource to win awards it has to be providing value!

 

Another issue that plays into the disease favour is the fact that there is not the same stigma attached to diabetes compared to other diseases such as depression and Sexually Transmitted Infections (STI).  This makes it easier for a community to form and to openly participate in a conversation.  It takes a great deal of courage for a depressive or HIV positive patient to openly talk about it online.  Whilst there are resources where patients can do this anonymously there is still a fear that somehow someone will find out.

 

Technologically linked disease

 Given the need for blood glucose monitors diabetes is also a disease that has been more closely linked to technology from an early stage.  This also helps when it comes to building resources and patients using the resources.  It means that marketing teams are possibly a bit more technology aware – but patients are to a degree too (this may though just be me being optimistic!).  It also means that it is easier to tie technology solutions together to provide value (e.g. linking a glucose monitor to an app).  Again this feeds into the value creation concept.

 

So to the answer to my question then would be that diabetes is a disease that patients are more open about, that receives more investment from the pharmaceutical industry and where digital really can provide measurable value.  My hope is however that other diseases such as depression will now also get more attention and investment – fingers crossed!

Digital Media Agencies not doing digital

Today one of my twitter chums, Andrew Spong, posted a very valid comment on twitter about digital agencies and their own use of twitter (see the image).  Essentially if as a digital agency you are not regularly using your twitter account then do not highlight your twitter account on your home page.  Very wise words indeed.

 

 

This reminds me also of a comment made by @skoko a while back about digital media agencies practicing what they preach.  How can a digital agency be credible if it does not participate actively and effectively in at least some form of digital media.  Most digital agencies now have very snazzy websites – and how those that do not (and they do exist) get any digital business is beyond me. 

 

Websites are still generally the first port of call for potential clients and as such a website needs to accurately reflect the business you are in and your skill areas.  If you are a company supposedly skilled in digital having a poorly designed website is not a good start.  There is of course the danger that some websites become too “over-ambitious” – lots of dazzling flash imagery and pop-out boxes all looking great but not much actual content.  Websites need to be visually appealing but also need to be functional.  They need to grab enough attention to hold the visitor when they first land on the website – and here the visual impact is crucial – but also contain the information a visitor is looking for and expects to find on the website.  This information also needs to be easy to find or the visitor will give up and look elsewhere.  This is actually a big problem with pharma websites but that is worthy of a post all to itself.

 

Some of the things to consider for websites are:

  1. Objective: What is the objective of the website?  Is it to sell products / business, provide information, etc?
  2. Audience: Who is the target audience and what is of value to them? What content do you expect and need to find?  How are they accessing the website? What search terms are they using to get to the website? etc
  3. Internal factors: What are your internal resources dedicated to the website now and in the future?  Do you have the manpower to keep the website updated?  Do you have the budget to maintain the website? etc
  4. External factors: How is the competition using their website?  Are there industry events that will impact traffic to the website? etc

 

If as an agency you have not looked at the above when building your own website then how can you advise clients on theirs?!

 

These days I also expect to see a link to any social media on the homepage (and this goes for pharmaceutical companies too).  I expect a digital agency to be active on twitter, have video footage on YouTube and to have a blog.  I am not that fussed about a Facebook page to be honest – to me Facebook is a personal space and I do not go there for business – but if your business is digital you probably should have a presence on Facebook.  Of course it goes without saying that you also need to make sure your company’s Linkedin page is kept up to date.

 

Starting with Twitter, and Andrew’s tweet, I think it is fair to say that not all digital companies are doing brilliantly well here and Andrew is quite right – if you are not doing it well do not highlight it!  I know of one UK digital media agency at least that as of today had not tweeted since the beginning of May – that is over one month of nothingness. I also recently had a discussion with another agency (also not very active on twitter) that said twitter was too time consuming.  My response to that both these points is . . . yes building relationships is time consuming but that is what business development is also all about!  How can you advise clients on how to run a twitter campaign if you yourself are unable to actively and effectively use the communication channel?  Personally I have made some great business contacts through twitter and I strongly believe that by being active on twitter I as an individual build up my credos in digital media (providing I stick to saying relevant things and do not start drunk tweeting!).

 

My advice regarding twitter would be to make it the responsibility of one person and make it part of their job role.  The chances are there is already at least one person in the office active on twitter – maybe see if they would be interesting in taking on the role.  Another option is to split the responsibility up between various people – but personally I am not a fan of this method.  Twitter is about a conversation and developing relationships – unless the team working on this are very clearly aligned and have very similar communication styles and closely follow what the others tweet it could soon become a very disjointed twitter account – essentially a multiple personality twitter. As to the time element – tweeting is not about taking hours out of a day.  A quick glance at the twitter account a few times during the day (which takes all of five minutes all being well) and posting, responding or re-tweeting once a day (which again takes all of five minutes) would suffice.  

 

The other bit of twitter advice I would give is not to just post company information such as “check out our new blog post” or “we just won this shiny award”.  While that obviously should be tweeted that type of content is not particularly engaging – and personally I find it a bit dull most of the time.  What makes for an engaging twitter account is not only posting new content (and yes here you can post the corporate blog posts) but also re-tweeting and sharing interesting articles (not written by the company) and taking part in conversations.  An example of this is some of the agencies, such as @aurorahealthpr and @streamingwell, who take part in the various tweet-ups such as #HCSMEU.  Not only do they engage using twitter they also highlight their expertise and knowledge.

 

Moving onto YouTube – admittedly not every agency will have video content but if they do then it should be on YouTube and sign-posted to via the corporate website.  What every agency should have however are slide decks which they can share – for example the standard “this is us” pitch deck – and this should be shared.  It can be turned into a video – you can add music, a few images etc – and then posted on YouTube or it could be shared via Slideshare (an under-utilised resource in my opinion).

 

Agency blogs are also a bit hit and miss – some agencies have regularly updated, content rich blogs/articles  (e.g. http://creationhealthcare.com/articles/) whilst others have blogs that they only update sporadically and others have no intellectual content at all.  Blogs and articles are essentially a great way of highlighting the company’s thinking and its intellectual capital.  If a potential client reads a really engaging and thought provoking blog post or article they have a more positive image of the company.  Of course the opposite is also true – a badly written, poorly thought-out blog post or article leaves clients walking away with a negative opinion.  Whilst not updating blogs is obviously a sign of how furiously busy an agency is doing tons of great work (!) it is also a lost opportunity to share the agency’s great thinking.  The time element again crops up with blogs – writing articles and posts is time consuming and very few people really have time to dedicate to this.  One way round this is to encourage all employees to write blog posts (which can be signed off by a dedicated blog person) – why should it be down to just one person to do all the writing?  If it is down to one person then this clearly needs to be part of their job role and they need objectives set up against this.

 

As to Facebook – wary as I am of corporate Facebook pages I think if you work in digital and you will be advising clients on the use of Facebook you should really have a Facebook page yourself.  However I say that because I think I ought to – if you do not have a corporate Facebook page no worries!  As long as no one else sets one up for you instead that is and hijacks your brand name.  As Facebook pages move more towards a blend of website and twitter streams though I think it is getting easier to have a corporate Facebook page.  You can stream your tweets via it already providing you with regularly updated content (that is if you have followed the above advice about twitter).  You can also post your updated blog posts on Facebook (again providing you are writing decent blog posts).  You can also use the Facebook page to share interesting articles – except of course you are already doing this via the twitter account – doh!

 

What is important with a Facebook page is the ensure it is regularly checked and comments responded to (if appropriate).  Engagement can be solicited by posting questions – for example The Cat’s Whiskas (aka Whiskas cat food)  regularly asks its fan’s what they are up to, what their cat likes, etc – and fans do respond.  Today The Cat’s Whiskas posted a new Maru cat box video (and if you have not see Maru do his tricks check this out: http://www.youtube.com/watch?v=TbiedguhyvM) and within three hours it had over 270 likes and 78 comments as well as tons of cat posts on the wall.  It comes back to the human element of social media – whoever is posting for The Cat’s Whiskas on Facebook has personality and the posts always feel personal (as opposed to corporate) and by someone who gets cats. 

 

This really is perhaps one of the main rules of social media even when it is from a corporate perspective.  Social media is about relationships and people.  Any social media elements need to be sufficiently personal in order to be effective.  Ideally it needs to be done by someone who is social, has decent social skills and who enjoys social media – and this may not always be the most “appropriate” or senior person in the organisation.  Being active on social media from an agency perspective is not only a good way of demonstrating the agency “gets” social media it is also a good way of making the agency more personal and highlighting the agency culture and thinking.  When it comes to choosing which agency to work with clients essentially buy people as well as skills – it is all about the personality and the ability to communicate effectively.

The Light Fantastic

Last night I watched a very poignant documentary about Terry Pratchett, the author of The Light Fantastic, and assisted dying in Switzerland  (http://bbc.in/lFzMAQ). Terry Pratchett happens to be one of my favourite authors and he is a very articulate man who also has Alzheimer’s – making this a very moving and thought provoking documentary.

 This documentary covered the very controversial and highly emotive topic of assisted suicide – and whether terminally ill people should have the right to die at home, without pain and at a time of their choosing.  It is a very difficult and painful topic and, for anyone discussing this online via social media, potentially fraught with some very vocal opinions and unpleasant discussions.

 Looking at this issue, and some of the potentially controversial opinions that get raised via comments and online discussions, makes it a little easier to understand pharma’s reticence to get involved in social media.  Here is a very good example of the difficulty in enabling comments on Facebook pages and other social media resources – potentially the resource could get inundated with controversial comments.

 It also highlights the importance of monitoring but also the potential size of resource needed to do this.  Any topic that people feel strongly about is more likely to get shared and lead to more comments.  This means that the there needs to be daily monitoring of comments – and by daily I do not mean one hour in the morning but I mean at intervals throughout the day. 

For blogs, such as this one, the issue is easier to handle as you can approve the comments before they go live however when it comes to Facebook the action is retro-active – meaning that there is a real sense of urgency and speed.  Any potentially offensive, harmful or illegal comments need to be removed (ideally) immediately.  This naturally does not happen if you only have a single person checking the page once a day – by the time they check the next day the discussion could have blown up and taken over – making it very hard to handle.

 The trouble is however with restricted (and often decreasing) budgets how can a company ensure that they can fund the necessary resources needed to monitor a social media initiative? Often it falls under the marketing team’s remit to do this monitoring in addition to their day jobs and essentially this may mean a once daily check – but as already mentioned above this is highly unlikely to be sufficient. 

 One option is to use an external agency or programme – but again this can be very expensive.  Another option is to consider using a “cheap” resource such as an intern or fresh graduate recruit to do the regular monitoring at various points throughout the day.  This would need to be set up by starting with some very clear general guidelines but also guidelines specific to the initiative itself.  These would provide the intern with guidance in the day to day handling of the social media initiative.  However there would also need to be some more senior (and consequently more “expensive”) input but this could be limited to providing guidance (e.g. via weekly meetings) and then being on hand to step in during times of crisis or particularly strategic conversations.  This way cost effective, ongoing monitoring can be provided whilst at the same time having resources on hand for any negative eventualities.

 With sufficient resources and ongoing monitoring in place a pharma company could set up a social media resource and would be ready for any comments – even controversial ones

Mature products and digital

This morning I was reading about the approval of Mylan’s generic version of the Alzheimer’s drug Aricept – yet another reminder of the patent cliff Pharma is currently going through. One way that pharmaceutical companies try to stem the loss of revenue brought on by patent expiry is through the release of a “new and improved” version. In this case Eisai is introducing an extended release version which will clearly benefit both patients and carers. Generally though the loss of revenue, even when there is a successor product in the wings, is considerable.

This means that as products mature and go off patent their marketing budgets decrease significantly and marketing focus moves onto newer products. In these circumstances digital can play a major role. The costs related to maintaining a digital resource can be considerably lower than a standard offline marketing presence. This does not mean that digital is necessarily cheap – it is well worth investing a reasonable budget in setting up a solid digital presence for mature products. However once this is done – and done properly – the expense is minimal.

Unfortunately what often happens is that the budget to start with is minimal meaning that only a basic – and often pointless – digital presence can be developed. This provides little value to the customer and will not generate the desired ROI – and in turn will have minimal impact. Digital is like so many things in life – if you build a solid foundation you can build on the structure and it remains standing and provides value, even for off-patent products.

So how could the mature brand teams use digital?  What does value look like?  This obviously is different depending on the product, the customer etc but looking at general trends and data some top level recommendations can be made.  For HealthCare Providers (HCPs) once a product moves into the mature category it loses sales force representation and it can become harder to obtain information about the product itself.  Ensuring that product information is available for HCPs online is a first step – but in order to provide value (and generate return visits, ROI, etc) there is limited point in developing a standalone website for each product.  HCPs want all the information in one single location.

 Having a website or a digital centre with information about all of the companies products, both mature and new products, is a good step in the right direction.  A key element to consider when setting these resources up however is that the information needs to be quick and easy to find and the resource needs to have a good search function.  Many pharmaceutical websites have very poor functionality and search options – HCPs visit them once to find the product information and get frustrated trawling through the mix of corporate information, press information etc before they get to the product information they need.

 The problem for a pharma company in setting up a resource such as this is that it is expensive to do well – but also requires co-ordination across brand and therapeutic silos.  And as to including mature products in the resource this is further complicated by the treatment of mature products once they come off patent – relegated and forgotten about.

 Included in digital resources and digital budgets however mature products can still provide value – they just need to be given a chance.