Digital: bridging the gap between doctor, pharma and patient
pharmafile | August 8, 2014 | Feature | Business Services, Manufacturing and Production, Medical Communications, Research and Development, Sales and Marketing | digital, doctors, pm society, social media
Digital technology is moving on apace, but is the pharma industry keeping up and just what are the opportunities to reach out to key stakeholders using digital?
A recent look at two doctors’ digital habits during a PM Society Digital Breakfast BrightTalk webinar showed some fascinating insights. The relatively young clinicians (aged 27 and 33) spoke about their digital consumption and that of their peers and painted a picture of a real-world scenario that replicated normal life in most instances.
In line with this standard technology adoption lifecycle, some doctors are: digital innovators, some early adopters, and a few are laggards. Age does appear to play a role in doctors’ digital consumption habits, but in reality most of the audiences pharma must target for success are embracing digital channels more frequently.
External factors are also very influential. It would appear from the doctor’s feedback that the NHS is often the issue with regards to digital adoption, not the doctors/healthcatr professionals (HCPs) themselves.
As ever, the NHS is not one large streamlined organisation but a series of different healthcare providers operating under one brand, so what is the lowest common denominator? Assume no YouTube, no Vimeo and no access to commercial sites without jumping through hoops with the IT department. FaceBook and Twitter? No way!
Doctor trends
Neither of the doctors we talked to use their phones much during working hours, although they always carry them. Usage tends to be limited to making and receiving calls and texts and monitoring, but not replying to, email.
There is a potential role for commuting doctors to use ‘train time’ to browse the internet on a smartphone, or use apps to catch up on medical news – but many drive or cycle to work. Phones aren’t provided for work unless it is to replace a ‘bleep system’ where you pick it up at the beginning of a shift and leave it when you finish, and these are basic. One NHS body was mentioned which has started to use tablets instead of a bleep system, but the integration of these new technologies is patchy.
Although these data are not robust, the choice of device does appear to show some sort of trend. For example, the doctors interviewed think that senior clinicians are more likely to have an iPhone – guesstimated at around 90%, but go to the SpRs and trainees and its more likely to be a 50% iPhone, and 25/25% Samsung-HTC split.
The Android and even Windows platforms proportionally appear to be a strong match for Apple’s iOS software. Of course from two doctors this is simply their observation, but could illustrate some iOS preference in the UK.
When it comes to email, quite rightly patient confidentiality is a barrier to allowing access for NHS emails on any portable device. This means that there is a divide between home and personal email accounts and work-related business, carried out within the healthcare setting.
Doctors.net.uk was regularly mentioned as a source of information allowed by NHS IT gate-keepers, which provides useful medical information and some pharma updates. It seems that almost every younger doctor will have a doctors.net.uk email address and many will route/POP these into other regularly used accounts.
With regards to medical reference websites, the doctors may use Wikipedia for very basic information and as a launch pad to more refined sources, but generally the most cited were Up-to-Date and Medscape. The British National Formulary app was thought to be a bit cumbersome and slow, and the paper version won hands down with one of the doctors.
Interestingly, the fact that a website was made by a pharma company would not prevent a doctor from viewing it, but there were caveats. Good referencing and an associated bibliography, together with useful information presented in novel more and dynamic way – possibly with case studies – were considered one of a number of positive ways to communicate about the value of products or healthcare improvements.
However, there could be barriers to accessing such information in the healthcare environment, and policies on ‘allowable’ sites vary from one NHS body to another.
One doctor was also very clear that he would never go looking for information from a specific pharma company, but would review information received – say via a doctors.net.uk email. Both doctors also liked the concept of live webcasts or webinars as a “nice way of accessing information and having an opportunity to discuss things properly”.
One of the doctors has found value in LinkedIn, using it to network with medical professionals, academic colleagues – and in some cases those that might not normally be points of contact such as industry or other commercial organisations. The fact that he can share his profile and interests and that others with similar interests can get in touch, has led to quite substantial research collaborations, he says.
Social media and patient power
But generally social media comes with a warning: patients may attempt to contact their doctor via Facebook but these requests must be ignored as inappropriate. Usage – if at all – is linked to friends and social occasions, but definitely not in a professional capacity.
Twitter has greater potential for patients and there are several forums for groups talking about specific diseases, which are useful when the information sources are credible. There could also be a role for Twitter in allowing younger patients – as they transition to adulthood – to network with people and families who share the same condition as them.
Increasingly patients are turning up to the doctor armed with information having researched their symptoms online, although probably only 10% actually bring printouts. It is seen as a good discussion focus – either to talk about research and around any concerns, or to give out correct information and resource references if a patient has gone down the wrong online route.
For patients, patient.co.uk scored on clarity and quality of the information. Doctors do use information provided by their NHS body and print it out for patients. Depending on the disease area, they may also point patients to condition-specific websites, usually run by patient organisations and reliability of source is key to credibility here.
Asked what they would advise pharma, one doctor suggested that good face-to-face relations remain important and that this is his personal preference. However, this should be augmented by digital with channels such as doctors.net.uk a useful reference point – particularly because information can be downloaded (meaning you don’t have to have Wi-Fi access).
Another general comment was that pharma sales reps must be well-informed and able to answer questions. That way doctors are more likely to listen to what they say and see them multiple times, but at the same time digital is currently under-invested and a ‘missed opportunity’.
So how important is digital really, when there do not appear to be simple pathways to reach doctors or help patients achieve better outcomes? The answer is that it is critical to those who find it useful or preferable as a way of receiving information and engaging. Target them this way and you will have greater success, in the same way that you might still choose to campaign in the tabloid press to try and make the government sit up and take notice on a particular issue.
Opportunities and communication
The proliferation and diversification of the way that various organisations communicate with people is indeed a complex opportunity to pick, and the era of glaringly obvious ways to reach segmented audiences are gone. Where pharma is concerned one fact is clear: consumer companies have become experts at weaving digital strategy into their communications, and pharma needs to play catch up.
Virtually every medium now has a digital form, whether it’s the Guardian online or the red button gaming option on the BBC’s Antiques Roadshow – it is no longer a choice, but a requirement to at least consider this space.
So what are the opportunities for pharma? First, the digital enthusiasts among us must never lose sight of the basic principles of marketing. Digital is part of the ever-diversified range of opportunities to engage with the people that we need to talk to who can help our businesses to succeed.
Alex Butler, who was a pioneer in digital for pharma with his former firm J&J (and is now an MD at The EarthWorks agency) recently spoke alongside Kai Gait, GSK’s global digital director and in addition last year’s PM Society Digital Pioneer.
Butler commented on the buzz words that are ‘multi-channel marketing’: “It is a question of nuance and the reality is that you have to integrate channels whilst understanding their distinct value and properly resource what you do,” he explains.
Essentially, you need to know what you need to say, to whom and at what time – and that applies as much in digital, if not more, as it does in any other communications channel. This activity doesn’t need to rely on a huge sales force, but it does need marketers to connect the data they so avidly collect and for this to happen, companies must break free from their silo mentality.
mHealth
mHealth, or mobile health to give it its full term, has enormous potential and is likely to explode with the advent of iOS8, the Apple operating system that is predicted to have a biometric mHealth suite dubbed ‘Healthbook’ inbuilt.
This was launched in June at the Apple developers’ conference, and if previous launch patterns are followed it could arrive as soon as autumn with the awaited launch of the iPhone 6.
With mHealth comes, for example, the potential to monitor and understand how nutrition impacts a chronic condition in an individual. If you are travelling, your device may be able to warn you about pollution and tell you how you can better manage your condition.
“Innovation is the application of new ideas and technology and it is the application that is the important part,” says Butler. “It is not an innovation if it can’t be applied and this is where we are at with mobile health at the moment. Devices such as Jawbone can already track mood, nutrition and sleep and essentially know everything about an individual. With the advent of iOS8, which will almost certainly have a biometric suite that apps can tether to and use, the landscape will change overnight.”
The doctors we talked to saw new health monitoring accessories as a great and under-utilised opportunity, although they did say that some are ‘unreliable’ and that they would want to personally test any they recommend to patients. Already, our insiders said some respiratory specialists are using apps for continuous ambulatory pulse oximetry monitoring that automatically transmits data to the team, while cardiologists may use remote blood pressure and pulse monitoring tools.
They suggested that there is also great potential in diabetes and glucose monitoring and in endocrinology. One particular collaborative initiative mentioned was with AbbVie, called Talking AS. It allows patients with ankylosing spondylitis to keep a diary monitoring the condition and automatically relay that to their consultant.
So apps do have a place but when talking about the proliferation of apps, Gait warns: “At the end we really need to have a purpose for any activity – who is it for, what is it for and who ultimately is the end user. If you look at the industry as a whole, we are saying we are doing more digital but actually we are equipping more reps with iPads.
“Pharma does digital on top of traditional channels, but it isn’t perfectly integrated – we are building on top of it. It isn’t wrong to equip reps with iPads, but the biggest challenge for them is accessing doctors, so is making them digital the right investment? I don’t know!”
Think outside the gadget and gimmick
As an industry we are excited about equipping reps with iPads, yet the doctors interviewed for our Digital Breakfast were concerned more with the content of approach than the accessory. If the rep is talking sense and providing information in a concise and interesting way, then they will be able to build a relationship with the doctor. It really doesn’t matter whether it’s via a tablet or paper.
Interestingly, both doctors stated around 50% of the reps they see have iPads. When asked whether an iPad made any difference to the call, both said not. A good call was due to a good rep and the content/information they had to share.
“Can pharma play [in the mHealth space]? It better had or we aren’t in the game anymore. We have to be in this mHealth space,” Gait warns. “The future is in our hands and it doesn’t have to be the most comprehensive, budget breaking project in the world. Think about how you run the project over two years, have iteration phases, take out what fails and keep trying to make it better. The key thing is you think about the budget in year one, two, three and beyond, because you are in it for the long-haul and that they need to fund it on a continuous basis as your customers will still be there.”
Gait concludes: “Finally, be simple. It doesn’t have to be new tech. Think about SMS – it may be ‘old school’ but it has massive reach and penetration. Look to what is effective and can make change happen.”
The key things to take away are this: know your audience, reach out to them in a way which you know they prefer. Personalise your approach, or at least manoeuvre defined segments in a personalised way and look to engage – not just push out information. Finally, embrace technology but remember that innovation is in the way that it is used to effectively reach your target, not in the use of the latest gimmick or gadget.
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