We have previously examined healthcare and the pharmaceutical industry in Russia. The other markets of Central and Eastern Europe (CEE – usually considered to comprise the Czech Republic, Slovakia, Poland, Hungary, Romania and the Balkan countries of the former Yugoslavia) are less often considered as a separate entity – either they are added on to general European plans, or are linked with Russia as “former Communist countries”. However, individual consideration of these markets is warranted as they are a growth area for healthcare and the pharmaceutical industry.

Andrew Widger, Director, Media Relations EMEA at Pfizer, says he believes a local view is necessary when planning engagement in the CEE region:

“‘With such diversity, the opportunities and challenges may be equally diverse. Network coverage, local regulations and restricted access to certain networks, literacy, language, cultural reference points – all these and more point to a need to approach opportunities with a local view.”

Operating and producing in the CEE markets

The CEE markets are highly diverse in terms of economic development, the healthcare landscape and internet usage, although there is the common factor of general growth. According to a report by Espicom, the  pharmaceutical market of Central & Eastern Europe is estimated at US$59.8 billion at retail prices in 2011; it is expected to reach US$94.5 billion by 2016. Other aspects of the healthcare market, such as medical devices and the provision of private healthcare are also growing. Thus, the CEE markets could represent a growing focus for pharmaceutical companies in commercial terms.

The mainstay of pharmaceutical sales in this area is branded generics – indeed a number of generics companies (including Krka, Gedeon Richter, Polpharma and Zentiva) are based in the region.

The CEE region may be of interest to pharmaceutical companies in the current cost-saving environment. The workforce in these countries is often well-qualified and English speaking, with lower salary expectations than Western Europe. Geographically, it is easier for countries based in Western Europe or the US to work with CEE countries, than with Asian countries.

Many of the CEE countries rely on imports of medical equipment, particular of more sophisticated devices. As joint ventures in Russia help increase local production of pharmaceuticals, which benefits the economy, the population and the investing companies, external medical device companies may wish to consider partnering with manufacturing firms based in CEE countries.

Social media usage in CEE

Whilst looking at joint ventures in Russia, the potential role of digital engagement was highlighted. Could a digital approach be of use in the CEE countries, for pharmaceutical companies looking to expand into the area commercially and in terms of production?

Internet and social media usage in CEE countries is diverse. According to reports published in 2010 by ECCO Social Media, the most advanced country in terms of internet usage in the region is Poland, which can be considered to have a “Western” pattern of usage with a delay in uptake of innovations. At the time of the survey, over half of Poles were aware of social media, two-thirds of Polish internet users used at least one social network and over a third created their own online content. Videos were popular, with 88% of Polish internet users watching video content. A report by Pyramid Research in April 2011 showed that over 50% of mobile phones sold by the country’s main operator in the first quarter of the year were smartphones.

Figure 1: Home page of one of the most popular Polish social networking websites, which offers a "meeting place"

The situation in the Czech Republic, which has a much smaller population than Poland, is slightly less advanced, but moving forward nonetheless. Around a tenth of the Czech population uses Facebook (alongside social networking sites that are specific to the Czech Republic) according to ECCO Social Media; mostly these are people in the 15-24 age group. Interest in smartphones is growing – in 2010, 2.3million phones were sold in the country, 111,000 of which were smartphones. It has been predicted that smartphone sales rates will increase further in 2011, with over 200,000 Android smartphones alone being sold. However, there is somewhat less interest in blogging and use of Twitter amongst the Czech population.

Figure 2: Facebook is popular amongst Czechs - this example shows a large number of discussions on a "Czech Facebook" page

Romania has the fastest internet speed in Europe, along with Lithuania, Bulgaria and Latvia. Its broadband penetration rate is not correspondingly high, but it is growing quickly, having risen from 17% in 2005 to 43% in 2011 (according to GFK Romania, a market research company based in Bucharest). The GFK Internet Monitor describes the average Romanian internet user as being an urban citizen aged 18 to 44, and claims that although social media is used by a large number of marketers and communication professionals, the average budget allocated to social media activities is usually too low to set up a campaign with clear and established strategies and objectives. Social media is still generally viewed as an experimental tool.

Hungary had a broadband penetration rate of around 58% in the last quarter of 2010, close to Western European rates. eCommerce is thriving in this area, with the retail sector experiencing sustainable growth; eHealth is also growing, with a number of well-established patient portals, such as HáziPatika, WebBeteg, Weborvos, and Figyelek Magamra (translation: I am taking care of myself/I am paying attention to myself). According to Dr. Bertalan Meskó, Founder and Managing Director of Webicina.com, HáziPatika is the most popular Hungarian patient portal, with over 2.5 million visitors a month. The portal provides a space where patients can interact with each other via the forum, as well as games that encourage website visitors to learn more about various subjects such as dry skin, baby food and vitamins.

Hungarian language presentations on the web, mostly created by digital agencies, suggest that there is a significant digital innovation movement in Hungary, with experts recognising that the pharmaceutical industry tends to lag behind in social media use. Mobile is also experiencing sustainable growth: in June 2011, the number of Hungarians paying for mobile data plans was reported to be just over 1.5 million (around 15% of the population).

Figure 3: The 'Figyelek Magamra' portal links to an online quiz that measures the reader's risk of colon cancer

Conclusion

The countries of Central and Eastern Europe have growing healthcare markets and general economies, and are also developing in terms of internet and social media usage. Taken together, this could represent an opportunity for pharmaceutical companies to expand into the region, in a sustainable, mutually beneficial and commercially viable manner, or to further establish their existing presence using digital methods.

It is necessary for any industry players interested in engaging digitally in the region to consider each country individually, not as a part of a generic “former Eastern bloc” group. As demonstrated above, each country has unique characteristics in terms of internet and social media usage, and these would need to be taken into account when designing and delivering an engagement campaign.

Since its launch in 2009, the Healthcare Engagement Strategy Awards have become a forum for sharing and identifying the world’s most effective strategies in healthcare engagement.

Previous winners have included initiatives and people in pharmaceutical companies, NGOs, hospitals, televison broadcasters and social networks.

What are we looking for?

The 3rd Annual Healthcare Engagement Strategy Awards will recognise the strategies, initiatives and people that have achieved the most effective outcomes in health or healthcare during 2011. Any channel, any region, any area of healthcare. If it’s engaging people and achieving health or healthcare outcomes, it’s eligible.

We’re looking for innovation; new ideas that others can learn from. But not for its own sake – we would be likely to rank a low-tech strategy that’s achieving great outcomes higher than a shiny digital campaign that’s not making a diffence.

We’ll include initiatives that have been on our radar over the course of 2011 in the nominations, but we want to hear from you: what have you seen, or been involved in, that we should celebrate? Who is behind the most effective healthcare engagement strategies of 2011?

Why enter?

A Healthcare Engagement Strategy award means genuine recognition for the winner. But more than that, the winning strategies provide a legacy of great practice for others to learn from. Ideas and strategies highlighted in previous years’ awards have inspired others to  innovate in the months and years that follow. The heart of the Healthcare Engagement Strategy Awards is to see continually-improving engagement that changes lives.

How to nominate

It’s free and easy to nominate, so you can suggest as many entries as you like. Forget those lengthy award submissions – you can nominate with just one tweet! To nominate an entry, use any of the following methods:

Send a tweet with hashtag #hesawards

Post a suggestion on our Facebook wall and tag it #hesawards

Or, email hesawards@creationhealthcare.com

Tell us what or who you nominate, and why. Include a link if relevant. We’ll contact you if we need more information.

About the judging process

Judging will take place through a review process with an international panel of over 30 judges made up of experts located around the world. A multi-stage review process leads us to a final shortlist, with finalists interviewed in detail about their experiences, outcomes and lessons learned.

You can read extracts from interviews with previous winners in our book, Winning Strategies for Engagement in Healthcare.

Timetable

Nominations are open now, so tell us who or what should be recognised by email or social media as described above.

Nominations will close on 31 December 2011.

Judging will take place in January 2012.

Winners will be announced in January 2012 edition of Healthcare Engagement Strategy, the e-journal for leaders in healthcare, which will be published on January 31, 2012.

View all the previous winners

2011 Healthcare Engagement Strategy Award Winners

2010 Healthcare Engagement Strategy Award Winners

In the midst of all this social media talk and the Internet being completely global, one of the essential aspects of effective healthcare delivery is often overlooked: the connection between clear communication and cultural background. When stakeholders come from different backgrounds, clear communication, and subsequently competent healthcare delivery may be hindered.

It is important to recognise that not everyone possesses Western views in relation to healthcare, illness, and treatments – both in the physical and spiritual sense, as the cultural backgrounds of patients can shape their views on the topic of well-being.

While a health belief model that attempted to explain patient behaviour in relation to cultural background was developed by social psychologists in the 1950s, it is important to explore the ways in which it is possible to predict and explain health behaviours in an era where digital health information is more widespread than ever.

Traditionally, studies on patient compliance are produced from a medicocentric perspective, where non-compliance is seen as a problem. If we consider non-compliance from a patient’s perspective, however, we may learn more about what motivates their actions. An anthropological study on patient attitudes towards drugs and illnesses concluded that non-compliance is rarely the result of patients misunderstanding the doctor but rather a result of them having different ideas and applying their rationality vis-à-vis the doctor’s. This rationality is comprised of political, economic, and social elements.

In the aforementioned study, Van der Geest, Whyte and Hardon concluded that especially in non-Western societies, pharmaceutical products are often recast in another knowledge system and used differently from the way they were intended in the regime of value where they were produced.

In order to exemplify just how relevant cultural background is from a patient’s perspective, we will take a look at a few examples.

According to a survey conducted by the Taiwanese Bureau of Health Promotion, up to one third of asthma sufferers in Taiwan do not take any kind of medication for the condition, and another third only use inhalers occasionally, or in the case of emergency, as opposed to taking long-term anti-inflammatory medication. A deeper look into Taiwan’s attitudes towards well-being reveals that almost 80% of asthma sufferers in Taiwan prefer to control their symptoms through a balanced diet and exercise, according to another article in The Taipei Times. Although the Taiwan Association of Asthma Education is encouraging sufferers to find out what their allergens are and take anti-allergy drugs, asthma is the 12^th leading cause of death among Taipei city residents and Hsu Shi-ta, director-general of the association states that it is often difficult to identify mild asthma symptoms, as they are viewed as ‘habitual’.

Another interesting example to consider, as presented in the study featured in the Annual review of Anthropology by Van der Geest, Whyte and Hardon, identifies a tendency towards what the author calls ‘defective modernisation’ in South-East Asia. This trend manifests itself through the belief that health is something one can obtain solely through the use of pharmaceuticals. A potential upside to this is the fact that commodification of medicine in the area means that patients have more choice and are able to put more pressure on healthcare providers by refusing a treatment.

Lastly, we will also look at how outlooks towards prescriptions can differ from region to region, also based on Van der Geest, Whyte and Hardon’s anthropological study.When medication is seen as the essence of the medical practice, prescribing is the main action that will be expected from the physician, perhaps serving as a legitimization of sickness. Whilst in some cases, not prescribing might be preferable on medical grounds, it is not rational according to cultural criteria and doctors might feel like they have to comply with patient demands. A refusal to prescribe may cast doubt over the genuineness of the patients’ complaint, so it can be said that in certain regions prescriptions serve a social and cultural logic. A written referral to a medical specialist may often serve the same purpose.

The concerns associated with this practice are many: it may lead to erratic buying of medicine, it might encourage patients to self-medicate by imitating the prescriptions they have received, and in poorer areas it might force patients to choose arbitrarily from the long list of medicines prescribed if they cannot afford them all (the cheapest one, the first one on the list, the one in stock, etc.)

All this being said, however, it is preferable not to make assumptions regarding an individual’s health beliefs based on their cultural background, as opposed to simply asking about their own understanding and concerns, advises the UK Health Protection Agency.

Conclusion

Although anecdotal, these examples show us that that understanding attitudes towards drugs should be a priority for pharmaceutical companies looking to launch a drug in emerging markets, as it is in these markets that one tends to be confronted with less conventional attitudes (at least from a Western viewpoint) towards illness and wellbeing. That is why deep local knowledge and market-tailored decisions are necessary to transform information into healthy behaviours. Patient-oriented analytics are also needed to extract meaningful intelligence from large amounts of information about populations and patients.

Creation Healthcare helps pharmaceutical marketers and communicators to translate insights about stakeholder behaviour into successful engagement strategies. With specialists in fifteen countries, Creation Healthcare supports global and regional strategy leaders, informed by local insights. To talk to us about how these insights can inform your international engagement strategies, click here.

We have previously looked at aspects of the drive to improve healthcare outcomes in Russia and considered channels such as telehealth, which are part of a wider governmental focus. Since 2005, $19 billion has been spent on improving the healthcare system and so far, various interventions and programmes have led to infant mortality  being reduced by a third, and life expectancy increasing by 3 years.

In parallel to this “Health 2020” agenda, President Medvedev has a “Pharma 2020” plan, which encourages domestic production of pharmaceuticals. Currently, Russia is reliant on imported products, and Medvedev hopes to change this, through investing in the establishment of “modern advanced enterprises”, capable of producing modern medicines.

To achieve these aims, partnership with foreign companies has been encouraged, and a number of key pharmaceutical players have started to get involved, setting up joint manufacturing plants with Russian companies. The latest partnership was between Aurobindo, an Indian company, and OJSC Diod, who have formed a joint venture, Aurospharma. The  focus will be on the provision of “socially significant” medicines to the Russian, Belarusian and Kazakh markets, and the plant will be ready for business in 2013.

Such ventures are likely to bring benefit to various stakeholders – the Russian population receives improved access to good quality pharmaceuticals, the Russian economy is boosted, and investors get to share in the significant growth of the local pharmaceutical market.

What role for emerging technologies?

Setting up a joint venture has its challenges though, particularly where the parent companies are based in different countries, meaning separate organisational cultures and employees who may not share a common language . However, it is critical that internal communication is efficient and able to add value.

Large pharmaceutical companies such as Pfizer, which have acquired various smaller companies, and which operate globally, have risen to this challenge through an increasingly social approach. As well as expanding the company’s social media presence externally, Pfizer has also updated its internal communications system, re-launching the Pfizer World intranet with a greater social focus. This is intended to improve communication throughout the company and encourage the generation of fresh ideas. Companies in other sectors are doing the same – innovation company Spigit specialises in providing internal social communication solutions to a variety of companies, and has served clients such as Lloyds TSB and AT&T.

Building on the social model, a number of pharmaceutical companies have adopted an “open sourcing” model to stimulate innovation whilst reducing the cost of R&D. Such a model could work well in Russia, to help overcome problems of geographical access and maximising the impact of the country’s scientific talent. Furthermore, Russia has been said to be experiencing a social media “boom”, with rapid and sustained growth of use. Twitter use grew three-fold in 2010 and the under-24 age group in Russia is the third largest user of “advanced mobile data” in the world. According to a Comscore survey that took place in 2010, Russians spend more time on social media sites than any other nation.

To assist with the language aspect of joint ventures, Google has a range of easy-to-use tools. Google Chrome has an inbuilt translation feature, and Google’s search engine also offers a user-friendly translation tool. Judgment is of course required when using such tools (in the example below, the Russian adjective “pharmaceutical” translates into the Hindi word for “drug”), but they may be of help in facilitating day-to-day communication.

Figure 1: Pharma2020 homepage - Google Chrome automatically suggests translation

Figure 2: Google translate. Here it translates the Russian adjective "pharmaceutical" into the Hindi word for “drug”

Conclusion

The Russian government is prioritising the nation’s health, and accordingly, the local pharmaceutical industry. As part of this, joint ventures between Russian and foreign companies are being set up. Emerging technologies may be of help in ensuring the smooth running of such ventures, and in facilitating the design and development of new products – particularly in Russia, where engagement via social media is strong.

Creation Healthcare helps pharmaceutical companies all around the world to perform better through improved colleague collaboration. To find out how we can help you, contact us.

With some interest, I have been following the Association of the British Pharmaceutical Industry (ABPI) innovation project looking at ‘Real World Data’. Just this month the ABPI launched its ‘Vision for Real World data’.

One of the key drivers for the ABPIs project team overseeing this project is to better understand and define the value of Real World data – the actual reality in the context of health care delivery (outside of a randomised clinical trial setting) and the impact this could have on decision making about treatment options.

In discussion that Creation Healthcare has had with patient centric organisations such as PatientsLikeMe and CureTogether, they have for some time faced challenges in determining how their ‘real-world’ data sits in the evidence spectrum – particularly in the context of the clinical establishment.

In the following video Allison Jeynes-Ellis, Medical and Innovation Director for the ABPI, introduces the guidance they have issued on the subject, making the point;

“Real world evidence is going to be crucial for success in this area”

Kate Pepperell also speaks in the video to explain that real world data is obtained through normal clinical practice, outside of a clinical trial and may include; data on treatment pathways, NHS resource use, models of service delivery, or real patient and clinical outcomes.

Real World or non-interventional data falls outside the clear definitions and regulations of randomised control clinical trials, and there is no single clear directive at the European Union level.

Therefore it is critical to define how to collect robust data, and this new guidance from ABPI forms a practical ‘how-to’ guide for industry.

There is no doubt that the Internet will play a role in helping to understand the ‘real-world’ context of treatment, and to this end it will be interesting to see how the industry interprets and utilises this new guidance from the ABPI.

Further information

• Download the Demonstrating value with Real World data document from the ABPI library
• Press release: ABPI produces guidance to help industry demonstrate value for its products

This month, several passionate digital strategists convened on Brighton – in spite of the looming and blustering tail of Hurricane Irene blowing in hard from the south of England.

My colleague Marie-Claire Wilson has commented on the day itself, however a highlight for me was my lunch-break conversation with Miguel Tovar, a pharmacist and consultant based in Barcelona.

Amongst other interesting topics relating to the Spanish pharmaceutical industry, he introduced me to a fascinating program from the Hospital Clínic of Barcelona, which is pioneering a use of telemedicine to care for several hundred HIV-infected patients.

“Hospital VIHrtual” is a tool that uses a webcam to provide virtual consultations in support of traditional in-person visits. This virtual hospital service adds a layer of control and convenience for patients, and means opportunities for regular communication are not limited by diary conflicts or travel considerations.

With increasing pressure on national health systems, governments the world over are seeking to cut costs and improve efficiency, yet it would seem that some of the most basic technological capabilities are as yet not effectively utilised by so many countries. Whereas examples such as “Hospital VIHrtual” show the significant difference that strategically applied communication tools can make to patient care, and wellbeing.

Importantly, Barcelona’s virtual hospital has reduced the duration of a consultation (and the space required) from 20 minutes to 10 minutes. There are also fewer people involved in managing the relationship, which ensures efficient care and improved adherence.

From a patient perspective, there is less of a requirement to invest time or money in frequent trips to a physical location – with the exception of analytical extraction, reducing the number of visits by up to 50%. More information about the online services can be found here.

Patients with chronic (but stable) conditions located throughout world could easily benefit from similar virtual care programs.

Across the Atlantic Ocean, the Mayo Clinic has also piloted virtual care schemes which in a similar way help to reduce ‘wasted’ time in first consultations where the same basic questions are asked by every new patient. Using video frequently asked questions (FAQs), the centre seeks to improve patient outcomes by ensuring actual face-to-face consultant time is focused on the unique characteristics of the individual patient in their journey, rather than elementary information that can easily be disseminated via pre-visit communication.

Another scheme which is disrupting the traditional model of care is AmericanWell’s platform for managing the complete care cycle. Patients can find a provider, have a virtual consultation, and share information via Microsoft’s HealthVault electronic medical record portal. For healthcare professionals they can improve the efficiency of their own available consultant time by also using an online planner to connect with patients.

With various organisations now seeing the benefits of introducing even the simplest telemedicine solutions for virtual care, we are entering an age of what I call ‘pCRM’ – that is ‘Patient Customer Relationship Management’. Although there are inevitable challenges for each country around data and privacy considerations, there is no question that our current model for care is terribly inefficient for both patients and providers.

Tailored communication prior to a consultation can improve the outcome of the visit, reduce the number of staff required to administer the patient-healthcare professional relationship, and most importantly for tax-payers, governments and health insurers; reduce the cost of care.

How will pCRM change your role in patient care?

Background

In 2011, the organizers of e-Patient Connections Conference approached Creation Healthcare’s Founder, Daniel Ghinn, after the company’s analysis into recent social media crises in the healthcare arena. They asked if Daniel would prepare a workshop to equip communicators and business leaders in healthcare organizations to be better prepared to identify and respond to a social media crisis, and to facilitate this workshop at e-Patient Connections in Philadelphia. What follows is a summary of the workshop’s content.

Defining Social Media

“Social Media” is a widely-used term, and is just as widely interpreted. When discussing social media, some may think of popular web-based communities they are members of; others might consider applications that keep them in touch with friends or colleagues via their mobile devices. For the purpose of this discussion about social media crises, let’s define “social media” as follows:

Social media includes any online media outlet, application or tool that allows people to collaborate and share information. Access may be via any Internet-connected platform including a desktop computer, tablet or other mobile device.

Many social media sites encourage people to publish information about themselves as a ‘profile’, and allow users to share that information online with others. Social media encompasses a wide range of categories, including but not limited to the following:

Social Networking tools such as Facebook, Badoo, QQ, or LinkedIn; Social Bookmarking tools like Delicious or StumbleUpon; Social News sites including Digg and Reddit; Community Forums such as CafePharma; Social Wikis, like Wikipedia and Intellipedia; Blogs, with tools including Blogspot and WordPress; Microblogging tools, of which the most popular is currently Twitter; and other Sharing sites such as Quora or Answers.com

What’s the Tone?

The way people talk about social media can be an indicator of their feelings towards it. When we consider the kinds of words used to describe social media amongst individuals in any organization we often find a mix of fear and excitement, with each person experiencing more or less of one or other emotion at any time.

Is Social Media Changing the World?

It might seem a bit far-fetched to think that social media could be changing the world, but let’s take a closer look. What is the role of social media in the events that shape history? Does social media change the way in which social events occur, or the speed at which events develop?

Consider this quote from the Los Angeles Times, August 28, 2011, in an article describing recent events in Egypt and Libya:

“…young Egyptians armed with Twitter accounts instead of assault rifles emerged as rebel darlings.”

Or this quote from the UK’s news publisher The Guardian on August 16, 2011, in an article describing how police in London accessed BlackBerry messages as a source of intelligence during the recent riots in UK cities:

“Police revealed they had considered switching off social messaging sites including BBM [BlackBerry Messenger] and Twitter.”

Reports such as these are only likely to heighten the sense of both opportunity and danger associated with social media. For healthcare organizations it is certainly no longer possible to ignore the fact that the engagement landscape has changed forever.

From spark to inferno

Here’s another quote that seems especially relevant to the current social media environment, written well before you or I knew of Facebook or Twitter:

“A tiny spark can set a great forest on fire.” (James 3:5)

In the context of your own organization it can be helpful in crisis planning to consider what a ‘forest fire’ would look like. What is the worst case social media scenario you can imagine? Now, working back from that, what series of events would lead to such a crisis?

Be Prepared

If you can spot the potential ‘forest fire’ when it is just a spark, you can much more easily deal with it, as long as you have good procedures in place. Being prepared starts with listening. There are many ways you can do this – pharmaceutical company Boehringer Ingelheim has developed a comprehensive custom tool to track social media activity around their brands. Others manually monitor social media activity or employ others to do this.

The Price of a Social Media Crisis?

On March 30, 2011, KV Pharmaceutical ranked number one in the Wall Street Journal’s ‘NYSE Biggest Percentage Decliners’ list with a share price that dropped over 20% in one day and, at the time of writing this article almost six months later, has failed to recover.

What went so badly wrong for KV Pharmaceutical? Let’s work backwards…

Earlier the same day, March 30, 2011, the FDA clarified its position with regard to KV Pharmaceutical’s product Makena and stated that it does not intend to take action against pharmacies that compound their own version of the synthetic progesterone product to prevent premature births.

This was important because just three weeks earlier, the FDA had granted orphan drug status to Makena, meaning that only KV Pharmaceutical would be able to sell it for the next seven years. However, when KV Pharmaceutical announced a significant increase in its pricing for the product, angry patients united on a Facebook page entitled “Shame on you, KV Pharmaceutical and CEO Greg Divis”.

The Facebook page rapidly gained hundreds of followers, who were actively engaged in discussions about the product, brand, and the price point. In just three weeks, the page’s 1,400 fans had reached a far wider community and were sharing stories, photos and strategies to engage policymakers.

I asked Christine O’Connell, the Facebook page’s founder, about the role of Facebook in the campaign to rally support. She told me that it provided the best platform to reach many people quickly and share ideas:

“I started this page quite simply because I was outraged. I knew if other people knew about this unconscionable price increase, they’d be outraged too. Facebook gave me the best platform to reach a lot of people in a short time.

My hope was that we’d stir up enough public anger to somehow force KV Pharm to right this wrong. I wasn’t sure how the page could achieve that, but I believed that if we put our heads together, we’d figure something out.

And that’s exactly what happened. Not only did affected moms and dads get involved, but doctors, news reporters and medical organizations joined the conversation. We shared information and ideas on everything from boycotts to contacting our Congressional representatives.

I really think this was the power of social media to inform, educate and rally people at its best! I’m so pleased that common sense has prevailed.”

Social Media vs Traditional Media

Whilst traditional communications processes might have been adequate for most public relations challenges in the conventional world of the established media, this example illustrates how social media has completely changed the rules of engagement. Digital consumers are not playing by the same rules that might have been good enough for crisis management plans based on traditional media.

The reach and speed of a platform like Facebook completely change the environment in which corporate and brand communicators operate. Here are just a few ways in which social media is different from traditional media:

• The ‘journalists’ of social media do not call your press line to ask you for a quote before they publish
• Social media publishers ‘go to press’ at any time of day or night
• Compelling stories have the potential to achieve huge reach very quickly – before you have even woken up
• In social media, everybody has a voice, instantly.

Digital Governance

Thinking back to the ‘forest fire’ example, it may be helpful to consider the approach taken by fire rangers who look out from towers to spot signs of danger early. In a sense, good digital governance is like good fire rangers. Good digital governance means being in control of your organization’s digital engagement and having clear systems and processes in place to manage this. This is covered in more detail in Robert Hanvik’s article on digital governance.

Some organizations, such as the US Air Force, have developed a clear ‘decision tree’ system to facilitate a rapid and consistent response to digital engagement. Within healthcare, others have learned from this too. In Canada, Pfizer has implemented a similar system that informs an escalation processed based on clear indicators.

Developing a Crisis Plan

With an active listening strategy, and sound digital governance in place, you will be well equipped to develop a social media crisis plan. Your plan should include identification of roles and responsibilities, bases for consistent decisions about engagement, and most importantly it should be well tested.

You can test your social media crisis plan by carrying out a ‘war room’ exercise modeling various social media scenarios. Include anybody who may have a role to play in responding and identify their responsibilities. Such an exercise should help you identify any weaknesses or possible gaps in your systems.

Learning Through Engagement

In the world of healthcare, Johnson & Johnson has had its fair share of social media engagement and, it might be suggested, crises. Amongst the most memorable was the ‘Motrin Mums’ incident in 2008, where an advertising campaign failed to hit the mark with mothers who reacted angrily on Twitter, creating a social media outcry over one weekend that led to wider mainstream media reporting.

The legacy of this social media crisis lives on; social media assets created at its peak are still online including a Youtube video that has had over 111,000 views to date.

Johnson & Johnson was quick to respond, however, using the same channels of engagement as the online community, apologizing via its blog, JNJBTW.com.

In fact, Johnson & Johnson was already, and has continued to be, proactive about its social media presence. Running a Youtube channel since mid-2008, where a high level of engagement takes place, and lessons are learned, the company later established a Twitter presence in 2009.

When I spoke with Rob Halper, Johnson & Johnson’s Director of Video, whilst judging the Healthcare Engagement Strategy Awards in 2010, in which the company won Best Engagement Through Video, he was happy to share advice from his own experience engaging via the J&J Health Channel on Youtube, which posts videos open to comments and has to date served up more than 4.5 million video views. Here are five lessons he shared:

• Keep the content fresh
• Monitor comments every day, on a regular basis
• Be open and honest. If you make a mistake, or offend somebody, take responsibility for it.
• Don’t try to sneak in a commercial message without being transparent about it.
• Remember it’s a living organism – it’s not something that’s static. You have to get your hands dirty. And it’s fun!

Has this proactive engagement approach paid off for Johnson & Johnson? I’d say it has! Consistently ranked amongst the top corporate brands in the world, the company was the top pharmaceutical brand and the second corporate brand amongst all sectors in the 2011 Harris Interactive Poll, beaten only by Google.

Engage

So, you are listening to conversations in social media; you have sound digital governance in place; and you have a well-tested crisis plan. Now you can confidently engage via social media, making the most of every opportunity, responding appropriately and safely to all your online stakeholders and reaping the benefits of a successful social media strategy.

To speak with Creation Healthcare about putting in place a safe and effective framework for digital engagement, contact us now.

This month, Paul Grant and I attended the Healthcare Social Media Twitter Community Global Camp (#hcsmgbc). This was the third annual event hosted by the community, and it demonstrated how the #hcsm movement has grown from interested individuals interacting on Twitter, to an informally-structured think tank.

Twitter interaction around the topic of healthcare and social media began with the hashtag #hcsm, and regular chats moderated by Dana Lewis (@danamlewis), based in the US. In 2009, an EU specific community (#hcsmeu) was set up by Andrew Spong (@andrewspong) and Silja Chouquet (@whydotpharma). Since then, further regional chapters have been established on Twitter, such as #hcsmanz for Australia and New Zealand, #hcsmin (India) and #hcsmla (Latin America), as well as national chapters.

The EU community holds weekly moderated tweet-ups, or discussions on Twitter, around questions relating to healthcare and social media, which can be contributed by anyone who follows the community. A definition of the hcsmeu community, and its initial aims and objectives can be found here.

The Camp

The camp took place in Brighton, UK on 12th September. It was organised by Andrew Spong and hosted by John Worth (@johnworth01) of Worth Digital. There were attendees from a number of European countries, and digital consultancy, engagement strategy, the pharmaceutical industry, patient advisory groups and the healthcare profession were all represented on the day.

The day included 3 break-out groups and corresponding report-back sessions, with the following topics:

• Trust filters and health information: In this session, groups explored the concept of filters in the often confusing world of healthcare information. We discussed how both technology and healthcare professionals could act as trusted filters of information for patients
• The evolution of the patient-HCP relationship: Here, we looked at the changing dynamics of the doctor-patient relationship, its importance for health outcomes and the role digital media has played here
• Healthcare design, healthcare delivery: social media, the ideal and the real. In this break-out, the potential of social media tools for improvement of healthcare services was examined, and current real-world examples were reviewed.

Each topic sparked much discussion and idea generation, but often raised yet more questions. Summaries of the discussion outputs are available on the #hcsmeu Facebook page.

The day ended with a live Twitter session, answering questions posed from around the world.

Reflections

The coming together of a Twitter-based community “in real life” to discuss healthcare and social media demonstrates quite clearly the power of Twitter to create genuine networks. What began as a group of geographically dispersed individuals swapping comments and ideas online has grown into a movement, with real interpersonal connections. This phenomenon also highlights the existence of a relatively large number of like-minded people – a vibrant group of diverse professionals who are committed to the concept of improving healthcare through digital/social media.

Currently, though, there is a large gap between the thoughts and ideas generated by groups such as these, and what is possible in practice. For example, in the UK, service redesign would need to take into account not only the needs of the patient and potential offered by new technologies, but also crucial cost saving imperatives. Furthermore, not all healthcare professionals and managers are bought into the concepts of social media in healthcare, or participatory medicine.

The next step for communities such as hcsmeu could involve the participation of managers or policy makers in healthcare, who could provide financial and logistical perspectives on the sometimes harsh realities of day-to-day co-ordination of healthcare environments.