No one wants to be wrong; ever. As much as there are trendy business mantras such as ‘Fail Fast’ which apparently encourage failure (as long as you learn quickly), it somehow just doesn’t translate to the world of a pharmaceutical company. In fact, ‘fail-fast’ is really an engineering concept that is most often considered in a research and development phase, long before a product reaches the general public where it might affect reputation.

To be fair, any kind of ‘failure’ in the world of pharmaceutical companies can potentially result in a significant loss in some form or another which could include shareholder value, customer confidence, or general credibility, not to mention individual careers.

Consequently, we are risk-averse. Rightly so.

As much as no individual wants to make a mistake generally, it is especially true that no one within a pharmaceutical company would want to be responsible for leading their organisation into a situation with negative outcomes. Each person will therefore look to innovate only within the realms of what is possible, rather than ‘push the envelope’ just for the sake of it or just because everyone else is apparently doing something.

Yet the rise of ‘social’ media has created an unusual scenario. On the one hand it seems safest to simply not do it at all. Yet on the other hand there is potentially an even greater risk by avoiding it, where a company is simply not able to participate, mitigate or mediate in a conversation when an incendiary or inflamed online situation gets out of control.

Adding to this, the fact that technology and online capabilities are constantly changing means that even when a ‘safe place’ is found within the social space, there is a reasonable chance that the ground may be moved underneath us. In the most notable of recent examples, Facebook have and will continue to introduce changes that cause speculation and reactive planning to cope with the implications.

So it may well be that quite a few people are losing sleep at night.

If you can relate to this unnerving state of change, then I would like to offer you some hope. The help of an external, independent, consultancy can help to alleviate some of the ‘what does this mean for me?’ or the ‘how are we going to deal with this?’

Creation Healthcare is on a daily basis partnering with lawyers, medical teams, communications teams, brand teams, and senior leadership to help formulate appropriate responses to the changing landscape. There is no pre-defined ‘right way’, but in each case a need for discovery.

Ultimately, we recognize that there is an element of risk in everything that we do.

It is however important to establish ‘what level of risk is acceptable?’, and ‘how do we minimize any risk?’ where the company may be exposed.

In reality, sometimes a company is just not able to cover the bases using internal resources alone.

For example, when considering a new digital initiative in a social platform like Facebook, is it really feasible that either a brand team, or the legal team, or the medical team, or anyone else within the company is in a position to comprehensively evaluate all the possible functional scenarios that may open the company to risk? Every back door needs to be explored, and someone needs to know whether there is an unconsidered exposure for any new step, or any change that happens after the initiative is in the public domain. Traditionally, the IT department may have been able to test security and standards for a company-hosted website prior to launch, yet as more initiatives move onto third party platforms they may no longer be the experts. It is simply not advisable to just ‘give it a try and see what happens’, as the ‘Fail Fast’ proponents may advocate.

When considering whether to use a third party or social networking site, a pharmaceutical company needs to be asking a much bigger internal question which might be phrased “Do we want to be social?” If so, “Will this loss of technology control cross a threshold of our agreed acceptable risk?”, and “Are we prepared internally to handle real-time processes that come with this risk?” All of these questions (and more) can be answered with time, research, thought and discussion, which can lead to a paradigm shift in the company culture.

Another consideration with this new era of communication is around whether a third party platform will even be around in years to come. Recent history shows that Google emerged as a global entity in only 4 years; MySpace.com fell from popularity; even Facebook is recently experiencing big traffic drops. There is no certainty about any of today’s major players, no matter how large and monopolising they may appear. Consequently, some companies are deciding to move their focus away from transients to commit to a risk/opportunity strategy around broader fundamental areas (such as search, video, networks, mobiles etc.) rather than platform specific areas (such as Google, Adwords, YouTube, Facebook, iPhone etc.).

Naturally any emerging platform, channel, or technology has an inherent ‘volatility’ which is born from not having experienced the thorough testing which comes with a critical mass. Twitter occasionally can’t handle the capacity that it needs, Facebook often launches a new feature without fully considering the implications. Google tends to have a lower ‘volatility’ due to more established testing protocols and having been in the market for a longer period of time. So a company needs to consider the ‘volatility’ when deciding whether an emerging channel is appropriate for their organisation.

Certainly, for a small amount of time it seemed that a new and rapidly growing audience could be reached through websites such as Facebook, and that a company could effectively host an otherwise standard ‘broadcast’ page around the company or a campaign – albeit in a social networking environment. Those days now seem numbered, as Facebook, Twitter, Google and others push new ‘social’ features which essentially change the way that the platform works, or affect the privacy, terms, and conditions. New questions arising from these changes about what is or isn’t within the control of the company, can make the difference between compliant communication and a breach of local regulations.

All of these considerations affect the inescapable ‘risk’. For a pharmaceutical company that risk can be a significant burden to bear. As new code guidance, policies, and regulations are brought in to address the changing landscape, this can potentially even heighten the sense of threat and reserve. In the United Kingdom this week, the industry body ABPI released a whitepaper which explains:

“…the complex regulatory requirements for pharmacovigilance, brought in to protect patients at a time of information scarcity, are now acting as a barrier to the use of this information as an important additional resource to protect public health”

Wouldn’t it bring peace of mind to know that there are people that really care about you getting it right? That they also don’t want you to have the proverbial ‘egg on your face’? That they want you to succeed, in an appropriate and measured way?

This is what Creation Healthcare consultants do every day. We are not lawyers, we are not ‘technical geeks’, we are not publicists or communicators. We are strategists, with a pedantic insistence on doing things in the most considered way possible – according to legal guidance, according to what is best for the client, and according to what may be best for the people that are interested in what the client is offering.

Creation Healthcare is a specialist consultancy working with executive and cross-functional teams in pharmaceutical companies. For assistance with assessing and managing risk, or to better understand appropriate engagement strategies for your company, contact us on +44 (0)207 849 3167 to arrange a confidential meeting.

It was ironically only a couple of weeks ago that Creation Healthcare published a piece about “Healthcare engagement in the absence of regulatory guidance”. In that article, I made the point that “specific social media guidance cannot keep pace with change”, and more importantly that when using 3^rd party engagement platforms like Facebook, Flickr or Twitter, a pharmaceutical company needs to ‘plan for change’.

In what I perceive as a positive step, the PMCPA recently issued guidance on ‘Digital Communications’. I was pleasantly surprised to see a certain level of clarity and an attempt to be non-technology specific. I still felt that in some cases it was too specific, which I will explain as you read on.

Even so, the inevitable ‘What does it mean for me?’ has me once again turning to interpretation and best intent, rather than an exact rule of law that some have called for.

A ‘forum’ for debate

For pharmaceutical companies, the most significant lines in the new guidance, in my opinion, can be found in Guidance 4 (p 6) where we see the words “Can companies run discussion forums?” and:

“Before undertaking such an activity the company must be confident that it can moderate the site such that the only content to appear complies with the Code”.

You may at first think, “Well that is fine; we are not running a forum”.

Yet so many 3^rd party platforms are perhaps not technically described as a ‘forum’, yet have the characteristics of one. Consider Facebook, Twitter, Flickr, or indeed any place where it is possible to submit user-generated content in some form or another. The main difference between them is the speed of response between participants.

Some platforms may not even be designed with two-way conversation in mind – instead to merely provide a means for a person to comment – yet when used in a particular way can certainly become conversational, albeit not in real-time.

The real issue here is not whether it is a forum or not, but the fact that people can enter free-text.

Free text creates the possibility for a range of potentially problematic content, such as: mentions of brand names which might be construed as promotional content (intentional or otherwise); discussions about off-label use of medicines; or spontaneous Adverse Event reports.

I would suggest as a general thought that the PMCPA might want to change some of the technology specific terminology like ‘forum’ to a broader description around a ‘text submission’. By all means, they may wish to illustrate the point with examples of specific technologies (like Twitter, Facebook etc.) however the guidance itself should ideally not be so tightly defined.

That said, let’s now consider the second part of Guidance 4 “…the only content to appear complies with the Code”.

Reading the guidance here (in the ‘spirit of the code’) has major implications for current and future Pharmaceutical communications activities. Here is the gist in my interpretation:

Content MUST be pre-moderated.

‘Pre’ versus ‘Post’ versus ‘Both’

Until now, some pharmaceutical companies have used ‘best intent’ and ‘due diligence’ to implement strategies and processes that accommodate the constraints of some 3^rd party platforms such as inability to pre-moderate user generated content.

If the new guidance really does clarify that all content must be pre-moderated, I predict that in the place of some currently innovative pharmaceutical communication initiatives, you will see a return to company controlled dedicated websites with built-in functionality for moderation. You may even see many companies move away from social media altogether.

It may well be a step backwards from ‘fishing where the fish are’, but will also call for new ‘innovation born from adversity’. I’ve always believed that the very best creativity comes when there are constraints. Like the artist with only three colours in her palette, or the architect with a limited material selection, there is always a solution. Conversely, give an artist unlimited budget and unlimited time, and you don’t often see something of artistic merit.

So, moderation is the one big element of the guidance which has me really thinking. From my perspective the moderation issue is not quite ‘black and white’. There is quite a bit of ‘grey’.

The extent of this issue

Let’s consider some examples of this ‘greyness’ in context:

Have you created a Facebook page? Perhaps you decided not to open the wall for comments, to prevent user-generated content. Well, let’s say someone has gone ahead and ‘Liked’ your page and thanks to Facebook’s new image gallery on pages (launched March 11), decides to click on an image. There they discover that they can add comments to the images within the gallery. If your pharmaceutical company is monitoring this, any non-code compliant comments may be deleted; yet this would be a post-moderated step that only happens at the point of awareness of the comment.

Facebook has and is likely to continue to move its platform away from simply ‘hosting’ product or awareness pages, forcing conversational features on page owners.

Perhaps you have enabled Facebook’s new word filter and listed all of your product names in there to avoid any unwanted brand mentions? Yet let’s assume that someone enters a comment on your wall and has not spelled your product name correctly. It has made it through the moderation filter and you now need to delete it. Once again, post-moderation is required.

What about the clever pre-populated sharing tools that are on a website? If a pharmaceutical company provides a means for a user to share a website or content about a campaign, that user can modify the final submission in keeping with their own message; yet the pharmaceutical company cannot moderate this. Whether the company is responsible or not is likely to depend on a number of factors including whether such shared comments appear on any platforms hosted, managed or endorsed by them. Of course a person can also share content of their own accord, using their own preferred sharing tool.

Responsibility

In many ways, it is the ‘responsibility of ownership’ which truly defines what is or isn’t possible.

What is made very clear through the new guidance is the extent to which a pharmaceutical company is responsible for content when on 3^rd party websites, and indeed on sponsored websites (See Guidance 5, pg 7). The definition of “arm’s length” and ‘unrestricted grant’ really does show that the only way that a company is not responsible for the ongoing activities of a sponsored website is if it does not ‘initiate the material, or the concept for it’; that is has no ‘influence’ on the material, and that it does not ‘promote the social media site in anyway unless all of the content complies with the Code’.

I’m not saying that any pharmaceutical company would knowingly sponsor a site which promotes prescription-only products. However, by sponsoring a site it appears to me that the Code requires the pharmaceutical company to indefinitely be aware of the content on that site; even if the recipient of the grant or sponsorship has breached the Code at a much later date.

This raises one of the evolving considerations for pharmaceutical companies in digital communication. What is the true cost of ownership of a social media campaign? At what point in time is it no longer an obligation? Are we forever committed if we engage with the public?

This new guidance is likely to accelerate the pace of change within pharmaceutical brand and communications teams, as they look to increase capacity and skillsets for keeping abreast of all that is happening in the digital space across multiple digital properties.

Where to from here?

Certainly, we are all navigating in uncharted territory. I believe that as an industry we really want to do the ‘right’ and ‘best’ thing for our customers. Yes, I did say ‘customers’.

The PMCPA, the ABPI, the FDA, and the many Pharmaceutical companies who are trying to meet the customer on their ground, still have a long way to go before the customer receives anything like the level of engagement which they are used to from other industries and which they expect in regard to their own personal health information needs.

I can’t help feeling that the various attempts to understand, describe, and provide boundaries for changing communication platforms is making this all much more complicated than it need be. I also wonder if the guidance could instead be summed up in one sentence:

If you are a pharmaceutical company in Europe, don’t inappropriately promote your prescription-only products through digital, or any other channels.

In the world of emerging digital channels, pharmaceutical companies would then be free to adapt to the changing landscape and innovate in a regulatory-compliant manner.

In early March 2011, at a pharmaceutical marketing conference in Munich, Heather Simmonds of the PMCPA gave very much the same perspective on UK and European regulatory guidelines that she has for the past few years. There were some murmurings amongst the crowd from those who had heard it all before.

Refreshingly, at the same conference, Ray Chepesiuk of Canada’s Pharmaceutical Advertising Advisory Board presented a somewhat enlightened and progressive approach to emerging channels such as social media and forums – explaining how his organization established guidance on two-way engagement dating back to 2005.

Having attended and presented at many pharmaceutical marketing conferences throughout Europe, Asia, and the United States (see where we’ll be in the coming months here), Creation Healthcare very often hears delegate concerns and frustration about the lack of guidance from regulators and industry bodies. The organisations that provide guidance to the industry are currently under a lot of pressure to understand the implications of something which is in a constant state of flux, and in which they themselves have very little experience or expertise.

In the United States just this week, the ‘Eye on FDA’ blog published a latest statement from the FDA which explains that they have been researching issues such as:

• Responding to unsolicited requests
• Fulfilling regulatory requirements when using tools associated with space limitations
• Fulfilling post-marketing submission requirements
• On-line communications for which manufacturers, packers, or distributors are accountable
• Use of links on the Internet
• Correcting misinformation

Their statement goes on to say that they only expect to have draft guidance on “at least one of these topics during the first quarter of 2011”.

Meanwhile, the capabilities of the Internet and the expectations of the people who are increasingly seeking health information and engagement online are exponentially changing.

What if we actually had guidance?

What would really happen if the PMCPA or FDA were to say “these are the new rules of engagement for social media and emerging channels”. In actual fact it may not be as beneficial as everyone expects; indeed it could be crippling to the daily innovation which already exists amongst pharmaceutical and healthcare companies.

Certainly at the current time, many appropriate and interesting decisions are being made by individual pharmaceutical companies in response to the changing landscape – all within the existing rules and regulations and based on learning from what has been done before.

Another point about producing guidelines is that a company actually needs to acquire experience for itself over time to best understand how to use emerging channels. Simply specifying guidelines might open the possibility that a newcomer to this form of communication may badly interpret the guidance and create the first ‘alarming’ example – which then hinders other ‘good’ practice initiatives.

What is potentially ‘right’ for one company isn’t necessarily a rule for everybody – if they are not also in an appropriate place to understand and implement with sufficient resource and process.

Rather, if a regulatory or industry body was to actually survey and collate the many intelligent solutions and precedents which have already been developed amongst pharmaceutical brands; they would immediately have a non-technology specific guidance which would be light-years ahead of anything that they would be likely to conceive themselves.

This is why Creation Healthcare has repeatedly called for regulatory leadership in bringing together global knowledge and to help form useful guidance.

Specific ‘Social Media’ guidance cannot keep pace with change

There is a well-worn expression that says, “The only certainty is change itself”; quite fitting when observing the platforms and technologies that are evolving into ‘normal’ life. To illustrate how guidance cannot sufficiently address specific technology challenges, consider that Facebook this month made several new changes to their system which affect the way ‘Pages’ operate.

On one hand this has created some welcome new opportunities for pharmaceutical companies to choose how conversations are managed.

On the other hand, these changes could have easily been for the worse.

The point is that they could have provided a new feature which suddenly added functionality – perhaps welcomed by other industry sectors – but which creates a regulatory compliance or pharmacovigilance issue for the pharmaceutical industry. This would immediately have ramifications for all of the companies that are using Facebook for corporate communications, health awareness or patient safety campaigns.

Guidance simply cannot keep pace if it is only aligned to specific technology or functionality.

The challenge for a regulated pharmaceutical company online is that when Facebook, Google, or another web-based software company produces an ‘update’, it potentially introduces a new piece of functionality which was not considered or approved when any pharmaceutical sponsored initiatives were conceived and developed; potentially creating brand new project parameters without the pharmaceutical company having any opportunity to consider or approve this.

Such is the nature of this changing landscape, and something that we have to get used to.

Planning for change

When Creation Healthcare considers the various platforms available for a project it is based on a careful evaluation of the constraints, opportunities, and risks which exist for that solution. We also know that the Internet changes quickly, and that the solution which was successful in one campaign will not automatically be the most appropriate solution for the next campaign, even if very similar in principle.

In thinking about the ‘certainty of change’, here are just a few key principles for creating successful long-term engagement using the Internet, and in the absence of specific regulatory guidance:

1. Plan for change within the development period of your initiative – and more importantly ongoing after the release. What will the process be for evaluating the impact of new changes and for making updates to internal approvals?
2. Carefully consider who and how administrators are set up for 3^rd party websites such as Facebook – if a user is blocked or deleted, or no longer has access, what are the implications for your initiative?
3. You do not have control over 3^rd party websites – they can and will change things without your permission. Expect it, and be ready to escalate to the appropriate level depending on the implication of the change.
4. At any point, your 3^rd party website initiative can be removed, irrecoverably lost or be unavailable – in such cases the process or access to customer support is often not guaranteed. What will the company response be, and through which alternate channels?
5. Consider that you do not usually own the rights to content on 3^rd party websites – they may remove or reject your content at any time, and may be able to retain rights to content for longer than the duration of your initiative.
6. Whether an internal resource or an external trusted consultancy like Creation Healthcare – someone needs to watch and document relevant industry changes on your behalf and build a repository of knowledge about your company initiatives
7. Take a view on the landscape around you, the experience you have to date, and choose engagement initiatives in keeping with your own resources and risk profile – do not attempt to do something just because it is possible or because another company is doing it
8. With best intent, always clearly demonstrate compliance with existing code and regulations – increase efficiency by establishing a repository of precedents and lessons learned within your company, to be reused and adapted for future initiatives

Creation Healthcare is a specialist in healthcare engagement for pharmaceutical companies. For assistance in developing best practice change response processes, or to better understand guiding engagement strategy principles, contact us on +44 (0)207 849 3167 to arrange a confidential meeting.

Since the fall of the Soviet Union, the poor state of health of the Russian population has been a topic for national and international discussion. Life expectancy is around 15 years less than in most European countries, and HIV/AIDS, cardiovascular diseases and alcohol-related problems are all major concerns. The Russian population is declining, and inequalities begin right at the start of life – a baby born in Russia is more than twice as likely to die by age 5 than a baby born in Britain.

As grim as this picture may seem, much of the disease burden is preventable. The real problem lies in delivering public health initiatives in a country where many of the aspects of unhealthy living, such as excessive alcohol consumption, smoking and risk-taking behaviour are commonplace. Additionally, ensuring consistency of healthcare services and messages in a territory that spans 9 time zones and encompasses a variety of ethnic groups, standards of living and religions, requires an innovative approach.

A number of governmental and government-associated initiatives have been set up in Russia, aimed at preventing disease through encouraging a healthier way of life, and requiring effective engagement with the population.

So healthy, how great!

The Ministry of Health’s “Healthy Russia”  project has a number of components, including the website www.takzdorovo.ru, the name of which has a double meaning -  “so healthy”, and “how great!”. It is a portal for prevention-related activities and represents a communication channel between the Ministry of Health and the population.

www.takzdorovo.ru

Users can gain a greater understanding of disease risks through questionnaires, create profiles with health goals and progress charts, and connect with others as “friends”. The site offers information on healthy living, covering topics such as choosing foods correctly, giving up smoking and examining alcohol intake, as well as specific diseases.

Examples of information, tips and tests featured on www.takzdorovo.ru

The site is linked to Twitter, Facebook and the Russian networking site Vkontakte, and features running totals of users who have committed to give up smoking or eat more healthily for example, harnessing the power of popularity, which may help to normalise the concepts of disease prevention; additionally, there are a range of options for “liking” or commenting on articles.

Welcome bar showing running total and network activity

Users are encouraged to engage, with “likes”, comments, Tweets and shares

Interactive and informative sites such as www.takzdorovo.ru thus educate users about improving health and preventing and managing diseases, as well as provoking discussion and providing calls to action. They have the potential to develop further still, with “friends” networks becoming powerful resources where patients, the health-conscious and healthcare providers can interact.

Health centres

Information on the network of health centres, including location details and a range of  educational brochures is available on www.takzdorovo.ru. Health centres were introduced in 2009, and this winter, child-specific centres are planned.

The centres provide free health checks and advice to all health-insured Russian citizens. Attendees can choose to undergo tests such as assessments of the cardiovascular and respiratory systems and disease risk; where the investigations suggest a health problem, referrals can be made to local specialists. Advice is provided on healthy eating, exercise, safe use of alcohol and smoking cessation, and each person receives a Health Card after their first visit.

Health centres are centrally planned, and across Russia have the same equipment and multidisciplinary teams. Some centres offer additional services, though, such as exercise rehabilitation and a “Health School” for children.

Health centres are a tangible aspect of the drive to improve health – in contrast to hospitals, with associations of sickness, health centres are proactive and convenient. Anyone can drop in, have their questions answered and be directed towards a healthy way of life. Whilst online engagement is important for raising awareness and enabling the Russian population to re-brand itself as health conscious, health centres can reach non-internet users, and facilitate further change in those inspired via the internet.

Other initiatives

There are a number of other organisations that hold conferences and run projects for improving health across Russia, such as the League of the Health of the Nation, and the Healthy Russia Foundation.

The Healthy Russia Foundation currently has a range of engagement programmes, including a healthy lifestyle education programme for young people, Text4Baby, HIV communication training for healthcare professionals and HIV prevention initiatives, aimed at reducing transmission in drug users, as well as a pilot scheme for reproductive health.

It is thus clear that Russia is aware of its health challenges and is approaching the main problems in a number of creative ways.

Conclusion

Overcoming Russia’s health problems is a huge task, but engaging the population in prevention activities, and using social media-type platforms to provide information and normalise the concept of healthy living may provide a viable way forward. Digital media may be particularly helpful in driving change across such a large country, but other forms of communication and action are important for a diverse society.

As the focus of the current initiatives is preventative, it may be that a difference will not be seen for some years, but it is clear that Russia is an area where engaging with the population about health will have a decisive impact on the country’s society and economic well-being.

If you would like to have a conversation about healthcare engagement in Russia or other emerging markets, a member of Creation Healthcare’s team would be very pleased to speak with you. Simply contact us now.

Every once in a while I gain the slightest ‘glimpse of the horizon’ of emerging channels and technology platforms for healthcare and the pharmaceutical industry. It can be quite hard to really know what the future holds, and which of the many innovations will make a mark. It was therefore very apt and quite inspiring when a former colleague tweeted a quote from Alan Curtis Kay this week, which says:

“The best way to predict the future is to invent it.”

One such individual, based in Romania, is ‘inventing the future’ in the area of dedicated online monitoring for pharmaceutical companies. Together with a former high-school colleague (now in the United States), Horatiu Mocian started working full-time on Newistic in 2009, transforming it into a business. The roots of the company can be traced back to 2006, when he and Ovidiu Dan started working on a news aggregator as a hobby/research project. After participating in several ‘seedcamp’ and incubator projects throughout the following years, it was only in May 2010 that the team decided to focus completely on social media and healthcare.

Horatiu quietly approached me after a recent conference to ask if he could show us this software. Creation Healthcare had been presenting new research on ‘Reportable Adverse Events and the Worldwide Web’, from which quite a few people noted our methodology for finding potentially reportable events; minimising the potential processing requirements for pharmacovigilance teams through category rules.

Our consultant team developed sets of keywords for these category rules to identify overlapping sets of online conversations which contain a brand or active ingredient, as well as a known side effect, and lastly a ‘conversational tone’ which may indicate the presence of an individual adverse event.

It is probably fair to say that any person seriously involved in the business of online engagement strategy and measurement has a suite of software and tools for passive and active monitoring. Yet many of the tools used by PR, communications, and marketing professionals for the purpose of ‘Buzz Monitoring’ or ‘historical analysis’ are in fact quite similar on many fronts, excepting for the subtle idiosyncrasies that you inevitably come to recognise with repetitive use.

Newistic has approached this concept with a completely different focus to the ‘one-size-fits-all’ monitoring competition. Their private BETA version web-based platform “scans patient communities, blogs, comments, Twitter, and other social media for the opinion of patients and specialists on drugs, pharmaceutical companies, diseases and treatments”.

While not revolutionary in terms of general monitoring features, there are a couple of more ground-breaking and potentially game-changing features which I believe are more worthy of further attention;

Automatically populating side effects

There is a built-in symptoms and diseases database which automatically searches and populates based on the conversation stream;

Direct sourcing conversations from patient communities

The tool is focused on patient communities particularly, which are selected and added based on integrity and relevance, along with partnership agreements where required.

Brand and active ingredient database

The correct taxonomy is also auto-completed for a comprehensive range of brands and generic variants;

Even with these unique and industry-specific features set aside, the piece of the story that is perhaps most exciting, is the company vision to not only very deliberately seek out and identify known side effects, but to also attempt to identify any trends or new anomalies that may benefit product development and patient safety in the future.

Challenges and solutions

Objectively speaking, one potential business challenge for such a product revolves around ‘who is the customer?’ for this product. Aside from regulatory monitoring, I believe a market-ready version of this technology could actually make the job of online pharmacovigilance significantly easier and more effective – especially by automatically processing many of the unwanted results which ordinarily can make online monitoring a laborious task.

For example, it was clearly evident through Creation Healthcare’s international monitoring research across ten therapy areas that there is a startling amount of medicine-related Spam – not just in email (which most people are accustomed to) – but in blog comments, forums, micro-blogs, and social networks.

Newistic is also having to face and solve these challenges, yet I have been impressed with the speed at which changes and my own personal recommendations have been adopted within the development team. This young company is willing and able to build a tool that could really benefit health outcomes and the industry at large.

I can’t help wishing that a market-ready version of the tool had been available when we began our own study several months ago. Yet in the final analysis of our research we determined that every company can and should take an active interest in tracking down and understanding every earnest conversation about their brands. This new tool has some of the features that the major players do not, specifically for this industry.

Would you like to be involved?

If you have read this article to this point, I suspect you are sufficiently interested in this topic, and potentially even the Newistic software. If so, I would highly recommend requesting access to their private BETA program to add your voice and opinion in evolving the development of features and capabilities that will make everyone’s monitoring work easier. See their home page for more information: http://www.newistic.com/

For medical information professionals, the Internet presents an interesting dilemma. On the one hand, it is a chaotic environment; a dangerous place for a medical information professional. Yet on the other hand, it is difficult to ignore the testimonies of patients whose lives have literally been transformed through a wealth of health and medicine information, and by participating in online communities.

For many in the medical information and pharmacovigilance field, social media and the Internet have previously been best handled as ‘no-go’ areas for pharma. However, I sense that the tide is turning as many professionals in this field recognise that the Internet has a role to play that goes well beyond marketing.

New perspectives on the role of medical information

This week I took part in the DIA (Drug Information Association) 4th Annual Clinical Forum in Lisbon, Portugal. Also at the conference were around 400 experts in clinical, medical and regulatory affairs from pharmaceutical companies based all around the world, in global and regional roles. I was there to speak about the role of social media, together with UCB Pharma’s Frank Vanderdonck, Knowledge Manager Global Medical Affairs based in Brussels, Belgium in a session put together and led by Sharon Leighton.

The conference was split into nine specialist tracks, and I spent most of my time in the ‘Medical Information and Communications’ track. Spending three days immersed in the medical information environment, tackling issues from legal and copyright to communications technology and customer service, I came away with many new perspectives on the role of medical information colleagues and certainly a fresh appreciation for their work.

In my day to day consultancy work with Creation Healthcare I often work with medical colleagues in pharmaceutical companies. To date, this has primarily been for the purpose of ensuring regulatory compliance during the development of engagement strategies led by marketing and communications professionals. We encourage pharmaceutical marketers and communicators to connect with their medical information colleagues as early as possible in strategy planning. This approach has certainly helped to ensure the efficiency of compliance approval, and medical colleagues have often also been able to help shape the strategy itself.

Through the DIA Forum however, I was able to go beyond my previous experience and see pharma with medical information at its core. I saw a passion for the work that pharmaceutical companies do. “I’m proud to work for pharma. And I’m proud to work for Pfizer!” said Aaron Cockell, Pfizer’s Medical Information Director, EMEA as he opened an excellent session on globalisation and rationalization of medical information.

Challenges and opportunities of the Internet

The challenges and opportunities of the Internet for medical information came up time and time again throughout the Forum, and I took every opportunity I could to discover the views of other delegates and speakers on this topic.
I met some who believe that digital engagement around medicine products should be owned and led by medics, rather than marketers. Some felt that medical information and pharmacovigilance colleagues should take a lead in defining a company’s social media policies, rather than Corporate Communications leading this activity.

I also met medics who were tasked with justifying to their business why they should invest in producing a global medical information website. It was encouraging to hear that such a conversation was taking place.

Medical information or promotion?

Just two weeks ago, I was taking part in DigiPharm Europe Conference 2010, the European conference for digital in pharma. Primarily attended by marketers and communicators, it was encouraging to also meet a small number of medics there who had a special interest in the role of digital engagement. I met a medic with GlaxoSmithKline, for example, whose role specifically focuses on digital engagement.

At DigiPharm, Heather Simmonds, Director of the PMCPA (Prescription Medicines Code of Practice Authority), challenged delegates, not for the first time, to take advantage of the opportunity to at least publish online all the patient information that their companies are allowed to. But she also said that with regard to compliance with the ABPI (the Association of the British Pharmaceutical Industry) Code of Practice, which prohibits the promotion of medicines to patients in the UK, pharmaceutical companies should assume that any communication with patients is promotional unless it can be proved otherwise.

Given that most of the delegates Ms Simmonds was speaking to were marketing and communications professionals, this is an interesting challenge. Surely, by definition, the role of a marketer is to carry out marketing. Why would a marketer communicate anything about a product without intending to promote that product?

The answer to this dilemma is surely in medical information. I believe that medical information professionals not only have the opportunity to provide patients with approved medical information via the Internet; they have a duty to do so.

Responding to customer needs

To illustrate the dangers of the legal minefield in which pharmaceutical companies operate, Hein van den Bos, a legal expert with NautaDutilh based in the Netherlands, provided examples in his presentation at the DIA Forum of recent legal cases against pharma including Pfizer’s USD $2.3bn settlement last year over the marketing of products. Today, it seems few pharma professionals want to risk making decisions that result in the next multi-billion-dollar pharma lawsuit.

Yet the challenge is, what if the next lawsuit is not about what a pharma company did online, but what it failed to do? Consider some known facts about the behaviour of patients online (if you do not consider these to be facts, you only need to carry out a small research initiative to prove them for yourself):

• Consumers discuss disease, medicine and health online
• They also search for information about disease, medicine and health online
• When they do so, they information from a wide range of sources, much of which they will trust, and most of which has not been written by professionals
• Patients openly share information online about the side-effects of medicines they are taking
• Patients also openly discuss off-label use of medicines online
• Healthcare professionals trust information they find online about medicines and disease

In this context, is it not the responsibility of a pharmaceutical company’s medical information professionals to ensure that appropriate, accurate, reliable and compliant information is available to those who seek it?

The task of engaging stakeholders in a relevant and compliant way is not trivial. Patients pay little respect to national boundaries governed by different regulations, but consume information and take part in conversations based anywhere in the world. Medical information professionals seeking to engage patients online must consider practical solutions to handle global regulatory variations. In most cases a global online medical information strategy, informed by local insights and with support from local in-country colleagues, will be necessary.

All of this requires significant collaboration between colleagues across functions and regions. At the start of my presentation at the DIA Forum I made the point that social media is about people first.  It is not primarily about technology, and it is not primarily about marketing.

Bridges to build

I sensed from some who I met at the DIA Forum that they hold their marketing colleagues responsible for an erosion of credibility of pharmaceutical companies, with the implication being that colleagues in marketing might put product sales before patient safety or health outcomes. Whilst this viewpoint is certainly not held by all in medical information, it reminds me of just how many opportunities are missed when marketing and medical information fail to collaborate effectively.

In a nutshell (and I know I’m oversimplifying things here), a research-based pharmaceutical company must discover new products that address a medical need; ensure the efficacy and safety of those products; and then get them to the patients who need them. They must do this in a manner that is legal, regulatory-compliant, and profitable. This requires a breadth of stakeholder engagement led by pharmaceutical professionals with a wide range of skills.

Today, the Internet and social media have a broad role to play in every aspect of pharmaceutical companies’ engagement with health stakeholders; from clinical trials recruitment and support, to engaging healthcare professionals, to developing health literacy and supporting patients.

The power of social media in patient support is not just an idea amongst marketers. Last year I reported on a study by the University of Warwick, which found that in a trial, diabetes patients benefited from peer support gained through being connected with other patients through a virtual community via the Internet.

What next for medical information professionals online?

One thing that I was reminded of at the DIA Forum was that there are few medical information professionals with time to spare. Perhaps this is why for many, serious consideration of the opportunities and challenges of the Internet and social media have simply been pushed aside for more urgent demands of the business.

With this in mind, I would firstly encourage medical information professionals to proactively plan for engaging stakeholders online. Don’t leave it all to your colleagues in Marketing and Communications roles. Consider the role that the Internet could play in helping you achieve your medical information goals.

If reading this has inspired you to take a more proactive role online, here are a few steps that you could start with:

1. Try using the Internet as a patient. Search for information about a disease, or a medicine, as if you were a patient. Are you happy with what you find? From a medical perspective, what would you want to change about the patient’s experience?
2. Review your own company’s information online. What medical information do you provide, and is it easy for relevant stakeholders to find it?
3. Consider organising an informal or formal workshop with colleagues from other business areas. Taking the lead in a collaborative initiative with marketing, communications, IT, and legal, for example, could help you and the whole business to be more effective online.

If you would like help with any of the steps above, or if you would simply like to talk about where to start, Creation Healthcare will support you. We can help by conducting research into Internet user behaviour, facilitating workshops, or supporting strategy development. With a global team in fifteen countries and offices in London and Tokyo, we can help you develop a global strategy informed by local insights.

“This house believes patient care will be enhanced through pharma’s involvement in social media“. So read the title of the debate I was invited to take part in at the PIPA Annual Conference 2010 on 5th July.

I was especially excited to take part in this debate, not only because of the opportunity to participate alongside an excellent panel of experts on the subjects of pharmaceutical companies, social media and regulatory affairs – Andrew Spong, Klynn Alibocus, and Sam Temple-Scotton. Even more so because the debate was hosted by PIPA, the Pharmaceutical Information and Pharmacovigilance Association.

In their own words, ‘PIPA is the professional organisation for individuals who are involved in the provision and management of information and those involved in the fulfillment of regulatory requirements relating to drug safety‘. In other words, the debate was hosted by regulatory, medical information and pharmacovigilence professionals. The fact that such an organisation placed this important topic on its Annual Conference agenda is an indicator that the questions being asked by pharma about how to engage through emerging two-way channels such as social media are being taken seriously.

At Creation Healthcare, one of the most enjoyable, if sometimes challenging aspects of our work is when we get to bring together internal stakeholders from across a pharmaceutical company – communicators, marketers, legal and medical colleagues, to develop healthcare engagement strategies embracing emerging channels. And from my experiences of this I know that amongst visionary pharmaceutical companies it is possible for these colleagues to strategise proactively together to achieve real health outcomes through innovative use of social media and other emerging channels.

Sarah Dunnett, Senior Medical Affairs Manager at Baxter Healthcare and PIPA President, chaired the debate and asked for a pre-debate vote. 42 conference delegates agreed with the motion (albeit some with caveats) whilst 21 disagreed, to at least some extent.

Not one to miss the opportunity to encourage healthy discussion about healthcare and social media, Andrew Spong kicked off the debate, playing devil’s advocate as he argued against the motion and highlighted some favourite objections including adverse event reports.

I followed with a brief outline of seven examples of pharma’s involvement in social media, outlining how each example demonstrated the potential for enhancing patient care. I included some of my favourite examples such as Johnson & Johnson’s Health Channel on Youtube, UCB’s partnership with PatientsLikeMe, Boehringer Ingelheim’s sponsorship of a Tudiabetes video, and AstraZeneca’s engagement with healthcare professionals through doctors.net.uk.

Sam Temple-Scotton then supported the case against the motion and pointed out that pharma is struggling to keep up with the level of change in digital channels.

Finally Klynn Alibocus made some excellent points about the breadth of ways in which pharmaceutical companies can enhance patient care through social media, drawing the debate away from marketing to consider other areas including clinical trials recruitment.

In the discussion that followed between the panel and PIPA delegates, some key issues were debated including trust, transparency, responsibility, stakeholder partnerships, business process change, and resourcing. Many of the most challenging issues were raised and debated. From my perspective, there was general agreement about points including:

• Pharma is generally mistrusted and this makes social media engagement difficult; but social media might play a role in enhancing trust through transparency
• Given the amount of discussion taking place by patients using social media about health issues, pharma has a responsibility to get involved
• Regulatory constraints make it difficult, but not impossible, to plan proactive engagement
• Avoiding adverse events reports by not listening to social media conversations is not the answer
• Successful social media engagement may require changes to the way pharma operates

Finally, a post-debate vote revealed the extent to which we had convinced PIPA delegates: after all the discussion, just 39 delegates agreed to any extent with the motion – a reduction of 3 – whilst 23 disagreed. On the face of it, it appeared we had done more to convince pharmacovigilence colleagues not to support pharma’s role in social media! But all in all I believe the debate was healthy, timely and relevant and I hope will encourage some of the PIPA delegates to take a proactive approach to working through some of the challenges with colleagues in their businesses. I am still reassured that 63% of pharmacovigilence professionals believe pharma’s role in social media will enhance patient care.

I understand that a more comprehensive report on the debate will be published in PIPA’s journal, PIPELINE. In the mean time, feel free to tweet me with your comments at @EngagementStrat.

How healthy is your digital engagement strategy? World-class ‘olympian’, or ‘gasping for breath’? We’ve put together a quick and fun tool for you to self-diagnose the health of your digital engagement. Just answer the seven questions below and see how your score adds up.

We recommend that you take this simple self-diagnosis check whether your focus is on product development, policy, corporate communications or marketing, and whether you are in prescription-only or over-the-counter medicines, medical devices, patient treatment or care. You will discover just how healthily you and your organization are engaging through digital.

A healthy digital engagement strategy allows you to connect with patients, healthcare professionals and other health stakeholders in a way that is relevant to each of them, and to achieve results aligned with business goals. Not only that, it allows you to discover which activities achieve the best outcomes so that you can continually improve effectiveness.

7-Step Self-Diagnosis

Simply answer these seven questions, and add up your score. Each question is worth up to 2 points. Find the closest response and score yourself accordingly. It’s entirely subjective and just for fun, so you can keep it to yourself or feel free to tweet me your score or comments (@EngagementStrat)!

1.

Who are the key stakeholders you want to engage? Patients, carers, healthcare professionals, government? Do you have a strategy in place to engage each of them online?

Award yourself between 0 and 2 points:
(2) I know all stakeholder groups and we have strategies for engaging each of them online.
(1) I know who our stakeholders are, and we connect with some of them online.
(0) I don’t know whether our stakeholders are online.

2.

Are your digital engagement activities and campaigns aligned with specific business goals? Are you able to measure the extent to which these goals are being achieved through digital activities?

Award yourself between 0 and 2 points:
(2): I understand our business goals; we have digital engagement strategies closely aligned with them. I am able to identify digital outcomes and their contribution to specific business goals.
(1): Our digital activities are designed in line with business goals, but I am unable to identify specific business goals that have been achieved through digital engagement.
(0): Our digital campaigns are not set up to demonstrate results against business goals.

3.

Is your digital engagement strategy an integral part of a broader business, communications or marketing strategy? Are you integrating digital engagement with your offline marketing or engagement activities such as advertising, sales, policy activities, clinical trials?

Award yourself between 0 and 2 points:
(2): Our digital engagement strategy is fully integrated with our business, marketing  or communications strategy. We plan for the online impact and opportunity with every offline activity and do not operate ‘digital strategy’ distinctly from non-digital engagement.
(1): Some planned integration exists between our online and offline engagement activities.
(0): We have a digital strategy that is completely distinct from our other engagement, marketing and communications strategies.

4.

Thinking about your key therapeutic areas, do you know what topics or words Internet users in your territories are searching for? And when they do, do you know what they find?

Award yourself between 0 and 2 points:
(2): We proactively analyse search activity and keywords around our key therapeutic areas, and I know what online resources we compete with for Internet users’ attention. We have a strategy to use search to connect with the right people at the right time.
(1): I know who are competitors are online, but we do not proactively analyse search behaviour or develop strategies based on search.
(0): I do not know what people search for around our key therapeutic areas or what they find when they do.

5.

If your digital engagement strategy includes a website, do you know how and why people find the site? Have you included clear goals you want visitors to achieve, and are you monitoring user journeys that achieve these goals?

Award yourself between 0 and 2 points:
(2): Our websites have clear outcome goals, we track user journeys and use this information to improve outcomes.
(1): I have access to key analytics data for our websites, but I am not able to align this data with tangible outcomes or goals from user journeys.
(0): We do not measure user journeys on our website.

6.

Is your approach to social media proactive or reactive – are you deliberately starting social media conversations, or listening and responding? Whichever approach you choose, do you have a plan in place to monitor and respond to social media events in a timely way?

Award yourself between 0 and 2 points:
(2): I know why we use social media; we engage in dialogue and we have an approved plan in place for managing conversations and outcomes. We are able to identify the results of social media engagement in terms of business goals.
(1): We use social media to connect with people, but we do not proactively listen to conversations outside our chosen channels of engagement.
(0): We use social media channels to make announcements; or we do not get involved with social media.

7.

Think about internal stakeholder engagement. Are your colleagues from legal and medical departments envisioned about your digital engagement strategy? Are you talking with company employees about social media and how to use it responsibly, in professional as well as personal capacity?

Award yourself between 0 and 2 points:
(2): Colleagues across all relevant departments understand the role of digital engagement in achieving our objectives, and we have a clear policy on social media engagement that colleagues understand and find helpful.
(1): We work with colleagues in different departments to plan proactively for social media engagement.
(0): We do what we have to, to gain approval from legal and medical colleagues before launching digital campaigns.

How did you score?

OK, add up your scores from the above and see which category you fit.

11-14: Olympian

Congratulations! You have pioneered, envisioned colleagues, and have a healthy approach to digital engagement. You understand that it’s a competitive environment, and you have measures in place to engage in a way that is continually relevant to stakeholders. You are achieving demonstrable business results, and you know exactly why.

You already know that in the world of digital, new platforms for engagement constantly emerge and user behaviour is unpredictable. When you need a partner who you can trust to give you independent advice about keeping your digital engagement strategy in top shape, contact Creation Healthcare. Like you, we care more about your outcomes than your digital agency.

6-10: On the mend

It’s likely that there are some areas where you are very strong. Your overall digital engagement health might be hindered by one or more areas of weakness. You probably know what needs to be done to change things for the better and you are close to having a digital strategy that delivers continually improving results.

By addressing those areas you know need work, you will move on towards Olympian level. At that point, your digital engagement activities will enable you to compete effectively online, achieving planned outcomes against business goals. To get you to that next stage, you might want to speak with an independent consultancy who can help you to make those improvements. Contact Creation Healthcare to discuss how we could help.

0-5: Gasping for breath

First, the good news: from the questions above you will probably have identified the areas you need to focus on to improve things. From a healthcare point of view, you are either in very poor health, or you are newborn – just starting out in digital engagement.

Look at the areas where you scored lowest, and select one or two to focus on. Don’t try to change everything at once. When you feel that you need extra help or advice, Creation Healthcare will guide you through the steps to healthy digital engagement. Contact Creation Healthcare at any time for a confidential discussion.

If you would like an ally in the ever-changing world of healthcare engagement, or a second opinion on your self-diagnosis, talk with Creation Healthcare.

When it comes to supporting patient care in a relevant and engaging way through digital technologies, there is a huge amount of potential yet to be exploited. Last year we wrote about ‘serious games’ for health, and Creation Healthcare’s Susi O’Neill outlined how technology can be used to make healthcare fun.

Serious games can provide a refreshing change for patients with long term diseases when it comes to their treatment, which could be especially effective in treating children with chronic diseases. That’s the thinking behind Bayer’s DIDGET™, a blood glucose meter designed for children with diabetes. As Sandra Peterson, Head of Bayer Medical Care explains:

“Up until now, blood glucose monitors have been created with adults in mind. This product was inspired by a parent of a child with diabetes, to directly address the challenges facing kids with diabetes and their parents. Bayer’s DIDGET meter offers play with purpose to encourage kids to regularly monitor their blood glucose and begin to view regular testing as fun.”

Connecting with games systems

The DIDGET™ system connects directly to Nintendo™ DS and DS Lite gaming systems, awarding points for good testing habits. After testinjg, children can transfer points to their Nintendo™ games devices and redeem them for new characters, costumes or mini-games.

Bayer’s DIDGET website includes a demonstration of the product and how it works

John Gregory, Professor in Paediatric Endocrinology at Wales School of Medicine, Cardiff University explains why this is important:

“One of the biggest challenges facing parents of children with diabetes is the constant struggle to instil the habit of regular blood glucose testing…”

“Bayer’s DIDGET meter can help ease the parent/child tension that testing often creates by adding an element of fun and rewards to the routine. Because it is designed with children in mind, Bayer’s DIDGET meter can transform a child’s blood glucose testing experience from something they have to do into something they want to do.”

Initially available only in the UK and Ireland, DIDGET was launched in Vienna at the Annual Meeting of the European Association for the Study of Diabetes (EASD) last September and is expected to be available in the US, Croatia and Slovenia shortly. In the US, the FDA (the US regulator) cleared the product last December.

What patients are saying

The launch of DIDGET in the UK has generated much industry and media interest, and a great many blog and social media posts mentioning the product. We carried out some simple research into social media conversations about the product, and found most of them to be from observers in technology companies and industry observers.

What we really wanted to know was what diabetes patients using the product thought of it. Naturally, with the product aimed at children aged between 5 and 14, we didn’t expect to find a highly active community of UK bloggers amongst target users. We did, however, find discussions amongst parents of children with diabetes based outside the UK expressing disappointment at not being able to obtain the product in their markets.

Amongst UK social media activity, it was interesting to learn that the product is not only being used by children. Analysing social media conversations amongst UK diabetes patients, we found comments such as this one, from a 23-year old diabetes patient living in England:

“The other meter I’ve been using at work for a few month now is the Bayer Didget. This meter is similar to the contour (uses same sticks) and I like it as you have the option to mark each test with a pre-meal, post-meal and small book marker on the system. Tests are quick (5secs) and don’t need much blood, so I prefer it to most others.”

The same user also comments on the game:

“The didget works with the Nintendo DS, it comes with a game and the tester can be plugged in the DS and good test results will reward players. The game is average, but I reckon it’d be good for getting kids to control their levels.”

An interesting observation from these comments is that it is the tester’s ease of use that appeals to the adult user of the product. Perhaps there’s a lesson here for medical equipment manufacturers: design for children, and adults will appreciate your products too.

When we announced the Healthcare Engagement Strategy Award winners in January, we awarded PatientsLikeMe the ‘Changing Healthcare Award‘ for having the engagement strategy we felt was most likely to change healthcare. Speaking with PatientsLikeMe co-founder Ben Heywood, it was clear that there was much more to come from the team behind what must be the world’s largest and fastest-growing set of specialist patient communities.

This month we’ve taken a look at new developments at PatientsLikeMe, including some exciting partnerships with pharmaceutical companies.

Novartis gets closer to patients

Earlier this month, PatientsLikeMe announced a new collaboration with Novartis to create a community for organ transplant recipients. It’s a brand new community and already includes over 600 patients.

Novartis CEO Joe Jimenez outlines why connecting with patients online is important for shaping the way Novartis works:

“We need to be closer to patients to understand their experience and their needs. An online experience allows patients to open up and share in a more personal and frank way.

“Our commitment to supporting this transplant community will shape the way we do our work, and ultimately help improve transplant patient outcomes now and in the future.”

This is the 12th disease community for PatientsLikeMe, and the second PatientsLikeMe community supported by Novartis who have already been actively involved in the multiple sclerosis (MS) community. In 2008, Novartis were amongst the first pharmaceutical companies to use social media for clinical trial recruitment when they engaged PatientsLikeMe’s MS community to boost registrations for a study.

UCB looks for adverse events amongst epilepsy patients

On the day we named the Healthcare Engagement Strategy Award winners, PatientsLikeMe announced a new epilepsy community in partnership with biopharmaceutical company UCB. In its first two months since then, the community has already grown to over 1,000 patients.

The partnership includes an interesting proactive patient safety initiative designed to capture adverse events associated with approved UCB epilepsy therapies, and report them to the FDA (Food and Drug Administration, the U.S. regulator).

Iris Loew-Friedrich, UCB’s Executive Vice-President, Chief Medical Officer says that the partnership with PatientsLikeMe will help UCB to understand patient needs:

“We believe this community will be a source of information that will allow us to better understand people living with epilepsy and may help us design clinical programs that incorporate real-world patient needs and experiences in a measurable way.”

Pharmaceutical companies: how to connect with patients

Pharmaceutical companies have many reasons to engage patients – for clinical trial recruitment; to learn about the needs of patients; to learn about use of their products; to educate patients about their treatment options – the list goes on.

Working in partnership with existing or emerging patient networks can be an excellent way to rapidly reach thousands of relevant patients online.

If you are looking to make the most of the Internet to engage patients, Creation Healthcare can help you to identify and develop suitable partner relationships, plan for their success, measure results and understand the strategic impact of the partnership.

Contact Creation Healthcare if you would like a confidential discussion about your patient engagement needs.