• Dr. Samuel Grief, Family Medicine, University of Illinois
• Dr. Ranjita Sengupta, Cardiologist, Somerset Medical Center
• Dr. Guy Bernstein, Urologist, Bryn Mawr Hospital

The first question…

How are you using smartphones at the point of care?

Dr. Grief: The smartphone is a very useful tool for me. Not only is it useful for me to educate myself, but the information on medications that I look up I share with patients.

Dr. Sengupta: My iPhone is always with me. I think the iPhone is phenomenal. Not only do I use it for texting and calls, but I use it to look up results from studies, search new medications and look up information asked by patients. I open up Epocrates, look up medications and help patients become familiar with their medications.

Dr. Bernstein: I need a little bit bigger of a screen. In terms of interaction and reviewing larger text documents so the iPad is best for me. But, time is so pressed, especially in sitting and discussing with patients. So, I’ve used the iPad a lot less than what I imagined when I purchased my iPad.

Dr. Sengupta, cardiologists are second only to oncologist in tablet use, do you foresee using tablets in your practice?

Dr. Sengupta: I agree with Dr. Bernstein. I need a larger screen for certain things. But the size of the iPad still is a little off for me. It’s slightly larger than I’d like to carry with me, but doesn’t give me the same experience as my laptop.

Dr. Grief: Let me add to that, I believe the future of medical communication is not shrinking information but also having the ability to expand, to go deeper.

What role does mobile technology play in improving health literacy of your patients?

Dr. Grief: The way I envision using mobile to improve health literacy is to share the information I know about medications and treatments with my patients. To increase the health literacy, it’s up to the doctors to be a teacher. The way I see mobile playing into that is to provide the physician the ability to point a patient to sources of information with mobile friendly tools.

Do you recommend apps to your patients?

Dr. Bernstein: I don’t recommend a particular app but the apps that allow patients to track their own information, access it, and share it with me during the consult are the most useful.

Dr. Sengupta: I definitely encourage my patient to use apps to track their health and vitals. I constantly have patients coming in having used apps and ready to talk about their health. For example, they are using an app to track their BMI and are coming in to my office to talk about how to lose weight.

With the increase of medical devices that have wireless connectivity that will be flooding the practice with real-time information, how do you anticipate your practice evolving to

Dr. Sengupta: In my office, we have a rotation of doctors who is responsible for reviewing that data and responding to it. So it’s blended into our practice now.

Dr. Grief: In the family practice, we have much fewer emergencies but we are still getting information in to our office that we are reviewing.

What percentage of your time do you estimate that you spend online or on different devices?

Dr. Bernstein: Most of my time online is spent reading and responding to emails.

Dr. Sengupta: Yes, I would estimate that I spend 11-ish hour online each week. My personal computer at home is being used by my family, so my mobile phone is my best friend when at home. I would say 50% of that time I’m looking up patient care information.

Dr. Grief: For me, it’s more than 11 hours. The real question is whether using our mobile devices in front of the patient is disrespectful. It seems that patients are beginning to expect that the physicians is referencing a mobile device at the bedside and understand it’s necessary.

Dr. Bernstein: I would disagree with that. I think the physicians who are only looking at their device and not making eye contact and having a one-to-one conversation are being disrespectful and are not making a connection with the patient.

How do you prefer to receive communication from pharma companies?

Dr. Bernstein: For existing medications, I tend not to open up electronic information. I pretty much know everything I need to know about that medication. For new medications, I do read the information and actually prefer to have an in-person conversation with a rep.

Dr. Sengupta: I agree with Dr. Bernstein.

Dr. Grief: To be blunt, face-to-face communication is what we have become accustomed to it so it’s most comfortable. Ultimately, I would welcome electronic communication because I have the ability to read it or ignore it if I don’t think it’s relevant.

“Awesome apps combine value with cool”

- Lionel Carrasco, Founder & CEO of Leapfactor

2) The future is about interactive content delivered via HTML5. But reality is that content will continue to exist in analog formats.

3) Today’s CRM is limited to contact management. Engagement is very limited and visibility into sales rep’s behavior is poor. Little value for user hasbeen offered.

4) iPad provisions would not guarantee adoption. App abandonment rate is higher than consumer apps due to the “bore factor.”

5) Systems integration adds tremendous value. Process integration may offer too little of a return when it comes to sales enablement.

6) Intensive CAPEX (capital expenditures) associated with IT projects could force projects into a long journey. It’s important to keep engagement systems with loose integration.

“Patient engagement is the blockbuster drug of the century.”

Doug Elwood, MD, director of Global Medical Information Strategy and Innovation at Bristol-Myers Squibb, set the stage for his presentation on “Understanding the Digital Landscape Through the Customers’ Eyes” by sharing a September article featured in Forbes titled “Patient Engagement is the blockbuster drug of the century“.

For a great read outlining the major shift in the healthcare and pharmaceutical industry – specifically how physicians and brands can shift to achieve success – I highly encourage you visit the Forbes article.

…and for even more insights and trends in marketing in a Post-RX world, GSW Worldwide’s Leigh Householder is presenting this topic at 11:40 a.m. in Track C. You can also view and download her presentation here: Power Shift to the Patient: Best Practices for Marketing in a Post-Rx Marketplace.

“You should not build new communities, you should come to where we are.”

- Kerri Morrone Sparling, ePatient (@SixUntilTime)

• Price pressure on payers
• Restrictions to access by payers
• Regulatory/legal risk aversion
• Decreased sales rep access
• Decreased reimbursement to docs
• Adoption of EMR
• Interaction with consumers via social media
• MD use of mobile devices

Study: Pharma executives expecting to shift spend from physicians to payors

In a recent study of pharma executives, it’s evident that most are expecting to decrease their spend on physicians (32% decrease) and key opinion leaders (12% decrease) and shift their spending to payers (47% increase) and key accounts (32% increase). This is definitely causing a shift in the type of marketing activities. Among the top activities that pharma execs are expecting to increase their spend on is:

• Innovative pricing strategies (59% increase)
• Payor collaborations (59% increase)
• Pharmaceutical studies (55% increase)
• Direct-to-consumer (48% increase)

Consequently, pharma execs are preparing for a shift in the way their reps spend time on their core product. As time with physicians continues to decrease, strategies are shifting to the areas in which physicians spend time. Consider this:

• 99% of physicians have a computer or laptop
• 84% of physicians have a smartphone
• 54% own a tablet

The research backs this up too. Physicians are shifting their preference to digital channels for information. In fact, in a recent Manhattan study, physicians are believed to be 2X more likely to seek out a digital channel for information than a print piece. Google has data to support this notion also.

• 84% of physicians use search engines for professional purposes (94% turn to Google specifically)
• 39% visit portal websites specifically intended for physicians
• 7% seek out pharma/biotech product websites
• 7% seek out pharma/biotech corporate websites

But, physicians still want to see reps

While physicians are becoming more digital active and prefer digital interactions, we’re not at the end of the road for the in-person pharma sales rep.

• 79% of primary care physicians prefer in-person dialog with reps
• 74% of specialists prefer in-person dialog with reps

And while physicians are seeking out information online, they don’t have quite the same sentiment when it comes to computer-based, remote detailing by a rep.

• 23% of primary care physicians prefer computer-based, remote detailing
• 28% of specialists prefer computer-based, remote detailing

-Peter Dannenfelser, Director of Digital Marketing North, Janssen

Today’s Panelists:

Brad Sitler, Principal Industry Consultant, Center for Health Analytics and insights, SAS

Eugene Lee, SVP, Media Innovation & Analytics, Communications Media, Inc.

Kellie Boyle, Senior Director of Marketing GlaxoSmithKline

How can pharma advance their adherence and compliance program to meet the demands of a value-based system?

Kelli: There are so many opportunities for the industry to partner to understand patient segments, create messaging and develop programs for very targeted groups. We need better ways to segment patients in our programs. Do I understand who you are and where you are that helps me help you?

Eugene: For us, the delivery of the message must depend on where the patient is in their journey for us to provide them with utility and purpose in our efforts. Hopefully, when they go through that journey and we know where they are at, we can develop metrics to monitor the effectiveness of our programs.

Brad: The major problem with our adherence programs today is that most of the participants are already highly engaged with their disease and treatment plan. Pharma spend millions of dollars talking to patients who already understand and buy-in to the program. That is one reason why we don’t see the needle move – the participants are already adherent and we’re ignoring the ones that are not. I’d really like to see a strong partnership between a pharma brand and a payer on developing an adherence program that caters to those who are not adherent.

Should pharma companies really be focused on the parts of patient outcomes that are based on lifestyle components (diet, activity level, etc.) or remain focused on treatment (medication choice, adherence, compliance)?

Eugene: If positive patient outcomes are the true goals, then pharma should be involved in all aspects.

Kelli: The only reason this question is asked is because people do not trust pharma. The answer seems obvious to me: yes. Now is the opportunity for us to begin to partner with patients and other groups to deliver value-based healthcare as opposed to tracking how many ‘scripts we’ve wrote.

What programs are you favorite right now? Which ones have the most promise?

Kelli: I have several favorites. WellDoc is one that always comes to mind. It’s in a very early stage but their objectives and structure are really well thought out. I’m also an avid user of Fitbit. It’s not hard from these solutions to imagine how we can involve

Brad: Novo Nordisk has a great program they are working on for diabetes patients. It seems to capture all aspects of a patient’s life from activity and diet to medication adherence.

Eugene: Something like Patients Like Me is the type of program I really enjoy. Giving people that opportunity to connect and converse with other people on a similar journey seems like an intuitive experience and one that can have a major impact.

We’re starting to see physicians incentivized for positive health outcomes, what are your thoughts on patients being incentivized for positive health behaviors and outcomes?

Brad: Yes, we absolutely need something like that. Take Cleveland Clinic for example: They are incentivizing their employers with cash for improving specific readings like BMI, cholesterol, and blood pressure. They have even eliminated all the fryers on their campus.

- Ryan DeShazer, GSW Worldwide

Below are two slides that capture the points and counterpoints from the discussion.

- Joyce Ercolino, CSL Behring (@jearch)

• Educate patients on their acid reflux disease and its symptoms and the unique benefits of DEXILANT
• Drive patient-doctor discussion about DEXILANT among pre-qualified GERD sufferers

With those goals in mind, the team launched a pilot program called Quality Conversations. The program was designed to take patients through a flow of information and call-to-actions.

1. Attract patients to an email touchpoint program.
2. Align the right patients to the most relevant offers
3. Activate patients through targeted messages and channels
4. Convert patients to DEXILANT by educating and engaging on disease state and DEXILANT’s value proposition

DEXILANT’s Quality Conversations Pilot program

The first step was rolling out the pilot program. The goals were to develop and approve a library of brand resources and then build a communication engine to disseminate that content. In the DEXILANT program, there was a very specific program flow they hoped to achieve:

1) Deploy an email series that prompts a patient to learn more about DEXILANT through a microsite.

2) Once the patient access the microsite, they are encourage to download a conversation guide for a consult with their physician.

3) With the download guide in hand, the patients were then encouraged to print a coupon for DEXILANT.

Through this program flow, a patient was walking into their doctor’s office with information on the brand, a conversation guide, and a coupon for their prescription. While DEXILANT’s MLR team wouldn’t allow for specific numbers to be shared, the marketing team found that overall prescription number increased and noted excellent prescription rates for those patient who entered the top of their funnel by receiving the email series.

Chad recommended a framework and tips for running a marketing pilot.

Goal: Set performance criteria and expectations upfront.

Time: Actively participate in evaluating the real-time analytics and making optimization decisions or delegate this function back to your marketing partners.

Optimization: In addition to overall program results, explore specific areas in the overall flow where your program isn’t functioning to identify additional opportunities to optimize for better results.

A web-based platform that allows brands and treatment teams to become partners in patient education, Fluent allows a brand to create a library of content (branded on non-branded) that physicians can access, choose the most relevant tidbits, and assemble into a booklet to be delivered digitally to a specific patient or group of patients.

We highly encourage you to visit iQfluent.com for more information. You’ll find a breakdown of features, ways to get receive a demo and even tech specs for the IT enthusiast.

Disturbing, right? Physicians are using digital tools but don’t have a reliable, easy-to-navigate platform for disease state and medication information. That’s why we created iQ.fluent, a simple patient education platform that allows treatment teams to access and deliver brand or disease state related materials to patients.

If you’re at Digital Pharma East, we encourage you to stop by our booth (GSW Worldwide #27) for a quick demo at the next break or visit iQfluent.com for more information or to request a demo for a later date.

Google is predicting that mobile search will surpass desktop search in the next 12 – 18 months.

2. Data is the new creative

The creative work of the future will be driven by data. Metrics and monitoring will begin to take a bigger role in marketing and the creation and use of specific copy and art.

3. Quantified Self

Health sensors will become as mainstream as mobile phones. Today we have devices like FitBit and Nike+, but the quantified self movement will move toward ingestible devices that keep real-time health data.

4. Targeting behaviors, not groups

In the future, we will no longer be conducting exercises like customer segment and buyer personas. The future will consist of targeting behaviors, not demographics.

5. Focus shift to managed care

As physicians continue to see less sales reps, we will see budgets shift from sales activities targeting physicians and increase toward key accounts and payers.

6. Open culture

Open culture will allow people to behave in a more intuitive ways. The ways that feel natural versus creating a structured environment that people must conform to. Marketing will began to take that same shape. When people are able to self-organize, the participation and engagement is much higher.

7. Privacy Rules

As digital opens the world to more and more data about individuals in their behaviors, a tipping point is approaching for privacy.

8. Empowered patients and caregivers

The future will reveal that patients will become more educated about their own disease states than their physicians. Before long, all patients will become “ePatients”. The question then becomes how do we be where patients are searching for information.

9. Digital expectations recalibrated

The dominance of digital channels will continue – so much as that everything may one day be considered “digital.” There will be no difference between watching programming on your TV or on YouTube on your iPad.

10. Gamification of health

The principles of gaming have a direct impact on motivating health consumers. In fact, research is starting to pop up that proves that gaming elements are improving health outcomes. Today, there is a variety of games and a few hardware providers (Fitbit and Nike+). The future will see the health gaming category attracting more and more players – both participants and developers.

11. Differentiation beyond efficacy

12. All media is social

Ever read a newspaper article and then see a link below it so that you can go online and comment on the article? All media (including print) are becoming more social in nature.

13. Whitespace keeps getting whiter

The trend of no-see physicians will not reverse. Tools like eDetailing platforms are helping to engage physicians but the trends are pointing toward tools like self-directed details and other digital properties that physicians can access at any time.

14. Measuring what matters

Digital platforms have added to the robustness of what we can measure in pharma marketing. The sophistication of metrics and monitoring will continue and provide marketers with the ability to hyper-target specific behaviors (see: #4)

15. MLR adapts, driven by pressure

The existing MLR process was designed to mitigate risk. But the process was designed around channels that really didn’t change much (Print, TV, etc.). The organizations who help their MLR adapt to the ever-evolving channels will have an advantage in creating relevant marketing tools in the future.

Good morning! The iQ team is back in Philly for this year’s edition of Digital Pharma East. Consistently one of the top digital conferences in the industry, this year’s agenda features a dynamic mix of marketers from the client side, agencies, and iconic companies like Google and Facebook.

Throughout the week, our team will live-blogging key topics here at What’s Your Digital iQ. Later today and tomorrow look for recaps from the following sessions:

• Improving Diabetes Outcomes via Digital Innovation
• Future 15 Pharma Trends
• Digital Engagement and Customer Centricity
• Driving Innovation in our “Slow-Moving-Ultra-Conservative” World of Pharma
• Innovations Enhancing the Impact of Physician Engagement Activities
• A Practical Guide to How Pharma and ePatients Can Work Together
• Transforming the Experience of Reviewing Patient Information through Digital Storytelling
• and more…

Live-blogging isn’t all we do here, though. At the GSW Worldwide booth (Booth #27), we have an entire team of people sharing the latest and greatest with all of iQ’s products. For more information or live demos, visit the GSW Worldwide booth or visit our product sites for more information:

• iQ.mercury: A complete eDetailing system
• iQ.align: Salesforce Data collection and analytics
• iQ.fluent: Patient education portal
• iQ.rival: Tradeshow and mobile gaming platform

We hope you’ll join us throughout the week reading, commenting on, and sharing this week’s insights from Digital Pharma East and inquiring about more information on the 4 products we’ll be featuring.

Responsive web design is all about providing the most optimal experience for your end user. In the development sense it’s a combination of flexible layouts, imagery, and CSS media queries. In the world we live in right now, that typically points to mobile strategy when creating the user experience. Whether it’s a laptop, desktop, smartphone, or tablet the interface should adjust accordingly for the screen real estate. If you’re doing this correctly the capabilities of the device being used are exploited for the users benefit. Mobile content needs to be concise, valuable, and to the point. For example, find out the top three things your user wants and give that to them right up front. You can always allow for an entry way into the full desktop experience. This is well worth careful thought and planning with half of the adult US population owning a smartphone.

With all this being said, the question is how could this type of design impact the distribution of important healthcare content. That goes for both the patient and the physician. There is an overwhelming amount of this information available online, but what if there is a more specific story to tell. It could be in regards to an obscure disease, or simply a disease state that is misunderstood. If you start with that lens you can evolve to a responsive web design approach that will give a respective user some real value as it pertains to healthcare. Healthcare related websites are clearly using this type of lens when defining how to approach mobile and responsive web design.

Two Approaches to Know

To break this down a bit further, there are 2 approaches when it comes to mobile that are worth mentioning. There is the standalone mobile site, and the responsive mobile site.

The standalone mobile site will typically be more direct with less information up front. It is staged with a mobile URL such as m.webmd.com. If you come to a mobile responsive web design it takes the entire desktop website and reconfigures on the fly. You end up with all the content from the desktop site, but just presented in a way that leverages the mobile interface. This type of website can be found with the same URL as the desktop website.

What does that look like in the pharma and healthcare information space? Here are a couple effective approaches to healthcare information that uses the principles of Responsive Web Design, and mobile strategy.

Drugs.com uses responsive web design principles: www.drugs.com

WebMD uses device direction to a mobile specific website: m.webmd.com.

There is a debate right now as to what the best strategy is when it comes to responsive web design. Should you use a mobile only optimized website, or a web responsive approach? It really depends on your target goals, audience, and the type of content your providing. If you feel that your audience is limited in time, you may want a very simple direct mobile website. If you are a Drugs.com with lots of information that requires access at all times it lends itself to responsive web design.

Healthcare information is using a number of paths when defining this strategy. The essence of the approach will certainly have a great impact on pharma and healthcare information the more it evolves. It will ultimately define the way people want to consume all types of healthcare information.

The panel:

• Stead Burwell, CEO, Alliance Health
• Michael Spitz, SVP, Managing Director, Healthcare Interactive Technology, ZEMOGA
• Dorothy Wetzel, Founding Partner & Chief Extrovert, Extrovertic
• Moderator: Stu Klein, Healthcare Practice Lead, Interpublic

They point to some of the richest opportunities is to get involved:

Customer service: Answering the challenges and questions that people post online. It’s an opportunity to use what your company already knows (the tracking in IT, the content in patient services, the response in PR) to proactively serve patients. Great examples include how BI has answered patients (mostly overseas) and AZHelp’s response engine:

Stimulate the conversation: Diabetes is a chronic disease that requires daily, sometimes hourly, tweaking and it’s interwoven with devices.  Tens of millions of people with diabetes are engaged online – talking about managing the disease as well as the particular devices they use. Engaging the talk leaders in that community creates new opportunities to start conversations.

Ask for the review: See the blogger perspective and get the reader response to understand the real conversation around your product.

The panel also talked about some critical success factors:

How you treat your audience and your bloggers is extremely important. Both deserve respect and transparency. That means treating the blogger almost like a reporter – giving access, information, tools. Not expecting them to repeat or tote the brand line.  Just ask Samsung what happens when you don’t.

Rethink the role of the brand. Traditionally brands have been seen as something invincible and pure. Something to be protected. Now they’re organic, living creatures, evolving with their customers. That’s the approach to take with bloggers – open, not hidden; transparent, not controlled.

Know when to go offline. It’s common to give bloggers direction on what to do when a conversation gets too detailed into the prescribing information around a drug, but it’s important to have a plan for how the brand will respond, too. The FDA has given guidance on unsolicited requests for off-label information – both those that come directly (think email) and those that are posted in a public forum (think message board). Those guidelines are a clear blueprint for an internal plan.

Text isn’t enough: In the content you share and track–video, images and other media are critical. Many people start with video, not text – we have to make our content media agonistic.

Tips to get started:

1. Listen first to determine what people will be interested in
2. Create content and response strategies
3. Get down to the details – boiler plate responses, get them approved
4. Put resources and infrastructure around it. Make it prescriptive enough to avoid unnecessary risk, but native to how people are communicating today

In their research, people have said there is no go-to online source for general health and wellness and chronic condition-specific information. (Sorry, Dr Oz!)

Among their panel of digitally-engaged consumers, Catalina has found two primary starting points for personal health research–Google (for its reach) and WebMD (as a primer, starting point). Where they go next is all over the map: AARP to Kaiser; RealAge to Walgreens; WeightWatchers to Livestrong.

What else they’re doing now:

• 64% are using online resources to access health
• 43% access health online once a week
• 30% monitor or refill prescriptions online
• 24% download health and fitness apps
• 23% visit medicine websites
• 8% share medical issues via social networks

Next Catalina asked people what they’d rather do >> What kind of site or tools they want to use and would keep them coming back for more.

What they want: One personalized location that can provide:

• A general health and wellness center
• Chronic condition center
• Prescription tracking
• General health tracking
• Rewards

They said: Make the information relevant to me – know (and use) the conditions I’m dealing with and my age, lifestyle, etc. They want to find personal stories and expert information.

The reward options that were most appealing included cash cards, retailer gift cards, coupons for items related to your medical condition, and coupons to offset prescription co-pays.

The more personal benefit – in content and rewards – that the site provides, the more willing people were to share their personal information.

Note: Catalina talked to 150 people, selected to represent different types of chronic conditions.

Best practices of a true health destination:

• Create multiple dimensions: Not just about one product or condition, but a more holistic experience
• Make it dynamic: Add new content
• Ensure relevance: Customize by age, gender, life stages, lifestyles
• Consider rewards: Incentivize healthy behaviors
• Provide tools: Help monitor progresss/symptoms and facilitate discussions with health care professionals
• Make it personal: Create a safe environment for sharing

He shared the big data trends the data geeks are watching:

EMR is posed to provide the largest cache of clinical data ever. It will blow away the idea of a sample and create a holistic view of American health. Its eventual integration with social media / social intelligence will show the health connections between people and populations. Some researchers have been able to use social – without the EMR connection – to start to map population health. Adam Sadilek at the University of Rochester and his team analyzed 4.4 million GPS-tagged Tweets from over 600,000 users in New York City over the course of one month. They trained their artificial intelligence algorithm to ignore tweets by healthy people such as those claiming they were ‘sick’ of a particular song, and trained it to find those who were really ill. They were able to create models that not only showed the instance of disease, but also predicted who would catch the flu next.

Privacy remains a concern for most Americans. When it comes to health content, people are most concerned when they’re on their smartphones (primarily because of the portability and perceived risk of losing their device) – 70% are concerned with health privacy on their mobile; 48%, tablet; 46% PC. (ComScore, Jan 2012)

Crowdsourcing is a growth area for big data. One example is Google’s new smartphone mapping tools. As you follow directions, the map knows how fast you’re proceeding. That makes every user a sensor, sending constant, real time information about traffic. The Nest thermostat has been able to do something similar for its customers – by tracking the behavior of people and machines over time.  One example, your air conditioner is made up of two energy consuming parts–the compressor and the fan. The compressor uses a lot of electricity while the fan uses very little. The Nest found that the compressor coils can generate cold air for 5-10 minutes after the compressor is off. Once it knew people’s behavior and when they planned to change the temperature, it was able to turn that compressor off sooner, saving electricity in individual homes and across the grid.

Micro and biorhythmic measurement – using tools like Fitbit – will create both personal trending and longitudinal pictures of personal action vs. health, potentially creating new insights into how to preserve and protect our health as we age.

Best practices of privacy-protecting research:

• Only capture what you need: People won’t share data that seems disconnected to your stated goal (it’s a trust factor)
• Aggregate data: Use the back design test to be sure it’s truly anonymous
• Use methodologies that obfuscate data: Limit what you collect at the point of collection to limit liability
• Disconnect PII from data: Keep the personal information in a different database than behavior
• Sometimes its better to ask: If it’s really sensitive, ask subjects to provide their own data
• Have a strong privacy policy: It should be like a constitution - something your write once, write really well, and change rarely

*ComScore has one of the best views into our online behavior today. They have a panel of 2 million people who allow them to collect all of their online data + they have deep web analytics data from their clients, ongoing monthly surveys of hundreds of thousands of people, and more.

• Wendy Blackburn, Executive Vice President, Intouch Solutions
• Bill Drummy, CEO & Founder, Heartbeat Ideas and Heartbeat West
• Ross Fetterolf, SVP of Digital Strategy, Ignite Health (<< one of our favorite people!)
• Brendan Gallagher, SVP, Emerging Technologies & Channels, Digitas Health
• Moderator: Bob Ehrlich, CEO & Chairman, DTC Perspectives, Inc.

Some of our favorite ideas and quotes:

• Best way to look at a trend is not the device, but how we create value on these new platforms
• Manufacturers Credibility Syndrome “MCS” – consumers will always be skeptical about apps and tools created by manufacturers (that’s why things like Kelley Blue Book exist)
• We have to create something that meets an unmet need or does something better than everything else
• Within 6 months, 95% of apps are not used at all
• One underserved area is using apps to support the dialog between healthcare professional and patient
• Ask yourself: Is your app being used to meet the customers’ needs or to serve the company’s needs?
• Mobile puts a premium on location and service. Years ago, everything analog became digital. Now everything digital is becoming mobile. In 2013, we’re going to see mobile becoming increasingly analog – becoming part of our real world.  It’s the post-digital manifestation of online and offline really coming together
• That’s one of the areas to be really excited about – devices (like Fitbit or Fuel) that integrate seamlessly between offline products and on-phone apps
• Apps have to be so easy that they’re almost mindless to use
• Don’t make a new work flow, have it be part of their current work flow
• A pill is one way to change an outcome. A pill connected to a system designed to promote adherence can do so much more. It’s industry redefining.
• Most controversial question from the moderator: Most of our industry’s customers are 50+. Do older people really use apps? YES.
• One of the biggest things we’re watching is WellDoc’s work around getting a CPT code whereby a physician actually gets paid to use, or have a patient use, an App as part of the care process. That could be game changing!
• Just yesterday, the FCC officially allocated a portion of the wireless spectrum to MBAN and wearable sensors, powering the growth of the quantified self
• If you want to see where it’s going, look at kids games. Physical cards that interact with games. Motion response. Really innovative interfaces.
• A simple win: Start thinking and sharing more digitally
• Another simple win is optimization. Brands that optimize their sites see a 15 – 20% jump in traffic
• Best approach for most brands is responsive web design –  building one site that flexes to whatever device your customer is using
• To support MLR, think prototyping, not wireframing. Let people get their hands on it.

People are not using mobile health care apps

• There are more than 40,000 healthcare apps available
• But only 10% of smartphone users have actually downloaded health-related apps
  (Pew Internet and American Life project, 2011).
• That number has remained pretty consistent since 2010.

So, why not?

• Health apps force people to take notice of their health and to accept and take notice of their own behavior (their own failures). It’s documented, right there in your face and you can’t get away from it.
• People are leery of their legitimacy and purpose – who created it and what should it really do?
• The apps don’t move and adapt with patients.

That doesn’t mean mobile can’t have an impact on patient adherence. We just need to go about it another way.

One example Michelle shared was developed by Janssen Pharma for Psoriasis suffers – people who say their painful itchy skin is embarrassing (65%), frustrating (73%), and a very big problem in their everyday lives (76%). It’s a chronic condition that patients feel controls and defines them.

Stelara is a Jannssen biologic indicated for adults with moderate to severe plaque psoriasis. Its given four times a year. That’s important because sufferers want three things: efficacy (that’s tablestakes - get rid of the red, the itch, the flaking), relief from treatment burdens, and emotional relief. They want to feel in control.

Those needs help Stelara ladder up their core messages from attributes and features to functional benefits to the ultimate emotional benefit: FREEDOM.

At that moment of relief, they feel motivation. They’ve gone from “I’m suffering” to “I found something that’s working and I want to keep it working.” DraftFCB created content to support that patient transformation. They aggregated healthy content focused on keeping that great healthy skin >> not just with medication, but diet exercise and stress reduction.

So, how to deliver that great content?

We know people can’t live without their mobile technology–22% said they’d go without a toothbrush for a week before going without their cellphone (55% said they’d go without caffeine; 33%, sex; 21% SHOES).  New content delivery systems – like iPads and other tablets – created even more game-changing content delivery possibilities.

Stelara and DraftFCB decided to leverage the Adobe Digital Publishing Suite to create, distribute, and optimize engaging content for tablet devices. The final product was an eBook with an incredibly interactive interface. Patients can pinch, zoom, and slide all the way to feeling in control. The eBook / app is used as an incentive to enroll people in the CRM program. Its supported by a content calendar that ensures frequent updates and a live metrics dashboard that helps the teams deliver ever-more relevant content.

Look for it in two weeks in the iTunes store soon: titled the Journey For Healthier Living app.

This team works in metastatic breast cancer. It’s stage 4 of breast cancer – when the breast cancer cells spread into the body. It effects 170,000 people. And, it’s a terminal disease. One that can be held at bay, but cannot be cured. The average survivorship is three years.

It’s an incredibly hard diagnosis to know how to cope with. Most of these people have had a primary cancer. Something they were inspired to find and beat. That’s very different than knowing how to accept and deal with a terminal disease.

There is deep, vocal, support for people fighting breast cancer – advocacy, fundraising, community support. But a lot of that drops off when you reach stage 4. In the breast cancer community, the focus is really on survivors.

So Celgene asked people dealing with metastatic breast cancer what they needed and wanted for help and support. Practical daily support, definitely. But also empathy – an understanding that it’s no longer about the pink ribbon, it’s about extending life.

Celgene’s relavant product is Abraxane. It competes against generic options. Of course, patients and physicians ask,  ”Is this treatment worth the cost?” The opportunity for Celegene was to deliver those services and support that help deliver optimal patient care (and can’t be matched by generics).

In the Pledge to Fight Forward, Celgene invested in igniting a sense of hope and optimism, educating patients and their caregiver partners, and joining them in a shared mission during Breast Cancer Awareness Month.

The critical part (that tested well) was the The Pledge – finding something to fight for again. Keeping an optimistic spirit for making progress without looking back. Being able to do something.

Creating a site like this required a strong partnership with the regulatory team. It was Celgene’s first DTC campaign; so, they had to fully illustrate relevant experience to help regulatory understand the issues and create a review plan. That included creating the brand’s first social media policy.

Look for The Pledge to expand its reach in the years to come – through new indications, advocacy partnerships and PR initiatives.

The Pledge is the cornerstone of Celgene’s commitment to these communities and how their internal teams stay close to the patients and families they ultimately serve.

Buddy Scalera, SVP Interactive Content and Market Research, at Ogilvy CommonHealth, is a passionate advocate for better content strategy. As an industry, we say “content is king.” But we treat it like a pauper. Content is something that’s shunted off after we do the big digital strategy. It’s left to a junoir editorial team, wearing Birkenstocks and horn-rimmed glasses (<< at least at Ogilvy ;)

Content planing is something we’ve been doing forever, but the texts we all refer to were written in the last few years. Buddy took us back – in his PowerPoint time machine – to meet Grok, your average Cro-Magnon and the first health educator. He had critical information to share: Which berries were safe to eat and which were not. He took that information to the common cave wall and inscribed it to share the valuable information. It was used, shared, and the tribe grew as the education helped them eat and live more safely. Eventually he became a subject matter expert and his seal of approval (“Grok berries”) became valued. He created new ways – leaves, rocks, WOM – to make it easier to share person to person.

Advertising evolved much the same way. We’d create a valuable message and plaster it in key places. Then realized that place wasn’t enough. The message had to spread to multiple destinations and media.

That’s where content strategy comes in. Content strategy is a driver to create channel agnostic content. It’s what makes our ideas and information portable across new mediums.

Content is how consumers make decisions.  It’s where we find the opportunity to build valued connections:

That’s hard. People take between .5 and 1 second to decide if a website is for them. If it’s not, they click off.  It’s like a first date. We make an instant judgment.

Marketers make the same mistake that a lot of people make on those first dates. We demand too much too soon (asking for tons of personal information). Or we overshare (telling them everything all at once).

There is a better way.  There are more considered principles of good content marketing:

• Content is more than text. It’s the non-verbal cues, the pictures, the artifacts, the tools, the interactions.
• Content is not always consumed the way you think. People don’t read it like a book and follow neatly along the narrative. It’s much messier than that. Content is often gulped on the fly or read in a sound bite.
• Starting with the right infrastructure is critical – the content strategy is that blueprint.

We all have content. Some of it’s in details, some in pamphlets, some on the web. But it’s not all fully aligned or used to its greatest potential. To make the most of that content, start with an asset audit. Find what content speaks to the right audience at the right time, when they’re ready to take an action.

Most brands will be surprised by how much content they already have.

The next step is a content matrix – how we’ll use that content, modify it, and make it work aross channels. To do it right, Ogilvy starts with the end in mind – aligning the content against the goals and metrics for each tactic (without aligning those metrics, we won’t know whether it’s “time to open a bottle of champagne or put our resumes on Monster”).

That ultimately creates a brand footprint. One that shows a complete, complementary ecosystem: What people will learn in social and search, what they’ll find on an unbranded site, what they’ll learn in branded.

This is the point where we start the site map. Surprised? That’s where teams often start, but without this content planning, site maps are full of missed opportunity. The content and content strategy help copywriters:

• Write toward user needs
• Understand and help deliver on KPIs
• Know how to personalize or cross market
• See how content will evolve over time

Content strategy is like business planning for your content. It’s putting business rigor to the content you’re investing in. Your content strategist is the key person who understands how all that content interplays and how people can find it, use it and share it. That strategist unifies measurement and optimization across all those channels. She owns the goals and identifies micro conversions. She knows what people will share. And, how it should be delivered differently on the big screen, the middle-sized screen, the small screen – all the screens.

In short the strategist owns the content strategy: the plan for the creation, publication and governance of useful, usable content.

Five principles for how marketers can be good managers and advocates of content strategy:

1. Ask a lot of questions
2. Figure out what the customer wants
3. See what you already have
4. Think like a publisher
5. Make it part of your process

• Dave Nussbaum, SVP, ImpactRx
• Haren Ghosh, Chief Analytics Officer, Symphony Advanced Media
• Dan Stein, VP, Analytics Services & Product Strategy, Crossix

Some of our favorite insights from the panel:

• We’ve been good at developing proxy metrics to try to infer value – like surveys of intent. The challenge has been showing real impact and optimizing in real time. We’ve wanted to connect Awareness, Engagement, and Sales data… now we can.
• This is in an environment where literally 99% of your exposed audience is not clicking on ads. What value is that 99% still getting from the exposure? Crossix is creating ways to track that exposure (not a click) to sales. They integrate Acxiom consumer data with Rx data to track sales from exposure.
• There’s a big difference between ROI in a single channel and overall effectiveness. Overall effectiveness requires comparative campaigns and integrated impact.
• Most of us have our personal information collected at every interaction with the health care system. That information can be rolled up to the doctor – showing the impact of each prescriber on population behavior.
• The audience challenge: If we have all this cross-industry data, why don’t we know the benchmarks by channel? Can we publish that data? The panel says the variables – from audience to message to disease state – are too great to allow easy comparison.
• The new standard in defining reach will be data tracked across screens. Haren says we’ll see real innovation around that within the year.
• As we’re able to better integrate data, we’ll be able to see real patient pathing, too. Actionable research that will show where the real barriers are in the patient journey.

At Pfizer, patient engagement has always been a priority. More patient engagement creates more patient benefit:

• More knowledge (replacing confusion)
• Better decisions (dispersing denial)
• More action (fighting inertia)
• Real long-term behavior (winning over competing priorities)

Those engagements require both education and motivation – in an environment of rapid change:

• Constant real-time access
• Collaboration, triangulation, consultation with a myriad of others on each decision
• Comparison and competition – no need to default to the standard option

All that information creates confusion and questions. To replace that with clarity, experts – like Pfizer – need to establish and maintain a strong voice in new channels and communities. The goal is clarity and trust through dialogue, customization and valued tools.

To break through the clutter and create that clarity, Pfizer is focused on three strategies:

1. 2-way dialog with consumers and patients
2. Increased personalization and custom content
3. Higher levels of engagement beyond the product experience

Tawana pointed to four OTC examples that show best practices:

Centrum: A multivitamin

This a category that’s really confusing – there’s new news and new products every week. Worse, it’s a faith-based category. People take vitamins because they think they should, not because they can see it work.

For this 55+ crowd, Pfizer developed Nutrition Possible with WebMD. It includes personal assessments, content from other experts (like WebMD and Mayo Clinic), and complete nutrition solutions (product plus).

Since the launch in January, 2 million people have taken the assessment.

Robitussin: Cough & cold

This is another really confusing shelf – even if you’ve figured out whether you’re dealing with a cold, flu or allergies, you’re confronted with a sea of possible options to treat it.

To help that confusion and help consumers at their point of need, Pfizer developed an app.  Robitussin Relief Finder helps people find the right product, delivers flu-fan data and creates moments of personalization.

The reviews have been outstanding and people are holding the app up in the aisle to match the product packaging.

Children’s Advil: Fever relief

Today, people – mom’s especially – are putting their questions out to the crowd and looking for information back from people who have similar experiences.

Pfizer wanted to support the conversation between new moms and experienced moms. They used an influencer program to connect with those moms by providing free samples and information at a time when it was really needed (when Children’s Tylenol was taking off the market).

54% of the reviews during that time contained the message Pfizer wanted: 8-hours of relief, top-selling brand.

Thermacare: Heat wraps

Pfizer wanted to build year-round engagement in social channels. The right place to start was a small, passionate community that uses a product year-round, like the Thermacare fans.

The Thermacare Rally for Life brings together a community of like sufferers in a light way – rallying around getting back to what you love to do. Using a Facebook app, 10,000 users built avatars to celebrate what they wanted to get back to – running, biking, hiking.

In the period the app was promoted, total sales increased and coupon redemption was up 50%.