Archive for 2008

Today we tune out until January 5. It’s been a fantastic and productive year, thanks to friendships old and new. We really appreciate the support.

May your Christmas bring happiness, festive cheer and plenty of time with family and friends.

Have a great break, and we hope to see you all in the New Year.

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If you’re anything like me, you always read the Sunday magazine before the rest of the paper. Not that I don’t want to read about what’s going on the world, but most often, I only have 10 minutes to actually look at the Sunday papers!

A couple of Sundays ago, my eye was caught by the picture of Angelina Jolie on the front cover of the magazine. She’s beautiful – but more than that I thought there might be a picture of Brad Pitt inside. I was to be disappointed, but what I did find was an interesting – and disturbing – article on the “postcode lottery” pertaining to cancer treatments. I couldn’t believe this was still going on in that Primary Care Trusts (PCTs) have the authority to decide which drugs it will fund for patients in its area.

PCTs hold 80% of the total NHS budget. It is possible to challenge a PCT decision on drug funding – the patient has to demonstrate that he/she is an exceptional case, but this varies from PCT to PCT. I agree with Penny Wilson-Webb CE of the Rarer Cancers Forum that this is a “bizarre and demeaning process”. Imagine being forced to plead for your life by having to demonstrate that you are an exceptional case… what does an exceptional case look like? Is one life more valuable than another? Who decides?

It is astonishing that policies differ so much between parts of the country, and indeed, between neighbouring PCTs. But it’s not just postcodes that make this a lottery. The women featured in this article were middle class, educated; they had a voice. Who speaks for unempowered patients – those who don’t understand their choices, who have little support? A policy of one voice, one rule would solve this.

In April 2008, there was a “dramatic expansion of the patient choice initiative” in the NHS.  Patients referred to see a specialist can now choose their hospital (any that meets NHS standards). However, this doesn’t seem to cover cancer treatments. Why the lottery still?

I felt immensely for the individuals that have been affected by the decisions made by their PCTs. I also felt that doctors had in some way let down patients by not standing up to their PCTs, by not asking the difficult questions. I guess that no-one wants to put their head above the parapet and be seen to be causing a problem… or dare I say it, actually do what they believe to be right in the treatment of patients.

Recently, I had the privilege of attending a conference where William Burns, CEO of Roche was speaking.

The thing I found most fascinating was his future view: “the patient of tomorrow will be in the driving seat”.

As he says, today’s patients research via the net to talk to other patients about which trials, medicines, doctors and hospitals might be best for them. They then make informed decisions and requests based on this and will argue with multiple gatekeepers to get there.

I’m interested to know other doctors views on this….Should an informed patient be feared or encouraged?

Although many people on this side of the Atlantic feel that the US Direct to Consumer advertising has taken things too far (and I would definitely agree) I do think there is more that should be done with Direct to Patient communication.

The internet is a great leveller given that everyone can put content on it, and increasingly acts as a first stop for many patients. But it does seem bizarre that in the UK, the pharma industry, who have access to the most information on products, are prevented from joining that discussion.

A couple of stats Mr Burns gave us made me think….

• 33% of the public use the internet prior to a doctor’s appointment
• 40% of the public will do so after a doctor’s appointment

Hopefully, the current EMEA debate on DTP communication will mean industry is more able to contribute in future.

Last Friday saw me showing my mum and girlfriend around my nearly completed extension. Excitement and stupidity led me to fall (off what will be the retaining wall,) landing and cracking my ankle. Result – me, prostrate on the concrete floor and what has become a huge blue foot/ankle/leg, a pimp style limp and walking stick that has cheered my colleagues up no end.

Having left it a number of days, I finally hobbled down to St Charles Hospital’s Minor Injuries Unit for a check up and X-ray expecting the usual secondary care inner London cliché. What greeted me was an organisation that sang with efficiency and care. Each person I hobbled passed asked, ‘did I need a hand?’, and ‘whether I knew where I was going?’ Furthermore, each initiated interaction contributed hugely to my view of the NHS as a service. I couldn’t help but ask the source of this feeling. The receptionist, porter, doctor, and nurse all were consistent in their answers. They put the amazing vibe of the hospital down to it feeling autonomous, working within a clear process whilst having the freedom to use their initiative,  team and individual visibility,  defined roles, and putting the patient right at the centre. I raised this last night at a meeting with a strategy head of a large PCT, and he aired the view that Polyclinics are aiming for exactly this – smaller, autonomous, organisations, staffed with empowered carers all driving towards a better patient experience. I only hope this can be realised.

As part of my development plan I recently attended an event celebrating Women’s Enterprise Day. ‘Rising to the challenge’ hosted a panel of award-winning women inventor-innovators sharing first hand experiences of overcoming the many challenges of getting a new product idea to market and establishing a young business.

Notebook in hand I was aiming to learn what it means to be innovative – what are the secrets behind it and indeed is there a set formula that can help us to ensure that our work is always as relevant and insightful as possible.

Speaking at the event were 4 successful inventors all well in the swing of marketing and production and on their way to what seemed to be a fairly common goal of making money! What interested me the most was the similarities in the principles and attitudes of these inventors to our industry. So what did I learn…?

The need to have an idea but to accept that it will evolve was potentially the rule that most resonated for me. Ideas – no matter how inspirational they may be, need to adapt and change and most importantly they need to be relevant to the end user. Without knowing your customer, what makes them tick and why they would be interested, your idea is likely to sink. Whilst these 4 inventors were unique in the way they described their experiences, they all had this understanding in common. They demonstrated a vast understanding of the market within which their product/idea sat and talked passionately about who their customer was and how they interacted with their product. Finally the importance of having a brand that wraps the idea and being a true advocate for the brand (with a small air of arrogance and belief) was something that I’m sure has guided their success.

Whilst I am still not convinced that I have a set formula in my armoury to help me to learn the art of innovation, I was certainly reassured that we too are doing something right…

More than 50,000 people gathered outside Hive yesterday to watch the Regent Street Christmas lights being turned on. Colleagues, friends, sisters and WAGs gathered in the office to drink us dry and eat 200 of my sister’s cheese straws.

This year the theme is stars and with this in mind the organisers dug deep in their credit crunched pockets and hired McFly. (I thought a McFly was a happy meal). This bunch of plucky funsters took time away from their busy schedules to throw the switch. Next year we are pretty sure they will available to check the bulbs.

Want to experience it for yourself? Click the video to see what the Nokia N95, a window ledge and Verve Clicquot can achieve when combined to capture the magic of an event.

 So Obama has won, history made. But what a legacy Bush has left him with. Economic chaos and 2 wars to name just the obvious challenges he faces. Traditionally the healthcare industry is highly sceptical of Democratic nominees, but this election has been a little different. Donations to the Democrats are up 15%  and the industry seems more relaxed about Obama’s intentions than one would expect. Quite how things pan out is still anyone’s guess. How much focus can health get when there are such monumental issues facing the US economic and foreign policy programmes?

What is clear though is that drug prices will get severe scrutiny, generic drugs will feature heavily in both his and medicare’s planning and he wants an expansion in healthcare benefits to the uninsured. What he is also wedded to is investment in STEM (science, technology, engineering and mathematics). Over the last few years the US as a centre of innovation has been on the wane. Less graduates in science, less investment, less of everything. He has been clear that he wants greater investment in healthcare research, he is a firm believer in biological knowledge and stem and genetic research. These areas will be reinvigorated by his election and with his support the palate for cutting edge research may just be on the turn.

 What the real impact of all of this means is anyone’s guess, but if his mantra is true and “change is coming” I sincerely hope it reignites the exploration of life changing research.

I recently attended a webinar on the barriers faced by organisations and communications teams to internal engagement and was really interested in the differences and similarities between internal communications and marketing.  

In the internal comms world there exists a common frustration with the disciplines lack of ability to get serious attention and ongoing commitment, especially when compared with its revenue generating cousin. A situation that was not expected to improve with the impending financial crisis, and its subsequent pressure to decrease ‘non-essential’ spending.

What also struck me as interesting was that when we discussed communications some of what we take for granted in the marketing world is not adopted within internal comms. Marketing tend to build a foundation for any activities on understanding our audience, their perspective, what they believe. All of which can be much easier when we are removed by the mere fact that we are ‘not one of them’. It seemed to me that viewing the internal audience as ‘one of us’ can tend to skew the approach one takes when communicating with them. This was discussed in depth by the attendees, with the majority considering this to be a challenge that the discipline needs to grapple with.

Despite this, so much is shared between the disciplines. The idea that communication professionals are integral to achieving the organisations goals is certainly common, as is the constant efforts to convert too-often tactical activities into strategic activities and is the need to get the balance right between leadership expectations and communicators’ ability to deliver.

It was a fascinating webinar, and really good to spend some time interacting with a brilliant, diverse group of internal comms bods, I for one was delighted to see audiences/beliefs being pushed to the forefront.

This week we welcome Helen Scott into the Hive. We have worked with Helen previously and have a deep respect for her account management skills.

With a degree in Pharmacology and Medical Neuroscience (she’s a geek), Helen has long been attracted to healthcare work – blood and needles excluded. She has substantial agency experience with Rx and Pharmacy brands.

Having been here all of two and a half days, Helen is full of enthusiasm for the challenges of working in a start up (evil laugh goes here). She looks forward to working on a variety of projects and accounts and getting stuck in on the new business front.

Helen’s worst job was standing in Sainsbury’s for five days, promoting Nectar Card in a very bad purple outfit. We hope to offer her a bit more stimulation. Also, we’d like to see the outfit if it’s still around?

Her first impressions of Hive are pleasing.  ”Everyone admits when they’re winging it, but seem to have an enthusiasm and experience that means they must be getting it right! ”

Thanks for joining, Helen – undoubtedly you will be a real asset in helping us grow into great shapes.

Today is National Poetry Day, which aims to explore the relevance of verse in modern-day life. We love this poem by Elspeth Murray, which echoes our frustration at the complexity, jargon, irrelevance and clutter that litters much of communication today. Elspeth wrote the poem for the launch of the cancer information reference group SCAN (South East Scotland Cancer Network) in January 2006, which has been trying to improve the quality and speed of services for people with cancer. © Elspeth Murray.

Baffled by Wikis?  I really liked this crystal clear explanation from the guys at Seattle based Commoncraft – a great video production company specialising in educational content.

All work is driven by ideas. For us, ideas drive numerous rounds of amends, spreadsheets, all-agency meetings and the odd product launch on a spinning boat in The Thames.

However, the value of these ideas is massively underestimated – it’s rare that agencies are paid on an idea basis. The reason? Ideas are an intangible asset. As vital as they are to business relationships, ideas can’t be easily measured. This is a pity, because great ideas take time to perfect. That lightbulb moment that tells us when an idea is worth shaping, is only the beginning.

I often realise the irony of the best ideas – stunning, clear thoughts received with surprise and delight – being the ones that take hours and amendments galore. But shaping ideas is surely more of a craft than generating them – so why don’t we like to admit that we spend time on the process?

I recently presented an prescription campaign which has taken us a few weeks to get to the standard we wanted, and mentioning this effort felt like an embarrassment. It was really difficult to admit to the challenge of delivering huge – not ad-big, but big idea-big – ideas. OK, it wasn’t a straightforward brief. But more than that, I suppose we fear that “the process” makes our ideas less pure, less special.

The truth is, marketing doesn’t often deconstruct stuff into a single grain of truth. We more often assemble and dissemble things into a desirable outcome. We often collaborate with each other in doing so.

Let’s not be ashamed of that. Let’s admit to the hard work of it, and be especially proud when it has taken several minds to get it right. Without wanting to hang on like a dog with a de Bono, I must add that ideas are never owned by one department. As a great art director once said to me: “Everyone should have an idea, or be able to make mine much better”.

It turns out that it’s a lot easier to peel a banana if you start from the ‘wrong’ end.

You don’t even have to use your teeth.

Here’s the thing: I know this. I’ve tried it. It’s true.

I still peel a banana the hard way. It feels like the right thing to do.

Convincing my friends of this change has been much harder than I thought.

Because it doesn’t feel like the right thing to do, it’ll be a tough thing to teach.

In the healthcare comms business, there are LOTS of bananas … things that people do because of convention, tradition, or simply “that’s just the way things are done.” For example, why is it that we have spent most of our time in Rx focusing on understanding the prescriber and not the uncompliant patient?  Why do ideas always have to be based on an a4 ad format.

The lesson for me is to consider everything we do. Are we making decisions because that’s just the way you’ve always done it? Or that’s the way all of our competitors are doing it? If so, you’re peeling the banana from the “right” end. Pick one of these things and, turn it around to see what happens.

We’re still a young outfit, and our first premises are unlikely to be our last. Thus we have furnished the place simply. One of the larger walls seems to cry out for dressing, however, and we often muse together about the artistic possibilities – something 3D, healthcare-inspired of course. Tim fancies a PVC nurse’s outfit encased in glass like a museum piece. Debbie would like to have installed a human skeleton with a single pink capsule suspended on fine wire inside the abdomen. Ian rebutted this idea because he said it would scare his kids (and anyway he wants a huge plasma screen and a wii).

But I’m the one who made the obvious connection with Damien Hirst. Don’t think diamond encrusted skulls – think Pharmacy restaurant, medicine cabinets, syringes and paracetamol tablets on canvas. Problem: Medicine Cabinet sold for £190,000….back in 1998.

I have no problem asking for things. So I got in touch with his agent suggesting a loan of a piece…

Dear Jas

Thank you for your e-mail but I am afraid that Damien doesn’t loan works for this sort of request.

However, best of luck with your business

Andry

It was worth a shot. Nice to receive a blessing from the art world anyway.
Now then, any artists out there who want a wall to play with?

This week saw us pushing the boundaries on training (reps, pharmacists, other HCPs etc). When dealing with a new client, we grappled once again with the limitations of paper-based training or the ‘usual’ ShockWave Flash. Both are fun and interactive, we explained, but struggle when you have anything that requires more than a simple question and check box answer.

With this client, it’s not an option financially to bring everyone in for a conference or a regional meeting series. So we brought in some of our technology friends and got thinking. What emerged, and what we are proposing, builds upon what geeks know as gaming and us marketeers know as just plain cool.

While our version is still in development, I discovered that Virtual Worst Case Scenarios are being used to great success already. They are gameware-like programmes increasingly used to train emergency medical staff in the US. In one worst case, a freight train derails near a heavily populated train station and releases cyanide into the air. Victims pour from the station and the player – as medical commander – must set up a triage area and sort through the patients as quickly as possible, making sure proper treatment is administered. It’s been very successful at making participants develop real time decision-making skills, under realistic and pressured conditions. It forces the participant to act on their feet, make snappy value judgements and succeed in the chaos that ensues.

Can you imagine how far this kind of thing could go in our industry? And all without ketchup and actors…

Kieran wrote a post a couple of months ago called “If you always do what you’ve always done, you’ll always get what you’ve always got”. This phrase keeps coming back to me. I have just read another post by Bill Taylor at Harvard Business review which expresses very eloquently the thing that was hounding me.

Bill refers to the concept of “Vuja De”. Credited by Bill to George Carlin, it seeks to explain the need for a different approach. Déjà vu is something we all encounter and are fascinated by; even in film The Matrix attempted to explain it. But in a business context, déjà vu is the dragging sense that we’ve been here before. How often do briefs ask the same thing over and over again? How often do we look to point out small differences that for prescribers, or more importantly patients, make little or no difference.

The art of competing in this increasingly complex, increasingly pressured healthcare environment requires us to be braver about how and what we are asking. More importantly, we need to refresh the ways in which we answer key questions. To stand apart we must be brave enough to be apart. We must approach the same problems with completely different ideas, taking inspiration not from what has gone before, but from what has not. As Proust says “the real act of discovery consists not in finding new lands, but in seeing with new eyes”. Looking at the same thing from a completely different point of view – hence “vuja de”.

We need to look outside our restrictions and ask what we should do, rather than what we can do. To our minds this means it’s about “who should we talk to?” rather than “who are we allowed to talk to?” As Kieran says, this sort of thing brings risk, but aren’t the risks higher if you keep running with the pack?

From the excellent holiday read Wikinomics comes a great case study for field personnel living the brand. Geek Squad is the answer to the layperson’s techno-phobic prayers, devoted to keeping technology running smoothly in the home and office. It is also among the best branded services out there.

What I read, gave rise to many questions about our as role as marketeers in enabling our most important resource to thrive.

Geek Squad is a rich source of learning for those of us who consider the healthcare field force an underused tool. The geeks on patrol are not only unified by the company’s branding theme – they are the brand. Each is dubbed with a title like “Special Agent”/”Covert Operator” (depending on duties) and is dressed to fit the part. Q: How successful are we in healthcare at engendering unity amongst our field-based colleagues?

Geek Squad’s mission is to “alleviate the world’s computer problems, educate people to fearlessly embrace technology and practice the art of human interaction.” And although their core business is PC troubleshooting, a little over 10% of their calls involve helping those who are having problems with other technicalities – such as setting up an iPod or putting the clock on your DVD recorder right. Q: What additional services could our reps perform that would contribute directly or indirectly to our bottom line?

Team members are encouraged to share their day’s tribulations with anyone, air issues and ask for help from peers, quickly and efficiently. Have a problem with a reboot or difficult customer? Up to 10,000 other agents are available to review your issue, comment and offer support, advice and fixes. Q: What do we have in place to facilitate best practice – or even best communication – between team members? How successfully do we facilitate dialogue across all corporate levels?

Answers on an e-postcard to the usual address…

It had been a few months since we worked with a client running a competitor Wargaming session. Finishing one this week reminded us of a great way to get a team of multidisciplined experts aligned and agreed for a common purpose.

Wargaming can achieve a number of different outcomes. There is a conversion of data and information (e.g. on market or competitors) into actionable intelligence that adds real quality to the strategic planning process. It also delivers a result that could not be arrived at by any individual present alone. It demands collaboration and a fresh perspective. Role playing brings colleagues closer together, juggling insights and skills. It’s a productive day’s work for the whole team.

You can achieve a lot in a planned and well-paced day. Spending the morning getting under the skin of your foe, planning their launch, and agreeing the likely story to the market can not only be fun, but really sharpens the mind in preparation for the afternoon. That’s when you plan your defence and the activities you can do to protect your equity.

And another thing: wargaming provides your agency with an opportunity to show you creativity that’s not restricted to an A4 page.

Something seems to come over us when we write an ad brief, my planner friend reminded me this morning. It’s the way we do our best to cram everything about the product/condition/patient into one ad. We forget completely how we as consumers interact with ads; forget that below-the-line materials are on this earth only to communicate the underlying support for the product story.

I had a quick browse of OK! yesterday afternoon (dermatology research). The ads in there are graphic and simple. Their feel and message happened to me automatically, without conscious decision. Clarins just stepped right on in there. Bang, I was Gucci’d. But that’s a good thing. I didn’t have to waste time and delve into reams of body copy to know what it is these brands were trying to say to me. The same thing they were saying in their first, second, 500^th print ad. One-dimensional, loud and clear. Intent – a quick reminder of high-end status. (Plus a little eye candy for the logo lover.)

We’d hardly dream of addressing healthcare professionals this way, because we seem to feel we need a myriad of reasons to excuse ourselves. The disease area needs innovating, here’s why, here’s how we help, here’s the whole deal in microscopic detail. Certainly, HCPs need this information – but a brand ad just can’t and shouldn’t carry all of it. Instead, we must communicate quickly the offer/ position in the one elegant wrapper of a creative idea or perhaps like Gucci, a proud identity. To keep our messages simple we can use a separate, successive approach – that’s why we often roll things out in campaigns.

However, healthcare is a major area of research and advancement and that’s why drugs and services are constantly turning over. Research shows that a small amount of inner detail is appreciated by HCPs, so we have room for a couple of clear sentences in our work. OK, our clients are not Gucci, but we can still learn from such brands. Manufacturing processes kept to the label, leather ageing techniques communicated in store, deals kept to a business-to-business environment, and endorsement happens via PR. The ad is left to communicate the feel of the brand as simply and elegantly as possible. Isn’t what really sticks in our heads the stuff we don’t have to think about too much?

To build upon this and make it relevant to our proposition here at Hive. Using the ad to communicate an element of the story, and the whole mix to contribute to a bigger idea which exists outside and above that of the ad concept seems to us to be a better way, and should provide not just a brand feel but a story and richness that contributes to a truer more in depth relationship.

I was once told across a crowded meeting room that maintaining the divide between business and personal life is important. “It’s business, not personal” still rings in my ears today.

Now I am part of our own agency, I feel I can stand back with a little more authority and give thought to this mantra.

The idea that what I do during the ‘day job’ is very different to who I am on the weekend, is one I have at times aspired to but never really succeeded at. I find it impossible not to be worried at home by worrying office stuff, or for a successful workday not to give me the foundation for a great evening out with my mates. Thus far the flick of the switch on the No. 38 to Angel has eluded me.

The strongest and best relationships we have are ones where we allow ourselves to be human, working alongside other humans, who worry, laugh, err and create… whether that’s at home discussing broad beans or striving for patient-integrated Rx strategy.

Being ourselves and keeping it personal was built into the agency culture from our earliest plans. The business side made Barclays happy and ensured we had rigour and efficiency. But by valuing personality we don’t break people down and rebuild them the ‘hive’ way, or force a process on a relationship. All actors are free to contribute ‘their’ way adding to what we are as an organisation.

What we want most is for people to say that we understand them at a personal level: what they want, where they plan to be, what they love, what they don’t – not just the business of the brand, political situation and process.

Because of this our business could never be anything other than personal.

It was invented by the Egyptians as flat, round, sweetened bread. Its name in Britain derives charmingly from the Norse “kaka”. Today, it’s the soft, melting centre of a swaggering power struggle on Regent Street.

We’re having a cake-off at Hive to celebrate six months since our inception; our demi-birthday if you like. This competition was conceived in an entirely non-calculating move by Timothy D Scorer. We hope you all agree that Tim’s cake (looks like a snowman) isn’t all that much to write home about, seeing as he has actually earned money as a professional chef.

Please vote for the cake you most admire in terms of concept and appearance. The rules are simple: cakes have to have something to do with us – our humble beginnings like the proto-cake of the pharaohs’ intrepid bakers…. our steady and determined rising from 3 to 8 staff despite working in essentially a moderate oven (we have a bit of an air conditioning problem some days)….our proud selection of clients as diverse as a handful of hundreds and thousands.

We have a panel of tasters judging taste, etc, but every rising talent knows it’s the public vote that counts, so click for your fave between now and Monday evening, when we’ll announce the winner. Who doesn’t actually win anything but gets to batter the rest of us with eternal smugness. Thanks!!

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When trading becomes challenging, businesses of all sizes generally have two choices. First, cut cost in line with reduced revenue and wait for better times to come (and hope they do before the money runs out). Second, invest to become more competitive and attractive under the new market conditions. Design provides limited advantage in the first scenario, but is essential to the second, as are foresight and bravery.

Change is a good thing! I can’t deny that I enjoy a certain comfort zone within my professional and non-professional lives. Doing something I know and the sense of familiarity I get from that gives me a security which I find both appealing and comforting. However the problem is that security and comfort generally become boring with a significant lack of enthusiasm.

I guess this is the reason that I chose to live and study out of London for 3 years and thereafter set off travelling for 15 months. Exciting these adventures certainly were but they brought challenges too. I learnt that being able to adapt and adjust to new environments/situations (broadening one’s horizons, etc) is one of the most important skills a person can posses. Big rewards often carry an element of risk – and let’s face it, risk is never boring!

Design can be risky when there is time and money at stake. But in today’s world, it is only through creativity and exploration that people can better themselves and their work. So don’t be afraid to bring brand new ideas to the table -if you want to get better than you’ve already got.

‘What we say matters little compared to how we say it, no matter what medium we use to convey the words. To communicate with influence it is important that we are able to use language that engages the hearts and minds of our listeners.’

Sue Knight (NLP at work, 2^nd Edition) here explains the importance of influence in any kind of communication. When it comes to advertising, I’d have to disagree that the subject matter is of little consequence – after all, the message is why we open our mouths in the first place, and deserves to be carefully strategised and crafted. It’s obvious though that talking in a truly engaging way is an art form. In everyday life, charisma comes more naturally to some than others; in business we strive for it.

How do we get people to listen? The simple answer is to use the right language – not just clear and concise language, but the same language as our audience. I don’t mean English, Spanish or Italian, but fact that we need to aim for immediate understanding.

We all know what it’s like to venture into the doctor’s, smell that overpowering medicinal aroma and sit in a sticky leather seat – and then divulge all your ‘private information’ to help the Doctor to find out what on earth is wrong. He or she listens; the medical mind takes over and envisages the physiological processes, what reactions are taking place and what pharmacotherapy could be used. He or she needs to translate this into a way that I, the patient, can understand, relating to my personal knowledge of the body.

Having a Pharmacology degree, it’s not too challenging to express myself in medical language, so that doctors can usually tell me quite quickly what is wrong and what could be done. But if I keep very silent – perhaps like many other patients – I see a difference in how I am spoken to and what is said.

My point is that communication is a tricky thing and that’s why we invest heavily in order to get it right. We need skills and experience to explain both technically and promotionally how things work and who could benefit. That is the only way the consumer- doctor, patient etc. – can retrieve enough information to drive their decision on whether to buy or not to buy, to use or not to use, the product.

The art director fairy breezed into Hive last week and deposited Kieran. He’s a tall, laid back bloke who is fond of cashew nuts and Corona and whose desk at this very minute is peppered with ideas and design of a vibrant calibre.

Kieran, where have you been all my life? Actually, it’s just a few months since we began feeling the need for another full-time workhorse. Since then, we’ve gathered even more exciting brands and are gearing up for some roaring creative.

Kieran and I are not a traditional creative partnership. Forgive me for finding the concept rather insular, somehow greedy – definitely 1980s-like. Maybe I’m just sulking because no-one has never wanted to be my creative partner.

There’s something special about two people on the same mission, hence marriage and comedy partnerships. This helps you raise children and write entertaining stuff, which must both be really hard. Also, we like to see people playing together. But when you’re at work surrounded by loads of different brains, why milk just the one?

Working with others helps people thrive intellectually and creatively, and for me, the more other people, the better. Everyone’s creative. The message is true to Hive’s goals – we all get stuck in. It’s nice.

It’s the way forward. The days of saying “creatives” and “suits” are surely slipping into extinction. It’s my prediction for the decade. (Note: only 2 years left, people!)

Anyway, I’ve completely drifted from the key message of this article which was to say….

Welcome to the buzz shop, Kieran.

The 6 months since we all we moved in have flown like mad. I look back at the days when we were not quite an office – days which we filled with countless calls ordering phones, desks, sofas, IT equipment and data cabling. They seem so far away. With this in mind, it’s time to take stock, pull up a few chairs and review how it’s all been.

We have grown at a massive rate, faster than we expected. Within 6 months we have delivered to a broad base of client companies and across a really diverse and exciting number of brands. Reviewing the business plan, written way back in Festival Hall (our surrogate early day offices) shows how we have exceeded all our expectations.

The biggest and best surprise is the approach of many of our clients. We are used to reading about the currently slower-than-expected adoption of innovation, so it was always a source of big discussion when we were forecasting. Will we have something that is wanted? Why change a method that is deeply established (even if it’s a little broken)? In hindsight our doubts were futile – an experience that has made us all exhilarated and proud as punch.

When we sat down and decided that a change was a good thing, that our brand of “different” could be better, I couldn’t help but feel deep down, late at night, whilst lying there in my heavily mortgaged flat, kicking our strategy around in my head, a fear that “different” might not be desired. Thankfully my pessimism has not been substantiated. We have an idea and approach that is really hitting home, really making sense, and moreover is really delivering results to our clients, in the here and now.

Time to put the chairs away and go do some more, I think.

So POM to P switches are 25 years old, but for me everything changed in 2002 with the publication of the list by a RPSGB led working group of potential candidates for reclassification from POM to P. At the time there was talk of an avalanche of switches coming through the system, the industry got itself all expectant, the pharmacy profession was nervously excited and everyone prepared themselves for the new era.

So what happened? Despite all the positive hype, it hasn’t quite worked out as hoped for, either for the industry or the profession. Certainly the avalanche never arrived, and I doubt now it ever will.

I think if you asked industry executives, hand on heart, has switching been commercially successful, so far most would admit it hasn’t. If we believe POM to P has a role to play in the future of treatment management, and that pharmacy has a key role to play in diagnosing and managing conditions – both of which I passionately believe in – we really need pharmacists to start proving that they believe it too.

I have no doubt that for a host of conditions and ailments, the best place to treat and manage (and even diagnose) is in the pharmacy. Some 30 per cent of GP consultations are for minor or self-limiting conditions, most of which are in areas that pharmacists are either well or sometimes better equipped to deal with.

Couple this with the fact that our healthcare system has disenfranchised so many people and that vast tracts of patients/consumers are increasingly looking to their high street clinician – the pharmacist. One begins to wonder how it could go wrong.

I run a communications agency and over the years I’ve worked on a host of switches. I’ve spent a great deal of time talking to pharmacists about their role, their attitudes to conditions and treatments, and most importantly how they interact with their customers.

We develop training and tools to support pharmacy knowledge, and to help create a positive dialogue with customers around a condition or treatment. We also spend a great deal of time talking to the pharmaceutical industry about how to support pharmacy – so I do see things from both the industry’s as well as the profession’s side.

As far as the industry is concerned, innovation drives growth. Generic proliferation and own-brand competition mean that you can’t sit still. POM to P switching provides a huge area for innovation. It’s a ready-made pipeline of proven products for key conditions and it can breathe extended life into brands coming off patent.

With the new community pharmacy contracts and the evolution of pharmacists into service providers, the case to move more chronic care into pharmacy is compelling. Diagnose simple and even not-so-simple conditions, and the management of complex conditions follows closely behind. Whether pharmacists acknowledges it or not, the industry believes that the high street has a vital role to play in the future health management of the nation.

There is no doubt that the pharmaceutical industry produces fantastic support for pharmacy. The quality of support that exists for POM to P switches keeps getting better and better. The extent of investment in pharmacy for launches is now greater than I’ve ever seen. And it’s not unrecognised. Pharmacists acknowledge it openly. So why is it so difficult to get lift-off with a new POM-P medicine?

We acknowledge that the industry believes in pharmacy, but I believe, more importantly, that consumers believe in pharmacy too. So who is missing from this picture?

In truth, no one. Industry, consumers and the profession are passionately committed to an extended role for pharmacists. So it’s a perfect storm then? Sadly not. Because whilst the profession is supportive, there is a latent caution that affects launches so overtly that it brings to question whether switching is a viable long-term option.

From conversations with pharmacists this new world seems exciting, but quite daunting too. Diagnosis, long-term management, counselling, guidance, advice… all words that to a greater or lesser degree create nervousness. This new way has an impact on the way pharmacists operate – much more front of counter, the visible face in the store, more time intensive. So who sorts out the prescriptions? Who does the things that keep pharmacists so busy normally? Are they really able to diagnose? It’s a brand new world, and for many a scary one.

In reality switches should be the ideal conduit for this transition. The regulatory framework around switching is rigorous, designed to protect all, often to the detriment of efficacy. The products switched invariably fulfil a clear consumer need, and driving new people into pharmacy for new solutions should be good for all.

Consumers are open. They too like innovation, they want better treatments, to be able to quickly fix problems, get an appointment on their terms.

Sure it’s true that they are not yet used to more complex discussions with pharmacists. They feel a bit uncomfortable, unsure – but that’s easy enough to fix, isn’t it? Professionals, on the high street, ready to put people at ease? Perhaps the truth is that pharmacists aren’t used to these sorts of discussions either or just scared to have them.

The traditional role of symptom management will never disappear, but with the competitive environment the industry operates in being unsustainable without innovation, the truth is that without pharmacy engaging with POM to P switching and supporting it as a category, the industry will have to change tack. It cannot afford for innovation to go unrewarded in terms of sales.

This brings me to a final conundrum. I regularly hear cynicism from the profession that POM to P switches are just a route to GSL, and that pharmacists are being ‘used’. There is a truth that brands switched from P to GSL see improved sales performance, but for me it’s just a natural extension of life cycle.

An established brand with a profile for broader access, one that doesn’t need the time commitment from pharmacists, should be GSL. It’s not some conspiracy; it’s just a business reality. I worry that if pharmacy does not start to properly support POM to P switches, their cynical worrying becomes a self- fulfilling prophecy.

Pharmacists must demonstrate that they believe they are the rightful place for condition treatment and management to exist. This is so important, because once this true partnership is in place, the value of the consultation and improved experience for consumers will not only enhance their view of pharmacy as a solution, it will radically change the industry’s view. Why switch to GSL a brand where the role of a pharmacist is so intrinsic to the consumer’s experience?

This post also features in this months Pharmacy Magazine supplement reviewing 25 years of POM to P.

Any healthcare industry observer knows that today’s patients participate more actively in decisions affecting their health than ever before. This is facilitated by a less stigmatised approach to personal health, and by the internet as the ‘premier’ source of healthcare opinion and information.

Aside from some downsides (see previous posts) , most of us see knowledge-empowerment as a promising impact on health outcomes. However, it’s unfortunate that EU citizens are restricted to gaining information online peer to peer (via discussion forums) or from company sites in unrestricted markets, such as the US. This information rarely represents local indications or local market conditions. As a result the patient reviews information that is not always relevant to them, with products that are not always available in their market.

The European pharmaceutical industry has become an outsider to this information exchange. They are legally liable for the products they produce, but prevented from providing a regulated information source to the concerned consumer.

Isn’t it about time that Pharma be recognised as important contributors to health information alongside healthcare professionals, patient groups and regulatory bodies?

The recent European Federation of Pharmaceutical Industries and Associations (EFPIA) call on policy makers to improve access of citizens to medical information seems sensible and long overdue.

The EFPIA have proposed 4 main information categories to clarify the discussion. Firstly, pro-active information, which is provided unsolicited to the public, should be limited to general information on diseases, e.g. covering awareness, prevention etc. but not mentioning specific medicines. Secondly, reference information, covering diseases and medicines, which is sought by patients as in a library, e.g. through the internet. Thirdly, reactive information on medicines in response to enquires received from patients. And finally, support information supplied to support compliance with a prescribed medicine.

The European Commission is also in the process of reviewing the current practice with regard to information to patients on medicines and plans to announce its findings in October 2008.

The European Commission fully supports that better information available to patients can contribute to achieving better health conditions, a more efficient use of resources and better adherence to treatments. And has further concerns over inequalities of information provision across EU members, and the lack of quality standards. In addition to this it also recognises that Member States authorities may not be in a position to fully address patients’ needs in terms of the substance of information and the access via different means.

It would appear that the EFPIA and the European Commission are on the right track and we could expect to see at least a recommendation of harmonisation across member states.

In the mean time consumers of medicines in the EU remain exposed to inaccurate information and at potential risk to their health.

A Cambridge University academic is leading a call to dispense with medical jargon in favour of everyday language. Dr Melinda Lyons claims in the Lancet that patients can get dangerously confused by unfamiliar and similar-sounding terms (intra vs inter; hypo vs hyper), particularly in stressful and noisy situations.

This is something to be grateful for, because it’s more proof that healthcare is becoming more patient-focused. While not without its challenges, communication built on the needs and expectations of the end user is clearly the way forward. Dr Lyons’ work, and the fact her research featured in the morning Metro, reminds us that everyone has a stake and a growing interest in what happens in the healthcare world.

But it also reminds us that people aren’t the same. Words that are necessary to one person may patronise another. At Hive we play our part by first understanding who the end user is. Only then can we get the dialogue right between that person and the person looking after them. We do this by letting the HCP know more about who’s in front of them.

It’s a subtle thing, joining the dots between different mentalities and creating proper engagement, but it’s not new in marketing. Without the correct delicacy however, you get a fumbling disaster which tries too hard and fails.

So, between the patronising and the ancient Greek, lies a tone of voice that resonates. Finding it is a beautiful thing.

Recently we have been working on a brief to improve the provision of information to people with massive mobility and dexterity challenges. We needed to communicate the product, how to use it in a way that is really useful, and most importantly why the choice has been made for them to be on this therapy.

Our initial discussions revealed that beyond who they might be and what they have been diagnosed with, little solid research in terms of their feelings or how they live with the disease was known. As a consequence we needed to get to grips with the patients, not only in terms of information requirements but also their idiosyncrasies and physical disabilities.

We wanted to use an approach that we have come to know as ‘Accessible Design’. This approach is huge with car designers in Japan, who need to feel how the rapidly aging population of Japan experience their cars. As young, progressive designers, they don’t have a problem getting into a car, adjusting seats, twiddling knobs – but the end user might. To combat this mismatch between audience and output Nissan invented the old-suit, an outfit which simulates the effects of aging. Strap it on and you’ll immediately feel stiffer, heavier, less able to balance, and the included goggles will make it harder to see. And its works – their design teams know, empathise and design better for an audience they do not relate to physically.

It’s obvious how this relates to the work we do. Patient materials are too often overlooked as bits of collateral that ticks the patient communication box but mean little to the actual user. While we create more relevant content for our audiences, really getting to grips with the problems they face and the questions they have, it’s essential to package this content appropriately. While product manufacturers make sure their goods are easily accessed, we must produce healthcare information in such a way as to be easily consumed.

Our conversations with patients and professionals unearthed difficulties we’d never have dreamed of (door knobs, envelopes, ring pulls, Velcro, shiny surfaces, stockings etc). Following an accessible design approach proved hilarious and humbling. With no Nissan suit budget in place, we had to get creative and find ways of ‘restricting ourselves’ based on the patient insights we had. Enter ski gloves, mittens, industrial strength elastic bands, bags on hands and training weights on arms. We played, we learned, we were astounded. The result is a range of materials that have been thoroughly tested as ‘end usable’. Alongside a better understanding of what they need and want to know we have solved the problems of this audience in a more relevant way, for a brand that can only benefit from this approach.

This project has been a real learning curve for us. We have looked at real end user requirements, translated this into design and content objectives, and injected these into our tactical material briefs. We have also gained useful insight into what it’s like to live a tiny period of time with a disability that impacts so much.

As far as we are aware this is the first time an accessible design approach has been used by a communications agency and that makes us totally happy. It’s an approach that is now an intrinsic part of our materials generation process.

We have been thinking about agency-client relationships this week, with a request from procurement to build a multiagency-relationship-measurement thing. That is, something that gives visibility to the relationship status between the agency and the brand team.

It’s typical for an agency to be measured primarily by its output. But if you agree that a brand’s health is the key to organisational profit and the quality of your agency-client relationship is a major driver of brand health, then the health of that relationship becomes a key driver of your profitability.

I did some truffling around and found a great article written by Douglas T. Moore from General Mills which just seems to hit home. (More than that actually- I think I would really like the guy.) We plan to use his ideas for our relationship measurement tool. Doug has given us seven areas to work with:

Top-to-top trust – Trust between decision makers enables everyone to take bigger risks and grab bigger opportunities. It does this by speeding up problem-solving.

Agency talent – The best minds in the agency create brand ideas, never letting process, politics, or even budgets get in the way of great work.

Focusing on talent doesn’t just mean recruiting the best. It means finding them, developing them and above all giving them great reasons to stay. Stability is critical, rapid change at an agency can create problems.

Client talent – The great ones realise they shouldn’t ‘manage’ the relationship. Instead, their role is to inspire with the sense that anything is possible; make sure the strategy is insightful and simple; recognise talent and shape it; sell it through client personalities, fears, and politics.

Ideas atmosphere – Cohesion, openness, trust, sharing, and a willingness to dream. The key is creating a collaborative, ideas-driven atmosphere at the core of your partnership. Act like a start-up (easy for us to say). All ideas are welcome. Success is rewarded. Team is sacred. Speed and strategy is fundamental.

Money as a positive force – Passion gets business going… cash keeps it flowing. If your deal is too good to be true, it probably is. Top talent needs to be compensated as such. Equally the agency needs to work with what the business can afford. Consider incentives at an appropriate scale. Try a pilot, put ’significant’ money into an incentive pot, tie specific, quantifiable objectives to it, and track performance changes.

Lots of conversations about what matters – Agreement on the path to brand success is crucial for all – and I mean we must really, really agree, not ‘meeting nice’ agree. Relationships can drag all kinds of ’silent’ issues around for months, sometimes years. Senior leaders on both sides must keep talking about where the brand needs to go and potential worries around trust or ideas.

Shared disciplines – Semantics and language can hinder or enable progress. No matter how many agencies businesses may work with, it’s essential to embrace each unique culture. But having a common framework for discussing brands, strategies, projects, and simple things like clarifying roles and responsibilities, makes a huge impact in success rates and speed.

I love Doug’s list and everyone in the agency is excited by his points. Soon we hope not only to put them into practice, but have ourselves measured against them.

Bizarreness reared it six eared head last week, when hordes of photographers and art fans descended on Savemain pharmacy in Essex Road, Islington, after Banksy painted a large mural on the wall depicting three children pledging allegiance to a flagpole with a Tesco plastic bag flying from it. As a fan of the artist, a person fascinated with HCPs, and this being my local pharmacy I felt I had to go and have a look. Speaking to Anand the pharmacist at the family-run business, he said: “We are a little bit surprised at all the fuss – it’s certainly not something we see every day. We had no idea, we just came into work on Monday morning and there it was. Hopefully no-one will do anything to damage it. It would be nice if it helped business.” His uncle Raj hilariously added that “they were considering whether to sell it”

The Islington Gazette has subsequently carried a comment from a spokesman for Tesco, who have a store in Essex Road, who said: “If this proves to be genuine and all indications are it is, then we’re flattered to have been thought of by one of the UK’s foremost contemporary artists. However, we’re not art critics and will leave it to individuals to decide on its poignancy.

Have they missed that this is clearly Banksy’s comment on the demise of the independent pharmacy?

In the Rx marketing process, healthcare professionals have long been viewed as the biggest kids in the room, the holders of the power. Our first need was to have them on board, understanding and agreeing with our key messages, weighing up the facts and writing scripts like mad. Get the gate open – step back and watch the newly medicated sheep trot through. Understand the HCP, connect with their emotions and functional requirements and bang, product launched, sales incoming, off we go.

In these less bullish days (fewer new products, more chronic care, empowered patients), a new challenge has knocked on our door. Driving depth of use, and not just breadth, is an urgent requirement. It’s no longer enough to get a prescription written. We need to ensure that the sufferers have some part to play – complying, understanding, loyalty, enjoyment.

But as we shift towards end user strategy, we cannot lose sight of the HCP role. We need to acknowledge that instead of guarding the gate, the professional is becoming part of the medicine experience for the end user. This new dynamic means different ways of insight delving, tactical delivery etc.

We would be daft not to review how other industries have made this transition, especially other industries with gatekeepers as part of their brand journey. There isn’t a direct equivalent for the healthcare professional in industries such as automotive/computer/banking, but a lot of our challenges have been faced by these groups. In other words, these professionals are rarely or never responsible for public safety, but they also contribute to the brand experience for that most important player – the end user.

BMW invests hugely in understanding its end user. Only then does it understand its store environment, and then its independent sales advisors. In reconciling these insights, the showroom scene becomes a piece of the brand experience set up to gain loyalty from the customer.

I was lucky enough to sit next to a biggie at First Direct at dinner recently. With this service offer, their telephonists are the main touch point for consumers, their position is of unusually high responsibility within the brand journey. The satisfaction and loyalty of First Direct customers in general suggests that other companies could do well to infuse their call centre staff with new levels of responsiveness.

These two examples, and countless others, are strongly relevant to the healthcare model. They can help us learn how to respond to this turning environment, as we stand besides an open gate and really get to know those sheep.

A few weeks ago we were delightfully asked to present our credentials to a prospective client. A meeting was set up, but soon we received another call. Instead of presenting creds, could we help contribute to solving a problem? Would we immediately take a brief and instead present our thoughts on the issue? Absolutely! we cried in unison, excited at the prospect of adding value from our very first meeting.

After receiving the brief, we formulated our plan, reviewed our existing knowledge, spoke to contacts in this category, defined areas where we had gaps, gathered 2 (Qual) groups of healthcare professionals, confirmed/chucked out some stuff, structured our argument and wrote the presentation. Last Friday, we got on the train, rehearsed, arrived and presented.

Once it was over, we began to think about this slightly off-centre approach. Why do we stick with generic credentials presentations that often serve up a beauty parade of materials but don’t get to grips with our team, approach and hunger? Getting instantly into a project with a challenge is a better test of our strength. We’re here to solve problems, not self promote. It struck us was how much better it feels to be serving a purpose. Rather than demonstrating the past, we worked with the present to directly benefit the team we were with.

The agency world insists on its clients understanding its audience. We strive for brands to have meaningful conversations with people, not self-obsessed monologues. It’s great to be afforded the same with the agency brand and its potential client team. I guess for us the learning is always to ask whether there is something we can help with, rather than taking the easy option of the off-the-shelf slide deck.

Printing guilt. When a simple web document inexplicably turns into tens of senseless, almost clean pages spitting out of the Laserjet. When the last page of your print-out is a single URL or a useless banner (Streetmap.com – sort it out!).

Until now, those with a conscience have tried fiddling with printer settings (e.g. choosing “Page 1 only”) or ditching hard copies altogether for downloadable PDF views. Now there’s freeware that does this for you, and more. GreenPrint analyses web pages and allows you to bin those with insubstantial content, saving on paper, ink and time. You can also choose which pages, images etc. you want to build into a PDF version of your document. GreenPrint even keeps track of what you’ve saved in terms of pages, cost (in USD) and number of trees. Also, anything that reminds us to print double-sided and on waste paper, is a good thing.

It’s not preachy, it’s practical. Result: Big thumbs-up from Hive. Click on the banner below to start printing green.

For the best blog post we decided to give away 2 months free use of Napster. We have this playing in the office and its brilliant – every album and every track you’ve ever loved instantly at your finger tips. Millions of tracks, from a catalogue of 5 million. Dozens of suggestions of other artists – its totally changed the way we listen to music here.

Well after much heated debate, we have decided to award two months of musical brilliance to twice posting Bambi. Access details on their way, enjoy April and May on us.

Healthcare is a complex world to work in, whether we sell products or services. On top of our day to day business, we’re struck by reams of science, mode of actions, molecular specs, and more.

The result is that in healthcare, we are surrounded by distractions. When we’re asked to explain what it is we do, we get immediately sidetracked into describing stuff that is really besides the point. To be fair, there are times when we have to pass the time; fill in gaps in conversation. Perhaps this is why this kind of pointless talk has been described as “elevator speech”, or the more stylish “martini monologue”.

But sometimes it invades boardrooms, too. We lose sight of our brand as “the moral of our story” when we plan our communications. Or maybe we understand our brand in our own heads, but fail to produce a short, consistent description when asked. We prepare in the wrong ways, getting tangled in details when it’s really not necessary.

How do we get to that core of what it is we do? By asking yourself one question: why it is that we (or our service) can meet customer’s needs better than anyone else. If you can find a way to verbalise this to a stranger in a lift or a brand director over lunch, you’re practising engagement. That brand story will find its way into communications materials too – the places that you build on with key messages, that complicated MOA diagram, and so on.

Martini anyone?

Hope everyone enjoyed the OTCs last night as much as we did. Well judged, great food, lots of laughs all round. Huge congratulations to those who bagged an award. Very deep thanks to organisers Debbie and Val for letting us sponsor the event with our charming honey vodka-issuing ladies Ebony and Danielle. We trust everyone had a chance to sample our nectar. All together now: 1, 2, 3, 4, Hive!!

Fact: the green stamp WILL fade eventually – don’t panic. (If anything has worked for you please let us know.)

All of us here are getting ready for the OTC Marketing Awards. A few last minute emails to write, one job bag to put to print. Hope to bump into you there, after dinner enjoy a shot on us.

A recent comment from a client made me think about how pharmacists act as brand enhancers for patients/consumers.

Pharmacists are highly educated healthcare professionals. Patients have long relied on their valuable skills and used their advice to make a purchase. However, it has been traditional for organisations to communicate with them principally in business terms. This retail-led approach creates dissonance between the relationship pharmacy has with a brand’s manufacturers and the one they have with the brand’s users.

The new Contract, however, changes things. Although the uptake of enhanced services seemed slow to begin with, pharmacy’s growing relationship with patients is now much in evidence. (As it is with other HCPs: the growing weight of pharmacy has strengthened links with prescribers.) With almost 2 years since the independent prescriber act, there are far better opportunities to be had than talking “stock pressure and profit on return”.

Instead, manufacturers who understand and enhance the close relationship between pharmacist and consumer will gain more end-user engagement. A recent study showed that when pharmacists intervened in the sale – not by recommending, but by providing an informed brand initiation – patient compliance increased and patients were more likely to make a repeat purchase. Proof that what can be good for profits can be great for patients.

As the professional identity of the pharmacist sinks in, their challenges revolve around setting the clinical scene and promoting new services to patients. Pharmaceutical companies must continue to track areas of progress and deliver a rounded offer that benefits in-house experts and their patients.

There’s a really interesting new theory circulating called transmedia planning. A quick background: transmedia storytelling was a trend identified by the cultural academic Henry Jenkins, where entertainment brands used different media streams to tell pieces of a story or plot. Transmedia planning was born when a number of strategists, including Faris Yakob, adapted Jenkins’ theory for the marketing world.

TMP places control in the users’ hands by asking us to “Allow your audience to assemble your brand story”. It’s an interesting evolution of 360° marketing where one idea is expressed uniformly by multiple channels. TMP allows ideas (or parts of ideas) to reach consumers from a slightly different point of view, but deliver consistent value and meaning around a brand.

Hive’s business plan adopts a transmedia approach in the context of the important changes happening in healthcare. You don’t have to have read our recent blog comments to know that informed, or partially informed, patients are increasingly the norm. Growing access to different information sources gives patients more control over their treatment. The web allows communities to form and discuss treatment and results. Consumers are showing they need more than shallow promises and that’s where TMP fits the bill.

We have to remember though that the transmedia concept evolved in an unconstrained consumer world. In its purest form, TMP can’t apply directly to prescription brands because of the necessary limitations on patient communications. However, prescription drug users still form communities to share experiences about treatment, particularly those with chronic conditions. Using a transmedia approach here involves setting up the dialogue between prescriber and patient, but acknowledging that some of the dialogue and beliefs around the brand may also be acquired from less informed sources. The reality for patients/consumers is, the relative weight of advice sourced online vs the prescriber is not always as you would imagine.

Building relationships in any industry is about engagement with people. In the healthcare mainstream, the critical commitment may still be the prescriber’s. But it’s vital to remember that the prescriber is not the person experiencing the brand in a hands-on manner. Its time our communication to professionals and patients alike began to reflect that.

The 2004 “Choosing health through pharmacy” programme envisages that by 2015, pharmacy will be our first stop for health matters. Pharmacists will be qualified to identify disease risk factors, suggest the appropriate treatment steps and refer practitioners when necessary.Going hand in hand with this is the increasing switch of prescription-only-medicines (POMs) to P status – medicines that can be provided by a pharmacist without the need for a doctor’s script. This is good for the drugs bill and so far, good for patients – with a pretty clean slate for switches so far in terms of safety.

Mixed reactions come from pharmacy itself, however. On paper the industry are largely positive but seem reluctant to practice on real life customers. This is not the proactive response that government and industry had hoped for.

Some believe it is too much, too soon, to expect pharmacists to accomplish a GP consulting approach. The first and biggest hurdle may be acceptance. To quote a pharmacist I recently spoke to: “If I had wanted to be a GP I would have become one”.

But the cost of switches must be recouped. So are we doing something wrong? Pharmacists know that switch products have met stringent risk-benefit criteria – I believe so. They value the training on offer – yes. Should we be more aggressive – less trusting of their professional instincts, less patient?

I don’t think a macho upbringing makes strong people. So we need to think hard about support. While the NHS is the main driver of change, we cannot expect that our responsibilities end with branded training. Instead, we’re going to need to co-create opportunities with government and pharmacy to build the secure, confident community practitioners of the future. Watch this space.

Freerice.com is a new interactive charity site that donates free rice for every word you know the definition for. It’s highly addictive, improving our vocabulary, is free and donates rice to the 3^rd world as part of the UNs bid to end world hunger. It donated 1billion grains in its first month. It generates revenue to do this through ads on the site. Its genius. Have a go and donate some rice.

Those of us on the industry side of healthcare may dismiss today’s news as another headline doing damage to an industry that delivers benefit to millions. But in claiming “The difference in improvement between patients taking placebos and patients taking anti-depressants is not very great”, lead researcher Professor Irving Kirsch raises some undeniably challenging questions.

For one thing, the “effect” is not limited to mental health trials. One RCT in patients with acute duodenal ulcer (Lanza et al. 1994) consisted of three treatment arms: the then-new drug lansoprazole (Zoton/ Pravacid), an older drug, ranitidine (Zantac) and placebo. As per experimental law, the 44 patients receiving placebo had the same diagnosis as the other patients and were examined alongside them. After two weeks about a third of the placebo patients were healed, and after four weeks just under half of them were healed.

Here’s another in angina: (Boissel et al 1986) 35 patients with severely limited functional status were treated for 6 months only with placebo and short-acting nitroglycerin. The placebo dosage was blindly titrated over this time until an “optimal” response was seen. Twenty seven of the 35 patients showed substantial improvements over this period. Overall the number of angina attacks dropped from 10.3 to 2.4 a week with a corresponding decrease in nitroglycerin tablets used. It seems unlikely that these people would have simply gotten better had they stayed at home and had no treatment. But, with inert treatment in a clinical trial, they did get better.

Let’s not forget that a placebo isn’t necessarily a tablet. In two studies (Cobb et al, NEJM 1959. Dimond et al, J of Cardio. 1960) surgeons were only informed once in the operating room which patients were to have a complete internal-mammary artery operation, and which were to receive sham surgery. Both studies showed that most of the patients were much better after “surgery” regardless of whether they had actually received it or not.

These examples of a high response rate in a placebo arm are not uncommon. For centuries, it has been known that sick people frequently get better when administered an inert intervention by a healer or medicine man. It’s hard to account for the substantial improvement in these patients.

Increasingly, the term “placebo effect” has been a dismissive one, given to justify a response that cannot really be understood. To me, it seems that at some point the role of the patient’s ‘mind-over-illness’ must be considered. Indeed, the word “placebo” is being challenged by medical anthropologists, who ask how placebos, an inert substance by definition, can have any effect at all. If it does something, it is not inert. There must be something else at play driving this change.

Daniel Moerman in his excellent book Meaning, medicine, and the “placebo effect”, suggests a very different approach to this problem. He uses the term “Meaning response” and defines this as “the psychological and physiological effects of meaning in the treatment of illness”. The meaning response can be applied to most of the results traditionally attributed to placebo effect. As a definition it gathers the elements of the non-physiological into treatment success, aiming at a better understanding of this phenomenon.

Once you acknowledge that treatment ‘meaning’ exists alongside mode of action and plays a role, it’s only a short distance to another important realisation. This is directly relevant to us: by understanding meaning in the eyes of the end user, we can feed this insight into the HCP strategy. Adapting and optimising our communications can only help drive a better brand experience, a better consultation and perhaps better outcomes.

What do you think?

I have been ‘doing’ billable healthcare digital for 14 years. In the beginning there were video presentations, online Q&A sessions and clinical summary downloads; more recently, a wealth of Flash-enabled tools. To date it’s been pretty easy to repurpose content or repackage it as a digital thing and sell it as exactly that – a thing, a tactical item, a separate channel for delivering traditional content. “A better mousetrap” as Ian would say.

The digital gold rush has produced an interesting response in the healthcare agency world. First, we have learned to bolt Shockwave Flash capability onto an existing production function. We expanded our in-house capability to do this, or outsourced to those talented Shockwave Flash savvy freelancers/e-lancers available locally or globally.

The second reaction is more radical. Agencies have been set up to focus purely on the digital channel, merging a healthcare marketing background with the ability to talk to internal and external audiences entirely through online means.

We’re responding to the rise of what we know as web 2.0 (every evolution must be named!). The success of brands such as Google, Facebook, eBay, YouTube have forced the agency world to find ways of incorporating the Web 2.0 experience into our healthcare approach. It appears no longer acceptable to consider “digital” as remote from the strategic process, interactive paper that crops up when useful. We must use its real advantages: to assist brands not only with functional delivery, but emotional answers and even a service offer.

It strikes me that an uptake of “real digital” in healthcare, and the correct use of its communication opportunities, calls for agencies to evolve and not necessarily clients. For years I sat with numerous agencies and moaned about the slow adoption of digital in healthcare. Over time I started to see how the digital evolution meant an entirely new strategic process. Forget the production bolt-ons, our work now is a total re-think from the earliest stages of brand planning. That’s when we will see brand values such as ‘community building’ being agreed on and more importantly, delivered.

We’ve just returned from saying hello to old and new OTC friends at the delightful SMART awards held in Birmingham last night. An excellent evening wonderfully organized and hosted by the team at CIG.

Congratulations to all the 2008 winners. Judging by this morning’s breakfast attendees an excellent time was had by all.

A recent comment from a client made me think about how pharmacists act as brand enhancers for patients/consumers.

Pharmacists are highly educated healthcare professionals. Patients have long relied on their valuable skills and used their advice to make a purchase. However, it has been traditional for organisations to communicate with them principally in business terms. This retail-led approach creates dissonance between the relationship pharmacy has with a brand’s manufacturers and the one they have with the brand’s users.

The new Contract, however, changes things. Although the uptake of enhanced services seemed slow to begin with, pharmacy’s growing relationship with patients is now much in evidence. (As it is with other HCPs: the growing weight of pharmacy has strengthened links with prescribers.) With almost 2 years since the independent prescriber act, there are far better opportunities to be had than talking “stock pressure and POR”.

Instead, manufacturers who understand and enhance the close relationship between pharmacist and consumer will gain more end-user engagement. A recent study by one of our research partners showed that when pharmacists intervened in the sale – not by recommending, but by providing an informed brand initiation – patient compliance increased and patients were more likely to make a repeat purchase. Proof that what can be good for profits can be great for patients.

As the professional identity of the pharmacist sinks in, their challenges revolve around setting the clinical scene and promoting new services to patients. Pharmaceutical companies must continue to track areas of progress and deliver a rounded offer that benefits in-house experts and their patients.

We loved this, it tickled our fancy.

I came back from a meeting yesterday to find that our big pink sofa had finally arrived. Naturally, this was a sign to put the kettle on and get comfy. Naturally, we got round to talking about what makes prescription brands “engage” with people.

Engagement stretches from a transient coupling of user and product to a loyal relationship rich in mutual benefits. This depends on how much emotional value is delivered. The most successful brands in the world, like Apple, appeal to our most highly evolved values. Healthcare brands with a life-changing reputation (Seretide, Herceptin) come closest to this.

Most Rx brands however, don’t inspire much in end users. We take them for short term relief, or because the doctor/pharmacist said so, and never develop more than a functional relationship with them. Medicine is not something we buy because we want to.

But even though we’re largely indifferent, we can still forge long-term commitments with treatments because “we probably should”. Millions stick with a daily hypertensive because their physician has confirmed that their lifestyle hasn’t done them many favours. Changing brands only happens thus, when the doctor sees fit. There’s no dialogue going on here, but while there is forced engagement, does it really matter? We believe it does matter.

As preventative medicine becomes more of a priority, competition will drive prescription brands into more emotionally accessible areas. Certainly they will have to compete for prescriber loyalty.

For patients, new ways of engaging might go further than driving revenue. Putting a friendlier face on those boring old blood pressure pills might make people more adherent to their medication and perhaps think about taking more control of their health in other ways.

A recent post about the rise of the informed patient attracted some insightful comments. Dr J got me thinking about knowledge, responsibility and a few things in between.

Patient education is a good thing and we need more of it. The EMEA roadmap for 2010 promises more access to accredited medical information. Ideally this will help override the reams of flimsy information that, as Dr J points out, are in abundance.

I think the EMEA have their work cut out for them. How much information do people need for a start? Is it OK to broadcast an advert simply telling people to be more active, or do we need a clearer link to the real consequences of obesity? And what if we overload people with information – will we scare them into doing the wrong thing? Will they just stop listening?

What really alarmed me was Dr J’s comment that, even when patients know their onions, they often balk at decision time. Perhaps we know enough, but we’d still like to blame someone else if things don’t work out. Or is it the other way round – are we being urged to take more responsibility for our treatment, but don’t have enough insight to make decisions?

There’s a great take-out from this: We must be on the ball if our minds are boggling with the same question that patients’ are. What we all want to know is: how do we embrace patient empowerment without compromising medical integrity?

Looking forward to your thoughts on this one.

This, made by Michael Wesch is probably the best way to describe the revolution that communication is undergoing. For too long linear development has created a well trodden path for communications evolution. This shows you what we feel. The world isn’t changing, it has already changed. Take a look and let us know what you think.

It seemed to be going so smoothly, getting our offices up and running in just a month.

The key word is ‘seemed’. We are wiser now. We have seen the gap between promise and delivery. We know how it affects users attitude and behaviour.

It’s nice to be sweet talked at times; it’s fun visualising how great things will be. It’s less thrilling to hang around waiting for non-existent goods to turn up. That’s when you feel disappointed and want to kick your bright, flawless, newly painted walls down.

Customer service is something everyone gushes about. “We are competitively priced, but our premium is justified by our outstanding commitment to…” You’ve heard it. Why is it companies and brands still haven’t got it? Buying a service is about the delivery, not the promise.

Things that should have happened naturally were eclipsed by a tortuous string of phone calls and frustration: Transferring phone accounts: O2 say ‘1 day’, our panel say, Att-Ahhhh 2 months of chasing, cajoling and being let down. In the end we gave up and went to Vodafone, finding out that it’s easier to change provider than stay with the same one… hello? Putting landlines in. Our provider says cat 6 will be fine, so that’s what we do. Our panel said Att-Ahhhh, I meant cat 5, not cat 6 cable – 2 days wasted.

I could go on but I’m starting to tremble.

Brands must contain a promise, but more importantly they must fulfil it. One company that would never let that happen is First Direct. Their brand promise (or should I call it brand truth?) rings loud and clear from their call centre upwards, for them it feels that delivering the brand is actually more important than communicating it.

Something always comes good from bad as my Grandmother used to say. It got us thinking. Do we in the pharmaceutical industry focus so much on selling to HCPs that we fail to properly consider the impact on end users? The token patient programme, the leaflet, the poster. Not being able to talk to consumers is no excuse, we can talk to patients. Even if we can’t hear their complaints, the rest of the world will.

The PM Awards came round again recently, another superb day in Mayfair. Congratulations to Paling Walters for cleaning up in many of the categories with their usual excellent standard of ads and matching collateral.

This was Hive’s first year at the PMs – our company not yet a month old – so we naturally made use of the opportunity for our unveiling. Our plan to treat guests to honey-vodka body-shots did not quite cut the mustard with the organisers so we were forced into some last minute guerrilla tactics…

And a little something after dinner…

Working the room after lunch, we found that faces old and new seemed interested in our proposition. Indeed, the number of website hits we had over the weekend suggests our message is well and truly getting out there.

In most EU states, over half of people are overweight or obese. In March 2005, the EU Commission created a Platform on Diet, Physical Activity and Health to address the problem. Its aim is to get stakeholders committing themselves to promoting healthy living.

This 30-second ad will reach 80-100 million viewers in 40 countries during each week of Champions League matches. It is totally free content. Abbott Mead Vickers BBDO made it for nothing and UEFA has promised the 30 seconds of match airtime it spares for social initiatives.

Do you like this ad? Is it a big idea – does it define a brand entirely? Or is it just one part of the story? What do you expect to come out of the rest of the Commission’s media plan?

A few years ago, the rest of this consultation would have been relatively straightforward. I would ask some questions, run a couple of tests, recommend a treatment and the patient would feel reassured. Nowadays however, it tends to go rather differently.The patient will, more than likely, have already been on various websites looking for a diagnosis. They may also have looked into the different treatments available, even compiled a folder of information for discussion. They want and expect to be actively involved in their diagnosis and treatment plan. And if they aren’t completely satisfied with my opinion, they’ll get someone else’s. In short, “trust me, I’m a doctor” no longer holds much water.

Never before have patients been so well informed, so involved and influential in their healthcare. With a finger on the public pulse, the government is planning for personal healthcare budgets so that each patient can choose their hospital, consultant and treatment. Since I graduated 10 years ago, the face of medicine has become almost unrecognisable. It’s more like going shopping than to the doctor.

How does this make us healthcare professionals feel? I’ll be honest; a little mixed. The quality of information available to patients varies enormously and can sometimes do more to confuse than to clarify the situation. On the other hand it’s likely that a patient who feels invested and in control of their wellbeing will live a healthier lifestyle and engage with the required treatment. Isn’t that the aim?

Whatever the implications, the NHS claims to hold the needs and wishes of the patient at its core. This makes sense ethically and politically. The question is, why are healthcare communications agencies still servicing healthcare professionals before satisfying the public interest?

The founding members of Hive (Jas, Tim and Ian) all met at Paling Walters, way across the mighty Thames. Each of us spent a number of seriously formative years at Palings. So when we moved on – well, we were never going to be let off lightly.But cheer up guys, we’re still your mates.

We were interested in the Consistency over coherence debate recently posted on adliterate.com, which questions the importance of identity-driven communication. Should a brand repeat itself for the sake of recognisability?

Convention in healthcare communications says yes. HCPs lack time – the mental link must happen, and quickly. Consistency also makes sense when global visibility outranks the needs of diverse markets. Waning production budgets make this a fact of our industry.

Clearly we need to retain some consistency in our creative work, but brands can also capitalise on the much bigger premise of coherence. That means staying true to your message first, thus having more freedom in its execution. This brings meaning to brands – your materials and tactics don’t just strike a chord because they look the same, they resonate because they mean the same.

It works because your big idea becomes more than the sum of its parts. When we talk to doctors, why not be that much braver – who says they can’t put two and two together after all?

The real benefits of coherence lie in consumer marketing. New media has a lot to do with patient power. As people search wider for answers in healthcare, so we gain new ways to reach them. Our brand becomes a stream of conversations that evolves along with the community around it. Take a step back and you see how big and relevant the picture has become.

Agencies must face facts – the definition of integration has moved on. Let’s commit to bigger, braver thinking in healthcare with coherent strategies that everyone can profit from.