Posts tagged "healthcare"

It would seem to me that in most other walks of life you know what you’re getting. I go to the supermarket and come out with £50 worth of food – job done. Go to the pub and get three pints for £10.40 (country prices, not London). Even pay the council tax and know that one day that hole the size of a Roman Emperors ego, outside my house, will be fixed. But why, oh why, when it comes to advertising are we so slow off the mark when it comes to testing whether what we’ve produced has worked? It’s not just down to ads but ideas. That beautiful, carefully crafted idea that we try hard to sell to clients, would surely be easier to sell if we knew that what we had previously developed had in fact worked. I find it a bizarre conflict that us, as pharma agencies, work with some of the best research specialists in the world (clients) – phase 1, 2, 3 and 4 clinical trials, the money that gets poured into it and yet there seems to be little demand to test the agency and their ‘mettle’. Come on – have a go if you think you’re hard enough.

So, my thought for the day, or should that be week, year, infinity is link communication (and ideas) to business performance. Communications are paid for out of profit (or if you get it wrong, loss), so demand to know what has worked and what hasn’t. If nothing else, in today’s lean times it may just be easier to hang onto your budget if you can prove that past activity has benefited the brand.

So far this week has had its fair share of highlights – last night I was told by one of our clients that I should investigate a career in phone sex (nb. pre multiple espresso Martinis!). However, the stand alone winner is Jas’ epic fail at getting through a door. The added bonus being it has created one of my new favourite photos – as Ian points out, she must have been pulling off a pretty jaunty strut to leave such a special smear pattern.

Anyway, this got me thinking. Our director fails to get through one of our internal doors – hilarious, unexpected, hopefully a bit of a one off (for Jas’ sake); but how can we expect proper new bees to get through our door if they don’t even know it exists?

I fluked upon this industry, this agency, this career. At uni, doing a science degree, I was given 2 career options: Science (of the hard-core lab variety) or the City (of the hard-core bank variety). Neither of which appealled – I’m pretty sure flourescent pink jeans are frowned upon in both settings, whereas at Hive they get called ‘bastard strides’ and prompt Tim to put on some sunnies. Despite knowing there must be something in between, it was bloody difficult to discover and relied on an awful lot of luck.

“What a ridiculous situation!” Hive cries…how can we fix this problem? How can we help young guns find out we exists? As yet we don’t know. It’s a work in progress, some serious thinking is about to be done (thinking hats on). Any thoughts/ideas give us a shout (unfortunately no ipad bribe this time). We’ll fill you in on the the thinking and if you’re really lucky maybe you’ll get an invite to the solution.

How our industry is seen is a present annoyance for me.  I was forced by to go to a recent boys charity do and with a load of  bankers – I was turned on with multiple questions on the solid nature of what I do. Apparently ‘Media’ (said with a lightness of voice – try Frank Spencer/crossed with Dale Winton) as a sector is just nonsense. Not real work. Staggering my fellow charity goers all are in derivatives traders – pot – kettle – noir I said – infuriating them further.

I can understand this portrayal of what we do as airy-fairy-nonsense. Last night I tried to explain branding to our old IT guy Tony, who errs on the side of functional to say the least.  He just wasn’t convinced. Despite wearing Nike, carrying blackberry, and swearing by Persil, outside The Blue Posts it became apparent that I was never going to convince him on any decision making other that rational. It was the source of some frustration and much cider. But then he loves Carling because its tastes better than any other lager. (A belief I am still staggered by)

Returning to the bankers, it’s possible the view of the man in the (city) street is of the Gucci loafer wearing, Hoxton types, designing for an hour a day in-between their table fussball games that they really object to. I think also it’s the thought of a group of individuals earning  ”footballer wages” (sic), miles always from any market forces that further angered these guys. These guys just didn’t get what it’s all for. Yet when you speak to them about ads – these seem to be a result of some higher power – that clearly has never been near to a fussball tournament or infantile hand shake.

We need to dissect the elements of creativity, how a piece works, which elements are working  which need work. Assessing ideas requires words borrowed from an emotive/artistic dictionary. Which is why a collection of (daft) terms surrounds us and why often this collection of terms makes very little sense to the un-initiated.  We are immersed in tone, value, emotion, function, all elements of an idea that does something to its viewers. Perhaps this is “not the sort of thing anyone believes for a nanosecond in the real world”. but it’s a reality of our life we need the words to do the job.  I have a feeling that these are totally important to us, it’s their public outings that tend to persuade non – industry bods that what we do is just nonsense. Looking around the 5,000 member Facebook group – “Don’t tell my mum I’m in advertising – she thinks I play piano in a brothel” perhaps sums it up. A good indication of the shame those in our industry feel. Perhaps?  Perhaps not?

Why we shy away from just telling it like it is I don’t really know. Basically all that stuff we talk is for one real aim – to better connect in some way with an audience. The creation of an idea is about savings, it’s budgetary. Really it is.  Whether you are a planner, creative or suit, the business is about efficiency. We just seem reticent to tell others that by doing it this way we connect cheaper. We find ways of developing  relationships with audiences and brands that would otherwise cost more. Agree or disagree, I am not sure why the industry continues to be scared of this – hire us we will save you money seems a blinding recessionary position.

Simple as that.

Ps. No rhyming slang has been used in this blog.

Most of you will know our entire business revolves around the concept of consumer empowered medicine. Patient centricity. It comes by lots of names, but fundamentally it’s about the future role of us as determinants of our healthcare solutions.

Many of you will also be aware of our enthusiasm for TED lectures, and particularly the TEDMED series which revolves around medicine. This morning on the train I watched on my smart phone a lecture by Dr Topol, (not of Fiddler on the roof fame), but about the evolution of wireless technology in medicine. It is fascinating and worth 16 minutes 58 seconds of your time. We are already using these types of technology for a client in chronic clinics, but this really broadens our ambition and the tech team are on it now. Hope you like it.

Thomas Goetz is a journalist and executive editor of Wired Magazine. He’s also a really smart guy. His new book, called The Decision Tree, is all about how people can take control of their healthcare using data and tools which are readily available on the internet. It goes above and beyond most other health improvement books in terms of rigour (it’s based on good science) and readability (it’s easy for me to understand) The big idea is this: Our health doesn’t happen all at once; it’s a consequence of years of choices – some large and some small – that combine to make up our health. Sometimes we’ve chosen wisely and we enjoy good health; sometimes we choose poorly and we suffer the consequences. A decision tree, then is a device that can make these decisions more explicit and more obviously something we are actually choosing – it’s a way to externalise, make a note of, the choices that we otherwise make without much thought at all. Research shows that when we actually engage in a decision (when we think it through, even if just for a moment) we tend to make a better decision, defined both as one that we’re more happy with in hindsight and one that bodes a better outcome. Also, we more likely to commit to our choice, to stick by it when faced with the opportunity to change our minds. By engaging with our health consciously and explicitly as a series of decisions, one leading to another, we can become “smarter” and enjoy better health. Click on the two podcasts below – Highly recommended.

Podcast – Introduction to The Decision Tree

Podcast – Chapter 1 of The Decision Tree

In marketing and management literature, the space in time when a customer and provider of a product meet is often called the service encounter. This encounter in the world of cars forced BMW to take servicing back into the fold. Desperate to get back an interaction that was far from Ultimate. And it contributed massively to Apple and Nike forming stores that were all encompassing controllable experiences.

With the service encounter increasingly front of mind for us, and in the past viewed as out of our remit, we seem to be spending a load of time understanding the many forms that interaction takes. The insight is being derived from mock-up consultations, anthropology style participant observation, even the more traditional scenarios and advisory boards.

With this geography now within the marketeers remit, it seems ever expanding. Interaction mapping within healthcare is loads more complicated especially in chronic disease treatments. Which prove a minefield of sub optimal interactions interrupting the brand experience.

It all proving interesting stuff. Expert/HCP marketing as an extension of consumer strategy – whatever next!

Ian handed me a fascinating article on ‘Should patients be paid for taking their medication?’. (He also said it was high time I wrote a blog. )The story described a trial where patients with mental illness were paid £15 for each fortnightly visit to their clinic where they were administered their depot.

My immediate answer was to say, of course they bloody shouldn’t be paid! Treatments are prescribed to make people feel better and help them function in the world, surely that is incentive enough?

Hold on, I thought – it’s plainly not enough. Poor compliance is a fact of mental healthcare. It’s easy to speculate on why these patients would avoid their medication. We need to ask about the conversations they are having with their HCPs. Are professionals helping patients reach an informed decision about treatments?

Well, at least one survey says not really. Here, 59% of patients taking an antipsychotic reported that other treatment options had not been discussed. Almost two thirds said that they hadn’t been given written information prior to starting their medication. And 46% said hey hadn’t been warned about its potential side effects.

The NHS and HCPs need to look at the way they are engaging with patients. How many have read the NICE guidance on patient adherence and choice, published in January? And how is the NHS supporting them in implementing change?

Of course, it’s not easy for anyone. The befuddling thing about informed choice is that patients can refuse medication, and the professional’s obligation is to respect this decision. But what if the individual is antisocial, or a danger to self or others? Why are we paying these guys, really – what are the savings down the line? To make a judgment on this pilot, we need to know more about these patients other than that they are poor compliers.

If the scheme sees the light, bitter laughter will accompany jokes about kids being paid to go to school and likewise to adults for behaving on a night out. No-one’s going to like the idea of a pay-for-peace society. Whatever happens, let’s hope these patients get something positive out of it.

I’ve been sitting here waiting to type this blog for about twenty minutes, trying to decide what to write about the launch of eBee.

I could mention the guerrilla marketing at the digital marketing awards.

I could mention that it was a night of firsts for me – first company I’ve launched, first time I’ve ever used spray paint, first time I’ve been asked to remove it.

I could tell you about all the people who have  made this possible: clients, patients, a team of inspirational, passionate individuals and the 5 months spent pre launch collecting amazing technologies to play with and developing the technical development capacity to make them work for brands.

I could tell you how lucky I feel to have been asked by the founders of Hive (the mothership) to turn a business concept founded on ‘borrowing’ innovation from other industries, making it healthcare relevant and turning them into reality.

But instead I’ll just invite you to visit and you can decide what you’d like to know for yourself

Thursday saw us in Manchester launching a biggie campaign to help patients discuss treatments with healthcare teams, solve problems with therapy and understand their treatments better.

We took an art gallery in Manchester’s trendy side and mounted an exhibition showing the issues at hand, the thinking behind the campaign, its development and the execution of some of the work of which we are so proud.

Catherine, who was responsible for one of the best briefs we have seen, was our curator for the evening, introducing how the collateral fits into the world. It’s a totally proud moment when you see your work being presented so fantastically, it brought a tear to my eye.

The show travels to three other venues, where it will be rolled out to community groups, opinion leaders, charities and internally.

It was a resounding success despite the usual courier mishaps, lost packages, countless hours hanging and discarded Dewalt batteries we closed the launch with rounds of applause, a real sense of purpose.

The morning saw us discuss with much mirth Jas dropping a 6ft high flower arrangement an hour before the kick-off! How we all laughed.

All ‘new’ industries strive for legitimacy, a movement that is often accompanied by an entire lexicon of terminology and process. For a long time we have been developing terminology and processes that seek to formulate an approach, clarify our position and differentiate our offer. The world of  demand chains,  brand onions and disruption is one that all clients and agencies occupy.

Case in point is the numerous phrases that describe essentially the same thing — brand essence. Some networks have gone so far as to trademark their terms and the processes they use for determination. End result = terminology galore and as much process explanation as strategic clarification.

Spending some time on holiday last week – I revisited Kotler (it was this or be left with a book about a girl in love with a complex man she couldn’t love in the world within which she had to live and her struggle to make do with an empty life with a simple but good man who provided everything he could but not enough for her to be happy) – a comparitively magnificent book on marketing that I first brought to enlighten me when I first came into the industry. It’s a dry read and although wanders into the theoretical it’s pretty refreshing in its lack of terms.

I like Kotler’s steadfast use of the term Unique Selling Proposition (in my mind a potential forerunner of brand essence), a concept developed and named by Rosser Reeves of Ted Bates & Company. A 50 year old term that has stood the test of time and been universally adopted. Some argue that with the advent of product parity it has evolved into the Emotional Selling Proposition. ESP is certainly a concept much closer to our common understanding of “brand essence,” as its focus is on the brand’s intangible differentiator. Although I find it hard to believe that me-too products are a recent phenomenon I think that the ‘U’ still stands up whether that be a feature led ‘portability’ or due to some emotional unmet need like ‘popularity’. Either way to be unique emotionally or functionally is still to be different.

This book seems to either have been penned prior to or has ignored the multitude of copyrighted verbs describing the logical processes for develop brands by agencies needing with some irony, you guessed it – a USP. I would love to see each agencies model worked through with their own brand – please someone in procurement construct this legend! Two birds (process understanding & agency offer) with 1 stone. Please, please, discounted please.

Reviewing the alternatives to Rosser’s, here is a collection of words and phrases used to describe what is unique about a brand:  Brand Essence, Brand Soul, Brand Heart, Brand Mantra, Brand Promise, Signature Strength, Core Strength, Core Attribute, Brand Description, Brand Differentiator, Brand Uniqueness, Brand Individuality, Brand Meaning, Brand’s Central Nature, Brand Proposition…

Any more?

 As usual Tom Fishburne’s nailed the process here.

Ps. A note to purists: I admit that there may be shades of difference between some of these terms. You could make a case that brand personality and brand promise, for example, mean two completely different things. My point is that the differences are largely semantical and do little to advance the clarity of the branding process.

We just won a pitch. A product we have been chasing for months. Hive day one started with a call to this marketing manager then I made up 2 office chairs to sit on. Seriously, its been this long.

It’s a biggie, a parent proof product. “Oh I’ve heard of that” replacing “What’s Commerce Anxiety Disorder”. My mum even wanted to star in the behavioural change application mock-up.  She got her dream. She had to be 67 and meek and mild – which caused a few issues as she has been 47 for as long as I can remember.

Today we visited a big glass building with fountains and manicured gardens, went to discuss examples of our work that correlated to their problem. “Makes sense but where has it worked before” – A cry we can now answer with examples and metrics.  Team back at the office nervously waiting. Hoping we closed the deal. Jackets on and shoes all shiny. We got it. This afternoon I made up our 15^th and 16^th chair.

Our new clients mentioned the passion (probably more nerves and need than anything) and about how different our offer is. It got me thinking and wandering around the web on my return in post win daze and stumbled back across a blog I haven’t been to for ages http://headrush.typepad.com/. The blog champions passion in business. The blog that I crashed into covered the difference between what we now consider “old-school marketing” (otherwise known as The Four P’s — product, price, promotion, and placement — heavy on advertising and “branding”) and the “neo-marketing”  which we consider our end of town.

Here are a few ideas on some of the differences all a light read on a Monday am.

Our ever loving ears hearken once more to the digital pitter patter of patient empowerment.  UCB Pharma have partnered with patientslikeme.com to bring an Epilepsy community to the site.

Patientslikeme.com is a privately owned initiative that encourages patients to post details about themselves. This real world, outcome-based data is shared with individuals and organisations who work to improve health outcomes, including pharmaceutical companies, research organizations, and non-profits.

30% of epilepsy patients are refractory to treatment, so this move is good news for patients, HCPs and even competing Pharma. Over 37,000 patients are already registered on the site as well as 3,000 caregivers. Any epilepsy community should include the voice of caregivers, as a significant proportion of epilepsy sufferers are elderly or have learning disabilities.

Patientslikeme.com doesn’t just collect data from patients, it provides quality information and allows them to blog and communicate with peers. It’s a site that really does seem to have patients’ interest at heart. That’s why we like it – and so congratulate UCB for being a part.

But it should be. Buried in amongst the papers this morning was the announcement from Sanofi-aventis of their intention to donate 100 million influenza vaccine doses to the developing world via the WHO. Well done Sanofi. See if you can find it on the BBC.

Sanofi-aventis to donate 100 million doses of pandemic influenza vaccine to WHO
Sanofi-aventis CEO Chris Viehbacher announced Wednesday that the company plans to make a donation of 100 million doses of influenza vaccine to the World Health Organization to help developing countries confront the influenza A (H1N1) pandemic. Speaking at the Pacific Health Summit, Viehbacher stated that “the future of our industry is linked to the healthcare solutions that will be found for emerging countries,” and added that the donation is being made in support of WHO Director-General Margaret Chan’s “call for common action to fight the pandemic.”

A report today by the BBC confirms what many of us have been expecting. The NHS has a big problem looming. Now I’m not an economist and my understanding of the financial levers required to prop up the economy in a downturn are pretty non existent, but I do understand what has happened before. Recessions hit tax revenues (less people working) and so the Government has less to spend. Even if we ignore all the other stuff like quantitative easing and budget deficits the simple fact remains, money is tight, and its going to get tighter. Add to this an ageing population, the threat of pandemic viruses and a grossly over-administered system the impact on the health service has no choice that to be considerable. Inevitably the spectre of large scale cost cutting, drug tariff pressure and even new drug prescription caps become the norm. There is no doubt in my mind that our industry and our clients business are in for difficult years as soon as the election is called. The policy maker the BBC interviewed called it 7 years of pain from 2011 . In my humble opinion the industry future requires us to be more innovate in the way we plan and launch new treatments, more cognisant of who needs to have meaningful relationships with medicines and more accommodating of the multiple layers of influence that will become normal. It’s true that innovation normally is more prevalent in crisis and whilst no one welcomes what is going on, I am confident that through adversity will come opportunity. We need to mirror the radical reform that our principal customer will undergo, recognise that doing what we have always done will not change anything and embrace the need for new thinking. Thankfully, that’s sort of why we set up…

 Almost a year ago I wrote an article on POM to P, a call for pharmacy to embrace the opportunity that new P brands offer. I stand by my argument that pharmacists’ role in consultation gives value to the consumer and allows pharmacy to become true healthcare providers of the high street.

A year on the opportunity arrives. We are proud to have been an intrinsic part of the launch of alli, a landmark pharmacy launch and arguably the most successful pharmacy switch ever. What is so important about alli is that the consultation is a critical part of the offer – more interaction than transaction. It’s a launch that emphasises pharmacy’s shift from a provider of products to an enabler of positive behavioural change. With alli, pharmacists must outline the personal commitment essential to weight loss, help consumers understand their responsibilities and manage their expectations.

To date both pharmacy and consumers have embraced this brand wholeheartedly. GSK have invested heavily in training and pharmacy have enrolled for that training at an unprecedented rate. It feels that this is the switch pharmacy are really going to get behind, proving once and for all that broader access to treatments is good for manufacturers, good for pharmacy, and most importantly good for us all.

Time will tell…

Patient choice is a hot topic in healthcare, so it was interesting to review the latest clinical guideline from NICE: Medicines Adherence and Patient Choice 

Hive’s focus is patient-centric communication, but we don’t claim to have all the answers on the perplexity of patient choice. It’s a tough one for NICE too, who admit that there are gaps in evidence-based learnings. I picked up on a more basic disconnect – NICE’s policy is one of optimal Adherence, but it is Choice that underpins any behaviour. So, more patient choice infers that adherence is optional rather than optimal.

Patient choice embraces much more than adherence. How the two fit together might go like this: more honesty and understanding between doctors and patients leads to shared decisions about treatment. This increased choice translates into a prescription that is handed over with the mutual assurance that every item will be taken as prescribed. Less wasted medicines and consultation time, arguably better health outcomes for individuals.  

Can this happen when medicine and humans are an unpredictable mix? Not only do people respond differently to treatments, but our choices change from moment to moment. We try things, get a result, forget what it was that gave us that result, and start from the beginning. We’ve only our own bodies to give us feedback, and sometimes that feedback isn’t clear enough to justify repeated behaviour.  

Still, people like the sound of choice, at least in theory, and NICE outlines the many ways that doctors can improve at delivering that right. The guidelines are a step in the right direction, albeit a giant leap from current practice. Eyes will be rolling in surgeries at the thought of fitting more whys and hows into a standard consultation.

Of course, the real mental shift lies not with providers but with users. NICE has not yet issued patient guidelines on choice, and whether or not they do, every patient must find out for themselves what choice really means and how to play it out. I often politely accept a prescription knowing I’ll never fill it. I think I would be braver in talking to the doctor about this if I had proof that there is value in doing so.

 We need a bit of genius to get this right. Let’s teach kids about choice: how to visualise the results of actions, verbalise the decision and analyse the outcome. What else – any ideas?

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.

 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.

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.

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.

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?

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.

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.

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.

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.

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?