By Sven Larsen (@zemoga)

On July 26 at the ExL Pharma 6th Annual Public Relations & Communications Summit, Deborah Sittig led a panel discussion called “Social Media in a Crisis” (for a full report on the session, including a summary from Sittig herself, check out John Mack’s post, “Using Social Media in a Crisis”).

A lot of useful information was covered: case studies; how to do internal preparation and external relationship-development, and the need for active discussion as the event unrolls. What struck me most, though, was a phrase from John’s article, in which he posited that “the time to start managing a crisis is BEFORE it happens.”

Yes, but no. That’s not enough. The forced transparency brought about by social media – the 24/7/365 conversation, the ability of a consumer to have as loud a voice as the official company line – means one thing:

Crisis communications as we know it is a thing of the past.

Gone are the days when it was admirable foresight to lock a dozen people in a conference room for a week to bang out information that would be stored in a fat three-ring binder on a shelf. Anyway, those reams of standby statements and org charts and contact lists usually functioned more as a superstitious talisman against the crisis ever happening than as anything practically useful.

Crises are now less predictable. Not their causes, of course – they always have been. If the causes of crises weren’t varied and surprising, they wouldn’t be crises, would they?

But we’ve lost any ability to figure out which will explode and which will only spark. Any calculus that we once used to try to forecast what situations might become problematic is outdated. That math won’t work anymore; we’d need a New Math to do that.

Consider this example: one patient experiences a non-life-threatening side effect. No one would have done a crisis session like I described to prepare for that. But Taxotere patient Shirley Ledlie became a force that sanofi-aventis had to reckon with – and she did it because of social media.

What am I saying? Should companies just give up? Hide? Embrace chaos? Admit defeat?

Of course not.

Because you can’t predict which situations will grow into crises, everything needs to be in place  beforehand. This isn’t crisis communications. This is just communications.

Get rid of the concept of crisis communications altogether. Stop calling it that. You’re implying that it’s a different animal, and it’s not. The only way to communicate successfully in a crisis in the pharmaceutical industry is to already have an organization of successful communicators.

You need a variety of honest, informative, responsive channels of communication, and you need them now – not when you have a crisis, and not in case you have a crisis, but because these are the new cost of doing business.

You need an empowered employee who is responsible for each of those channels – as part of their job description, by the way, not as an add-on.

You need to monitor for all mentions of your company and brands and executives.

You need to be using those communication channels to be talking to your customers, your investors, your media and your employees.

You need to be starting and keeping up the conversation, not waiting to respond.

That’s not crisis communications: that’s communicating. And that’s the New Math.

This post is part of a week-long series centered around the theme of communication. This week, we’ll identify important communities and provide tips and guidelines on how to effectively reach them.

By Russ Ward (@russcward)

Patient communities are, to many pharma executives, terrifying. They’re the Wild West – an untamed land where people say whatever they want to whomever they want. There is no regulatory-committee-approved language.. There is no stipulation against off-label promotion. There is no official method of reporting adverse events. There is no fair balance. Patient communities are, in short, conversations. Real ones.

Moreover, as online-community expert Dan Shafer said way back in 1999: “Perhaps the biggest single misconception about virtual communities is that they can be created.” So not only can you not control them, but it doesn’t even work if you try to create your own “safe” one? What to do? Stay as far away as possible, is what many have decided. But that does a huge disservice to the communities and the companies both.
Consider another quote, this one the tagline of the e-Patients.net community: “Because health professionals can’t do it alone.” This is probably a startling quote for many people. Perhaps to a highly trained HCP, it smacks of hubris on the patient’s part. “Do they think they know better than I do?” Perhaps to a pharma executive, it is exhausting. “Now patients want all of the complicated information as well as the softer patient-education materials? How are we going to do that?” But perhaps what it should say is something different: “We’ve always done this, but now we’ve banded together.”

There have always been involved patients: unwilling to passively accept their diagnoses and medications, they are the ones leading their care teams. They’re reading scientific journals; they’re comparing and contrasting different treatment options. The difference is that a patient community enables two things:

• Sharing. A group dealing with the same condition can compare notes, share findings, argue the relative merits of different studies or regimens.
• Encouragement. Patient are often discouraged, in small or large ways, from getting too proactive. Well-intentioned (and healthy) doctors and loved ones say things like “trust him”.

Historically, we’ve been more willing to trust our peers to provide insight and opinions that we will believe in, rather than listen to “experts”, but Edelman’s annual Trust Barometer survey found that while trust in companies, governments and “experts” is up, trust in peers has fallen. What does this mean for projects like the Society for Participatory Medicine, which runs e-Patients.net? Not much. Those are small percentage changes, and the movement is much bigger than that.

The best known of the e-Patients is ePatient Dave. In addition to his community participation, he’s got a blog and a prolific Twitter. His conversations give you a sense of the purpose of patient communities. They’re discussing billing errors, sharing interesting links, talking about news in their disease space. They’re commiserating, sharing jokes, talking about things utterly unrelated to their medical conditions. They are, in short, having a conversation. A real one. And they’re not going anywhere.

What should pharma do? Listen. Not try to orchestrate or create or pontificate. Just listen. See what matters to these patients, what they like, what they need, and what they’re thinking. Yes, report the adverse events. But mostly, just show a human face – one with two ears.

By Marty Hardin (@mjhardin)

What’s so great about the iPad?

Okay, let’s get this clear up front. I haven’t seen or touched the iPad. But based on 25+ years of using Apple products, a lifetime of observing people, and pretty good instincts, here are my thoughts.

I’ve been hearing vacillating perspectives. Most first-day reactions were: “Yeah, so?” Let’s face it, there is nothing revolutionary in how the device operates. Touch screen with gestures—been there, done that. Accelerometer-driven dynamic input? Ditto. Gesture-driven UI? Yep. Nothing new to understand. And, personally, I find that pretty exciting.

I had a former client tell me once, “Good design should be evolutionary, not revolutionary.” Taking that axiom as a touchstone, what has Apple done? They have taken an established platform, UI, and form factor and added something that I think people haven’t been aware they were dissatisfied with: size.

Is a larger screen and device that big of a deal? Take a look at most mobile phone users using their mobile applications. Their heads are down, elbows locked at the ribs, and the device is just below heart level gripped by both hands. It’s not comfortable for long periods of time.

Now, take a look at people reading magazines. They have various positions: head in hands while the magazine is on the table, reclining on the couch, magazine on their knees, or head up with a single arm extended slightly above heart level. You can likely think of a few more positions. Point is, the smaller device requires that we wrap our body around it to stabilize and focus on the smaller screen. As the screen gets larger, we don’t have to work as hard to keep it stable in our field of vision. As the size of the object increases, so does its mass. The greater the mass, the more physically stable it is. The result? Less is required of users to interface with the device, and users now have more options in how they interact with the device. The device revolves around us, not us around the device.

The other impressive feature isn’t the physical size of the 9.7″ screen but the phenomenon of the user’s perception of the screen size. Sure, today’s flat panel televisions are huge in comparison, but they sit across the room, not in your lap. Case in point: As I’m writing this, I’m sitting about 10 feet away from a 40″ flat panel, but my 15″ MacBook screen is perceived as much larger and brighter in my field of view. It is, perceptually, twice as large in my field of view. Even though the physical cues in my environment tell me cognitively that it is smaller, I perceive it as much larger. The smaller iPad screen will be held even closer and will be perceived as huge, bright, and crisp. Add headphones and a good movie and users will be fully immersed.

While many are hailing this device as the first major step in the creation of the “digital magazine” delivery mechanism, my biggest concern with the iPad will be its use as a “reader.” Additive light radiating from the device versus the subtractive lighting experience of light bouncing off of the printed page creates a great deal of eyestrain. Add the reflectivity of the polished iPad screen, and you have a device that will be hard to use for in-depth reading. A Web page or short report will be fine, but I feel reading long-form data will prove challenging for most users. If you spend hours reading from your screen, you will most likely do fine. However, I don’t know how the general population will fare.

(For more information on eyestrain from video and computer monitors, visit Charles Poynton’s Website: http://www.poynton.com/notes/reducing_eyestrain/index.html)

So what’s my take on the iPad? Having never touched one? There will be a rapid uptake by core Mac, iPhone, and iPod fans. They want to expand their user experience. The sales will stabilize and fall slightly after the first wave of buyers. But then, developers will create new and exciting apps. Leverage this with the “in-crowd” mentality of the larger consumer marketplace, and the iPad will become the “must have” personal electronic accessory.

So where does that leave the medical marketing community? For those smart enough to begin development and testing now, there is a golden opportunity on the horizon. Why?

In a world that looks at usability, market penetration, and uptake, we often forget that the most valuable aspect of any product is its function beyond its immediate use and its ability to integrate into our daily lives.

What everyone seems to be missing in the equation of evaluating the iPad and its ability to become a “medical device” is the fact that it is first, and most importantly, a “lifestyle device.” We as developers need to take a step back and rethink the philosophical aspect of the tool and the opportunity it presents to us. We need to see how we can make the integration of medical apps fit within the life function of medical professionals.

In the past, due to the physical limitations of medical devices, form, function, and use were locked. An ultrasound device was only an ultrasound device. Later, computers were added to the devices but with a use-specific function in mind—dedicated processing of the data sets from the device to which it was attached. It was all very elegant, from an engineering perspective. The device and its function were its only reason for being.

Now, we have a golden opportunity not to dominate a small segment of the doctor’s time but to be integrated into the HCP’s lifestyle. In the “always on” environment, it becomes easy to imagine a medical app icon sitting on the same screen as a social media app and a weather app. In the past, dedicated devices led to the segregation of devices and applications. Now, we can have a presence on a daily basis.

The challenge will be expanding our thinking beyond our old paradigm of functional applications and expanding the scope to include access to richer information. Research data, data tracking of patients, MOA videos, and CME are all ripe for delivery via our apps. Integration with our Web sites, print materials, reps, and customer service is ripe for the taking.

So what’s so great about the iPad? For now, it’s only speculative. But, I suspect that a year after the first units ship, many people will be surprised by the new and exciting ways they are using the device. Many will not realize how dependent they will have become on the device in their daily lives. And, a good many of those folks will be in the healthcare community. Are you getting ready?

Back in February, Damon Caiazza of GSW gave us a few good reasons not to abandon the sales force.  Now he’s back with another guest blog post packed with advice on how sales representatives can maximize their value to HCPs.   Read on for more of Damon’s insights.

By Damon Caiazza (@dcaiazza)

Knock knock!  Who’s there?  Pharma rep!  Pharma rep who?  Pharma rep with no new data or samples, but would you let me in anyway?

Far too often this is the reality for many brands.  In my earlier post “Don’t Abandon the Sales Force” I made my case regarding the value of the sales force.  The key to remaining valuable is being able to gain access to the practices, clinics, or hospitals in a rep’s territory.

Armed with no samples or new data, how does a rep still gain access?

My answer:  Find new and innovative ways for the rep to maintain a presence.  Only those reps that provide value will be successful.  Value is no longer just about the pills, it’s about a lot more.  To help you start down this path of value delivery, I’ll review 4 thoughts that are bound to be conversation starters leading to more access and stronger rep relationships.

Make the HCP Office more Productive

“Time is money” has never been truer in the daily running of a physician’s practice.  Given this specific pain point, pharmaceutical companies need to focus on solutions that make the office run more efficiently.  This can be anything from automated sample ordering, to reimbursement support, to billing systems and everything in between.

Open the door to more meaningful relationships with the office manager, physician, and nurse.

Help the HCP Better Educate Patients

The emergence of the ePatient has brought with it a lot of incorrect and misleading online information.  The more an office can provide in the way of patient education, the more certainty a physician has that their patients are getting the right help.  Who better to help provide patient education portals, customized patient education tools, and educational content than the pharmaceutical industry?

Open the door and build confidence with a valuable (and often overlooked) member of the team – the Nurse.

Share Your Marketing Know-how

There is no one in a better position to help the physician with marketing solutions than the pharmaceutical industry and its advertising agencies–agencies and resources that the average physician practice will never have at their disposal.  It’s time pharma unleash the big guns to help out those practices that want solutions which make them better marketers in an environment that will continue to get more competitive.

Open the door to key conversations with office mangers, often a key gatekeeper of the physician’s schedule.

Become an Information Clearinghouse

The pharmaceutical industry has a wealth of clinical and medical data at its disposal.  It’s time to leverage the enormous amount of content that is generated by your company in a meaningful way for the physician.  The more freely you share your content through HCP Web Portals, Mobile Applications, and in office Kiosks the stronger your relationship will be with the HCP and patient community.  Become a trusted partner, versus a necessary evil.

Open the door to more direct patient communication via the office environment and the health care professional.

The Key Takeaway

You may or may not agree with some of my suggestions, which is fine by me.  Regardless, what I hope you take away from this post is a new appreciation for the role a pharmaceutical company can play in the office and how it can enable its sales force to be the key delivery mechanism for solutions, not just samples.

Knock knock!  Who’s there?  Pharma rep! Pharma rep who? Pharma rep who is here to help you be a better practice.  [Door opens]

By Russ Ward (@russcward)

I was thinking that to have a close circle of good friends is to have a trusted relationship with each person. Typically we make regular contact with each other to share our common interests and keep up with what is happening in our lives.

When we think about what it takes to develop this level of trust and connectedness there are some basic behaviors that are necessary to get to this point. We need to communicate regularly with honesty and respect and our relationship needs to provide some form of benefit and relevance for everyone involved (not just what’s in it for me). In turn we generally recognize our own value and worth to the relationship, which positively impacts others and boosts our own self-esteem.

Relationships that are one sided usually don’t last very long especially if one party fails to feel that the connection is irrelevant to them or the trust level is diminished.

So it’s no real surprise that Social Networks on the Internet have some close parallels to the real life model. In the Social Media space we need to spend time developing and maturing connections – being these acquaintances, affiliations and friends. We need to do this with meaningful communication that has integrity and relevance that we hope over time will build respect and earn trust. In short building a network requires an honest effort.

Ok so I am restating the obvious – the effort to seek out people in social networks or accept their requests to do the same thing actually makes the connection, but the connection is not a relationship until we have established some level relevance, credibility and trust.

However, unlike real life the Internet has some interesting twists … how do we establish any level of trust and credibility with people when we are almost totally unknown except by a screen name or an email address? OK, granted, some of our connections are actually friends we know personally from our work or home life but these folks are usually the minority.  Don’t let this fool you, even in these anonymous scenarios people seek integrity and relevance.

In the realm of Information Science we can find that being relevant to the receiver or user is a vital part of the process. This reference describes how well the information matches the needs of the user. Naturally, if you produce relevant information over time you may become perceptibly credible in the minds of the receivers or users. In a gradual transformation, as one gains credibility the associated notion of reliability and trust slowly develop.  But, to be sure – the occasionally relevant communication will not make you friends to all. We need to continue to work at being relevant to our online friends and connections to build and maintain trust.

For corporations to develop trust the company must work very hard to be relevant to all manner of potential connections. This relevance needs to be on the users terms and not on the corporation’s terms.  Depending on the industry many corporations attract criticism and suspicion so it is even more important to work on relevance, credibility and trust.

1. Find out what type of content your users are looking for that will make you relevant.
2. Email, Tweet & Post regularly (weekly or monthly).
3. Be sure to provide contextually relevant and personally meaningful information for the user each time you have something to say.
4. Aim to provide users with valuable insights that they can recognize and understand.
5. Give the folks in your network the opportunity to be part of the conversation – one-way relationships are pretty flat.
6. Don’t use the Social Network space for your advertising blasts (I am sure we have experienced how it feels when a “friend” tries to sell you on some scheme that you’re totally disinterested in).

Managing your online social networks by communicating, creating profiles, blogging, tweeting, or placing links builds your network. To stay relevant to people in your network requires an ongoing effort.

Over time if you don’t respect and care for your friends and associates you will gradually loose them no how much you once might have meant. As your relevance drops so will their loyalty and eventually you and your web site will be all but forgotten.

Are your current communications relevant to your customers? Will you maintain their “digital friendship” with your current efforts?

Live From the E-Pharma Summit (#epharma)

Dave deBronkart, Co-Chairman of the Society of Participatory Medicine provides some unique insight in to the patient’s approach to digital media and healthcare.

Live from the E-Pharma Summit (#epharma)

Damon Caiazza of GSW explains why he thinks Pharma companies shouldn’t be talking too much about social media. Watch as Damon calls for an increased focus on underserved HCP communities and tells Pharma execs “Don’t forget the sales force!”

By DJ Edgerton (@wiltonbound)

Have you ever heard the expression “You’re judged by the company you keep?”

Now your social circle can even affect your credit.

Social media is being monitored. You knew this.

But it’s being monitored by financial institutions. You may not have thought about that. So far it’s just for marketing purposes, but it certainly puts the people you’ve chosen to connect to, and the information you share, in a different light.

That’s just the most recent way we’ve seen that our circle of friends can affect what we previously thought of as individually determined behavior.

We already knew that your friends can affect your weight and activity level. As the New England Journal of Medicine put it, “Network phenomena appear to be relevant to the biologic and behavioral trait of obesity, and obesity appears to spread through social ties.”

So here’s a controversial thought. Does it make sense to have patient support groups to be sick together?

If you want patients to get the benefit of talking to people who understand from personal experience, the good money looks like it’s on mentoring programs with successful patients.

There are many patient mentor programs throughout most disease states. But there are still many peer support groups, too.

And while there is benefit in a patient knowing others are struggling alongside him or her, in terms of truly improving health outcomes, patients don’t need commiseration – they need an exemplary friend, a coach who’s been there, a mentor. We’re encouraging our friends in healthcare to focus on developing more of these types of programs in their work.

What about your company? Will you be one of the organizations leading the way and developing mentor programs using social media?

By Dan Bobear (@dbobear)

Twitter is the current “mot de jour” and an increasing part of many companies marketing and corporate communications efforts. But like any media tool there are a number of “do’s and don’ts” that need to be observed in order to get the maximum benefit out of this exciting new tool. Luckily, for Pharma marketers, we can learn from other industry’s examples and also from the pioneers in our own field.

Online pioneer and Twitter superstar, Guy Kawasaki breaks the process of successfully utilizing all that Twitter has to offer in to five steps. These are:

1.Monitor
2. Sell
3. Support
4. Engage
5. Prospect

You can check out Kawasaki’s twitter script here.

The gist of Kawasaki’s arguments for using Twitter is that it’s an amazing tool for companies to carry on conversations with their consumers. And the important word here is conversation.

Twitter has had substantial problems with Spam since it’s inception and this has led to a very negative reaction to the use of autoresponders. Some companies have tried interesting solutions to the autoresponder dilemma. For example, AZ Helps is a twitter account that Astra Zeneca uses to communicate with customers who tweet about Nexium. A canned response provides an offer to help and invites the customer to dial a toll free number. While this provides some degree of comfort to a user, it doesn’t encourage any sense of engagement with the brand. Novo Nordisk’s Racing With Insulin account has been more successful. This is a sponsored Twitter account where racecar driver Charlie Kimball provides updates about his career and struggles with diabetes.

Companies looking to monitor discussion regarding their offerings can easily use Twitter search to find posts related to individual products or services. The can also use the hash tag convention (using a “#” sign before a phrase, e.g. #cancersurvivors) to find a series of posts or dialogue on a given subject. Monitoring is a good way to learn what is and isn’t acceptable in the Twitter world and there’s no better place to get started that Jonathan Richman’s Pharma Social Media wiki. This helpful site aggregates information on Pharma companies and industry observers who are using Twitter (as well as a bunch of other social media tools). Another interesting example of Twitter aggregation is Ignite Health’s website built around the #fdasm hash tag (a tag created to discuss the FDA’s hearings on social media). Being aware of conventions and practices (as well as the current state of the discussion) is essential for effective tweeting.

Sales may not be something that Pharma can actively engage in (fair balance and adverse effects reporting regulations keep many companies away from this) but customer support and service is one of the things that Twitter is being widely used for. The industry standard is Comcastcares, a corporate account owned by the cable company that has been famously used by Comcast to address service issues. While originally a one-man effort by Frank Eliason, this customer outreach program has expanded to include several other Comcast representatives. To date, there hasn’t been any breakout use of Twitter for customer service by Pharma companies (perhaps due to fears of adverse event reporting) but this seems like a natural use for this tool.

Engagement is an area where much of Pharma’s current Twitter efforts have been focused. Johnson and Johnson have been successful in supplementing their popular JNJBTW blog with a Twitter feed, JNJComm, that has attracted a healthy number of followers. Their tweets feature a diverse array of content and are a good example of how a Pharma company can engage in a conversation with consumers while being aware of regulatory constraints. Other companies like Pfizer and GSK may have attracted more followers but are less respected in the “Twitterverse” since their content consists almost entirely of links and re-tweets.

Overtly “Prospecting “ is not something that’s really applicable to Pharma. But isn’t it really the ultimate end of any marketing efforts. We’re always looking to bring in new customers whether we’re providing a service, educating consumers or simply allowing the public to learn a little bit more about us.

The final (and perhaps most important) tip about Twitter is … you don’t have to do it.

Twitter is a real time, online conversation, a tool that thrives and survives on multiple participants engaging in discussion about topics that are relevant to them. If you have a product that is not engaging to a wide base of people (say an orphan drug or little known brand) then Twitter may not be the right tool for you. Consider using Facebook or NIng or other social media to create a community. Or if you just want to let the world know what’s happening in your company, ask yourself if a blog or e-newsletter (tools that have less of a time constraint on their content and thus are easier to put through a review process) might be a better way to communicate.

Whatever you decide to do, remember, “keep it real”. After all, you want to be a trending topic because of the value you provide the community not because people are tweeting about how your company “doesn’t get it”.

Listen first. Engage with your potential followers. Then tweet away to your heart’s content!

By DJ Edgerton (@wiltonbound)

Have you ever thought of the government as a business partner?

Over the holidays I managed to catch up on a lot of reading. The always insightful Chris Brogan had an interesting post on how a music company had created a custom version of Tweetdeck (a Twitter aggregator) that was preprogrammed with interesting artists to follow on Twitter. Chris was pointing out that this kind of “extra work” could be done by a lot of companies and that it would really provide value to consumers.

Of course, I started thinking about how Pharma could apply this strategy. Like everyone else, I thought about the barriers first. How adverse event reporting requirements would stop companies from being able to recommend specific tweeters. But then I thought about how companies might be able to create other tools that used trusted third party information to achieve the same goals. Why can’t companies us e the wealth of information provided by the FDA, the CDC and other government agencies to build digital tools that inform and empower their consumers. Lysol’s Germ Information Center is a terrific example of this kind of project. And there are many more out there.

Yes, we live and work is in a very strictly regulated field. But hose same regulatory organizations also provide us with a wealth of resources that we can use to help the people who keep us in business. Barack Obama and his administration have been incredibly forward thinking in their use of technology to share information with the public. We  can learn from those efforts and use the tools they’ve created to make our customers lives better.

We’ve been doing a lot of brainstorming about this stuff at P & P lately and very soon we’ll have some news about a project that taps directly in to this type of thinking. In the meantime, ask yourself – why can’t my organization do something like this too?

PS: If you come up with a great idea but don’t feel that it’s something your company can do (due to regulatory restraints, budget restrictions or whatever) share it here. Somebody reading this may be able to take the your idea and run with it (and that benefits everyone)!