Digital Influence Mapping Project

Inside the Centocor Blog

Melissa Katz and Michael Parks from Centocor talked with a few of us and John Mack (thanks to JM) about their new blog:CNTO411 . It follows in the footsteps of very few, most notably Marc Monseau at J&J. That means they are still on the leading edge. Injecting social media into the communications practices (forget about the marketing side) remains a huge challenge throughout the industry. I remain convinced that a few fearless folks like Melissa and Michael are the key to introducing change. I mean not only do they likely have legal and their internal stakeholders nervously watching but they will inevitably be a lightening rod for the social media purists who will analyze their every move and comment vociferously.

Why now?
Melissa referred to their experience launching the film InnerStates and hearing a little bit of noise from John Mack about inviting him and other bloggers. This and other experiences convinced them there was a valuable collection of conversations and influencers and it was time to jump in.

The name?
CNTO411 - that's how they mark product launches - "CNTO". The 411 is "information."

What do they want to achieve?
The site is a corporate site. They may talk about products but it's not the core intent. They do not plan on using it as a marketing site at all. It should be a discussion about disease and conditions. Melissa will be the primary blogger (this is her primary job). They may have guest bloggers.

What might success look like?
Having a pretty fluid conversation going, gaining credibility in the blogosphere. They really want to walk-the-walk of social media.

Summary
It sounds like they are using this as a first step to get experience with social media within the organization. I asked Melissa whether the blog was a conscious attempt to give others within the organization some feel for social media - to gain confidence and understanding. The answer was simple - "absolutely" 

Neither Michael nor Melissa were very specific about the audiences they are trying to reach or how the blog will focus on topics. Sounds about right for a pharma. I love their openness about where this might go. Seemingly little efforts like this (I know it was probably a big lift to sell-in) will go a long way to introducing innovation in the pharmas not just communicate but behave. 

   

WeMedia 08/Miami: Digital Health Entertainment

Humana's Grant Harrison is VP of Integrated Consumer Experience. He is doing some really cool things.

They are investing in many initiatives that could be grouped under 'health entertainment'. Think of games that require kids to run around the house to get to the next level. What's really cool is that they are investing in bringing Velib bikes to the US the way that 20K bikes were distributed across Paris.

Very cool idea for a Humana to support. I wonder how much word of mouth that will spark (never mind 'earned media').

WeMedia 08/Miami: Digital Health Empowerment

At WeMedia 08, Scott Mowbray from Health.com is talking with  Kendall Lockhart, Co-Founder, Nenuphar Mobile Media (and yoga practitioner - you had to be there for his intro) about what it means to empower people.

Ways of 'digital health' empowerment
1. Voting
2. Personal empowerment: during a prsonal health episode, it is critical to know what to ask for, what to demand from all of the health providers involved in your care

Social Marketing & Community
Kendall asks 'What if people don't want to change (e.g. lose weight)'
I would throw back - "what about transtheoretical model of social marketing?" that and other models to describe what causes people to change is begging for the suport systems now possible through social networks/communites. In general there is too much emphasis on simple delivery of credible information (vs. building credible community).

Kendall: Is there more 'community' now?
Scott feels that we live in a one-brand (WebMD) world. We are at an early stage of development of alternative sources for credible information.
I would throw back - what about the vast array of LongTail patient affinity groups? Are we really headed towards a model of a handful of WebMD competitors or will it be long tail from here on in with patient affinity groups like those hosted by Inspire.com and PatientsliekMe?

A Health Social Network With No Professionals...

Social media amplifies everyones' voice. In many cases, it has broken the dominance of traditional media and corporate communicators by empowering "citizen journalists" to break stories and challenge the traditional headlines. Moms can connect with each other and get advice versus relying on the "experts" annointed by publishing houses and media companies.

But health is one of those areas where we may bemoan the tyranny of traditional medicine and the special interest influence of pharmaceutical and insurance providers, but I still can't diagnose a major illness never mind treat it. I rely on a doctor. (regretably as mine is such an old-school, "stop-your-whining"- kind of doctor).

iMedix just won the Crunchies for Best New Startup 2007. This is annointed them by the social media tech community from the Valley (I am guessing here as there were 0ver 122K votes cast to determine the winners) where the emphasis is on "tech" and venture capital. It is not a hotbed of medical innovation.

At it's heart, iMedix is a social network for people who want to talk with other people about common conditions and health interests. If I have thyroid cancer (I don't but do have a related thyroid thingee), I can type it into their super-simple interface and recieve simple web search results from prefered, brand name sources (are they "scraping?") and a number of people who have tagged themselves as interested in 'thyroid' or 'thyroid cancer.'

Now, I will admit that I am a bit curious about what the crowd makes of this weird phenomena of thyroid malfunction. I am suspicious of some environmental condition that will reveal itself someday (my wife, myself and our cat all suffer from a related condition). Still, why would I reach out to these people?

The iMedix social network has a lot of things going for it and most of those are in the simplicity of the interface, the function and the overall ease of use. It stands as a strong testament to the strengths of a Web 2.0 mindset. Still many services are trying a social network model for healthcare issues. Some, like Revolution Health mix community content and features with professional information from trusted brands like Cleaveland Clinic, Mayoclinic.com and others. There are even "doctor bloggers'. Inspire, formerly Clinicahealth, goes a different direction by offering a social network platform to those that share a condition and want to connect with each other. It might be the Preemie social network or the Diet and Fitness community at Discovery Health.

iMedix is a broader social network driven by a front-end search interface that drives you to people who have tagged a common interest. We don't know much about each other. The service is new and most profiles are half-baked or not baked at all. Mine included. I am just not sure how much of my health interests I want to put on my profile beyond the one I have shared in this post.

Problems with iMedix:

• The management team is all tech VC and start-up folks. Not a single health professional or pyschologist.
• No clear way to assign credibility to different members. I could easily get a bunch of hooey from folks with no repercussions to the service or that member.
• The homepage is a big stock photo. Don't these startups know that stock photography telegraphs - "don't trust us, we are creating an image here."
• The dominant member (or does he work there?), Sean, appears to be represented by a wonderfully attractive...stock photo! Remember the Macwarehouse catalogs in the nineties that featured thumbnails of their customer service people that were laughably stock images? - "Hi! I'm Gretchen. Call me." Well, it's not funny when I am suffering from a condition and you want me to trust you.
• There is no critical mass of members. Right now, the service seems stocked with test accounts and staff members.

I like the technical and user experience. But that's not a good enough reason to give it the best startup award (the awards were user-voted). We'll see if they get past the weaknesses mentioned above to unlock a truly powerful health social network. To do, they will have to probably partner with some of the more trusted information providers. It's not likely enough to aggregate their search results.

Will they change? Or does iMedix just want to flip the company? Or worse, are they struck by tech hubris that won't let them see through to these weaknesses enough to fix them?

Idea Bar #9: Health Fashion & Lifestyle Store

So many pharmaceutical companies want to build better relationships with patients and physicians yet get caught in the ruthless cycle of pressure for short-term product sales and safely navigating regulation or worse, the threat of more regulation. Launching a new drug is complicated. And it's a game with a lot riding on it. A game that can squash creativity in certain organizations.

Regulation like "fair practice," DTC rules and "adverse event reporting"  are hard enough. The effectiveness of the push and pull of TV adverstising for drugs is really not all that clear. 

So, how can pharma build that better relationship? Can they really balance product brand-building, corporate brand-building and sales?

The Well, Well, Well Marketplace

Someone needs to create the Well, Well, Well Market (WWWM). We're talking -  "well, well, well, don't you look good" or "well, well, well I thought you were sick but you seem to be doing okay..."

This is a market that sells products that help us all live well with our various diseases and conditions without sacrificing our taste. If we test ourselves because we are diabetic, we use cool kits like Stickme Designs. If we have to take food through a tube even after you are back at work (happened to a friend of mine), you have a cool shoulder bag with the tubing built into your shirt (remember the cool "stillsuits" from Dune? ). If your hair is out due to chemo, not only do you get much cooler scarves but head-care supplies like sunscreen and even some hat suggestions.

The bottom line - every condition that allows us to remain engaged in life we ought to enhance by putting our best fashion and design talent against it.

It's Alessi for devices. Donna Karan for chemo scarves. Dean Kamen for wheelchairs.

Marketplace of Ideas
And it's also a marketplace of new fashion and design innovations from the crowd. Look at today's NY Times magazine article on the 'craft-centric' cottage industries sprung up throughout the Web . This marketplace could become not just a breath of fresh and cool air for people challenged by conditions, it could also become a boost for those creative minds that would dream up super cool solutions.

One of the biggest hurdles for big business to develop lifestyle solutions for people without legs or with special medical needs is the small size of the marketplace. Yet their are many entrepeneurs who are motivated by the challenges they face or their loved ones face. They are more than willing to dream up fashion and design products without a million-dollar payday expectation.

Pharma builds the store 
What if a pharma built the store? One of the challenges here is that no one pharma has drugs for devices across a wide collection of conditions. While this one has deep expertise in diabetes, another will have deep expertise in cancer treatments. Maybe an independent needs to build the mall, but the individual pharmas need the opportunity to create a cool store for their patients (and physicians) that help them live well with their condition. 

Being 'of-use' to patients is a great way to demonstrate they really do care. And helping people with diseases or conditions lead a high-quality of life via the best style and usability in design is one way to do it. Even if a pharma just built a promotional 'window' for these great products and, in the process, motivated others to design even better looking chemo chapeaus. 

Pharma Opportunity: Health Fashion

I need a new blog category. Besides Idea Bar. I need a category for ideas we recommended that show up somewhere else completly independently (and corroborate that we are onto something.

Springwise - one of my regular must-reads - reports on fashion "carrys" for glucose testing. This is a simple step forward but in an intersting way implies a shift in approach for those with, in this case,  diabetes. Don't let your disease own you. Don't let the fashion-less product offerings from health companies own you.

In this case it took an entrepeneur (and woman with gestational diabetes) to offer a cool way to carry her gear. We recommended this to a pharma client a while back. Now they should buy her company. Not for the revenue but to make a deeper commitment to the patients they serve. Not just medicine but lifestyle in context to their disease.

I love that she has a "beta-stickers" program. If ever there was a company set up to succeed via word of mouth, this is it. I hope that's where she goes with her marketing.

Rickin Velte's company is called Stick Me Designs. Check them out.

An Exceptionally Curious Patient

I have been following Amy Tenderich, DiabetesMine.com, for some time. Recently, I got hooked into her challenge to improve the product design for diabetics and other patients. This garnered a design from Adaptive Path and lots of visibility.

Her blog is passionate and well written. The epitome of the empowered patient or, as she herself says, the "exceptionally curious patient."  Being exceptionally curious about her, I wanted to know more. So I asked. Here's what she said:

Me: What did you expect to get out of blogging when you first started? What did you think your blog would be "about"?

Amy: My diagnosis came as quite a shock, and I felt terribly alone and overwhelmed. So I turned to the Internet for help.  At that time, the Net offered nothing but a dizzying array of formal medical documentation and "bad-news" headlines. Patients had a very limited presence on the Web (chat and message boards), and nobody was talking turkey about what it's really like to live with this volatile disease. So I set out to create the diabetes site that I myself was looking for as a patient -- a place to share what I was learning, to “vent,” and to connect with others affected by diabetes.  I thought it would be mostly a personal outlet. Later, the news reporting and community advocacy dimensions just evolved; I ended up throwing myself into this thing 100%. 

Me: How do you feel about it now? What do you get out of it now?

Amy:  Right.  Fast forward to Fall 2007.  DiabetesMine is a nearly a full-time gig now.  I post almost every day. My site hosts advertisers.  I spend an absurd amount of time on the web, for a mother of three.  I attend industry events and sit in on webcasts; people send me news tips and requests to reprint my material and pleas for help.  I've learned a ton, but I am still no doctor.  I'm still just watching with wonder.  I remain an exceptionally curious patient with a compulsion to do something for people with diabetes. 

The outpouring of appreciation has been tremendous. I’m amazed every day by the emails I get from people touched by diabetes.  And I was honored to win the LillyforLife Achievement Award for diabetes journalism last summer. It's magnificent to know that all the time and energy I'm pouring into DiabetesMine.com is recognized by the community it's meant to serve.

Me: You have wrestled with a chronic condition in the established healthcare system, established a independent voice in the patient and healthcare "community", just attended Health 2.0 - what do you think the 3 biggest changes are afoot for healthcare as a result of digital innovations?

Amy: Lots of changes are on the horizon, based on everything I heard at the forward-looking Health 2.0 conference.  Three “movements” of note are:

Changed RELATIONSHIPS – all these interactive tools on the Internet provide patients with information, choices, and a public voice never imaginable before. As a result, our relationships with each other, and with our doctors and our healthcare insurance plans are changing.   When a patient goes to see their doctor armed with detailed questions about the new diabetes drug Januvia, for example, they not only help themselves, but also the entire patient community, by prodding that doctor to know the latest and greatest.  All of that doctor’s other patients will benefit from this as well.  The patient also changes their relationship with the doctor from a passive teacher-student dynamic to more of a partnership.

The PERSONALIZATION of medicine – part of the movement is doing away with the “cookie-cutter” approach to medicine, because experience shows that individual patients can respond quite differently to the same dose of the same drug. Through molecular analysis, we’re now able to identify genetic markers that help determine each individual’s health needs. The experts tell me it won’t be too long until we’ll go visit our clinicians, undergo genetic testing, and then get handed a miniature hard drive containing our personal genome sequence, which can later be uploaded onto publicly accessible databases. Sounds like science fiction, but it is in fact already happening.

An OPEN MARKET approach to health – visionaries actually foresee "disengagement of the employer as the healthcare payer" which will "open up a whole new market."  In a free consumer healthcare market, we might use something like a FICO score (rating of your financial credit) to rate your personal health.  The better your health, the higher your score, and it would be your doctor’s job to help you raise that score.  If your doctor doesn't help you improve your score, that would be good grounds to find another doctor.  Under this model, doctors would be directly accountable for the care they give, and patients would do a lot of shopping around!

Me: Healthcare is pushing from many directions towards the consumer more in charge of their own healthcare. Does "in charge" equate with "in control"? What has to happen to help consumers be successful at managing their health?

Amy: Through blogs, wikis, podcasts and more, consumers certainly have a more powerful voice in the healthcare arena than ever before.  We are definitely in the middle of a transition toward “consumer-driven healthcare” – although I’d say many of the core concepts haven’t fully materialized yet. 

Education is definitely key, not least because of the potential to widen the gap between the Internet “have’s” and “have-nots.”  There’s still a large portion of the population that doesn’t have access to all these nifty online tools. 

What would be invaluable, for example, would be something like the experimental Expert Patients Programme launched in the UK recently.  They took people living with chronic illnesses and taught them self-management skills over a six-week period, with an option for brush-up courses later on.  They dealt with problem-solving, managing stress, and how people can develop positive “partnership” relationships with health care professionals. The program was a huge success, at least from the perspective of the participating patients.  And I have no doubt that their long-term outcomes will be better than their counterparts who weren’t in the program.

Me: What's next for you?

Amy:  A lot needs to be fixed in healthcare in the US – from the insurance reimbursement model to the design of medical devices for patients with long-term illness.  I view technology and social media as important factors in bridging the gap between “the system” and its consumers.  I want to be an active part of the group that helps improve the situation through community involvement. I guess my specific goal is to help improve the lives of the people who depend on the healthcare system the most. 

Amy is smart and influential. If you are interested at all in what an exceptionally curious patient with a great understanding of social media thinks about healthcare and 'digital health', read her blog.

Idea Bar#8:Health Literacy

There's a lot going on in healthcare for the consumer. This past week, I attended and spoke at Consumer HealthWorld in Chicago. Innovation is happening everywhere in healthcare.

• Plodding along behind the scenes are many efforts - some of them contentious - to create a common and accessible platform for our health records.
• Consumer-driven healthcare continues to gain momentum with more and more ways to place me and you in charge of our healthcare management decisions.
• Social media impacts the broad industry on so many levels from offering patients peer-reviews of doctors and hospitals to condition-specific communities to grow and serve their common interests.

And business innovation. Two of the most interesting people I met were Janice Jackson, who heads up the Healthcare Innovations Center at AstraZeneca and Margaret Moore who runs Wellcoaches. Both represent a focus on business innovation. She is exploring different business innovations that could change how healthcare is delivered and how revenue is made. Janice participated in a panel that spent a fair amount of time debating the pros and cons of retail health clinics (e.g.  "Minute Cinics").

Margaret runs Wellcoaches which is a type of association for physical trainers and wellness coaches. She is part of an increasing focus on wellness and prevention versus treatment.

The Idea Already:

Health Literacy Programs for Consumers

With all this great change happening and new information and decision opportunities for the consumer - should I pay $40 co-pay with my doctor for a routine exam or stop in the minute clinic in Target - there is a terrific opportunity to provide health literacy programs to help all consumers get smarter about the healthcare options available to them.

Pharmaceutical Leadership Opportunity

This new health literacy program is the perfect initiative for a brand-conscious, consumer-committed pharmaceutical company. Each of the pharmas struggle between ambitions to make their corporate brand meaningful to consumers and their need to build product brands and sales. I am clearly talking about the former but firmly believe that any additional trust pharmaceutical giants can build with patients and physicians will utlimately (and quickly) strengthen their bottom line.

Right now, healthcare literacy is provided by that giant firehose of information called the Internet. Either you are getting expert information on heart disease from WebMD or hearing from a peer about their Lasik surgery on RevolutionHealth. You may belong to a patient community through Inspire (formerly ClinicaHealth) and may even get some "stay healthy' coaching through your HMO online. You are perfectly aware that there are agendas or at least POVs in collision out there: does your HMO just want to keep your benefits down? do the pharmas want to sell more pills at any cost? is your doctor struggling to achieve maximum throughput of patients just to maintain an entrenched business model?

We need an initiative akin to the media literacy efforts of the 60's and 70's that sorts out all of these new options and unpacks their meaning, bias and significance for people. Remember Paper Tiger Television - that was a grassroots organization that helped consumers understand the bias of media to better "read" what was delivered to them. The cable television industry created an initiative that continues today with Cable in the Classroom.

We need a health literacy initiative. In the age of consumer driven healthcare, we need to do better than just give people more control via new choices, we need to give them information that leads to decision-making tools and strategies. We need to help consumers understand and make these new choices.

The U.S. Government has an initiative afoot under HHS's Health Resources and Services Administration. They will have an event at the end of October which is apprently Health Literacy Month. NIH has it's own effort, as well. We should not leave this up to the government. A smart pharma could make this their signature CSR (corporate social responsibility) effort. It is an issue they could authentically get behind and rally their employees to be involved with. (The best CSR programs involve and inspire employees)

What would be the components of the program?

1. OurHealthLiteracy.com: Yes, I know that "literacy" is a mouthful for most consumers, but this is all about getting smart to be even more empowered and that is what literacy leads to. We are all illiterate in this byzantine, chaotic new world of healthcare change. There's power in knowing that fact and wanting to dig out.
2. Start with simple, DIY-style articles from different experts on the fundamental issues and choices out there. This would be a great way to solicit content froma variety of academic, commercial and consumer-created sources and build an overall "linkyness" to the site.
3. Build a mobile-accessible Health Answers FAQ - an ever growing database that reaches into a community for new answers much like Yahoo Answers. Each "answer-er" would need to identify their bias and enough about themselves that the person seeking their answer could judge the bias of the answer (all information has a bias)
4. Health: How it Works Video series: Video episodes that explain the fundamentals including the pros and cons. Imagine an episode on retail health clinics: what are they good for, what to watch out for, when to consider using them. Each video could allow for user comments to add to or debate some of the conclusions.
5. Syndicate content via widgets: create the Health Answers widget and give it away to everyone to embed in their sites and blogs.
6. Events during Health Literacy Month (October) that pull consumers, consumer advocates and helathcare professionals together to frame up additional curriculum for conusmers - what do we need to know now. these can feature blogging summits leading up to the event and live blogging/vlogging at the event to carry the proceedings farther while walking-the-walk of openness and participation.

Can a pharma really pull this off with credibility? They need a partner. But they can own it with that partner. Look at what WalMart is doing with their green efforts by linking up with key environmental organizations. Who would have thought?

This is the time. Consumers need this. Consumer driven healthcare needs this. I doubt HMO's ability to provide this but I do think the right pharma could.

We'll see.

The image? It is a concept-piece by Kristina Lee that "enables users to track their health through nutrition and fitness." A wild and woolly idea for the future that depends on health literacy today. See more about the phone here >.

Consumer HealthWorld: We Need To Get Pharma Talking to Grow

Big conferences aren't as much fun as small ones. Consumer Healthworld tries to pull off a big conference and has a very traditional executive conference feel. The funny thing is that they couldn't pull it off and that worked. Our social media sessions were intimate, vibrant discussions.

But it remains clear that pharamceutical companies are moving even more cautiously down this path than I had thought. Enough has been said about the reasonable ways pharma can manage adverse events reporting. We had a whole session that talked about little else. Consultants offer "rallying cries" and other dramatic deliveries of what pharma "should do."  Now it's time for pharma to start talking about its little experiments in social media. Now it's time for a pharma to openly discuss how it is actually listening to patients and/or healthcare providers. Some are listening. Some have pro-active AER procedures in place. I am sure some think that if their monitoring partner doesn't report any specifics they are spared the intent of the rule. (This is a risk I would not recommend) Many overestimate what they must do in regards to MedWatch. But there I go - another consultant telling the industry which way the wind blows. Change must come from a few brave souls inside the industry.

We all know a handful of stories from Communispace communities, to conversation monitoring to that dang Alliconnect blog.  Time for pharma to start talking about their experience. That's what will push the indutry forward into embracing customers in a new way and learning how to use digital and word of mouth marketing techniques to bolster the waning effectiveness of DTC.

We'll see if that happens at the Exl Pharma: Digital Pharma conference in Philly in October.

Healthcare and Social Media: Are we getting somewhere?

Event: The HealthCare Blogging Summit /Consumer Health World
When: September 17 - 19
Where : Chicago

I will be speaking on a panel at Dmitiry's latest healthcare and social media conference. These are all held within the Consumer Healthcare conference which draws quite a crowd from across the healthcare spectrum - pharma to mds to hospital CEOs. I spoke at one a year ago in DC.

The question is: what has changed?

1. There are a lot more healthcare Web2.0 companies up and acquiring users. In fact there is another conference on the West Coast called Health2.0 which will collect the best of those including Sermo, Healthline and others. This most interesting innovation happens here as entrepreneurs and venture capitalists try to create business in a new type of healthcare.

2. Some Pharmaceutical companies are deploying initial programs to get experience in and around social media. The best known right now include J&J's jnjbtw.com blog and the Alliconnect blog, message board plus product site.

Some pharmas are exploring with communties for patients like the kind created by Communispace. I thought this would all happen much faster. a year ago, I would have guessed a brave few pharmas would have tested the waters with more social media experiments. I was sure someone would challenge the prevailing fear that the FDA is waiting to react to a case of non-compliance with adverse events reporting.  Pharmaceutical companies are still held back by their individual approaches to adverse events. Basically, it's the legal department within a regulated industry. A recent white paper from Cymfony and Fard Johnmar pretty much coroborates this.

"The thesis of this paper is that, based on existing principles and precedents in the
regulation of direct-to-consumer advertising, marketing, legal and regulatory
compliance professionals can have a productive collaboration in helping their
companies incorporate emerging social media forms into their promotional mix."

Their message is directed to the legal department. The goal is to smooth talk them out of the bunker. The authors go on to summarize the type of issues the FDA has points of view on abd the principles at stake. It's a great article for pharma brand managers but I am not sure pharma lawyers will learn anything new. They go on to include a rating system like our national defense color-coding system for different social media tactics. This is broadly helpful but so much is determined by context that I would hope brand managers would only use this as a guide not a rule.

Other things impede including a marketing culture that is heavily weighted towards their brand of traditional marketing.   

3. Communities are springing up in patient groups like the ones maintained by ClinicaHealth, the Nordstrom's of health plays: Revolution Health and inside broad interest social networks like Eons.com.

4. More Americans use the Internet to access health information every year.

5. With the growth of "customer" reviews and the overall growth of the segment of the public creating content, new consumer generated media - like doctor and hospital reviews - will force change upon an old-fashioned industry.

6. HMO's aren't innovating their online customer experience fast enough. They have the most at stake in the principles of consumer-driven-healthcare, yet their own online offerings lag. see this Forrester report.

Two events that are coming and worth checking out:

Event: Health 2.0
When: September 20
Where : SF

Event: Exl Pharma: Digital Pharma
When: October 22-24

Where : Philadelphia