InSites Consulting Health Smartees Ghent April 25 2012

Healthcare Smartees April 2012 www.insites-consulting.com Ghent I Rotterdam I London I Timisoara I New York

09.15 – 09.45 Healthy welcome breakfast – thank you 09.45 – 09.55 Welcome @ our 2012 Health SMARTEES Thibaud De Meester, Research Consultant Life Sciences & Healthcare 09.55 – 10.40 Janssen Case - 3 steps to get to a winning new strategy in Diabetes using a mix of contemporary observational methods with patients Carl Vandeloo, Senior Research Manager Life Sciences & Healthcare Robert Dossin, Head of Life Sciences & Healthcare Research 10.40 – 11.00 Coffee break 11.00 – 11.25 Rules of engagement: What we can learn from conversations taking place on YouTube, Twitter & Facebook Saartje Van den Branden, Senior Research Manager Life Sciences & Healthcare 11.25 – 12.15 What is the role of patient services through applications? Patient Empowerment: Perspective of the patient Perspective of other healthcare stakeholders Sofie Bruggeman, Research Manager Life Sciences & Healthcare 12.15– 12.30 Questions? 12.30: Sandwich lunch and more time for networking Agenda

Rules of engagement What we can learn from conversations taking place onSaartje@insites-consulting.com , &&@Saartje_VDBhttp://be.linkedin.com/in/saartjevandenbranden www.insites-consulting.com Ghent I Rotterdam I London I Timisoara I New York

To what extent is social media integrated in your company? FMCG & Travel & Retail Healthcare Finance Media Tech & Telco Leisure Doing nothing with social media 4% 4% 1% 2% 6% 0% First small steps 25% 31% 32% 13% 10% 24% Setting up/ running pilot projects 23% 24% 27% 20% 15% 35% Integrating social media 30% 32% 26% 41% 46% 21% Social media are fully integrated 18% 8% 14% 24% 23% 20% Healthcare not very active on Source: Social media integration study – the Conversation Manager 2011 social media

Main barriers to integrate social media: „Legal conditions‟ was no answering option – for the pharmaceutical industry it is obviously one of the major barriers. 39%: lack of top management support 42%: no fit with product offering 48%: no clear financial benefits Main barriers Source: Social media integration study – the Conversation Manager 2011

(Health)consumerstake the leadWe believe consumers (includinghealth consumers) will take the leadin shaping any company in the future.We need to learn how to let go andtake down walls as companies andprofessionals who are actively listeningand involving (health) consumers willprevail. www.insites-consulting.com Ghent I Rotterdam I London I Timisoara I New York Health consumers take the lead

Never underestimate the power of 1 consumer, client or patient KOLe-Patient Dave@ePatientDave 38.780 tweets & 10.306 followers 1.351 friends on facebook. His presentation on TEDxMaastricht 2011 is viewed 6,711 times on YouTube. Active blogger:  e-patients.net  patientDave.blogspot.com  impatientDave.blogspot.com Patients are taking the lead

People use social mediato help make healthcare decisions Social media empower patients

The majority of online conversations is positive… Positive Negative In general 30% 11% On Healthcare 36% 19% On diabetes medication 33% 40% …except when they are about medication.© InSites Consulting Positive & Negative Health Study 2010 | How to engage in the conversation with empowered patients | © InSites Consulting, 2010. 9

Now, let‟s take a closer look at THE BIG 3 THE BIG 3

facebook

Awareness of Facebookis close to 100%More than 400 million people(>30% of internet population)use Facebook daily. facebook

Average Facebook session lasts37 minutes… facebook

Average number of fans per sector? FMCG & Travel & Retail Healthcare Finance Media Tech & Telco Leisure Average # fans 210.238 19.120 1.972.191 107.392 60.299 21.439 10% worst in class 15.883 670 2.376 42.423 7.890 3.90310% best in class 2.777.457 79.557 96.063 13.457.864 3.253.294 323.048 Media has the biggest fan base. Healthcare & Finance have the least number of fans. Fan bases on Source: BIG 3 study facebook

facebook

More fans = more conversations?© InSites Consulting Consumer activation Health Study 2010 | How to engage in the conversation with empowered patients | © InSites Consulting, 2010. 20

#Rule: A large audience You is not enough. You have to manage it! 0,92 Foto van circus Correlation between volume & #fans 0,63 But don‟t overdo it 0,11 either low medium high Conversation management % contribution of the group owner© InSites Consulting Consumer facebook activation Health Study 2010 | How to engage in the conversation with empowered patients | © InSites Consulting, 2010. 21

Some inspiration… Facebook is appropriate for  sharing corporate news  raising awareness on charity projects/CSR  showing your human side  making your beliefs tangible  communication on specific diseases through targeted groups© InSites Consulting facebook Health Study 2010 | How to engage in the conversation with empowered patients | © InSites Consulting, 2010. 22

YouTubehttp://www.youtube.com/watch?feature=player_detailpage&v=1Uov0cV8CdY

http://www.youtube.com/watch?v=x0n4Zu4ehK4&feature=fvsr YouTube

Some inspiration…YouTube is appropriate to  educate the audience on specific diseases (e.g. symptom recognition…)  show best practices on how to live with a certain disorder (e.g. coping T2 diabetics…) facebook

facebook

There is a bigTwitter paradox:80% is awareof Twitter, only 16%is using it.

Twitter

Tweetdeck

Local experts

Some inspiration…Twitter is appropriate for  …factual updates (e.g. FDA approval…)  …picking up on hypes (e.g. Movember)  …sharing links to online sources which are considered relevant by patients (& don‟t forget to use URL shorteners) facebook

Strategize Strategize first

www.theconversationprism.com Worry about the tools after

Respect theof engagement Know what you can & should do

Success is goingfrom failure to failurewithout a loss ofenthusiasm.Winston Churchill www.insites-consulting.com Ghent I Rotterdam I London I Timisoara I New York What would Churchill do?

Limit the number offailures with these tips:1. Set the rules: explain first what you can and cannot do2. Keep your website up-to-date in order to avoid tactical comments on your social media3. Focus on the patient, not on the disease or product and help them manage their disorder4. Entertain your audience, but don‟t overdo it5. Avoid on/off mentality6. Use an integrated approach across different social media7. Consider listening before facilitating and joining8. Always, always, always consult your legal department!

The power tools of the E4-patient How to Equip &Sofie@insites-consulting.com Enable the@sofiebruggeman Engaged & Empoweredhttp://be.linkedin.com/in/sofiebruggeman patient www.insites-consulting.com Ghent I Rotterdam I London I Timisoara I New York

Patients have stepped forwardto actively participate in theconversations about their health Empowered patients are a FACT today

1 2 3 A third globally impactful movement in history

e-Patient Dave @ePatientDave “Gimme my damn data” Diagnosed with stage IV kidney cancer 2007 Took an active role in his treatment & survived Inspiration for Novartis Current job: healthcare consultant! Who is this guy?

83%already used the internet… to look for information on healthrelated topics.The internet enables them to look forinformation themselves.Dr. Google is their guide in theirsearch.

of patients says60% info found online affects decision about treatments Online information is impactful. 56% says it changed their overall approach to maintaining their health or the health of someone they help take care of. 53% says it leads to ask a doctor a new question or to get a second opinion from another doctor.Source: http://www.slideshare.net/PewInternet/2012-1-12-12-rise-of-epatients-providence-st-joseph-medical-centerpptx

Companies (finally) start to realize! Social media is more than a marketing tool. It is a business strategy But healthcareSource: Social media integration study – the Conversation Manager 2011 has arrears

Patient powertool: personalinformationAn opportunity for theindustry to join or facilitatethe patient conversation! General information ≠ Personal information

Manual Automaticlogbook logbook Internet Logbook app logbook Evolution of logbooks

If patients (have to) trackinformation, they appreciate help. Convenience iskey, they already suffer enough.

#WhatsInIt4Pharma I “Pharma companies would do well to provide tools that help patients help themselves. Even if they’re not promoting your product, they can offer it as a service of their company. Then people who are swimming around in the current talking to each other say good things about the “ company because it helped E-Patient Dave them.” Healthcare consultant Boosting patient conversation

#WhatsInIt4Pharma II Building your CSR image More than selling products

#WhatsInIt4Pharma II "Many opportunities to improve health very much depend upon cell phone technologies, since cell phones are so rapidly expanding in many parts of the world that otherwise dont have much access to communication." — NIH Director Dr. Francis Collins CSR: Equip patients in the 3rd world

#WhatsInIt4Pharma IIIApps: think B2B2C Pharma companies Patients Physicians

#WhatsInIt4Pharma IV Apps thatboost sales directly (through compliance) Maximizing compliance

Higher or Lower than % ? What is the % of smartphone Source: Social media around the world by InSites Consulting - 2011 owners in EU?

% What is the % of smartphoneSource: Social media around the world by InSites Consulting - 2011 owners in EU?

25installed 12 in use Apps are selected Source: Social media around the world by InSites Consulting - 2011 carefully

1. Apps for practical purposes2. Apps for entertainment3. Apps for connecting with othersRoom for healthcare apps: 17% in 2012  30% in 2015! 17% today uses Source: Social media around the world by InSites Consulting - 2011 health apps

Appsthroughout thepatient journeyFrom prevention to insulin remindersApps are definitely not restricted tomedication reminders.Different apps have already beendeveloped for patients in differentdisease stages.Let‟s take a look at different apps in thediabetes patient journey.

Warning: patientfocus only GPs & specialists Nurses Pharmacists PATIENTS Insurers …

Case studyApps in diabetes TA… equipment which is enabling &empowering the engaged chronicpatient!to calculate the risk for a disease (prevention)to find info about a diseaseto keep track of what one consumesto support in changing lifestyleto create logbooks… Equipped diabetic patients

Prevention tools CSR opportunities 31 2 App example

Patients  news!Health generalinformationBroadTherapy AreaDiseasespecific App example

Nutrition coach Supporting (newly diagnosed) patients in their struggle with the disease or connect with people on a diet Daily totals for Carbs & Cals Store a Breakfast + Lunch + Dinner + 3 Snacks/day Calendar function to store and view past meals for“ up to 2 years For diabetic patients made by diabetes experts (extended usage opportunities: non-patients) App example

Financialcoach!Making (chronic) patientsconscious about healthcareexpenses360 view of health (insurance)spendingOverview of: total health care expense out-of-pocket expenses paid versus unpaid bills breakdown by family member App example

Glucose buddy – free appRanked the #1 diabetes iPhone app (for free) by Manny Hernandez(founder of TuDiabetes.com)Integrated with calory trackenter glucose numbers,keeping track of carbohydrate consumption,insulin dosages &activities. App example

Pharma companies startinvesting in apps as wellThey like to focus on the relation patient – health care providerBy Merck & Co.Integration of different aspects of diseasemanagement.Guiding the (newly) diagnosed patient tochange his life – Blood glucose monitoring – Activity tracking – Nutrition tracking – Weight loss (in cooperation with doctor) – Medication tracking – Progress charts App example

“Participatory medicine is not about patients taking over. Far from it – I‟m fond of sayingthat I‟d be in sorry shape if I‟d had to dream up the high-dosageInterleukin-2 treatment that saved my life.” E-patient Dave Dave is no threat for physicians

Gamification: a relevant trend forpatient servicesNutritional coach app for kids: carb counting with LennyCarb values for many basic foodsCustomize the food Guide by adding your own foodsFun, interactive games to test knowledgeCompete for game high scores against players acrossthe nation. Gamification for kids – boosting motivation

Gamification: a relevant trend forpatient services “I don’t always make note of my blood sugar values. But sometimes when I have issues, my doctor makes me do it. Then I have to fill in these huge cards with notes about what I ate, how much insulin I take… But it’s annoying cause people whine a lot about it. There are periods that I do a lot and when I don’t, my parents really Lara (14 y.o.) has been diagnosed with diabetes type I October 2nd 2006. make it hard on me.” Coping with the disease hasn‟t been easy for Lara. She realizes, she will have to deal with the disease for the rest of her life. Keeping track of glucose levels is boring

Gamification: proves tobe an effective trend!Patient insight:reminders and phone calls are just automatedversions of nagging parents. Bant (app) included a reward program. Once they leveled up, they were able to buy apps & music with the points redeemed. The rewards were quite the hit. Over a 3-month period they increased their frequency of measurement by 49.5%. Gamification is impactful

“A very well designed idea. It combines lifestyle and mental health and is expandable to broader groups. We love the idea to embed this game in a care group. Interesting that it uses a proven concept.” The Future of Health JuryHeartVilleWinner of 2012 Future ofHealth Award Gamification also for adults…

Manual Automaticlogbook logbook THE FUTURE - WHAT’S NEXT? Internet Logbook app logbook “It would be nice to have an app where all you would have to do is plug in your meter and it would take your results, and you wouldn’t have to do any more entering of info.” Patti Ruggiero Future of logbooks

Future oflogbooks

Start creating your own app is NOT the take away of this presentation Let‟s not go too fast!

Just 1 example,many more, so let‟s not go too fast!

Listening to whatthe patient needsApps for patients are only successful if they fill inan existing need of a patient & if they take intoaccount existing barriers(practical, emotional, physical…).Connecting with the patient in an ongoing wayis the key to success. Observe, get inspired & then act

Patients are engaged!But they are not similar!You need to observewhat they are doingYou need to engageWith the right patient! Need to engage!

You all remember Lara & for now in full pubertyShe was probably born with an iPhonein her hand Keeping track of glucose levels is boring

Meet Eddy. He is more criticalUsed to his way of keeping track of blood valuesfor years (written textbook) “Voor patiënten is dit ver van hun bed, het is misschien niet veel werk maar je moet het je wel eigen maken.”You stay or you move (no trial period)a tough decision “Ofwel ga je all the way ofwel blijf je bij wat je nu aan het doen bent. Ik wil toch mijn tijd nemen om dit af te wegen. Ik ga niet over 1 nacht ijs.”What‟s in it for me? Just doing the samewill not do the trick “Wat is mijn voordeel? Als het kan bewijzen dat het de Ha1bc waarden van patiënten van 75mmol/mol naar 53mmol/mol kan brengen, is dat voor mij wel overtuigend!” Not convinced of the added value of apps

Different barriers to overcomeDifferent motivations to useBut same end goal It is about coping with diabetes

………………………………………..……..…CollaborationInvolve customers inEVERYTHING you do.………………………………………..……..… Structural partnerships

Structuralpartnership is the future

In case you had asugar dip , I‟mhere to help you outApps enable …the pharma industry to connect with patientsthe pharma industry to build a CSR imagethe pharma industry to connect 2 stakeholdersBUT success depends on theunderstanding of the patient. Patients chooseapps very carefully (cf. +- 12 apps in use!)based on their needs otherwise“the giveaway will become a throwaway”& don‟t forget to make it fun

Patient apps dealing with headwind Sofie@insites-consulting.comPutting „patient servicesthrough applications‟ inperspective.Threats & Opportunities in thebroader healthcare area.www.insites-consulting.comGhent I Rotterdam I London I Timisoara I New York

What about them?

More apps & mobile contactmeansless offline contactless visitsless incomeAnother way to look at thephenomenon from a physicianpoint of view Are apps a threat for physician income?

Case telemonitoring by UZGent, Prof. Dr. Heidi BuysseTelemonitoring: digitally tracking of patient data (e.g. blood values, insulinintake…) that are afterwards transferred to & monitored by physicians timely (personalised) feedback by physician less transcription errors positive evaluation by patients & healthcare professionals! “RIZIV should provide a compensation for e-consulting” Case: telemonitoring (Dr. Buysse)

considered the other way2.070 Belgian people yearly around…diagnosed type I diabetes.1.180 patients are younger than 14years old890 are aged between 15 & 39 yearsold23.500 Belgian peopleyearly diagnosed withdiabetes type II.The growing number ofdiabetic patients, definitelywithin diabetes, puts pressureon the GP. Apps can release the burden…

considered the other way around…A combination of face-2-face & mobile/onlinecontact with patients, enables the physician toenlarge his/her „patient base‟ and serve theneed of newly diagnosed patients. Apps can release the burden…

Fact: physicians have only alow awareness of the app offer “I’d consider my doctor to be quite innovative, she tells me about innovative technologies, how the future of a diabetic patient might look like. I think my doctor would recommend apps to me, but I think she just doesn’t know about them yet.” Lara, diabetic type I patient, 15 y.o. The industry needs to inform them ass well

Apps have a public dimensionBetter healthcare quality for a lowercost. Apps are relevant for national policies

e.g. UK government made a list of 500trustworthy applications Positive effect on social security costs

Patientorganisations“The impatient patient is a force for good, to beharnessed in support of sustainability of healthcare systems.” Alexandra Wyke, CEO, Patient View

Patient organisations:Numeric impact (membership – e.g. VDV 23.000)Credible source for patients (domain expert & nocommercial interest)Covering more than just specific medical conditionsIn touch with multiple stakeholders – well-networkedLobbying for the needs of the patient Patient organisations are a partner

Diabetes UK released iPhone app Diabetes UK on track!

In case you had asugar dip , I‟mhere to help youout1. Physicians, pharmacists, patient organisations believe in the added value of patient apps & technology2. On the condition that it does not intend to replace the role of health care professionals3. APPS need to be positioned as an extra SERVICE towards end- clients (the patients)

Don‟t forget to communicate toHCPs or patient organisations as well aboutpatient apps (you created)!It’s hard to love or promote something“you do not know yet.” Boost HCP conversation!

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