7 leading doctors' social networks in 7 countries reflect on the history and future of doctors-only communities

1. 10 years of
doctors’ social networks
What have we learnt? What can we expect?
Views from leading doctors’ social networks
Len Starnes
Digital healthcare consultant

2. Sermo, USA
The Rounds, Canada
Coliquio, Germany
Doctors.net.uk, UK
Drportal, Hungary
iVrach, Russia
DXY, China

3. Peter Kirk
CEO Sermo
Osnat Benshoshan
CMO Sermo
www.sermo.com

4. 10 Years of Physician Social
Networks

5. What has been HCP social networks largest impact on
the practice of medicine during the last 10 years?
• The largest impact HCP social networks have had on the practice of medicine
during the last 10 years is the practice of medical crowdsourcing, which marks a
transition from working in isolation to collaboration.
• Most cases fall into a ‘grey zone’ meaning that the diagnosis and/or the treatment
are not clear, and the HCP isn’t sure how to proceed. HCPs have been conditioned
to work in isolation, so there wasn’t a way for them to get help on such cases
before these social networks existed – patients suffer, doctors suffer, the system
suffers.
• HCP social networks are carving out new ways for doctors to collaborate and work
in unison from anywhere on the planet, and its driving meaningful changes and
better outcomes.
– We saw over 7500 challenging patient cases posted by doctors last year – up
2,500% in three years.
– 89% of the doctors who posted got the help they were looking for within 24 hours.
– They are even asking for help on cases about themselves or their own families,
which goes to show just how much they trust the network to provide solid
information.

6. What has been HCP social networks largest impact on
the practice of medicine during the last 10 years?
• The second largest impact HCP social networks have had on the practice of
medicine during the last 10 years is the new way it allows medical knowledge to be
shared.
• There is a lot of official medical information out there – so much that it is difficult
to keep track of. In addition to official news, doctors make breakthroughs every
day. There hasn’t been a way to share these findings without going through
cumbersome channels, even though they may be relevant to a doctor’s day-to-day
work.
• HCP social networks act like ongoing medical conferences where HCPs can learn
from each other and stay abreast of the newest and most important findings. The
material shared is a pulled from many sources – pharma companies, governments,
laboratories – and is compiled along with actual HCP experiences, which makes it
more valuable than information from any single, sole source.
• Then, over time, the networks become massive databases of this information that
can be referenced when HCPs have questions.

7. What has been HCP social networks largest impact on
physicians’ behaviors and expectations during the last
10 years?
• The expectation used to be that doctors had to work cases alone – now,
more doctors are discovering every day that there are private networks
where they can collaborate on cases in an open way with other experts.
• This has changed physician behaviors. We see them:
– Becoming more comfortable admitting mistakes and things they don’t
understand
– Asking questions on behalf of their patients and sometimes
themselves or their families
– Sharing discoveries and triumphs to benefit others
– Actualizing issues that face the profession as a whole, and taking a
public stand when necessary
– Learning from other doctors and improving their patients’ outcomes
– Developing better practice management ideas, sourced from peers

8. How do you see HCP social networks developing in
the next 10 years, from a U.S. and global perspective?
• We think networks that are currently U.S.-only will find value in expanding
to the global stage.
– National borders don’t confine medical research, and we expect that
the ability to collaborate internationally will become more and more
important to U.S. HCPs with time, and will drive changes in their social
networks as well.
– The interest is already there from non-U.S. doctors – since we started
expanding globally, we get requests daily from all over the world to
join.
– International conferences are seeing attendance drop, due to price
and other concerns, but the need to communicate globally has not
diminished.

9. How do you see HCP social networks developing in
the next 10 years, from a U.S. and global perspective?
• Once global, the main way we see networks developing is by enhancing the way in
which they support the practices outlined above – medical crowdsourcing and
sharing medical knowledge.
• Much of medicine is anecdotal – its like searching for a needle in the haystack. A
global scale is useful because it combines more anecdotal evidence, but HCP social
networks will need to develop tools that help sort this information quickly in order
to support these practices.
• HCP social networks will also need to figure out how to protect the space they’ve
created for HCPs while harnessing the power of these networks to solve the
toughest cases. This may be through:
– Partnerships with NGOs, patient advocacy groups, or non-profits to source
cases
– Improved tools to find and compare similar cases and build progressively on
cases that have already been medically crowdsourced (searching images or
verbal content, categorization of cases, measuring quality of unique
responses, etc)
– Improved targeting and notifications to drive the maximum help from the
most relevant people in minimum time

10. Blair J. Ryan
Chief Executive Officer
The Rounds, Canada
Conor Cox
Manager, Strategic Partnerships
The Rounds, Canada
www.therounds.com

11. #HealthcareisSocial

12. What has been doctors’ social networks’
largest impact on the practice of medicine
during the last 10 years?
Doctors’ networks typically all set out on the same three
goals; save doctors time, money, and help them save
lives. The successful networks have found a way to
execute on at least two of those goals. The best ones
have gone above and beyond; not only are they
connecting doctors to one another, but they’re also
pulling all of the relevant sources of information into one
place.

13. What has been their largest impact on
doctors' behaviours and expectations
during the last 10 years?
Expectations:
Physicians have been empowered by technology; specifically
by doctors’ networks. They have come to expect faster (read:
instantaneous) access to the people and data they need; they
will not suffer second-rate user experience, and they insist that
their continuing education be on their terms (read: free, fast, and
on-demand).
Behaviors:
The behaviours are more or less the same; rather it’s the place
they go and quality/speed of the results that have changed. In
fact, it is our belief that doctors' networks wouldn’t work if they
weren’t analogous to ‘the old way’ only with better results.

14. How do you see them developing in the next
10 years, from a Canadian and global
perspective?
Doctors’ Networks as the OS:
Collaborative networks will no longer be seen as one of
the tools a doctor can use; instead they will become the
foundation upon which all other health IT will be built.
The doctors’ social network will serve as the ‘operating
system’ for physicians, as more IT solutions are built
out, and plugged in.

15. 10 years of doctors‘ social networks
Statements by Felix Rademacher, CEO and founder, coliquio, Germany

16. The physicians on coliquio
54.3 years
average age
Ø 2,000
physicians sign up per
month
more than 70
medical specialities
more than 4,000
new posts per month
Ø 13 years
professional experience
more than 165,000 physicians
signed up overall

17. What has been their largest impact on the practice of medicine
during the last 10 years?
Physician Only Social Networks (= POSN)
achieved something quite significant: medical
knowledge – once spread throughout different
sources and individuals – is now instantly
available for every doctor in one place.
Physicians interact daily on coliquio,
discussing patient cases and sharing their
experiences amongst their colleagues. As the
largest network for doctors in Germany,
Switzerland and Austria we provide a
constantly growing knowledge database.

18. What has been their largest impact on doctors' behaviours and
expectations during the last 10 years?
Having experience-based knowledge
available at our fingertips is more important
than ever in society. Today personal
recommendations are crucial for our
decisions. This also affects doctors’
behaviour. Todays’ physicians rely heavily on
the advice and the experiences of their
peers and other specialists. This way, they
are able to solve problems more quickly than
just by reverting to traditional knowledge
sources, like medical books for example.

19. How do you see them developing in the next 10 years, from a
German/EU and global perspective?
The digitization of the healthcare market will gather
speed, and digital channels will become more and
more significant – not only for the doctors and the
pharmaceutical industry, but for all the stakeholders in
our healthcare system. Closer connections have to be
established in order to make healthcare as a whole
more efficient. Such a development is not only
relevant from a German point of view, but also from an
European or global perspective.

20. How doctors work – then and now

21. Felix Rademacher, founder and CEO, coliquio
www.coliquio.de

22. Dr Tim Ringrose
CEO
M3 Europe
eu.m3.com

23. 1. What has been their largest impact on the practice
of medicine during the last 10 years?
Biggest impact has been the ability for doctors to gather
information and share opinion and knowledge within a trusted
network or community of colleagues. For example doctors can
discuss difficult cases and get advice from colleagues about
investigations, differential diagnoses, appropriate colleagues to
make a referral to and of course best treatment options. This
impact has been evident across both primary and specialist
care, but arguably its most significant for doctors working in
small or single-handed practices where they have traditionally
had little ability to get advice from colleagues without making a
formal referral.

24. (1. continued)
Online networks allow doctors to have instant access to a very
wide pool of colleagues – we see answers being posted within
minutes of the question being asked. Sometimes the discussion
continues as the patient progresses through a series of
investigations and this creates a repository of very valuable
information that all the doctors in the network can make use of
for their continuing professional development

25. (1. continued)
Over recent years it has been fascinating to see how pharma is
starting to engage with online networks. A lot of the time the
interaction is rather “old school push marketing” but that still
has some value with new products, but more and more
companies are starting the engagement trying to understand
the clinical viewpoint of a particular therapy area and then
working out how they can provide information or services that
are addressing the needs that the doctors see. For example this
can mean that an educational programme is the right option. As
a result of this we can see that the relationship between
doctors and pharma is starting to improve.

26. 2. What has been their largest impact on doctors'
behaviours and expectations during the last 10
years?
As already mentioned doctors are able to get advice and
information from colleagues with great efficiency and this
undoubtedly increases the standard of care they provide –
whereas in the past a doctor might have been continuing to
practice medicine in a way that was out of date this is much
less likely to occur now.
Doctors are also adjusting to the wider implications of the
internet – over 90% say that the internet has been a positive
impact on healthcare but it does require doctors to behave
differently.

27. (2. continued)
Doctors tell us that they are becoming less paternalistic and
are helping patients make more decisions for themselves and
they are investing more time in recommending good sources
of information to their patients. They expect the internet to
have even greater impacts in the next 5-10 years; rather than it
being about information they expect a significant proportion of
consultations to be done virtually and that near patient testing
will mean that trips to the hospital will become a less frequent
event for patients with chronic disease. All this means big
changes for the profession and online networks will continue
to help them adjust to the new normal.

28. 3. How do you see them developing in the next 10
years, from a UK/EU and global perspective?
Doctors.net.uk continues to see continued growth in usage –
each day over 50,000 doctors use the services and we
expect this to continue to grow. We expect to see use via
mobile devices to become the norm (it’s already very high)
and are investing in technology to support this.
I expect that across Europe we will see a lot of growth of
online networks and communities and it will be interesting
to see how much consolidation occurs.

29. (3. continued)
M3’s experience is that doctors are very driven to engage
with colleagues within the same environment as a priority.
That means for many doctors, engaging with colleagues from
other countries is a lower priority that some might expect
but this will change over time especially for specialists such
as oncologists.
I also expect that the mis-trust between pharma and the
medical profession will change to become more a
constructive sense of mutual respect. I think doctors will
increasingly see governments and healthcare regulators as
the enemy!

30. Gabor Gyarmati
Founder and owner
The Szinapszis Group, Hungary
www.qcg.hu

31. As of February 2017 Drportal is a medical
portal only.
Its views are included here as an example of
a portal which recognizes the critical importance
of adding community functionality to complement
its medical content offerings.

32. 1. What has been their largest impact on
the practice of medicine during the last 10 years?
Drportal was founded in 2009 so we cannot speak of 10 years
of history but only 7 years of experience in the Hungarian
market. As at this moment drportal.hu provides more than
4,000 articles on 20 therapeutic areas.
We have become a trusted source of professional information
for Hungarian physicians. As our portal is an independent
online network, visitors prefer our resource on professional
topics to pharma-owned physician sites. They use the
information found on our site in they everyday practice, and it
helps them to keep their medical knowledge up-to-date and
competitive.

33. 2. What has been their largest impact on
physicians' behaviours and expectations
during the last 10 years?
Based on our market research, Drportal (together with other
Hungarian physician sites) has totally changed the way Hungarian
doctors access medical information: fewer and fewer paper-based
articles are read, more and more clinical studies and CME are
accessed via the internet.
Drportal is changing doctors’ preferences towards personal
attendance at conferences and symposia; visiting our portal’s
conference videos and highlights summaries is a faster, cheaper
and more convenient way than travelling to big events…

34. (2. continued)
Besides these changes in doctors’ behaviours the largest impact
has perhaps been on the doctor/patient relationship. Patients
are becoming true consumers and see themselves as partners
with their doctors; this realization has been a major shock for
the Hungarian medical profession.
Our site helps doctors better understand patients’ changing
attitudes, preferences and behaviours, whilst providing advice
and best-practice tips on how to successfully manage the new
doctor-patient relationship.

35. 3. How do you see them developing in the
next 10 years, from a Hugarian/EU and global
perspective?
As we have seen during the last few years, online physicians’
communities and medical portals have helped doctors to
become increasingly digitally savvy. The next decade is going
to bring even more dramatic changes to the Hungarian
medical profession; doctors will not only be online but truly
connected with one another…

36. (3. continued)
Online physician communities should transition to be a channel of
the Internet of Things helping doctors to communicate with each
other, their patients, and all other healthcare stakeholders. They
should also help to connect doctors with patients’ tracking or
diagnostic devices.
These communities could function as dashboard for doctors to
enable them track patients’s vital data, while at the same time
providing essential professional therapeutic advice and
information.

37. 10 years of doctors' social networks
November 2016

38. Q: What has been HCPs SN
largest impact on the
practice of medicine during
the last 10 years?
A: HCPs only networks are part of wider social
media trend that had a significant impact on
medical practice. HCPs networks enabled instant
access to a wide circle of colleagues and thus
increased peer support availability at the point of
care. This is of a particular importance to those
physicians who work in remote areas and/or do not
have the whole set of consultants in their clinic.

39. Q: What has been HCPs SN
largest impact on doctors'
behaviours and expectations
during the last 10 years?
A: HCPs’ only networks changed the way of peer-
to-peer communication by creating a new
environment that facilitates clinical decision
support as well as peer verification of various
promotional claims and statements. This situation is
not going to fade over the next 10 years which, in
turn, is going to re-shape pharma-physicians
communication processes dramatically.

40. Q: Continued. What has been
HCPs SN largest impact on
doctors' behaviours and
expectations during the last 10
years?
In the past publishing a piece of content was the
final point of pharma marketing efforts. Today it is just
a beginning. Once published (or presented by a
rep) this contents is taken then to HCPs SN for further
peer analysis and review. As a result quite often
physicians get a list of additional questions to
pharma and expect collaboration with the industry.
Unfortunately pharma companies are still quite
ignorant of such post-publication developments,
loosing the opportunity to engage with their target
audience.

41. Q: How do you see HCPs’ SN
developing in the next 10
years, from a Russian and
global perspective?
A: From a global perspective over the last 10 years it
became clear that that HCPs’ online communities
cannot rely on professional forums only. On top of this
basic functionality physicians expect to get other
services as well, something that could help them
excel professionally even further.
For the region of our focus (FSU countries) the need
to access professional information on a cross-country
scale is quite strong and to bring global knowledge
to local HCPs’ communities will be an important task
for a HCPs’ SN working in this part of the world.

42. About us
We specialise in working with HCPs within specific geography that
comes usually as a blank spot on majority of reports and
presentations produced by western companies
Yet former Soviet Union (FSU) counties
have a large HCPs population (estimated
to be over 2 mln) and offer significant
opportunities for global pharma
companies, particularly so if reached by
cost-effective digital channel

43. iVrach is a gated portal for
for Russian-speaking physicians
We are in Top 3 most
visited HCPs portals in
Russia
We are a fastest
growing HCPs only portal
in Ukraine
We are building up
HCPs base in Kazakhstan

44. Thank you!
Oxana Kolosova
Managing Partner
London: +44(0)7496 812505
Moscow: +7 495 249 90 35
oxana.kolosova@ivrach.com

45. Stanley Li
Chairman
DXY, China

46. 1. What has been their largest impact on the
practice of medicine during the last 10 years?
The practice of medicine in China has evolved considerably over the
last 10 years. This change can be attributed to many different
factors including changing expectations of physicians and patients as
a results of improved access to health information.
At DXY, we believe that the increasing use of physician social
networks like ours has had a positive impact on the practice of
medicine. Convenient access to trustworthy and reliable
information from curated sources as well as from peers is one pillar
of the DXY platform. An effective editorial style to make this
information easily consumable is also an area where DXY invests
considerable effort. Information that is not quickly and easily usable
is worth very little!

47. 2. What has been their largest impact on
physicians' behaviours and expectations
during the last 10 years?
The impact of physician social networks has evolved alongside the
changing on-line behavior of physicians in China and around the
world.
The origin of DXY was helping physicians to access clinical and
research knowledge more efficiently. First that was access to
PubMed, later it evolved into access to a trusted peer network to
share medical questions and answers. DXY's history reflects several
generations of technology media, from BBS to web portals to apps
including WeChat today. This evolution of media will continue….

48. (2. continued)
Due to heavy case loads, physicians in China have always had
very limited time to stay informed about new clinical practices,
guidelines, pharmaceuticals, devices and other important
developments in their fields. DXY helps physicians to identify the
most important, relevant and reliable information quickly so that
they can focus on what really matters - patient treatment and
outcomes.
Talent mobility in the health care field is also an outcome of the
increasing use of physician social networks. This is improving
patient access to clinical talent throughout China.

49. 3. How do you see them developing in the next
10 years, from a Chinese and global perspective?
At DXY, we believe that the physician is core to a successful health
care eco-system. China's 13th Five Year Plan includes components
to improve access and quality of health care in China. As a physician
social network, DXY is designed to support these objectives. DXY
will continue to provide convenient access to reliable and
authoritative information to support the effectiveness and
efficiency of the practice of medicine…

50. (3. continued)
DXY has always been a connector within the health care eco-
system. As the eco-system evolves, this connector role will also
evolve. For example, while medicine becomes more personalized,
DXY is supporting physicians and enhancing the patient experience
by connecting eco-system participants seamlessly. We are investing
in these solutions today.
Physicians in China recognize that there are opportunities to
automate components of patient monitoring and care, especially
for chronic diseases. DXY has done extensive work with partners in
diabetes management. We believe that this work will dramatically
impact chronic disease management practices by lowering costs
and improving outcomes.

51. This presentation is part II of an analysis of the
history and future of doctors’ social networks.
Part I, ‘10 years of doctors’ social networks: What have
We learnt? What can we expect’, is accessible on
Linkedin Pulse:
https://www.linkedin.com/today/author/0_0RjhwUdn7
dGoo7K_oDlqHj?trk=prof-sm#

52. I would like to sincerely thank all the contributors
to this presentation and all those who helped to
make it happen:
• Osnat Benshoshan, CMO, Sermo, USA
• Conor Cox, Manager, Strategic Partnerships, The Rounds, Canada
• Mark Garlinghouse, DXY, London
• Gabor Gyarmati, Founder and owner, The Szinapszis Group, Hungary
• Nathalie Haidlauf, PR Manager, Coliquio, Germany
• Peter Kirk, CEO, Sermo, USA
• Oxana Kolosova, Managing Partner, iVrach, Russia
• Stanley Li, Chairman, DXY, China
• Felix Rademacher, CEO and founder, Coliquio, Germany
• Dr Tim Ringrose, CEO, M3 Europe, UK
• Blair J. Ryan, CEO, The Rounds, Canada

53. lenstarnes@gmail.com
T: + 49 30 781 5513
M: + 49 172 1788253
Skype: lenstarnes
www.linkedin.com/in/lenstarnes
www.twitter.com/lenstarnes
www.slideshare.net/lenstarnes
Len Starnes
Len Starnes Digital Healthcare
Research & Consulting