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From Crowdsourcing to BigData - how ePatients, and their machines, are transforming health


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Ferdinando Scala - Leandro Agrò …

Ferdinando Scala - Leandro Agrò

Today oceans of data are being produced and collected both by people and machines, at the same time changing the way we think about healthcare as a field of study; as a result Patients - actually ePatients - are becoming ever more informed and independent with their healthcare decisions.

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  • 1. FromCrowdsourcingto BigData.How ePatients, and their machines,are evolving Health.
  • 2. Aboutthe authorsFerdinando ScalaLeandro AgròFerdinando Scala is an International Digital Strategist at Razorfish Healthware, a PublicisHealthcare Communications Group (PHCG) company. His main fields of expertise are:Strategic Consulting, Digital Strategy, Digital Transformation, Digital Engagement, DigitalMetrics Modelling, Collaborative Media, Marketing, Communications & Change Management.An Alumnus of the prestigious Nunziatella Military School of Naples, Italy, Ferdinando holdsan MSc in Biology (summa cum laude) at University of Naples “Federico II”, and is currentlypursuing a BSc in Communications and Media at University of Salerno.He started his career as a researcher in the field of satellite- and airborne-based environmentalmonitoring, working in collaboration with Consiglio Nazionale delle Ricerche (C.N.R.), CentreNational de la Recherche Scientifique (C.N.R.S.), Deutsches Zentrum für Luft- und Raumfahrt(D.L.R.) and European Space Agency (E.S.A.). He successively spent 12 years in Big Pharmacompanies, holding positions in Sales, Marketing and Commercial Operations at both nationaland international levels.A passionate Wikipedia author (16.000+ contributions), on June 2011 he was shortlistedfor becoming a member of the Board of Trustees of the Wikimedia Foundation (WMF) andon February 2013 he became a member of the global Elections Board. He was finally theCandidacy Leader for the City of Naples, Italy, to be the hosting town for Wikimania 2013, theglobal conference of Wikimedia Foundation.Leandro Agrò is the Principal Experience Architect at Razorfish Healthware, a PublicisHealthcare Communications Group (PHCG) company. His main fields of expertise are:Service Design, User Experience, Interaction Design and Digital Strategy. As visiting Professorat Siena University and Producer of Frontiers of Interaction Conference, Leandro has also beenawarded by Venice Biennale of Architecture, ADI Index, TechGarage, New York Times, Wired,WebAward, and other International Institutions.Leandro’s education originates from the Italian design culture. He completed a post graduatedegree in Interaction Design at Domus Academy (Milan, Italy), winning the Interaction Designcompetition at Apple Computer, Cupertino, CA in 1997. As blogger and writer, Leandropublished more than 300 articles mostly focused on the consequences of technology andinnovation; he contributed to four books has spoken at TEDx, World Usability Day, UXCON,eTech, World Business Forum and BayCHI (ACM).In the last 15 years, Leandro designed the first UMTS/3G user interface ever developed; Hecontributed to patents in the photo-video field; and designed the first multimodal computer UIbased on eye-gaze (patented) used in the healthcare
  • 3. IntroductionThis whitepaper exposes today’s most relevant patient and healthcare datatrends for the benefit of health marketers, and how they will impact thehealthcare value chain.Today oceans of data are being produced and collected both by people andmachines, at the same time changing the way we think about healthcare asa field of study; as a result Patients - actually ePatients - are becoming evermore informed and independent with their healthcare decisions.This “perfect storm” in the making, revolving around new paradigms of“Crowdsourcing” and “Big Data”, will radically change the current healthcareIndustry and reality of marketers. The mode in which drugs and healthcaredelivery are to be presented to healthcare professionals, patients and otherstakeholders is increasingly important in this new data driven paradigm. As amarketer, are you ready to embrace this change?
  • 4. 4Razorfish | Healthware From Crowdsourcing to BigData June 2013As the seminal bookBlue Ocean Strategyby W. Chan Kim and René Mauborgne......demonstrated in 2005, real progress for a company does not lie in fighting for space in already crowded markets.Instead, the creation of new operative space, where to operate alone, otherwise known as “blue oceans”, is the soleviable option for building a consistent and durable strategic advantage.While being highly rewarding when a company manages to find them, “blue oceans” are not easy to spot or build.Basically, building a durable strategic advantage requires one to identify and put in relation concepts and resourcesthat are apparently unrelated. Normally, companies are not good at spotting new opportunities, since their operationalmodel is built to robustly guarantee excellence in delivering effectiveness around the available products andservices. The convergence of apparently unrelated concepts is in fact determining a quantum leap in the healthcareenvironment, and only the companies that are prepared to ride the wave will succeed in the next years.In the following paragraphs, we will show you how a monkey, a typewriter, the largest global encyclopaedia, yoursmartphone and your health records are all related; and will shape the future of the healthcare industry.
  • 5. 5Razorfish | Healthware From Crowdsourcing to BigData June 2013
  • 6. 6Razorfish | Healthware From Crowdsourcing to BigData June 201301
  • 7. 7Razorfish | Healthware From Crowdsourcing to BigData June 2013KNOWLEDGE IN THE AGE OF INTERNETAuthor: Leandro AgròNearly every possible question hasan answer to be found somewhereon the Net. This is valid if you aresearching for a theory, a pointof view, or relevant data andinformation. This statement, asextreme as it might seem, is trueirrespective to whether you arelooking for the manual for yourwashing machine, or want to build aspace rocket – or Satellite - in yourown back yard!Maybe building a satellite in thegarage is not the most practicalthing to do, but the fact that it ispossible shows that the knowledgeavailable to everyone on theInternet even makes an apparentlyimpossible task, such as spaceexploration, available to the masses.The same depth of information isnot limited to space exploration, butcould empower individuals in theirknowledge of other uncommonsubjects such as Physics. Forexample, Prof. Walter Lewin, fromBoston’s MIT Open Courseware,is one of the best professors ofphysics on the planet – and hisknowledge and highly entertaininglectures are available to everyone forfree on the Net.In summary, the Net today is therepository of the best informationever expressed by humanity invirtually every area of knowledgeand industry; and this knowledgeis growing in organized hubs. Forexample, TED conference ( a major destination of high-levelknowledge available to the public.Importantly, TED is delivered in alecture/audience format accessiblevia video. This leading conferencealso has a version called TEDMED, specifically focused aroundhealthcare ( universities, conferencesthat generate knowledge usefulto the future, new generationinstitutions like the SingularityUniversity (SU), as well as individualinvestigators who have an open-source mind set and raise revenueby means of crowd funding, allhave one thing in common: theyare collaboratively building anddisseminating their knowledge forfree on the Net. In this respect,SU is one of the most importantexamples of how this can happen.As an institution whose missionis “to assemble, educate andKnowledgerepositories: TED,amongst othersWe can hope that “soon” (in a few decades), we will reach the tipping pointthat will allow for accurate automated translations, for now we must makeuse of the only intelligence adequate for this task: multilingual humanbeings.Crowdsourcing is becoming the way to handle accurate and contextualmultiple language translation.Places like or (a video portal dedicated tohealthcare) are leveraging crowdsourcing to -potentially- translate and“language enable” all content for the benefit of users around the world.The Language Issue
  • 8. 8Razorfish | Healthware From Crowdsourcing to BigData June 2013Traditional knowledge buildingmodels are linked to the linear modelof thought. The organization ofconcepts into a coherent significantunit, like a speech, an article or abook, always requires the author(s)to plan in advance a logical structurecomposed by “buckets”, like issuesto be addressed or chapters. These“buckets” had to be organized ina linear concatenation, so that thereader could easily follow the trainof thought of the author(s). Moreimportantly, this kind of processwas considered as the only one toefficiently deliver coherent results.Linear knowledge building modelshave been put in discussion whenfirst confronted with the theoreticpossibility to have infinite timeand resources to build a logicalsequence of concepts. A well-known exemplification of thistheory is the so-called “infinitemonkey theorem”. According toWHAT IS CROWDSOURCINGinspire a new generation of leaderswho strive to understand andutilize exponentially advancingtechnologies to address humanity’sgrand challenges”, SU uses thecollaborative strength of its students,some of the most brilliant mindsin the world, to tackle and solveproblems which are out and beyondtheir normal field of competence.The reasons behind the successof collaborative phenomenon arecomplex, and they are eloquentlyexplained in Dan Pink’s TED lecture:The puzzle of motivation: ( order to understand how thecollaborative building of knowledgeis realized, and what implicationsit has for the information diffusionin general, and for the healthcarefield in particular, we need todelve deeper in the world ofcrowdsourcing and collaborativecommunities and projects.Career analyst Dan Pink examines the puzzleof motivation, starting with a fact that socialscientists know but most managers don’t:Traditional rewards aren’t always as effectiveas we thinkThe infinite monkeytheoremAuthor: Ferdinando Scala
  • 9. 9Razorfish | Healthware From Crowdsourcing to BigData June 2013this theorem, if a monkey (thereforea being not provided with humanlogic or sense of purpose) had atypewriter and infinite time at itsdisposition, it would be able to buildup the complete works of WilliamShakespeare by sheer brute force,by randomly tapping on the keys.Even if this theorem has somestrong limitations, it is very importantfrom the conceptual standpoint. Itconveys the idea according to whicheven in apparently unfavourableconditions (non-human being,random actions, lack of sense ofpurpose), by having infinite time andresources available, any knowledge-building task is possible.Things consistently change whenexperimental conditions change.When we have at our disposalsentient and self-aware humanbeings, who perform voluntaryactions, which are driven by asense of purpose, the time to builda knowledge artefact consistentlyreduces, in exponential relationto the number of individuals orresources available, even in theabsence of a formal scope ororganization.The conditions mentioned above areat the base of the crowdsourcingconcept, which first appearedin 2006 in a seminal article byJeff Howe in “Wired” magazine.TechnologyTriggerPlateau ofProductivitySlope of EnlightenmentTrough ofDisillusionmentPeak of InflatedExpectationsEXPECTATIONSTIMEAutomatic Content3D ScannersInternet ofThingsNatural Language Q&ASpeech-to-SpeechTranslationCrowdsourcingBigDataGamificationHTML5Wireless Power3D PrintingBYODSocial AnalyticsPrivate Cloud ComputingApplication StoresAugmented RealityIn-Memory DB ManagementNFC PaymentCloud ComputingMesh NetworksGesture ControlIn-Memory AnalyticsText AnalyticsHome Health MonitoringVirtualWorldsMobile OTA PaymentMediaTabletsConsumerizationSpeech RecognitionPredictive AnalyticsBiometric Authentication MethodsAudio Mining Speech AnalysisAutonomousVehiclesHolographic DisplayRecognition3D BioprintingQuantum ComputingHuman AugmentationAdapted from Gartner HypeCyclePlateau will be reached in: Less than 10 years More than 10 yearsCROWDSOURCING HYPEPositioned in the Gartner Hype Cycle 2012 the “Peak of Expectations”Crowdsourcing is still the “new thing”. Theopportunities to leverage this technology andapproach are in front of us, and the knowledgewe have infused in the Net is too much to behandled.
  • 10. 10Razorfish | Healthware From Crowdsourcing to BigData June 2013The author presented for the firsttime the possibilities offered bythe unstructured, collaborativeapproach for business purposes.Since then, the meaning expandedto a significance that here we defineas:Since this publication, the concepthas exploded in a series ofapplications outside the businessworld, of which Wikipedia is themost well-known example.Wikipedia is probably the best-known example of crowdsourcingapplied to knowledge building at aworldwide and cross-cultural level.Built from the collaborative effortof anonymous contributors, eachadding up a piece of information,revising grammar and formattingpages, Wikipedia is as of nowthe most complete repository ofhuman knowledge. One of theTop-5 ranked websites in the world,and consistently in first position inGoogle search pages, Wikipediacontains 23 million articles, hasabout 100 000 active contributorsand it is edited in 285 languages.In 2012, it received 2.7 billion pageviews per month from the UnitedStates alone.Also when examined in termsof quality of content, Wikipediashows good consistency andcredibility, despite it being theresult of unstructured work. In arenowned 2005 article in Nature,Jim Giles argued that, for somescientific areas, individual Wikipediaarticles had the same rate of errorsthat a review of the homologousarticle on Encyclopaedia Britannica(EB) could put in evidence. Eventhough the article was disputedby EB, eliciting a successiverebuttal by Nature, it remainsevident that individuals, simplydriven by their will to contribute,and working in an unstructuredway, can collaboratively achieveresults which normally impliedthe construction of a structuredexpert panel, and the investment ofphysical and economic resources.More importantly, it demonstratedthe feasibility of an apparentlydaunting scope: gathering all humanknowledge in a single place, inany possible language, and freelyavailable to everyone.While still probably surpassingThe totalencyclopaedia:Wikipedia“The use of crowd, withoutany formal or hierarchicalcoordination structureamong its members, forperforming a certainscope, in order to pursuewhich, an exceptionalamount of resources wouldbe necessary; where“exceptional amountof resources” means aquantity of time, money,personnel or skill, and theircombinations, which wouldexceed the capabilities ofany formal organization.”Author: Ferdinando Scala
  • 11. 11Razorfish | Healthware From Crowdsourcing to BigData June 2013Wikipedia articles in terms ofoverall content quality, EB fails in afundamental aspect of knowledgediffusion, i.e. the availability of itscontents in any possible languageworldwide. Furthermore, even if EBwould set itself to this scope, theamount of personnel, skills, andmonetary resources especially,would be prohibitive - and woulddoom the project to failure.In summary, from the Wikipediavs. EB example, we can derive ageneral theorem, which provesitself as correct when the followingconditions are respected:We have examined howcrowdsourcing generates hugequantities of organized data bymeans of the non-coordinated effortof unrelated contributors. Even ifthere is no hierarchical relationshipamong contributors, the creationof these huge knowledge bucketsis still strictly related to individualhuman skill and willingness.Once we understand the basicconcepts of crowdsourcing, we areready to revert the infinite monkeytheorem, and bring our analysis ona further level. The next questions tobe considered are:a. What happens when datagenerators are potentially infinitein terms of the number andquantity of parameters they takeinto account?b. What completely newpossibilities are available whendata generators are networkedinto a system running under a setof cybernetic rules, which ensureconstancy, reproducibility andanalytical accuracy of measuredphenomena?The answers to these questions arefound when examining the world ofBig Data, the concept of QuantifiedSelf and their consequences for thehealthcare domain.Today: All places that aremono-cultural or with a singlesender that operates in logicalbroadcast, make it increasinglydifficult to gain trust. Also, on theother hand, it is difficult todaythat a “pyramid” not sufficientlyopen - as is typical of crowd-mechanisms - can find thenecessary trust.Pyramids – as well as YouTube- were built by many. Stories,information or generally speaking,“content” define who we are andwhat we are able to do. While theold giants –like EncyclopaediaBritannica that are not availablein a print version anymore- aresilently passing in time, all thenew mega-content-structureemerges on the Web, shaped inourselves in near real time.The CredibilityIssue“Given a collaborativeknowledge-building task ofany dimension, the quantityof time and monetaryresources necessary forcompletion is inverselyproportional to the numberof contributors and theirindividual specific skillslevel; while the quality offinal outcome is directlyproportional to this numberand skills set.”
  • 12. 12Razorfish | Healthware From Crowdsourcing to BigData June 2013WHAT ARE BIG DATA?As the renowned physicist LordKelvin (1824 - 1907) proclaimed, “Ifyou cannot measure it, you cannotimprove it”. This law was designedby humans to meet the needs ofscience, which were becomingmore complex. Over a century later,we continue to find this complexityin every moment of our workinglives. Measuring everything hasbecome a “human centric” issue– about knowledge and controlin the Internet Age - exactly whentechnology was able to fill it. Butmore importantly, measurement hasemerged as a social need todaybecause we are living in real time inthe digital sphere. …and this WASjust the beginning of an incredibleemergent trend: In the InternetAge, or better yet, in the upcomingInternet of Things Age, we do nothave enough humans to take careof all sensors, devices, satellites,and –in general- infrastructures thatwe create. Measuring everything isan intrinsic need of the technologywe are leveraging to build our world.And actually it is also a need of theworld itself, as a planet, to face theimpetuous evolution of the humanfootprint. Measuring everything hasalready changed other industries –and healthcare is not immune.Patients are the biggest communityin healthcare and - today - thanks toall their portable smart technologies,they are becoming an active actorin health, nutrition and wellnessdata collection. The diffusion ofthese technologies is becoming sowidespread, sensible in terms ofmeasured parameters, and easy tocarry for people, that it is opening abrand-new opportunity, called theQuantified Self (QS) movement.The QS approach is to incorporatetechnology into data acquisition onmost aspects of a person’s dailylife in terms of inputs (e.g. foodconsumed, quality of surroundingair), states (e.g. mood, arousaland blood oxygen levels), andperformance (mental and physical).The primary methodology of self-quantification is data collection,followed by visualization, cross-referencing and the discovery ofcorrelations.This powerful trend has inspirednumerous hardware devices(mostly in the wellness area) thatleverage components for costreductions in sensor technology,mobile connectivity, and batterylife, and that have already becomepart of the everyday life of millionsof users. This trend resulted in theappearing and explosive expansionof products like Withings, Nike+,fitbit, as well as software apps forsmartphones used to track almostevery aspect of life.Behind the QS, there is an emergingdesire for an individual to improveoneself, and a natural humanMeasure Everything: Ifyou cannot measure it,you cannot improve itData sources:the Quantified SelfAuthor: Leandro AgròAuthor: Leandro Agrò
  • 13. 13Razorfish | Healthware From Crowdsourcing to BigData June 2013Data sources:crowdsourcing for menand machinestendency towards competition withinone’s own microcosm (friends &followers).The QS is also related to thephilosophy of interdependence,donating information about oneselfto be used as a contribution towardsnew knowledge about people’sbehaviour and habits as well as thediscovery of new medical cures.From the Pharma perspective,QS is creating an emerging andimmediately relevant group ofstakeholders. Right now, most ofthe work of data collection andpublication is made manually, whileevery day more and more devicesbecome autonomous.Using pen and paper, people arealready able to collect and sharetons of useful data. Using sharedtools such as Wikipedia –or anyother collaborative tools on theWeb- people are able to conceiveand evolve spaces of sense andculture.Powered by sensors – ever morepresent in many devices – andthanks to cloud computing – aremote service that collects andcrunches the data – people arere-writing their own knowledgeand, with it, a perception of today’sreality.The Net is both for humans andmachines, and today we shouldbear in mind that machines aremore numerous than their humancounterparts. The evolutionof human crowdsourcing andparticipation is a mixed human/machine crowdsourcing andinteraction.In the field of health, “we can benefitfrom the multiple data types comingon-stream at the same time. Theseinclude electronic medical records,inexpensive gene sequencing,personal sensor data, qualitativecontributions by self-tracking, andmore”. (Cit. When Data Disruptshealthcare need to talk with people, as wellas integrate in the “discussions” theyhave with their machines.This approach takes us to BigData, and unleashes the potentialof analysing information on aworldwide scale for almost everypossible topic or matter.The availability of different datasetspresents an opportunity for “HighTech Companies” because datascientists and technologistsalready have the skills to managethe data. We have already doneAuthor: Leandro AgròThe day in which we willproduce more content in asingle day, than the rest ofhuman history, is near athand.However, currently theamount of data produced byhumans is very much lessthan the data produced bymachines.
  • 14. 14Razorfish | Healthware From Crowdsourcing to BigData June 2013something similar in the financialfield. Today, almost completelydriven by machines based on BigData analysis, relevant results canbe found correlating the manyhealthcare data sources.Up to this moment, we establishedthe basic concepts of crowdsourcing,Big Data and Quantified Self, andwe could be tempted to considerthem as distinct and far away fromdaily reality. Quite the opposite,these technologies and trends arealready impacting the pharmaceuticalindustry. In the followingparagraph, we will understand howcrowdsourcing is impacting R&D.The traditional model for R&Ddevelopment in any company hasalways been based on the selection,hiring, and consolidation of thebest talent, to produce innovationtransfered into sellable products forthe market. This kind of processhas the advantage of ensuringconsistency and continuity of efforttoward a certain objective, whichfunctions well when the amplitudeof challenges is consistent with thedimension of the R&D structure.As a downside, having aconsolidated R&D structure implies:a) Consistent organizational effortin order to select, maintain, andmanage the right people in the rightplace: with huge expenses in termsof HR resources;b) Limited ability and capabilityto address prevalent scientificproblems; delimited by the individualand collective skills of the R&D teammembers; and the sheer number ofpeople, time and resources on hand.As a consequence, when an R&Dchallenge exceeding the talentpool or organizational resourcescapabilities arises, the developmentprocess can come to a halt, withhuge consequences in terms ofoverall financial and operationalcapability of the company.Crowdsourcing is a way of expandingthe available pool of talent, andeven gaining insights that would nothave been generated, due to thestructured development processesinherent to a corporate structure.Based on this concept, in 1998,some Eli Lilly executives generatedthe idea at the base of InnoCentive,a crowdsourcing platform whoseinitial field of application waspharmaceutical R&D, but todayextends its business model in otherareas like engineering, computerscience, mathematics, chemistry,life sciences, physical sciences andbusiness. The InnoCentive businessmodel is based on the online sharingof pharmacological or clinicaldevelopment problems, for whichit is unpractical to find a solutioninternally, and the call for proposalsto platform members. InnoCentive’smembers have thus the possibilityto contribute to the resolutionof proposed problems, earningconsultancy fees for their contributionranging from 500 to 1.000.000 USD.The model has encounteredconsiderable success, to the pointthat today prominent organizationsInnoCentive: a casestudy in crowdsourcingfor pharmaAuthor: Ferdinando Scala
  • 15. 15Razorfish | Healthware From Crowdsourcing to BigData June 2013in a wide array of business sectorslike BAE Systems (avionics),Booz|Allen|Hamilton (consultancy),The Economist and Nature (editors),Hershey’s (food), Hewlett-Packard(computers), Eli Lilly and Roche(pharmaceuticals), NASA (spaceexploration), PepsiCo (beverage)and Procter&Gamble (Fast MovingConsumer Goods) are currentlypartnering with InnoCentive inorder to solve their problems. TheInnoCentive community includesabout 200.000 individuals from morethan 170 countries. As of now, it hasdistributed fees for an overall amountof 28.000.000 million USD.All healthcare market players haveone very relevant thing in common:they produce data. The whole ofhealthcare is becoming an industrybased on Big Data.Could this high-end technology bean entry barrier in the healthcarespace?No. Dozens of companies arealready competing in the massivedata collection arena, fighting tooffer qualified – low cost – analytictools.Kaggle – based in California - isa good example. Financed with11.000.000 USD, Kaggle launched aplatform for predictive modelling andanalytics competitions. Companiesand researchers post their data, andstatisticians and data miners from allover the world compete to producethe best models.As an example of an advancedhealthcare company, BoehringerIngelheim (BI) is actively engaged inthis platform to further its business.Predictive “in silico” modeling ofbiological endpoints is an importantand useful component of the drugdiscovery process. To investigatepotential genotoxicity liabilitiesin small molecule candidates,the BI research team launcheda competition using Kaggle. TheBI team expected to realize thefollowing benefits:• Competitive advantage in timeand cost efficiency• Engagement with an externalcommunity of data scientiststo create an awareness aroundBI as a cutting edge, innovativeorganization• Reactivity: to almost immediatelydeploy the winning model(s)internally for use by medicinalchemists through Bipredict, orother local distribution platformsThe competition was launchedon 16 March 2012. As early as22 March there were 74 teams(comprised of 90 players) who hadsubmitted 277 entries. 24 of theseentries represented models thatwere ‘better’ (i.e. more predictive)than the best initial benchmark.The success of this project hasbeen covered in a BI press release,and received subsequent coveragein several blogs. Moreover, tweetsfrom both @boehringer and@boehringerUS have garnered>200K impressions to date.Kaggle Data ScienceCompetition: a BI casestudy in crowdsourcingAuthor: Leandro Agrò
  • 16. 16Razorfish | Healthware From Crowdsourcing to BigData June 201302“”Crowdsourcing, Big Data, and Quantified Self are important trendsrevolutionizing the development of new drugs and connecting inherentlylimited frameworks, like clinical studies.The impact of these trends, however, is not limited solely to the domain ofclinical research; they are also readjusting the way corporations communicateto their external audiences.In the following section, it will become apparent how traditional, linearcommunication models are being substituted by completely new ones. Theresult of this process is a brand-new marketing and sales paradigm, whichrequires pharma executives to readjust their cultural and operational models.
  • 17. 17Razorfish | Healthware From Crowdsourcing to BigData June 2013COMMUNICATION MODELSThe communication process istraditionally defined as the passageof informational units (content),coded into some sensorial artefact(language) from an entity whichproduces them (emitter) to anotherentity with receives them (receiver).Context and channel employed inpassing the informational units fromone entity or the other are pivotal indetermining the quantity of deliveredinformation and its interpretation.When described as such, it isevident that communicationhas historically been interpretedas a linear process, in whichinformational flow travels in onedirection, and no feedback isconsidered. This philosophicalattitude was the cultural substrateto the construction of the masscommunication system, whosemedia (newspapers, radio andtelevision) acted as unidirectionalchannels for message delivery fromemitters to target users. The resultof this model was that the owner(s)of media channels were also theowners of information. Mediaowners were indeed in a positionto determine the agenda, i.e. thetype, combination and frequency ofinformation which, when deliveredfrom emitters to receivers, massivelycontributed to build the audience’sknowledge, attitude and opinionsabout whatever issue the agendasetters felt functional to their ownneeds. In addition, agenda settersalso had the possibility to determinenot only which information had toflow from emitters to receivers, butalso which information should not bedelivered.Traditional advertising models alsoconformed to this hierarchical logic,in which there is a linear and non-equal relationship between theemitter and the receiver, where thelatter is passive in terms of acquiringinformation. Traditional advertisingis based mainly on the attractionof target users in predeterminedchannels; the offering of valuablecontent to them; and the applicationof the so-called contextual (printedpaper) or interruption marketing(radio and television). In thisrespect, the main strategy used byadvertisers to ensure their contentwas received was the saturation ofphysical (tabular advertising) and/or media (press/radio/television)space. This is so the end user hada higher possibility of encounteringthe message throughout the day.In parallel, within a specific medium(like television), the most successfulbrands were the ones having thepossibility to win the competitionfor the most fruitful time slots (primetime), i.e. the moment of the day whenmost users were connected to thatmedium/channel. Finally, persistenceof the message, and therefore therealization of sales, depended on thesingle campaign extended over time,and frequency of message repetitionHierarchical modelsand broadcastingAuthor: Ferdinando Scala
  • 18. 18Razorfish | Healthware From Crowdsourcing to BigData June 2013within a single day.While functioning well for manydecades, and allowing the surgeand fortune of a whole industrybased on traditional media, thismechanism has proved to beprogressively less efficient overthe last few years. In particular,television has suffered an extensiveloss of efficacy in terms of publicadherence, principally owing toan increase in the frequency ofinterruption marketing practices.The introduction of technologies likeremote control and TIVO stronglyempowered users against themounting wave of advertising slots,and their excessive frequency in thebody of programs. Furthermore,while remaining of interest to thegenerations who were involved inthis system of content broadcasting,television has progressively lostits power as a medium, especiallyfor the younger generations, thosewho first embraced the digitalmedia revolution and its mobiledevelopment.This resulted in the decliningefficacy of television as a means ofsales generation for Fast MovingConsumer Goods (FMCG), and inthe pharmaceutical field for OverThe Counter (OTC) drugs. Whilecommercial and pharmaceuticalindustries began to realize this fact,an increasing amount of investmentwas progressively diverted fromtraditional media to the new digitalchannels.The traditional sales force couldbe seen as the prescription drugequivalent of broadcast media; witha large number of representativesusing the same materials anddelivering the same message totheir customers. Pharmaceuticalcompanies have already beensteadily moving from this traditionalmodel by using customer profilingto tailor messages and interactions.This is becoming ever easierto manage given the variety ofdigital channels now available tophysicians.These past few years have beena testimony to the strength ofthe digital revolution, with theprogressive introduction oftechnological assets and toolshaving fundamentally changed thecommunication panorama. Thebuilding of the World Wide Web andits mobile development generated acompletely new system of relationsand communicational fluxes,identified as a “network model”The network model disrupts thetraditional, hierarchical models, bybreaking the linear and non-equalrelationships between emitter andreceiver. The receiver becomesan information selector and anemitter, whose influence and impactdepend on the extent and depthof their social network. The rateof disruption is so deep that thelexicon has changed, generatingthe neologism “prosumer”, todefine a new type of actor. Theterm “prosumer” results from themerging of the words “producer”and “consumer”. In the specificinformational domain, it has thesignificance of a “person who isThe network modeland P2PAuthor: Ferdinando Scala
  • 19. 19Razorfish | Healthware From Crowdsourcing to BigData June 2013simultaneously a producer and aconsumer of information”. Peoplepreviously known as “target” or“audience” have been enabledthrough the construction ofnetworking infrastructures and tools(social networks like Facebook orLinkedIn; collaborative media likeWikipedia) to exit the traditionalparadigm. Where they wereformerly absorbing informationfrom hierarchical, unidirectionalmedia, they are now informationemitters with their closely relatedpeers. It should be recognizedthat information exchange amongpeers existed prior to the creationof social networks. Indeed, a largepart of the traditional advertisingmodel was primarly based oninfluencing the so-called “opinionleaders”, i.e., individuals who had,because of their standing andmeasure of influence, the capabilityto spread, by affixing in the mindsof others, messages comingfrom the interested emitters. Thepharmaceutical world has alwaysrelied on this paradigm, e.g. passinginformation about new drugs,new indications and new clinicalstudies, to prominent physicians(Key Opinion Leaders - KOLs).These KOLs assumed the role ofinterpreters of the pharmaceuticalindustry’s data and messagingtowards the medical community.What has changed forever withthis advent of Internet and socialnetworks is the sheer number ofpeople simultaneously reached bya discussion about a topic, haschanged from a few (let’s say thedirect colleagues of a GP or thepeer Specialists in a Hospital, andgenerally limited to the immediategeographical surrounding); to manyhundreds (in relation to the extentof the virtual network a singleindividual has, and irrespective ofthe geographical dimension).In this context, while still maintaininga strong measure of influence, theopinion of Key Opinion Leaders issomewhat blunted and diluted bythe possibility that other subjects(prosumers) actively select andspread information, according totheir own rules and beliefs. Underthese circumstances, the personalrelationships among peers (where“personal” does not necessarilyimply a direct connection in thephysical world; and is measuredon the frequency and quality ofinteractions) are based on trust andcredibility.It is therefore important tounderstand the new rules whichapply to the new channels, whichare much more volatile andimmaterial than before.We shouldn’t consider this evolvedmarketing scenario -where peersneed to be frequently reachedwith coherent messages- just as afragmented target to address witha common message. EmpoweredHCP and Patients are walking awayfrom any kind of broadcast. Todaythe most efficient way to reach themis joining (or leading) the so-called“Conversation”.As a quick background about theReal time is formarketing (theCluetrain manifesto)Author: Leandro Agrò
  • 20. 20Razorfish | Healthware From Crowdsourcing to BigData June 2013idea of “conversation”, we shouldstart from the seminal book “TheClue Train Manifesto” (also known asCTM, 1999).The Clue Train Manifesto contains95 theses that re-defined OnlineMarkets and re-shaped marketersculture.During these years, powered bythe digital change, networkedmarkets self-organize faster than thecompanies that have traditionallyserved them. Thanks to the Web,markets become better informed,smarter, and more demanding ofqualities. In this new scenario –asdeclared by the first thesis of theClue Train Manifesto: markets areconversations.What does it mean when one says,“markets are conversations”?Authors assert that peopleleverage the “human-to-human”conversations with companies,which potentially transformtraditional business practicesradically in today’s reality.Conversation is the CTM keyconcept: According to the secondand third thesis reported in thebook, “Markets consist of humanbeings, not demographic sectors”and “Conversations among humanbeings sound human. They areconducted in a human voice”.These few theses are enough toradically shift what most companiesare doing in their communicationplane, both in the physical anddigital spheres. The consequence isthe communication of a totally newvalue chain, because “Hyperlinkssubvert hierarchy” and people –through the Internet - no longerdepend on traditional knowledgeand information sources.
  • 21. 21Razorfish | Healthware From Crowdsourcing to BigData June 2013INTRODUCING THE ePATIENTIn a world where a global conversationis evolving the whole healthcaremarket, people use the Internet to findtons of information about any disease,and to potentially contact anyone tocollect different opinions.The power of information-accessin the hands of any single persontoday, is bigger than the oneavailable to US President 20 yearsdiseases to which we are vulnerable.In just two hundred years we havegone from a society suspicious ofscience, to one centred aroundscience.Today we live in a world whereprivate companies such as SPACEXlaunch into the orbit rockets andsatellites and where ten percentof the gross domestic product ofthe world’s major economies isspent on health. In the world ofpharmaceutical companies, wefind examples such as Johnson& Johnson (the largest of all BigPharma), which is at 40th positionof the Fortune 500 ranking. Thesize of this company is based on its120.000 direct employees and over$60 billion in sales. In comparison,Apple, with its $65 billion and half ofthe employees of J&J, is just aboveat 35th position of Fortune 500(2012 pre-iPhone5 rankings).ago. Today we have the “big picture”of healthcare at our fingertips. Forexample, today we know that therehas never been a time in the pastwhen humanity was better off interms of wealth and health thanit is today. The video “The Joy ofStats: 200 Countries, 200 Years,4 Minutes” by Hans Rosling (BBCFour) could suffice to inspire thissystemic optimism.This depends on many factors,including what we know today aboutour health and how to treatAuthor: Leandro Agrò“The Joy of Stats”This video illustrates how over the past twocenturies, life expectancy and per capita wealth,have vastly improved for many nations. Of coursethe current state of health does not mean thatthere are no other potential alarms for the planet,BUT if you look at our health, we cannot miss theunderlying declaration of this video that WE AREGOOD and have NEVER BEEN BETTER.
  • 22. 22Razorfish | Healthware From Crowdsourcing to BigData June 2013The comparison - even that ofwealth – between the consumer-oriented Apple, and J&J or any otherpharmaceutical company, mightseem completely out of place, andactually, for a long time, it was.In recent years, however, themutation of both economic andcultural dynamics has madecomparisons of companies likethese more justified. The need tobe more efficient and closer tothe end customer, even in healthorganizations, is changing fromwithin.The digital culture that permeatessociety has changed the needsand expectations of customers,forcing entire industries to convertmentalities, or come to terms withthe traumatic entry of outsiders, whohave already done so. Regardless ofyour opinion of the Mayan prophesyannouncing the end of the Worldby 21 December 2012, that was theyear in which some major players inthe healthcare world went throughtheir “perfect storm.”2012 has indeed been labelled‘annus horribilis’ due to the numberof healthcare patents that areapproaching expiry. By 2015,following the expiry of very relevantpatents, the ranking of the 50 largestpharmaceuticals may undergodrastic changes or even somesurprising extinctions. This crisis hasforced many companies to return toheavy investment in R&D. By nature,this contemporary approach oftentranslates into research in the fieldof biotech. As a result, the culture ofmany companies is moving from a“cure-all drug” to a “drug tailor-madefor you.”A key point of this cultural shift is thechange in the almost total access tothe medical information base. At thesame instant in which a disease -especially if not particularly severe -affects us, we become transformednot into “sick people” but intoePatients: people who are able,through the distributed knowledge inthe Internet network, to learn abouttheir conditions as well as treatmentoptions, comparing the differenttherapeutic approaches and results.However, one needs to be carefuland not consider the ePatient as aconsequence of technology or anoutcome of the Facebook era.Dave deBronkart coined thedefinition of ePatient, madefamous with his speech at the TEDConference, when he narrated thisepisode:“That Fall of 1969, the Whole EarthCatalog came out. [...] We think ofhippies of being just hedonists, butthere’s a very strong component-- I was in that movement -- avery strong component of beingresponsible for yourself. This book’s(the Whole Earth Catalog) subtitleHealthcare is moving outof its “Ford” era just as theculture of the Internet isgrowing evermore rampant,and this mix is potentiallydisruptive.
  • 23. 23Razorfish | Healthware From Crowdsourcing to BigData June 2013is: “Access to Tools.”[...] TomFerguson was the medical editor ofthe Whole Earth Catalog. And hesaw that the great majority of whatwe do in medicine and healthcareis taking care of ourselves. In fact,he said it was 70-80% of how weactually take care of our bodies. Wellhe also saw that when healthcareturns to medical care because ofa more serious disease, the keything that holds us back is accessto information. And when theWeb came along, that changedeverything, because not only couldwe find information, we could findother people like ourselves whocould gather, who could bring usinformation. He coined this terme-Patients - equipped, engaged,empowered, enabled.”This hippie counterculture notehelps emphasize how seeing theePatient as an insignificant rolewould be a double faux pas. Firstly,since it is an ingrained, long-established phenomenon. Andsecondly because phenomena thatbenefit from digital advancementare rapidly approaching their tippingpoint: are motivated andprepared to do everything it takesto help save their own lives, andlooking at the opportunities thatthis change has created, youcould say this democratization andconsumerisation of healthcare is notnecessarily a bad thing.ePatients are not the only forcesthat are influencing the world ofhealthcare. The entire industry isaffected by new situations. Recently,in The NewYorker, an article waspublished with this provocative title:“Restaurant chains have managed tocombine quality control, cost control,and innovation. Can healthcare?”The thesis of this article issummarized as follows: TheCheesecake Factory, used as anexample, is part of the casual diningindustry and, present everywhere inthe United States, can serve freshfood, cooked on the spot, with agrowing price/quality ratio to eightmillion people each year. In attainingthis result, they have democratizedaccess to certain foods for lowerincome groups, and at the sametime, they had to influence theprocesses of supply logistics andtheir suppliers, optimizing logisticsand processes both internal andexternal.This action, which affects the source,is of course only possible when youreach a certain critical mass. Theprocess of improving the quality/costratio of the entire sector of casualdining, started when the chainsbecame protagonists. Now, thisvery same change is happening inhealthcare.“Medicine, though, had held outagainst the trend. Physicians werealways predominantly self-employed,working alone or in small private-practice groups. American hospitalstended to be community-based.But that’s changing. Hospitals andclinics have been forming into largeconglomerates.According to the Bureau of Labor
  • 24. 24Razorfish | Healthware From Crowdsourcing to BigData June 2013Statistics, only a quarter of doctorsare self-employed—an extraordinaryturnabout from a decade ago,when a majority were independent.They’ve decided to becomeemployees, and health systemshave become chains. In medicine,we are trying to deliver a rangeof services to millions of peopleat a reasonable cost and with aconsistent level of quality. Unlike theCheesecake Factory, we haven’t(yet) figured out how.”Similar examples can be drawn inmany areas across the world ofhealthcare. Even the area of medicaldevices is not without drasticchanges. Just going to the AppleStore, one can find many medicaldevices that cost less than ahundred dollars. Just five years ago,we could only find these devices ina pharmacy and we would only havepurchased them on medical advice.One example? Withings BloodPressure Monitor, for an easy andaccurate self-measurement of yourblood pressure directly on youriPhone. ePatients to the influences ofchanging forces across the valuechain, the world of healthcare israpidly changing. A key player inthis change is that of technologicalacceleration. When digitalizationaffects one industry, it does notleave it immune to its actors, orbetter yet, pulverized and in manyways expands the supply chain,requiring all existing actors todeal with change and possiblypredisposes it to new opportunities.Healthcare is not free from thisexplosive effect of digital andePatients represent the most visiblepart of this rapid change.ePatients are not special people. Weare ePatients when we:• Seek information on the Internetabout symptoms or diseases• Seek practical advice via socialnetworks and share experiencesrelated to health• Use self-tracking or wellnessdevices because we aspire tofeel better• Think of a hospital as a servicecompany• Look at the tools that doctorsuse and compare them withthe technologies that we havein-house• Look at drugs no longer asclosed boxes accessible onlyby doctors, but as products weuse and to which we subject tocareful scrutiny before purchase• We influence those around usby sharing our experiences onhealthAn article published on January16, 2012 by TechCrunch “PEWResearch was reporting that 17percent of mobile phone userswere using their devices to look uphealth and medical information, andJuniper recently estimated 44 millionhealth apps were downloaded in2011.”In 2011, in terms of earnings, thearea of mobile health applicationsreached $ 718 MM. The mainreason for the significant growth isan increase of smartphone users onthe demand side, and the increase
  • 25. 25Razorfish | Healthware From Crowdsourcing to BigData June 2013of mobile health applications on thesupply side that has doubled since2010.Many major healthcare companieshave found mobile healthapplications as being an effectivemedium to promote and deliverhealthcare products and services.More information on the mobilehealth application market can befound in the detailed report byresearch2guidance entitled, “TheMobile Health Market Report 2011-2016”, which describes the impactof smartphone applications on thehealth industry.As easily understandable, theabove mentioned trends are notrestricted to pioneer attempt towarda new level for patients to acquireand share medical information. Onthe contrary, it already generatedPatientsLikeMe, a very notableexample about how collaborativeattitude can incredibly improve thelevels of treatment and quality of lifeof patients.We, in Pharma, can’t drive,over-influence or hidethe global conversationePatients started abouthealthcare. We should bepart, and culturally lead it.A bright mind, an anthropologist, a TED fellow, recently discovered that hehas brain cancer.As an artist and freethinker, he decided to publish on the Net all dataregarding his disease. Unfortunately most of the data were recorded inprivate data format, hence were not visible and sharable over the Net.What did he do?He hacked the data, and published everything on a website. Thousandsof people read the data, hundreds of physicians participated by providingalternative information and data to him and to the medical staff.This Italian ePatient’s story was so largely followed by the media, that theMinistry of health declared their willingness to pass a law engaging medicalinstitutions to provide health exams in an open format.This is not the end to this story as this thinker – working closely with theauthors of this whitepaper – declared:“the ‘e’ before the word ‘patient’ is not there to testify technology. This ‘e’is there to destroy the word “patient”, usually considered as a subset ofpeople with inferior autonomy, power and will (as is often the case whensomeone enters in a hospital).”The Internet is a disruptive ingredient and ePatients will leverage thissuperpower to stay in the same category as the other humans. The nextword will be just “persona”.The World After the ePatients
  • 26. 26Razorfish | Healthware From Crowdsourcing to BigData June 2013PatientsLikeMe is a collaborativeplatform where patients andcaregivers have the possibility toshare their own experiences andproblems, in order to gather helpfrom people in the same condition.The platform was born in 2004 asa specialized sharing environmentfor patients affected by AmyotrophicLateral Sclerosis (ALS, or LouGehrig’s disease), a chronic anddisabling neurologic illness, whichhas an average fatality rate of39 months from early onset. Avery famous ALS sufferer is theprominent physicist StephenHawking; also a most unusual one,having survived the illness for morethan fifty years.The PatientsLikeMe (PLM) virtualenvironment was ideated by thefamilies of ALS patients, who weresearching for advice and supportabout how to better cope with theprogressive decline of their lovedone capabilities, while also ensuringthe best possible treatment andsupport strategies. What startedas a simple method for gainingsupport in response to a need, soontransformed into a powerful tool forpatients, caregivers, and, ultimately,doctors.Despite the fact that the person forwhich PLM had been conceiveddid not survive the disease andpassed on shortly after, hisparents managed to gather ideas,information and even economicsupport by simply relying onthe power of crowdsourcing.The platform was built so thatmembers can share with their peerssynchronic and diachronic dataabout their illness and treatmenthistory, and also more qualitativedata regarding their personal state,like the insurgence of depressionor mood during recovering, thequality of life associated with bothconditions and treatments, and soon.As a consequence to the approachtaken, founders were able to gatherfunds worth about 50 million USDin support of the ALS TherapyDevelopment Institute, a non-profitbiotechnology company whosemission is developing treatmentsfor ALS. Furthermore, when theplatform was opened to otherillnesses, there was a surge inmembership, which in a shorttime attained more than 100,000,distributed over about 1,200different diseases.When it moved outside the ALSdomain and differentiated its datagathering to include other diseases,PLM opened itself to become oneof the most prominent Web-basedclinical data sources in the world.This allowed it to include serviceslike those bringing awarenessto Clinical Trials awareness andscientific work. Opposite to thetraditional model for patientenrolment into clinical studies, whichis based on the referral of patientsto researchers by traditional referralsystems like hospitals and GPs;PLM was in the position to makeits members aware of ongoingclinical trials all over the UnitedStates, segmented by conditionand demographics, thanks to aPatientsLikeMe: a casestudy on the power ofePatientsAuthor: Ferdinando Scala
  • 27. 27Razorfish | Healthware From Crowdsourcing to BigData June 2013partnership with allowed patients to have adirect source of information aboutwhich studies of interest wereon-going, and taking steps forparticipating in them. This led to agreater speed in terms of enrolmentrate (which is always one of the mostdifficult and frustrating tasks forresearchers) and greatly improvedthe overall statistical significanceof the gained data, due to thelarger dimension of statistic sampleavailable.PatientsLikeMe is therefore asignificant hot spot of the newoperational landscape, occupiedby both physicians and pharmaindustry. On the other side,patients empowerment is not tobe treated as a menace by theabove mentioned stakeholders.Alternatively, the very samerevolution which is empowering thepatients, is empowering pharmamarketers with new powerful, highlymeasurable, and flexible tools for thediffusion of their messages.
  • 28. 28Razorfish | Healthware From Crowdsourcing to BigData June 2013Over the last five years, pharmacompanies have all been movingtoward the integration of digitalstrategy into their marketing mix; notlonger a “nice to have” addendum,but as an important pillar of overallbrand strategy. The rate and extentof this integration is such that insome cases and markets digital isbecoming immaterial, i.e. it is notanymore a part of the whole, butpermeates all the communicationactivities.The acceleration toward the creationof an integrated digital approachproduced a surge in the numberof digital assets available online,typically dedicated to brand ortherapeutic area communications.As a consequence, companies nowface a fundamental rule of digitalcommunications: rapid contentobsolescence. Differently fromprevious operational models, whoserhythm of content production anddiffusion was following a time scaleof approximately three months,digital communications erase thecommunicating power of contentmuch faster. Quite typically, contentis now considered obsolete in a timespan that ranges from thirty and fortydays maximum.These new conditions generated aparadox, under which companiesare forced to have a constant flow ofcontent in order to fuel their onlineassets (if they don’t do so, assets diequite rapidly due to loss of interest);while not having the economic andorganizational power to generateenough content to fill the gap.Again, acknowledging that ePatients(as well as eDoctors) are generatingand spreading content, andleveraging this phenomenon, canbe the answer to an apparentlyinsoluble dilemma. Therefore,content sources like collaborativemedia are pivotal in allowing a digitalasset to be constantly fresh andupdated. On the other side, thereis the problem of differentiating andselecting interesting content from thequalitatively unsuitable. This can beattained by individualizing the userswho produce content of sufficientquality in collaborative communities;and providing them with privilegedinformation in order to make theircontent production faster and ofbetter quality. This way, it is possibleto build a wide panel of affectionateusers, which entertain a strongrelationship with the company, anddevelop a mutually advantageousdynamic. By accessing privilegedmaterials and tools, to produce bettercontent they will have the possibility toshine in front of their social network;while delivering messages from thecompany with maximized qualityand credibility. And so, these contentproviders become the “KOLs” of thedigital communication era.ActiveMint is an interesting examplewhich uses crowdsourcing in order tomonitor and reward healthy behavior.CROWDSOURCING AND ePATIENTSFOR MARKETINGAuthor: Ferdinando Scala
  • 29. 29Razorfish | Healthware From Crowdsourcing to BigData June 2013This Web-based platform gathersdata from ePatients (defined notnecessarily patients, but as healthypeople) about their daily behavior. Inparticular, enrolled users continouslypost healthy behaviors on their profile.These posts range from behaviorslike taking a walk, checking in at agym, eating a type of food, drinkinga certain quantity of water. Thisvirtuous behavior is rewarded byearning points on the platform, whichcan be redeemed under the formof gift cards and other real worldrewards. The platform generated theinterest of a number of insurancecompanies, which finance therewards in exchange for advertisingopportunities on the platform.What is interesting and actionableabout this example is the possibilityof using the very same approach forpatient adherence initiatives. Thereis a possibility here to get patientsto adhere to a treatment schedule,by rewarding not only the timelydosing of their prescribed treatment,but also providing support forpatients maintaining a more complextherapeutic regime, such as followinga diet, practicing certain exercises,etc. From a marketing standpoint,this approach could be valuable togather reliable data about the rate oftherapy adherence, and also spottingcollective behavior which coulddeterminate adherence ornon-adherence, not normallyevidenced by means of customarymarket analysis techniques.
  • 30. 30Razorfish | Healthware From Crowdsourcing to BigData June 2013ConclusionsThe Internet Age has brought with it an almost infinite amount of information,allowing anyone and everyone the resources to build their knowledge –to build anything in fact! Crowdsourcing is an innovative way of workingtogether to pool and analyse more data than we could ever achieve alone.How can you use this vast resource in your day-to-day life as a marketer?Just spending 10-15 minutes of your searching outside of our comfort zoneof FirstWord newsletters, PM Live, MM&M, etc could open up a new worldof resources to mine for insights into the disease areas in which we work. Itcould give us the opportunity to become exposed to the thoughts, feelingsand motivations of people living their lives with these diseases; sharing thethoughts, their data and shaping their own futures.Have you considered ePatients as a stakeholder in yourmarketing plan?Whilst we cannot drive, over-influence or hide the opinions and broadcastsof ePatients we might consider how to engage with them, or simply use theirknowledge and resources to better understand the needs and behaviours ofyour most-empowered end customers.With these new paradigms of Crowdsourcing and Big Data, the ePatient isa force to be reckoned with, the perfect storm that will sweep through andradically change the future of the healthcare industry.Are you as a marketer ready to embrace this change?Want more?Follow us on our social media stream, or directly reach out to the authors forlearning how to align your brand / franchise / organization to the mountingwave of digitally-enabled healthcare.
  • 31. Razorfish Healthware is a global leader in digital and healthcarecommunications, leveraging a unique mix of insight, technology, creativityand industry savvy to deliver digital innovations, solutions and tools that driveimproved health outcomes.Our deep understanding of the innovation process, human-technologyinteractions, and the healthcare ecosystem enables us to generatetransformational experiences that empower people’s health and wellnessdecisions.Razorfish Healthware is a single organization able to deploy our fullsuite of services in support of any market with more than 300 dedicatedprofessionals based in 9 countries around the world: US, France, Germany,Italy, Spain, UK, Australia, China, India.Razorfish Healthware is part of Publicis Healthcare Communications Group(PHCG) , the largest and most innovative health oriented communicationgroup.Razorfish Healthware’s service offering is made up of three specializedbusiness units, an Advisory practice offering technology strategy andenterprise consulting; a digital communications and marketing practice anda solutions and technology practice offering a range of enterprise businesstools and related services.For more information please | t +39 089.3061.411 | f +39 089.3061.415US | t +1 888.463.3793 | f +1 646.935.4791AboutRazorfish HealthwareRazorfish Healthware@RazorfishHWVisit us on:Razorfish