Health Smartees 2012


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On April 25 2012, InSites Consulting organized a health smartees about our health research business in the InSites Consulting office in Ghent, Belgium. In this presentation, you can find all slides that are presented by multiple speakers. If you want to know more about our healht research solutions, do not hesitate to e-mail: (NL), (BE) and (UK).

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  • Afterenjoying a responsible energy boost, I’dliketo continue with the next step, namelyto start the conversationwithpatients.In the next 25 minutes, I’ll show yousomerules of engagement. We have distilled these rulesbyobservingconversationsthat are takingplace on the 3 biggestsocial media platforms of the moment: facebook, youtubeandtwitter.
  • Before we willdisclose the rules,I’dliketo start withanoverview of wherepharma is now, andhowtheyperform in comparisontoother sectors who are engagingwiththeir target groups as well. we asked 400 senior marketing managers towhatextentsocial media is integrated in the marketing thinking and acting in your company.Based on theiranswers, we seethatMedia, Tech & Telco are taking the lead.thathealthcareandfinance are laggingbehind.In order tounderstand the problemsthey’refacing, we askedfor the mainbarriers (next slide)
  • Whilepharmatendstositcautiously on the sidelines, consumers have rushedahead in searching the web for health information. They are voicingtheirexpectations, whichcanbeseen as a threat (cfrarab spring), but it’salso a major opportunity for companies to listen to. If we put it even stronger, itwillbecomemandatoryto listen toit in order toprevail in the long term.
  • One opinion leader which is often cited is e-patient Dave.A few years ago, Dave was close to being a “nobody”. Just lived his life, until he was diagnosed with stage IV kidney cancer. Sofie will tell you more about him later on. If we look at Dave today, we can easily state that he’s become quite influential: he’s spread over 38.000 tweets, and among his 10,306 followers, we spotted big pharmaco’s such as @LillyPad, @pfizer_news…). So apparently this guy has something interesting to tell.By the way, he’s getting close to our own Steven Van Belleghem @steven_insiteswho currently has 11,506 followers. Active on facebook, andmeanwhilehe’sbecome a professional speaker: His presentation on TEDxMaastricht last year has been viewed 6,711 times on YouTube.
  • Notonly “experienced” patientsusesocial media to share theirexperiencesand views on healthcare.For the averagepatient, social media is becomingan important source of information as well.This information is likelytoverylikelyto affect their course of action.Averageage 41
  • Op basis van gen pop (niet enkel experienced) merken we dat conversaties over het algemeen positief zijn, ook uit onze smn studies blijkt dit. Average sentiment is groter dan 0. Robert moet zeggen dat brand scores in andere TA’s positiever zijn dan bij diabetes.Uitleggen wat een conversation/post isThese figures arefromfacebookPharma company: 35% vs 7%Disease: 36% vs 20%=>comparabletopharma as a wholeOnlyformedication we seequite a lot of negativebuzz, but – as Robert toldbefore - the proportion of these product brandedposts is low withinmedicalcondition-relatedconversations (e.g. for diabetes this is 92%vs 8% branded). Robert needstoadd slide withamount of brandedconversations in diabetes.
  • We have distilled these rulesbyobservingconversationsthat are takingplace on the 3 biggestsocial media platforms of the moment: facebook, youtubeandtwitter.
  • Facebook gaat niet enkel over profiel updates (waar uiteraard ook info over merken kan woorden gedeeld), maar ook over groepen waar info over merken, bedrijven en TA kan worden geplaatst.
  • Gemiddeld bezoek aan product website duurt 5 minuten (veel korter dan facebook sessie!!)
  • Facebookusage is onething, but we as marketeers are mainlyinterested in the performance of ourdiseaseareas/brands on these pages. Therefore, we scraped the publiclyavailablefanpages of over 300 brands in 6 different sectors.Media has the biggest fan base – Healthcare & Finance have the least fans.Gemiddeld aantal fans is ongeveer 10e van FMCG, redenen;-patienten niet alles op FB gooien omdat het zichtbaar is voor vrienden en dus eeder in afgesloten communities gaan-weinig pharmaco’s actief zijn op fb OF er valt niet veel te beleven op die pagina. As such these figures more or lessreflect the integrationfigures.
  • Let’s first take a look at the best in class: Successstories
  • Also, if we move from general consumer care space to specific diseases, facebook pages can have a major fan base.Juvenation is a social network especially for people with type 1 diabetes and their caregivers which was created by the Juvenile Diabetes Research Foundation (JDRF) through an unrestricted educational grant from Novo Nordisk. According to JDRF, the goal of Juvenation is to facilitate a network of ongoing peer-to-peer support.Once a person registers with Juvenation, he/she can create a profile, participate in online discussion groups and forums, create and comment on blogs, upload videos, and more. Members share their thoughts, concerns and tips about living with diabetes. There is also information about new gadgets and technologies to treat type 1 diabetes.JDRF launched Juvenation on World Diabetes Day, November 14, 2008. As of this writing, the site has more than 14,000 members.
  • Abiraterone. Online petitie om aan medicatie te geraken in UK, want door NHS niet aangeboden
  • When Facebook changed its rules in August 2011 and requiredall Facebook pages to enable comments, some pharmaceutical marketersshut down their Facebook pages for just that reason. Othershave posted warnings and reserve the right to disable comments,although some noted that kind of policy can hamper the building oftrustingtwo-way relationships.But still others are trying and are getting kudos for effectiveness.BoehringerIngelheim is often cited as a pharma example of theright way to do Facebook.Visitors land on a “welcome” page, versusthe typical straight to wall postings on most pages.On the welcome page, the pharma company explains itsFacebook mission and policies in a friendly casual manner.The pagereads in part:“We have enabled our wall for commenting becausewe want to hear from you! Help us to keep this wall interesting byactively contributing in the spirit it’s intended for but please respectthe following otherwise our lawyers will be mad at us.”BoehringerIngelheim lists and offers a rationale for its postingpolicy:“The company reserves the right to remove any postings at itssole discretion (we work with serious medical conditions and wecan’t risk unmonitored or unverified medical advice being published).”A disclaimer/caution about not using the site as a substitutefor professional medical advice adds:“We know a lot of doctorsand trust us—they know about health!”
  • So as a company we have to do something in order to activate this unused social potential…One of the main strategies that is undertaken is to increaseaudience (= # of fans)But does a large audience lead also to more conversations?
  • Youcancompareitwithdoing a lot of advertisement for a new show: youcanconvince a lot of peopletocome over, but oncethey’retherenothinghappens. It couldbethatthere’s a brave person whojumps on stage, but you’dbetternotcount on that. Well, it’s the same on facebook, youneedto entertain them.However, you can also over do it. the moment that you have again too much conversation management, it seems that it becomes too much one way communication again…in this case your correlation is decling againExplain the term conversation management is
  • Human touch: employee of the month
  • Aantal nieuwe filmpjes op youtube per dag + aantal dagen in totaal al opgeladen => clutter er staat veel op, maar ook heel veel crap tussen.Dus: je moet iets doen wat engaging is, anders ga je er niet uitspringen.Zal eens voorbeeld tonen van BI: dit springt eruit! Heel veel likes, mensen geven er veel comments opFilmpje tonenGoede dingen voor te zeggen, want gaat zeker awareness verhogen en support of corporate branding.Maar als we het nader bekijken, kunnen we ons vragen stelen bij de relevantie. Kortom, wat heeft de patient hier aan op het moment dat hij ziek is?
  • Goede dingen voor te zeggen, want gaat zeker awareness verhogen en support of corporate branding.Maar als we het nader bekijken, kunnen we ons vragen stelen bij de relevantie. Kortom, wat heeft de patient hier aan op het moment dat hij ziek is?
  • Om te leren wat patienten willen: eerst eens kijken wat ze zelf posten. Ze gaan filmpjes tonen over een bepaald probleem, en hulp/raad vragen aan peers.Hier staat dus ook het therapiegebied + de persoon achter de ziekte centraal
  • Filmpje janssen schizo patientVersterkt de awareness van de symptomen => informeert over TA én toont de echte patient
  • Educationtherapeutic areaHow touse a product (aan Robert vragen of dit mag!!!)How to live withit => coping strategies, recipes
  • Maar toch vinden wij dat twitter de moeite waard is.Waarom?
  • Slide van janssen: prostatecancer1 factual updates (eg approvalby FDA)2 reflection of hypes (movember)3 links to sources considered relevant bypatients (use URL shorteners!)
  • Now, beforeyoustartrunning of to set up a facebook page, or to record a youtube move, remember a few thingsBesidescheckingwithyourlegaldepartment.
  • 2. Keep your website up-to-date in order to avoid tactical comments on your social media and do not consider your facebook page as a replacement for your corporate website6. Use an integrated approach across different social media:Eg: same look and feelFacebook link naaryoutubeenz)7.If you don’t know what to tell them: consider listening before facilitating and joining
  • I hope youallenjoyed the break & thatyourbatteries are fully re-loaded. Because POWER is the key term in this second part of our health smartees. We will take a look at the empowered patient in this part – more specifically we will focus on which tools & technologythis empowered patientneedstobe empowered & tobeengaged. Socentral question is howcan the industryequip the patient! In the final part of thispresentation, i willalsoconfrontyouwithopinions of other stakeholders in the healthcare are regardingpatientsapplications – as there are physicians, pharmacists, the government even & patientorganisations.
  • But let’s go backto the empowered patient is not a stand-alone concept. It totally fits the broaderuniverse in whichpeople anno 2011 & 2012 are living. If we take a look at the past year, empowered citizenswereabletobring down Egyptiongovernment in 6 weeks via a bottom-up initiative, supportedbysocial media. Arab spring showedus the power of the people in combinationwith new media. London Riots made itintohistory as the Blackberryriots. Technoclogy. We had initiativesbyBelgianpeoplewhoweretired of continuinggovernmentdebates & wantedto tackle the political issues. RememberPukkelpupwerepeopleoffered help via Twitter #hasselthelpt
  • Empowered patients are challengingphysicians more & more today. Todayoften a treatment decision is a joint decision made byphysician & patient, notone way anymore. In a survey a couple of yearsago, we askedwhich steps a patientstypically takes whenbeingconfrontedwithillness. The first step … nothingto do with internet, it is justwaitinghowitevolves. But on average, the second step is NOT tovisit a doctor, it is surfing the internet tofind out more on what’s wrong, what the diagnosis mightbe, whichtreatments are relevant… sothey are betterpreparedthan ever to enter the dialoguewith the physician!
  • Thepatient empowerment is even so big, experts refertoit as the a thirdphase in the liberation of men. It is the 3rd movementprovoking a clearrevolution, it is the start of whole new healthcare system reform. Thingswill never be the sameagain.
  • Eachmovementoften had a ‘face’, a representative. For the black movement, it was Martin Luther King, the womenliberationmovement. The first feminist wave, Virginia Woolfclearly had a centralrole & later on Simone de Beauvoire. Maybethisguycanbeconsideredtobe the face of the patientmovement… anyoneknowswhothisguy is? E-patient Dave. In 2007, he gotdiagnosedwith a fatal form of kidneycancer. Doctors gave him 6 monthsto live. He refusedto accept this verdict & startedsearchingfor a treatment, forpatients in similarsituationsthatwereabletosurvive. & he found what he was lookingfor. He found a mission in his life: beaninspiration & a guide for fellow patients. He alsoturned out tobeaninspirationfor the industry. More particularlyfor Novartis, the manufacturer of the drug Proleukin that helped him.
  • The case of epatientdaveillustratesperfectlyhow information canbe a power tool forpatients. The worldwide web facilitates the health consumer in their search for information, dokter google oftenbeingtheirwindowto the loads of data out there. They want to know what their disease is about and won’t just believe what their doctor says
  • The power of informationalso lies in the factthatit is notjustaboutconsuming the information, they do have anactual impact. A study we found concludesthat 6 out of 10 patientsagreethatwhatthey found online regardingtheir treatment, alsoaffectshowthey approach the treatment & howthey deal with it.
  • Needlessto say that companies also start torealize the power of the internet & social media fortheir business. Oursocial media integrationstudyconductedamong marketing managers shows a positive link between level of social media integration & financial results. Sosocial media is more thanjust a marketing tool, it is a business strategy. Howevernowpharma in particularneedto act uponit!
  • Time tothinkabouthow the pharmaindustrycanjoin or facilitate the empowered patientconversation. Saartje has touched upon how to activate the patient conversation via providing general information, news, updates… But there is another type of information that is even more powerful for patients – it is information about themselves, about their own chronic condition. What can the industry do?
  • Thisevolution of tracking mannersfordiabeticpatientsillustrates the empoweringrole of technologyfor the patient. First patientsneededtowrite down values in a notebook. The PC empowered the patientbygivinganoverview of the evolution of the values, patientscouldcalculateaverages! Then the automatic logbookserved the user frustration of alwayshavingto input data manually, nowtheyjustneedtoconnect a monitoring device with the pc to keep track of values. The logbookappforsmartphones in the end makesitpossiblefor the diabeticpatientwho is often on the go to keep track of values. 24/7, anywhereanytime.
  • So, the patientlikesappsthat help themwith coping with a disease in a veryconvenient way requiring the leastefforts & helpssaving time, which is a scarcegood. It is a service a pharmaceutical company can offer whichwilldefinitely boost patienthappiness. Let’ssummarizehowpatienttechnology – applicationscanbe relevant for the pharmaceutical company from a business point of view.
  • direct communicationfrompharmaindustryto the patient is almostimpossibletoday. As Dave states: these apps are a way to make the patient more enthusiasticabout a pharma company. Imagine a patientthatthankstoanapp is nowabletocentralizeall relevant values & numbersregarding his/her disease, thiswilldefinitely trigger a conversationEitherwith close peers or with fellow sufferers.
  • But apps or services do notonly have commercial relevancebyboostingconversationsamongstpatients. No, apps help companies tobuild a CSR image. Think of appsthat focus on prevention of diseases – itwould surprise peoplethat the industry puts the health of people first beforetheir goal of sellingproducts & medication.
  • In a CSR context,Apps have the potentialto make healthcare more accessibleforpeople in the thirdworld. Theycan boost awareness & commitment for health in a worldwhere access tofixed internet is problematic. Therechronicdiseases are ever more threatening
  • Apps last but notleastcan help in the relationshipbetween the physician & the patient. Helping the doctors help theirpatients, your end-consumers. Soit is alsoaboutservicingphysicians, whichstill have decision making power regarding the productsthey are prescribing.
  • We know how apps or patient technology can boost pharma business. How interesting is it to start investing in apps given the market situation. Let’s first take a look at smartphone posession. What do you think is the percentage of european internet users that have access to a smartphone?
  • 38% is the average number of people in europe owning a smartphone either with or without internet access (mainly android or iPhones are used)In the scandinavian countries it is even higher (+46%) & in west-europe it comes close to 40% Ok, we know that a big bunch of people own a smartphone, but what does that mean in terms of apps?
  • First of all, it is interesting to mention that 8/10 of European smartphone users have apps installed, at least one. The average number of apps installed is 25, but it does not mean that all 25 are used. In practice, apps users say they only use half of them.So users arecareful in selectingapps & someapps are notusedafterwards
  • People use various types of apps – mainly for practical purposes in daily life: e.g. 68% uses navigation apps 62% uses apps for weather forecasts Entertainment is very popular (56% hasapps for music like iTunes or for watching videos) as well as apps that connect them with others (59%social media apps). The good news is: there is room for health topics as well! 17% is using them already today. Another research predicts in 2015 30% of smartphone users will have used mHealt applications. So there is room for more! Opportunities are out there.
  • Let megiveyousome concrete inspirationforpatientapps. We will do sobygoingthrough the diabeticpatientjourney. There are appswith prevention purposesto start withonwardsto the final steps in the therapypath. nottoboreanyone of you, i includedalso non diabeticspecificexamples.
  • Before we dive in a diabetes case study, I liketomention I willsolely focus on appsdesignedforpatients, eithercreatedby the pharmaceuticalindustry. We are aware of the existence of apps of physicians (likedosage calculators, interaction checkers…), appsfor nurses (e.g. adverse event management, appsforpharmacists… these are categoriesthatwillnotbecoveredhere
  • Well, how equipped is the diabetic patient today? Within the cloud of diabetes apps I present you with a small sample of what is out there today. So, which different ranges of apps do exist today? …
  • Relatedto high prevalence of diabetes in Western Europe, prevention is necessarytoreducecostforsocial security system – next tothatit has commercial value as well!
  • Appsthat helppatients in receiving updates in the therapy area of their interest. We’veseen in the big 3 studyby Saartje thatpatients love news & thatit is somethingtheyoftenfindworthsharing. Sointerestingfor the sector to offer this.
  • Also fits in the range of prevention tools: nutrition coach. A typical coach of anapp relevant in a specificdisease area (diabetes) thatalso has relevanceforpeoplethat do not suffer from the disease. E.g. people on a diet, wholiketoeat in a healthy way can benefit fromusingthis tool.
  • healthcare is becoming ever more expensive, even more the case forthosesufferingfrom a chronicDisease. Withthis financial coach tool, designedfor the US healthconsumer, onecan keep track of allexpenseswith a health label. Alsofor Europe, where basic care is guaranteed & sponsoredbygovernment, a tool thathelps in managing healthcarecosts has relevance. E.g. itcan offer opportunitiesforhealthcareinsurances: based on patientscostoverview, insurerscansuggest new products or offers that are more in the interest of the patient or can get inspiredfor new insurance packages based on recurrentneeds …
  • In a more advanced stage of the diabeticpatientjourney, patientsalsoneedto take insulin, next tonecessary lifestyle changes, bloodvalue tracking etcetera. Appsthat combine different aspects of disease management are popular. There even is competitionbetweenapps on the number of aspectsthey cover!
  • Andsoon, companies followedwhowantedtoprovidetheirclientswith a logbook inadditionfortheirmedicines. Thisappgives a full treatment that takes record of your glucose, activitiy, nutrition, weight, exerciseandbloodpressure. YoucanalsoIdentify the medications you are taking, set reminders, and record when you take your medications. It includes charts where you can see your progress. The industry like patients to comply to their treatment as much as possible & the industry with their apps like to focus as well on the relation patient – health care provider, 2 important stakeholders
  • Previous wasallaboutpatients empowerment that is oftenconsideredtobe a threatforphysicians. However, this is not the intention of the empowerment patient nor of patientsapps. The needfor health care professionals & pharmaceuticalindustry on a research & development level has never been bigger. Withregardsto doctors: the empowered patient & new technology is obviously changing the relationship between doctors & patients, but it is definitely not undermining it! Apps/technology can definitely also facilitate the relation with doctors
  • To end the overview of patientapplications, i’dliketo point your attention to a general society trend: gamification. It is a helpfuladd-on, alsofor mobile applicationswhichcan boost motivation of e.g. chronicpatientsto keep track of values or to stick to diets… gamificationseemstobe a logical solution for a kids target group.
  • However, its usage can definitely be extended towards other target groups. Take the example of Lara. In daily life, especially keeping track of glucose levels is something she doesn’t like to do. It is such a hassle. On top of that, her parentsare constantly supervising her: ‘have you filled in your values yet’, ‘how are your values today’… It’s freaking her out!
  • In the case of Lara, gamificationcanbeaneffective solution. Because… we cannotmotivate Lara to keep track of values via simple sms reminders or phone calls as these are justautomatedversions of her naggingparentswhich do the opposite of motivating her. In her case, the gamifiedapp ‘Bant’ canbe the answer! With Bant, youngsterscan save points byinputtingvalues on a frequent basis tobuyapps or music. & itprovedtobe a success: up to 50% more measurementsby the target group! Worth considering.
  • & gamificationalso has relevanceforadults! For exampleHeartVille, the winner of 2012 future of health award is a social game that helps people to persevere in their lifestyle improvement. The initial target group will be psychiatric patients, who’s life expectancy is 25 years (!) less than the average population, mainly because of their lifestyle. In the heartville game, the patients need to restore the ruined village of heartville into a pardise. They can win points/material to restore the village by fulfilling personal lifestyle goals. Interesting: apps are also relevant in the context of mental health.
  • Apps are on the fast track! They have a short life span – so, it is goodto keep aneye on the future. One of the next steps after a logbookapp is the following: a monitoring device like the IBG star thatcanbeattachedto the smartphone of a diabeticpatients – the device measuresautomatically via a small amount of bloodthatneedstobe put on the strip & sends data to the iPhone app. A next developent, not in use yet, that has Star Wars allures is the fluorescence method: what is it? Injection of fluorescing pigment and sensor Nano molecules. These Molecules attach to glucose in the blood. It enables the patient to ‘Read their blood values with their iPhone via the Fluorescing Nano sensor-tattoo (device they can attach to their phone). Big plus: no need for a blood sample
  • As InSites, we truelybelieve in the power of technology, however, we do NOT think companies should start creatingtheirownappjustfor the sake of it or becauseall the others have ono. No, not at all. Apps are a means toan end: to boost or activatepatientconversations, or tobuild a corporate image or to support business. They are not a goal as such. Oneshouldknowclearlyupfrontwhat the goal of the app is & shouldalsothinkbeforeone acts.
  • Unfortunately, there are also quite a lot of examples of apps that were not successful. This app was created by Sanofi for parents with children suffering from ADHD to track mood & behaviour of their kids. What went wrong? Difficult to say, but we do know that it is important to know what your consumer wants & how he/she will use the tool in daily life to make it a success. Maybe parents are not 24/7 with their kids & are other stakeholders more important in the observation of their ADHD kid. Or maybe the values between which the patients needed to choose were not broad enough…
  • So, the message is: whenyouliketoinvest in apps, whatevertheirnature; first listen towhat the end user needs & how he/shewilluse it. apps are a seriousinvestments & needseriouspreparation & strategyaccordingly. Soconnectingwith the end-consumerbeforelaunch or even beforedevelopment is one way topreventfailures.
  • To illustrate this: in case you like to test apps upfront or in case you want to check whether an app concept is relevant; consider first to whom you want to speak. To illustrate for the diabetes case. A company wants to invest in a tracking app. Who should they speak to? Well, first of all, one potential end-user is Lara. The added value of new technology is very evident for her. She already is keeping track of her values in a digital way. Upon confronting her with the IBG star she was very excited: she immediately would like to try it out. No barriers for her, it is only a small step. She will find her way through the different apps today very easily
  • Diagnosedwith diabetes type I in 1976. Diabetes Promotie Manager at Vlaamse Diabetes Vereniging & past healthcare solutions manager diabetes at sanofi-aventis . Owner of a smart phone. AsIolanda, he keeps track of his values via a small notebook. It will take more time to convince him of using an app. He wonders what the added value of a mobile tracking app would be. It is interesting to see that he looks for compelling arguments e.g. if an app could prove it lowers his glycated hemoglobin values effectively, that would be a powerful driver to switch!
  • It is interestingtoseethattheyallstrivetowards living a life in whichconfrontationwith the disease is minimized. Theyall have a different experience of the disease & theyall are confrontedwith different barriersfrom living a normal & comfortable life. They are notmereindividual cases, but theyrepresent a specificsubgroup of yourpatients. So in case you as a pharmaceutical company or insurance company or device… want toactivate these specificsegments, youwillneedto take into account eachone of them & thinkabout a specificstrategyto target them: e.g. itcomes down tousing different arguments in communication, providingthemwith different content in wihchthey are interested. In case you are eagertodevelopanapp, youwillneed different functionalities in thisappto serve theirneeds & youwillneed different waystopromote these appstowardsthem. E.g. for Lara havingit in the iPhone store will do the trick, for Eddy youmightneedtoinvolve the physician or the patientorganisation.
  • So, finalmessage of thispresentation is: collaboratingwithyour end-clients is crucial in order tobesuccesfull in the productsyoudeliver & in the communication as a company towards stakeholders. Understand your customer & listen tothem, theycanprovideyouwithvaluableinsights & feedback. On the visualyoucansee a Ducati driver. Theyconnectwiththeir fans bylisteningtothem in anongoing way & itpays off! Their fans are not the average motor bike drivers, but they are amateurs, thatoftenliketodisassambletheir bike themselves in their free time, sothey are veryknowledgeableabout the product. As youcanimagine, they have lots of interesting feedback togiveto Ducati based on theirgained expertise & based on theirpassionfor the company. & afterall, youcanconsiderthemtobeactive employees that are not on the payroll  sostructural partnerships withyour end-clients is worth the effort.
  • Last week I was at Belgianpharmaceuticalconfrerenceorganisedby & BeApp. I sawthisinterestingpresentationbyGeert Noels, renownedeconomist & author of Econoshock. He predicted a switch to a new business model forpharma. One in which niche productswillbe the way to go instead of these hugeblockbusters. Pharmacoswouldalsoevolvefrom product developersto service providers, justlike Apple forexample. Therefore, Noelspredictedthat the involvement of the patientsthroughout product development stages in pharmaindustrywouldbecrucial. Soongoingconnectionswillbecome even more relevant, even outside the apps domain
  • Gamificationcanalso help to make it a hit ;-)
  • In the complicatedhealthcare landscape, patients services likeapps or other new technologiestargeted at patients are majorlyaffectedbyother factors. These factors needtobe taken into account as well whendevelopingpatient services, apart fromwhat the patient wants. Theycanbe a threat but theycanalsobe a good opportunity.
  • Let’s first considerwhat the HCP thinks of these patient services. We have seen a concrete application of how the patient-physiciandialoguecanbefacilitatedwithapps. But what is their opinion aboutit?
  • The majority of doctors in realityfearthatappswill lead to a decline of offline contactsresulting in a decline of patientvisitsmeaninglessincomefor a doctor. Sotheysee the negative side of technology & patient services.
  • But Is it a threat?Maybetherealready is a solution! For example Dr. Buysse, workingfor UZ Gent organised a study, a test case of telemonitoringfordiabeticpatients. Here,numbersrelatedtobloodvalues, insulin intakes … weretrackeddigitally in an automatic way & are transferredafterwardsso ‘monitored’ by the physician. It enabled the doctor togivepersonalised feedback & in time to the patient. It was positivelyevaluatedbyhealthcare professionals & bypatients as itresulted in betterdisease management. The case alsoclearly shows the needfor a RIZIV compensationfor e-consulting byphysicians. Thiscandefinitely open the debate & canstimulateopennesstowardsappsfromphysicians.
  • Definitelybecausepatienttechnology services have otheradvantages as well… as youcanreadhere: in belgianeveryyear 2070 patients are diagnosedwith diabetes type 1 & 23. 500 patients are diagnosedwith diabetes type II! So the ever growingprevalance of both types of diabetes put pressure on the GP, ever more patientsneed support… but appscan release the burden..
  • Example via a combination of digital & f2f interaction, the physiciancaneasily care for more patients & guaranteean in-depth follow-up forthosewho are newlydiagnosed. So, it is notonlyaboutlosing money, it is alsoaboutgrowing the number of ‘clients’ & a new system of compensation.
  • Last but notleast, in case the pharmaindustrylikes the physiciantorecommendappstopatients, theyshouldinformphysiciansabout the existence of theirapps. As physicians have no feeling whatsoever these dayswithpatientapps. Example Lara: if we asked her whether her doctor has ever spoken to her aboutpotentialappsto help her in diabetes management, soanswered the following: … So the industryneedstoinformthem as well.
  • The government isalso a stakeholder in relationtopatientappswhich is whyapps have a public dimension as well. Fromthis public dimension, we canobservethatappsguaranteebetteroutcomes on the long term in terms of healthcarecost as they help with prevention & automatecertainprocessessopatientcan manage owndisease in a more efficient & effectivemanner. Thiswillalsoreducetotalhealthcarecosts on the long term. It is a pityhoweverthatnotallnationalpolicies have this long-term vision in mind.
  • In the UK, government is alreadyconvincedhowever of the value of apps.This article proves that the UK government want doctors to describe mobile apps to theirpatients as part of the treatment. Of course not all applications are proven to bescientific & effective, soto help doctors make a selection of relevant apps, the government made a list of more than 500 trustworthy applications. Helping doctors help their patients.
  • Last but notleast, let’snotforgetpatientorganisations in therelationtopatientapps. As withapps, alsopatientorganisations are seen as crucialfor the sustainability of healthcare systems. Theycan have a positive impact on disease management as well & on effectivecommunicationtowardspatients.
  • If we consider the VDV. 23000 members, soquite a reach! Credible source forpatientsgiventheirlack of commercial interest in treatments. Patientorganisations are more than information providers or lobbyists. Theyalsoforeseeforexample in the offering of medicaldevicesfor a betterpricefortheir members. In case of apps, theycanbe a relevant partner to test the technologyfrom a practical point of view (e.g. recruitment of participantsfor tests, reality check of ideas…). The VDV was activelyinvolved in thepilot project we mentionedfortelemonitoringwithdiabeticpatients. Theywereanactive partner in R&D development
  • Even takingitfurther: diabetes UK even startedwith the creation of theirown diabetes tracking app! thismightbe the way to go forpatientorganisations as well. The question is: are theyhere a threat or a partner forpharmaceutical companies! Nevertheless: ifpharmacompanies are notprovidingthemwithapps, they are free tocreateonebythemselves!
  • OnceHCPsclearlyseeit asan extra service theycandeliverto the patient, theywillbeyour partner in promoting these forms of patient services. So do notforgettoincludethem in your promotion strategy!
  • Health Smartees 2012

    1. 1. Healthcare Smartees April 2012 Ghent I Rotterdam I London I Timisoara I New York
    2. 2. 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
    3. 3. Rules of engagement What we can learn from conversations taking place , &&@Saartje_VDB Ghent I Rotterdam I London I Timisoara I New York
    4. 4. 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
    5. 5. 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
    6. 6. (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. Ghent I Rotterdam I London I Timisoara I New York Health consumers take the lead
    7. 7. 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:    Patients are taking the lead
    8. 8. People use social mediato help make healthcare decisions Social media empower patients
    9. 9. 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
    10. 10. Now, let‟s take a closer look at THE BIG 3 THE BIG 3
    11. 11. facebook
    12. 12. Awareness of Facebookis close to 100%More than 400 million people(>30% of internet population)use Facebook daily. facebook
    13. 13. Average Facebook session lasts37 minutes… facebook
    14. 14. 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
    15. 15. facebook
    16. 16. facebook
    17. 17. © InSites Consulting facebook Health Study 2010 | How to engage in the conversation with empowered patients | © InSites Consulting, 2010. 18
    18. 18. © InSites Consulting facebook Health Study 2010 | How to engage in the conversation with empowered patients | © InSites Consulting, 2010. 19
    19. 19. More fans = more conversations?© InSites Consulting Consumer activation Health Study 2010 | How to engage in the conversation with empowered patients | © InSites Consulting, 2010. 20
    20. 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
    21. 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
    22. 22. © InSites Consulting facebook Health Study 2010 | How to engage in the conversation with empowered patients | © InSites Consulting, 2010. 23
    23. 23. YouTube
    24. 24. YouTube
    25. 25. 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
    26. 26. facebook
    27. 27. There is a bigTwitter paradox:80% is awareof Twitter, only 16%is using it.
    28. 28. Twitter
    29. 29. Twitter
    30. 30. Tweetdeck
    31. 31. Tweetdeck
    32. 32. Local experts
    33. 33. 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
    34. 34. Strategize Strategize first
    35. 35. Worry about the tools after
    36. 36. Respect theof engagement Know what you can & should do
    37. 37. Success is goingfrom failure to failurewithout a loss ofenthusiasm.Winston Churchill Ghent I Rotterdam I London I Timisoara I New York What would Churchill do?
    38. 38. 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!
    39. 39. The power tools of the E4-patient How to Equip & Enable the@sofiebruggeman Engaged & Empowered patient Ghent I Rotterdam I London I Timisoara I New York
    40. 40. Patients have stepped forwardto actively participate in theconversations about their health Empowered patients are a FACT today
    41. 41. 1 2 3 A third globally impactful movement in history
    42. 42. 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?
    43. 43. 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.
    44. 44. 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:
    45. 45. 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
    46. 46. Patient powertool: personalinformationAn opportunity for theindustry to join or facilitatethe patient conversation! General information ≠ Personal information
    47. 47. Manual Automaticlogbook logbook Internet Logbook app logbook Evolution of logbooks
    48. 48. If patients (have to) trackinformation, they appreciate help. Convenience iskey, they already suffer enough.
    49. 49. #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
    50. 50. #WhatsInIt4Pharma II Building your CSR image More than selling products
    51. 51. #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
    52. 52. #WhatsInIt4Pharma IIIApps: think B2B2C Pharma companies Patients Physicians
    53. 53. #WhatsInIt4Pharma IV Apps thatboost sales directly (through compliance) Maximizing compliance
    54. 54. Higher or Lower than % ? What is the % of smartphone Source: Social media around the world by InSites Consulting - 2011 owners in EU?
    55. 55. % What is the % of smartphoneSource: Social media around the world by InSites Consulting - 2011 owners in EU?
    56. 56. 25installed 12 in use Apps are selected Source: Social media around the world by InSites Consulting - 2011 carefully
    57. 57. 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
    58. 58. 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.
    59. 59. Warning: patientfocus only GPs & specialists Nurses Pharmacists PATIENTS Insurers …
    60. 60. 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
    61. 61. Prevention tools CSR opportunities 31 2 App example
    62. 62. Patients  news!Health generalinformationBroadTherapy AreaDiseasespecific App example
    63. 63. 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
    64. 64. 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
    65. 65. Glucose buddy – free appRanked the #1 diabetes iPhone app (for free) by Manny Hernandez(founder of with calory trackenter glucose numbers,keeping track of carbohydrate consumption,insulin dosages &activities. App example
    66. 66. 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
    67. 67. “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
    68. 68. 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
    69. 69. 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
    70. 70. 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
    71. 71. “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…
    72. 72. 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
    73. 73. Future oflogbooks
    74. 74. Start creating your own app is NOT the take away of this presentation Let‟s not go too fast!
    75. 75. Just 1 example,many more, so let‟s not go too fast!
    76. 76. 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
    77. 77. Patients are engaged!But they are not similar!You need to observewhat they are doingYou need to engageWith the right patient! Need to engage!
    78. 78. You all remember Lara & for now in full pubertyShe was probably born with an iPhonein her hand Keeping track of glucose levels is boring
    79. 79. 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
    80. 80. Different barriers to overcomeDifferent motivations to useBut same end goal It is about coping with diabetes
    81. 81. ………………………………………..……..…CollaborationInvolve customers inEVERYTHING you do.………………………………………..……..… Structural partnerships
    82. 82. Structuralpartnership is the future
    83. 83. 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
    84. 84. 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
    85. 85. What about them?
    86. 86. 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?
    87. 87. 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)
    88. 88. 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…
    89. 89. 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…
    90. 90. 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
    91. 91. Apps have a public dimensionBetter healthcare quality for a lowercost. Apps are relevant for national policies
    92. 92. e.g. UK government made a list of 500trustworthy applications Positive effect on social security costs
    93. 93. Patientorganisations“The impatient patient is a force for good, to beharnessed in support of sustainability of healthcare systems.” Alexandra Wyke, CEO, Patient View
    94. 94. 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
    95. 95. Diabetes UK released iPhone app Diabetes UK on track!
    96. 96. 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)
    97. 97. 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!