Hill+Knowlton Strategies

This is the third blog post in the series of nine, which follows on from the previous blog post, taking inspiration from the Cabinet Office commissioned report entitled MINDSPACE. Changing or shaping behaviour and inspiring or engaging people is often a perquisite of many of the work we do for clients at H+K. The MINDSPACE report sets out nine of the most robust (non-coercive) influences on our behaviour, which is captured in the simple mnemonic MINDSPACE:

MINDSPACE (Dolan et al., 2010)

+  +  +         #3  Norms         +  +  +

Norms – the power of social norms are such that if your brand sits outside of social convention it can deter consumers. Furthermore if your product is one that defies social norms, goes against it, then your potential consumer base becomes much smaller. Products and marketing have to stand out today in a competitive market place, but not go against social norms to the extent that it alienates the brand and turns away consumers.

However, social norms change over time and place. Often subtly or gradually, but it is for this reason why trends and different cultural appreciation becomes key to successful brand building. Local market PR and advertising activation is important to understand key opinion leaders and how to position a brand strongly in relation to social norms.

The Power of Social Norms

Indeed the subtle social norm differentials can be seen not just culturally and geographically, but also digitally. A random follow on Twitter is seen as great, but a random friend request on Facebook is seen at best somewhat eery. Furthermore, dating apps and websites invite a completely different type of social norm and etiquette to  everyday encounters in a bar. And also a different type of social norm with regard to other social platforms. Two seemingly similar online concepts of video messaging – Skype and chat roulette – but yet the social norms of these two digital spaces are stark. Parental caution is advised for the latter!

Brands also have the power to create social norms. In order to maximise the power of brands, these norms and reputations then need to be maintained. Looking at norms and product innovation – as is evident with countless examples – is a gradually, slowly changing process. A pod of vanilla in Coca Cola. A whiff of aniseed in Pimms.  A sprig of rosemary to Pringles. Adding a hint of coffee flavour to a Kit Kat, or a fifth finger, is something innovative, but not so far removed from the norm that consumers can’t still relate to the original product. Change the product from fingers of chocolate  to ‘toes’ of dried fruit and change the name to ‘Dit Dog’ and consumers don’t get it. Therefore, brands create norms in their marketing strategy – have a break, have a kit kat. Change the Kit Kat too much, and the hard work is undone. The power of the brands social influence can be diluted. Why is the Apple brand family evolving at what seems like a slower rate than mankind! Because actually consumers don’t like sudden change, and too much change can be bad thing for marketing.

New Product Development - Kit Kat Fifth Finger

It is to that end where brand management and brand reputation becomes crucial. To not allow hard work to be undone. To reinforce brand values and defend them when threaten. But also to create social norms and influence culture through branding and marketing. In brand messaging and communications, understanding and responding to the subtle social norm differentials that exist geographically, culturally and digitally are key to effective communication strategy and execution.

Follow me on Twitter @AndrewPCBarratt

A few weeks ago, this blog talked about how the rise of healthcare apps may have been cemented by the news that Apple were creating lists of the best apps for healthcare professionals. Now, the NHS has launched their own library of apps to help people manage their health. There are already around 70 apps in the library, which have been reviewed to ensure they are clinically safe and relevant to people in the UK. This process involves checking that all apps submitted comply with data protection laws and with trusted sources of information, such as NHS Choices, which are both minimum requirements. Apps that meet these minimum requirements will then be reviewed to see whether they could potentially cause harm to a person’s health or condition, and a clinical assurance team made up of doctors, nurses and safety specialists, will potentially work with app developers to make sure an app adheres to the required safety standards.

Of course, the NHS library could become a sort of stamp of approval for health apps in the UK, although with 70 apps already featured and seemingly minimal entry requirements, it will be interesting to see how they ensure people are being directed to the most useful and relevant apps for them. One consideration is that the scale of apps included could become overwhelming, while the quality and effectiveness of an app in itself will not necessarily be guaranteed provided it is not unsafe. The website does state that the review process will be updated and improved over time though, and this is still an important development for the industry.

In a similar vein, this post on The Health Care Blog by Leslie Kernisan, who practices in geriatrics, provides some excellent insight into how and why health apps should, if at all, be prescribed. Kernisan suggests that while many digital health enthusiasts expect that apps will become routinely used tools in healthcare, clinicians need be more thoughtful when recommending apps, basing their recommendation on medical rather than marketing considerations.

The article is an absolute must-read for people with an interest in digital within the health industry. It is really interesting to see someone take a step back from all the noise there is about apps and provide some genuine insight. Although the post focuses on the attitudes of healthcare professionals, there’s a lesson in there for communications professionals and the industry too. While it might be tempting to develop an app or some other creative digital tool every time you are handed a brief, it is worth taking a step back and assessing how appropriate and valuable this will actually be on a case-by-case basis.

Finally, it is worth reading this from the social media team at Intouch Solutions. On March 7, Facebook announced a major redesign to its News Feed and this article looks specifically at the implications the design change will have on pharma Facebook pages. If you or a client you work with community manage any pharma Facebook pages this is absolutely essential reading.

On Rare Disease Day last week, a new online community was launched for patients with Idiopathic Pulmonary Fibrosis (IPF) on the existing patient website, RareConnect. RareConnect is led by the non-governmental, patient driven, rare disease organisation EURORDIS, and makes information available via patient advocacy groups from a variety of countries. RareConnect also provides a forum style platform for patients to meet and interact, allowing users to share individual experiences about how IPF has affected them, creating a sense of community between users. The website even has a translation service for all of its posts, making information available in five different languages and allowing its reach to be truly global.

Rare Disease Day also saw the announcement of Boheringer Ingelheim (BI) working with the online patient community Patient’s Like Me to enhance the website’s IPF community. Patients Like Me is a similar type of platform to RareConnect, but the main differences are that it has not been set up by patient advocates and is not just for rare diseases. With BI’s involvement, it looks like the IPF community now have online spaces on the platform where they can meet others with similar diseases, also allowing patients to input their health info and track their diseases. Although these communities have been around for a few years now, the involvement of patient advocacy groups and pharmaceutical companies to help strengthen these sites is new, developing the pages to be more patient focussed and giving them more of a ‘community feel’. 

Tracking patients’ health data in apps and online is a trend we have seen increasingly and now, patient data tracking company, Qualcomm, and patient information site, WebMD, have forged a partnership to track patient data and make information searched for on WebMD, more relevant for the user. Qualcomm partner with a large range of medical devices, such as blood pressure and blood glucose monitors that are connected to the internet and have a cloud based platform, which stores and tracks the health data from these devices. The idea behind partnering with WebMD, is that rather than receiving generic information when searching, you can receive information that is relevant to you. The idea is not new, and we have seen Google collect search information to make searches more relevant, but this is one of the first ways we’ve seen the potential for this style of tailored information for patients in the healthcare setting. The partnership is still early in its development, but it will be very important to see how this develops, and if this style of searching for patient information catches on in the future.

Last week, a study was released in the American Journal of Medical Quality, looking at the correlation between hospital Facebook likes and the quality of the hospital. Not only were the hospitals that had the higher number of Facebook likes more likely to be recommended by patients, it was also positively correlated with the mortality rate, meaning that based on this study, the more likes a hospital had, the better it was. This study shows the importance of having a strong and engaging Facebook presence as well as demonstrating that patients increasingly want more information from hospitals to make a more informed decision about where they seek treatment.

In the past few weeks, we have talked about the growing trend for articles and blogs, which are digging deeper into social media and digital within the healthcare industry, providing more specific and detailed insight as the industry continues to grow in this space, and it looks like this trend is set to continue,

We have selected some must-reads for anyone with an interest in digital communications in the healthcare industry. This article on PMLive’s Smart Thinking blog addresses this issue specifically, stating that while we all tend to judge how well pharmaceutical companies are doing in social media by looking at their presence on Facebook, Twitter and YouTube, there are in fact many other ways of using social media that should be considered, including what is known as social innovation.

Although Twitter and Facebook are obviously parts of this, they are not the whole story, the blog argues. Other aspects of social media such as social bookmarking, wikis, virtual social worlds and crowdsourcing are also part of the equation and further inspection suggests pharma companies might not be as far behind as some people think when it comes to these less obvious forms of digital innovation. Indeed, the blog suggests that there are in fact plenty of examples of internal social media projects within the industry that are on a par with other sectors, with three of the top ten pharma companies (GSK, Janssen and Merck) using the enterprise social network service Yammer.

The article pulls out some encouraging examples of social media innovation within the pharma industry which back this up. Definitely worth a read.

Another article that caught our eye here at An Apple a Day was this one from Pharmafile, which covered some of the platforms more traditionally associated with digital and social media engagement such as Twitter and Facebook. The article looks at the ‘received wisdom’ that suggests pharma should be joining the online conversation and asks some very important questions about what sort of conversations are appropriate and inappropriate, as well as conversations actually worth engaging in.

As social and digital media continue to secure their place on almost everyone’s agenda, communications professionals will increasingly be expected to show they are capable of answering these sorts of questions and provide genuine insight, to ensure they are not just suggesting digital for digital’s sake, but are actually able to identify the most appropriate and effective solution to meet specific objectives.

(image: Cancer Research UK: Cell Slider)

In other news, Cancer Research UK has teamed up with Amazon, Facebook and Google to create a mobile game for analysing genetic mutations. Data is integral to finding a cure for cancer, however the challenge is getting the data investigated by human rather than machine eyes in order to be properly analysed. With this in mind, Cancer Research UK has teamed up with these US tech firms to try and build an engaging, fun and user-friendly mobile game, which can be used on the move. The charity has already developed a web-based game called Cell Slider where users look through archived tissue samples.

Finally, if you work in the oncology disease area, this interview on the Cancer Network website is really worth checking out. Dr Michael A. Thompson, an oncology specialist who writes a blog for ASCO (American Society of Clinical Oncology) Connection, talks to Cancer Network about the use of social media by oncologists, providing some great insights into the dissemination of research results, clinical trials, and other oncology news using social media.

In the past week, there have been a number of interesting healthcare stories that have been making noise in the digital world.

As we’ve seen on this blog, the number of healthcare apps are ever increasing and now this growth has been truly cemented and recognised by none other than Apple. For a while, Apple has been creating lists of its favourite apps for specific demographics, including children, parents and film lovers. The new Healthcare Professional (HCP) list categorises apps that HCPs can use for reference, medical education, imaging, patient education, personal care and patient monitoring. Although iTunes have only made these available in the US, what’s interesting is that the list includes apps from pharmaceutical companies, including Novartis and Medtronic. Understanding and keeping track of how to get onto the list could be crucial for pharma companies to gain more visibility for their apps and help bring greater HCP engagement to mainstream attention.

Another story that garnered significant attention was that of the world’s first live-tweeted C-section. The Memorial Hermann Hospital in Houston tweeted the whole C-section surgical procedure from beginning to end, with followers able to see the process in real time. Essentially an educational procedure, this garnered a large amount of traction, with an estimated 72,000 people watching the C-section live on Twitter and an additional 11,000 viewing it in another format. This is not the first time a surgical procedure has been live-tweeted, with the same hospital carrying out a live brain surgery and live heart surgery last year. The popularity of this is a clear sign of  the educational value this type of digital format offers as well as perhaps whetting the (somewhat gory) appetite of many online.

As communicators, when creating campaigns we know how important it is to target the right audience with the right message. Previously, studies have shown women to be the influencers and decision makers in the household, and the results of recent survey have now shown that women are more likely than men to search for health information and advice online. According to a survey from the Pew Research Centre, 79% of female internet users vs 65% of male internet users went online to look for health information. These percentages overall are quite high, proving the potential reach an online campaign can have. This also demonstrates that when considering a digital campaign, it is important to think about whether it is right for your target audience, and the stats below, although US focused, provide a useful breakdown of which demographics are most likely to engage in the online space.

As 2013 moves along, we’re seeing a wealth of articles and blogs highlighting digital and social media trends to look out for throughout the year. What is striking is the increasingly specific nature of these predictions. It is no longer enough to say social media or digital are important or that more people are using apps, these points are practically beyond debate. Now the questions being asked and the insights emerging suggest that there is a need to explore the particulars of these trends, how they might impact the industry and the opportunities and challenges they present, demonstrating how far the industry has come in the past few years.

A new report from Accenture is a case in point. The management consultancy has identified six technology trends set to influence companies over the next three to five years and they’ve now supplemented this with a report looking at how these will specifically impact the pharma and life sciences industry. The trends they’ve identified are quite technical and go beyond healthcare communications, but they certainly demonstrate the way digital is moving and how pharma companies are expected to respond to this shift:

1.       Context-based services: Essentially, the convergence of real world and digital data to draw conclusions about consumer experiences. Context based services have evolved from the rise of cloud computing, social media and increased usage of mobile devices. Crucially, the approach has already been adopted by pharma companies looking to engage directly with patients.

2.       Converging data architectures: This is about developing new ways for effectively handling data. Pharma companies have increasingly large amounts of data to contend with and are already demonstrating an appetite for exploring these new data architectures.

3.       Industrialised data services: In much the same vein as the data architectures trends, pharma companies are starting to realize the value of data as an asset that can be utilized for multiple purposes when shared more freely.

4.       Social-driven IT: As we all probably know, social media is a powerful catalyst that has changed the way customers, employees and partners use technology to interact with the world around them. While most pharma companies now accept this fact, the challenge will be to recognise its full potential and make the most of it, something we’ve mentioned numerous times on this blog.

5.       PaaS-Enabled Agility: You will probably have heard of cloud computing, even if you’re not completely clear what it is! Platform-as-a-service (PaaS) is an extension of this, which combines cloud computing with a series of software applications and allows apps to be created by users.

6.       Orchestrated analytical security: Of course, all this growth in connectivity, as well as presenting numerous opportunities, has also increased the potential security risks and pharma companies will need to show their ability to adapt to the changing environment and explore new ways of handling these risks.

There is a more detailed analysis of the insights on the PMLive website, which also provides some really good examples of pharma companies that are already adopting some of this new technology. Definitely one to bookmark.

Image from Geek and Poke

Finally, in another example of this more nuanced, specialized approach to digital insights, this thoroughly recommended article on the website Eye for Pharma looks at the role social media plays in patient adherence. The article suggests that just because a doctor recommends a new medication to a patient, it doesn’t mean that the patient will necessarily go along with it.  In fact, the article claims “…a whole universe of interactions takes place outside the medical environment that can change the direction of a patient’s care”.

Many patients will now look online to weigh up the pros and cons of a drug, and in fact 30% of the patient posts online that Eye for Pharma looked at, indicated that they decided not to take a physician recommended medication due to information they had received from their online peers.

This is a really interesting perspective on this particular part of the patient journey and a demonstrable example of the way social media is affecting the industry.

Sometimes, nothing can help make a point better than some good quality raw data, which is why in this post we’ve looked at a few studies investigating different aspects of digital health.

This week it was interesting to see a study published investigating how patients were managing their chronic conditions and the extent to which they used digital to do this. The study, which came out of the Pew Research Centre in the US, found that 62% of patients that had two chronic conditions tracked specific health measures, with 56% of these people saying the tracking had affected their overall approach to maintaining their health. 53% of these people also stated that the tracking had led them to ask doctors new questions or to seek a second opinion. Whilst tracking health measures demonstrated a change in behaviour towards a patient’s disease, what was really interesting is the data the researchers found on the use of ‘health tracking’ apps or devices. They found that a minority 21% used some form of technology to track their health, with 34% tracking it on paper and largest chunk (49%) of patients did so ‘in their heads’.

Apps such as GSK’s MyAsthma app, which intuitively build in an Asthma management diary, tests to track the progress of the condition and various other useful content for Asthma sufferers, can offer a patient much more than simply tracking in their heads. The MyNetDiary Diabetes app goes as far as helping with diet planning, with a barcode scanner to allow for easier tracking of a diabetes patient’s diet, and the iBGStar product combines an app with a blood glucose meter as an attachment, which offers a seamless mix of blood glucose testing, tracking and sharing with HCPs.

21% is not a small number by any means, and the fact that a significant amount of people are using these apps after only a few years of them being available is definitely positive. But the data shows that while there is still a relatively large market for these types of apps, more needs to be done to get people engaged and using them. Looking on the app market place there is no shortage of these apps; it appears raising patient awareness of the benefits of using them could be key.   

Moving on to the evolution of public health, a trend that has been surfacing recently is how powerful Twitter is becoming at helping predict public health trends. A study carried out by Bringham University looked at over 24 million tweets from 10 million users globally, and concluded that by monitoring health mentions in tweets, health officials can track, and even use the site as an early-warning system for, disease outbreaks. The speed and volume of tweets meant the information could be gathered faster than ever. This has evolved drastically from the previous days of health professionals having to collect health data over time before analysing.

Building on this, another study showcased how by collating what people said in Tweets, where they were when they said it, and when they were there, researchers could go as far as to estimate potential spread of disease between two users or even between users and their environment. The video below shows how researchers are even developing a web application, called GermTracker, which uses Twitter information to allow people to stay away from areas of ‘high risk of germs’. This is all in early development, but it will be interesting to see if this prediction of high risk areas can help pharmaceutical companies keep ahead of the trend and engage with patients in the right areas more effectively.

Since starting ‘An Apple a Day’, we’ve talked a lot about the rise of mobile technology, and with the healthcare industry increasingly viewing apps as worthwhile investments, we’ve seen plenty of examples, which cater to both healthcare professionals and patients.

In the last week, it has been interesting to see a number of new apps emerging aimed specifically at children. Take, for example, the new free iPhone app from Healthline Networks, as part of their “Big Shots Get Shots” campaign. The app is intended to help children overcome their fear of needles ahead of flu season, using an interactive storybook to distract them while they are on the examining table. The campaign also encourages parents to take an online pledge to end needle phobia.

Brush DJ is an award-winning app for improving children’s dental health by making brushing teeth both fun and effective. The app plays two minutes of music randomly selected from the child’s phone to encourage brushing for an effective length of time. It also allows them to set reminders to brush twice a day, floss, and prompts them about when next to see their dentist. Parents who are used to the daily hassle of getting their kids to brush properly will no doubt welcome this app!

In the US, the Apps for Healthy Kids competition, backed by Michelle Obama, challenged developers to come up with fun and engaging ways to get children to eat better and be more physically active. The winner, Smash Your Food, provides a fun, mess-free way for kids to “play” with their food whilst learning about nutrition. A multi-user game, the app asks players to enter their age, gender and level of physical activity. The app then tells the player what their maximum levels of consumption should be for sugar, salt and oil per meal.

What is particularly interesting about health apps for children is the potential to engage both them and their parents. There is arguably no harsher judge than a child, if content is not fun and engaging they simply will not use it, no matter what the health benefits may be. Children today are also among the first generation for which smartphones are the norm and social media is second nature, while parents are arguably more likely to engage in something in the digital sphere if they think it is going to benefit their little ones. Beyond this, somewhat blurring traditional ideas around target audiences and aiming apps at other family members, particularly those more likely to be using this type of technology, is certainly worth exploring. This could include apps for younger adults that provide info about their parents’ health or even apps for women about men’s health, which they can use with their partners. It will be interesting to see if this trend grows as the mobile health industry continues to evolve.

Welcome to the first post of An Apple a Day in 2013 – we hope you had a great festive break!

Before we look ahead to another year that promises to be full of interesting developments in the world of digital healthcare, we wanted to review some of our 2012 highlights. 

Here at An Apple a Day, we love a good infographic and last year we certainly saw our fair share of really creative examples. HIT Consultant has listed their top 20 most insightful healthcare infographics in 2012 – certainly worth filing away for future reference.

2012 was the year when Pinterest took over as the latest social media craze to emerge. While other industries were quick to adopt the new trend, many in healthcare digital communications were faced with the rather familiar challenge of trying to navigate around the regulatory environment to deliver something genuinely engaging.

Step in GE Healthcare, who have for some time now been a great example of how the healthcare industry can use digital and social media creatively and effectively.

Back in September 2012, we wrote about GE Healthcare’s Pinterest board, which capitalised on the clout of its parent group and the innovative work done in other areas of the business to transform apparently visually unappealing engineering and energy operations into captivating images and video.

If others in the healthcare industry can take the lead from GE Healthcare in the coming year, 2013 could be a really progressive year.

Another theme throughout 2012 was the popularity of mobile, with barely a week going by where we didn’t mention the launch of an exciting new app on this blog. This post on the website iMedicalApps looks at the most innovative medical apps of 2012 from a physician / HCP perspective and is well worth a read. Some highlights include Wrist Repair, which allows dynamic interaction to help doctors educate patients on the steps of a common orthopedic surgery; Doctor Mole, a skin cancer app which assesses moles and SimMon, a remote controlled patient monitor for medical training and simulation.

Finally, for a quick overview of the biggest hits in social media during 2012 check out this comprehensive infographic from The SEO Company.

That’s all for this week, here’s to an innovative and engaging 2013!

Fresh from watching the stunning (and stunningly long) part one of The Hobbit movie extravaganza, I am reminded of the lasting power of amazing content. I know every word of the book, so will happily stand online for all the movies — despite the fact that Peter Jackson’s version is way more gory video game than the novels I love.

Brands have been content publishers for even longer than The Hobbit has been around. The first infomercial was broadcast on the radio in 1922. I don’t know what the storyline was, but I’m guessing it was no sequel spawning epic. Yet if I make just one prediction for marketing in 2013, it’s this:
Brand content will compete with top shelf entertainment.

Like most year end predictions, this is of course already happening. And the reason digitally savvy brands put Hollywood levels of talent, craft and love into what they make is because they are competing for the limited attention of the very same people going to the movies, playing the video games, and yes, even reading books. Sticking ads around the entertainment is giving way to being good enough to be the entertainment. Hello Red Bull, Will it Blend, new style advetorials and every Facebook Page actually worth a Like.

What will content marketing look like in one year? We asked a few smart people for their sharable soundbite.

Many thanks to Claire Candler, Johanna Virtanen of Kiosked, Seb Bell and Brendan Hodgson for their views in the clip above. And thanks to our other D2 Content speakers who gave us some excellent Top Tips for Successful Content Marketing and Advice for budding Contentrepreneurs. Happy Holidays everyone and see you in 2013.