When social media first entered the lexicon of pharmaceutical marketers a primary concern was the burden of adverse event reporting.  The thought was that increased conversation and engagement would result in an unmanageable volume of reportable adverse events.

Many, including myself, did our best to quell those fears.  There are essentially two lines of reasoning when calming the nerves of the safety department at a pharmaceutical company:

1.)    People don’t want to report AEs using social media channels. There is a line of reasoning that says most people would prefer to follow traditional channels to report an AE and not take to the public forums of social media.  The idea is that there won’t be an influx in AE reporting because that’s not the intent or spirit of social media.

2.)    The other and more commonly used line of reasoning is that the data shows that the 4 criteria that constitute a reportable adverse event are rarely met online.

Folks like BuzzMetrics and Jonathan Richman have done phenomenal work to illustrate the validity of this point.  The fact is; reportable AEs are rare in social media channels.  It’s a compelling storyline: increased conversation does not have a direct correlation to increased adverse events.

Again, the data bears this out.  However, it doesn’t fully reflect the reality of the pharma landscape.  Recent conversations I’ve had have hammered home a point that has long been apparent.  For the safety departments at pharmaceutical companies, the fears of adverse event reporting were never about “reportable” AEs, they were about acknowledging the realities of their job function.  That reality means the safety department has to handle all possible AEs that come in through social media channels, not just the ones that are reportable.  This is where the overwhelming burden starts to become tough to manage.  As the engagement goes up, so does the frequencies of “possible” AEs.

Any social media engagement for a pharmaceutical company necessitates a policy change on handling adverse events and almost certainly increases the burden on the safety department.   This doesn’t mean you should shy away from social media entirely, but it does mean you need to acknowledge the task at hand for the folks in your safety department and work with them to enact effective policy change that mitigates the burden on any one department.  Chances are a good number of the current operating procedures for adverse event reporting can be replicated for social media channels.  Start by evaluating the current protocol and then fill in the gaps on the missing pieces for social media.

The good news is that more conversations (and even “possible” AEs) means more data.  Contrary to popular opinion, most healthcare companies want to know when their product does not work as intended.  Instead of trying to convince companies that the AE reporting burden doesn’t exist, let’s shift our attention to figuring out how to mitigate that burden most effectively.

Last week I wrote about the emergence of mobile apps as the new shiny object in pharmaceutical social media.  Because of the potential of mobile technology, marketers are left drooling at the implications it could have for the pharmaceutical industry.

But despite the fact that the potential is there, it still remains as largely untapped frontier.  True, there are  a number of mobile healthcare apps already on the market but it hasn’t reached the level of mass adoption—we are still very much in the bleeding-edge phase of development.  Why is that?  Why is it that despite so much potential some companies are holding back from this untapped frontier?

Perhaps part of the hesitation is that they are heeding lessons learned from past endeavors.  Sometimes it’s better to be a fast follower than the first to market.  Some pharmaceutical marketers might be holding back to see how mobile technology is applied by other companies before moving in.  In addition, the research on the effectiveness of mobile technology to motivate behavioral change is scant.  Until the effectiveness is proven beyond a mere hypothesis, some healthcare companies will remain reluctant.

But I’d venture to guess that the biggest hurdle to more widespread adoption of mobile technology by pharmaceutical companies is “silo thinking.”  By silo thinking I mean that most companies are evaluating the benefits of mobile technology through a narrow lens.  In most cases, that narrow lens is marketing.  Marketers lead the mobile technology conversation and it is always from the viewpoint of how to better push messages to the patient.  But that’s only one piece of the puzzle when it comes to mobile applications.  Because of its ubiquitous, always-on nature, pharmaceutical companies have an opportunity to leverage mobile technology across various pieces of the business.  Instead of a marketing tool, mobile should be viewed as what it’s always been—a communications tool.  When viewed a communications tool, the applications for the technology become much more abundant.  For example, mobile can help with marketing, arming the sales force with real-time information, communicating with physicians, patient adherence, communicating recall information and as an anti-counterfeiting measure to name a few.  Single-function technologies rarely gain support inside pharmaceutical companies.  In order to begin to see a more advanced and widespread use of mobile, the conversation needs to evolved beyond its benefit to marketing.

Recently I was working on a social media research project for a large healthcare company.  The task was simple: take a look across a variety of social media platforms and identify the most active blogs, Twitter personalities, Facebook groups, etc…and then determine why people were flocking to these sites and what information they were seeking.

Easy enough.

This wasn’t a unique assignment; I’ve seen dozens of similar requests.  These types of reports tend to focus on platforms—what is the most prominent group on Facebook?  But as I worked through my research it became abundantly clear that focusing on platforms is the wrong approach.  Instead of focusing on Facebook and Twitter, we should be focusing our efforts on identifying influencers.

This is a better approach for a few reasons.  For starters, social media is about 1:1 interactions.  Focusing on influencers rather than platforms puts the attention on building relationships and not on the social network of the day.  In addition, most of the key influencers in a given space have a significant presence across platforms.  It’s rare that you will find a well-respected, vocal presence on Twitter that doesn’t have a blog.  Influencers are highly regarded because of what they have to say, not where they say it.

Beyond focusing on building relationships, focusing on influencers rather than platforms shifts the focus away from the mentality that social media is about the tools.  Instead, social media is about the individuals, how they communicate and what they have to share.  Once you identify an influencer, you can then begin to understand how they reached that position and what content you can offer that would be valuable to that person.

Focusing on influencer relations demands an integrated approach to social media.  Rather than formulating a strategy for Facebook, Twitter and YouTube, you are forced to develop an umbrella strategy to form relationships with influencers.  Of course, this demands mircrostrategies on how to engage with each influencer (and you wonder why social media takes so much time and effort?).  By taking the focus off platforms, you remove some of the temptation to blindly chase after tools simply because it’s the hot social network of the day—maybe Facebook is not the right place for your business.

Social media platforms are important.  They are where the masses congregate and share information.  But as a company in the early stages of drafting a social media strategy, start off by thinking about influencers and you will find your way to the right platform.

Click Here to download a pharmaceutical social media eBook

The list of reasons why you can’t or shouldn’t engage in pharmaceutical social media is long.  Regulatory concerns. Fair balance.  Adverse event reporting.  The FDA.  Off-label usage.  HIPAA.  Lack of adequate resources.   All of these are legitimate issues when considering a social media program.

The list of reasons why you should use social media is not only longer, but also more compelling.  Humanizing the brand.  Creating brand advocates.  Enabling better patient outcomes.  Increasing Return on Health (ROH).  Establishing a relationship with the patient.  Better insights into the patient community. Greater access to information for the patients.  A quick response platform during crisis communications.

There’s no doubt, social media in the pharmaceutical industry is a difficult and complex task.  It takes careful planning, spot-on strategic guidance and flawless execution.  Sounds simple right?

To help navigate the murky waters of pharmaceutical social media, SHIFT Communications (my agency) today released an eBook aimed at offering practical advice on social media programs in the healthcare space.  The book outlines many of the issues that are unique to social media in the pharmaceutical space and offers tips on how to best mitigate those challenges.

To download the book, all we ask is that you do one of the following:

• Head on over to our site, leave us your email, and the eBook will be automatically sent.
• Follow @shiftcomm on Twitter and tweet something along the lines of, “Looking forward to reading @shiftcomm’s Pharma Social Media eBook, via @prforpharma” and we’ll get in touch with the link
• Join SHIFT’s Facebook Page and send us a message there

When you stack up the reasons for not being engaged on social media with the benefits of creating sustained engagement the question becomes: what’s the price of being absent altogether? When done effectively, social media has the ability to create a relationship with the patient that was never before possible with traditional marketing platforms.

With this eBook, we hope to provide a healthy dose of both strategic and tactical advice to help move social media programs in the right direction.  And of course, as always, I would love to hear any and all feedback you may have.

Raise your right hand and repeat after me:

I (Insert name here of pharmaceutical marketing executive) do solemnly swear to focus on the patient first in all my social media efforts.

I will ignore the desire to chase shiny objects, will not refer to Facebook as a strategy and will focus on setting a clear social media strategy before putting a finger to a keyboard.

All key stakeholders across the company regardless of department will be involved from the onset of a social media engagement (yes this means legal, regulatory and IT).

I promise to spend time listening to the social media communities I intend to engage with before I make assumptions on what they want.  I will commit to always representing myself and my company in an ethical, authentic and honest manner.

When offering content or having discussions on social media platforms, I will not resort to promotional messages and will instead aim to offer educational and helpful resources.  I will not merely use social media as a megaphone to shout messages to the masses.  Rather, I will seek to engage in a dialogue on a one-to-one basis whenever possible.

I will expect a crisis to occur and when it does, I will avoid knee-jerk reactions such as shutting down all social media channels.  There will be a crisis communications plan in place even when regulations limit what I can say.  I will let patients know that they have been heard and offer alternative ways to get information.

When I receive criticism via social media they will not be discarded as some rogue, disgruntled individual.  They will be considered carefully and remediation will be taken when warranted.

I will insist on social media measurement but not blindly demand ROI without a true understanding of what ROI is—a lagging indicator.  When I measure social media, it will be with a more sophisticated set of metrics tied directly back to my original strategy (see sentence two).

Above all else, I will make helping the patient my central goal  and will walk away entirely if that ever changes.

There is an old adage that necessity is the mother of invention.  Recently amidst the endless stream of Tweets I see, I saw a different take on this saying: “Crisis is the mother of invention.”

(I wish I could remember who Tweeted that so I could give proper recognition, but alas, I can’t.  So to my stranger-Tweeting friend, thank you!)

It struck me as a particularly relevant comment for the world of pharmaceutical social media.  I’ve touched on the fact that pharmaceutical stumbles in social media are a good thing and that it is indeed possible to use social media for pharma crisis communications.  My contention has always been that each challenge along the way illuminates the fact that social media is not some fly-by-night marketing technique.  There are always stumbles in a marketing program, and there will always be challenges, the belief that social media would somehow circumvent that has always hurts its credibility.

As pharmaceutical companies have encountered struggles in social media it has sharpened all of our thinking on the best approach to engagement.  In the early phases of pharma social media—a company was praised simply for showing up.  As well they should have been at the time.  A pharmaceutical company showing its face online was a novel idea three years ago.  During this period, our thinking was never stretched and our approach was never challenged.  It was kind of like elementary school—everyone got a gold star just for trying their best.

No longer.

The recent string of pharmaceutical mishaps has been the crisis that will spur invention.  It will force social media pundits to take a closer look at the thought process behind an engagement and reevaluate the best approach.  More importantly, it will force pharmaceutical companies to ask the right questions before embarking on a social media journey, pinpoint the right goals and insist on outlining a strategy and crisis communications plan.

Brief Programming Note: Apologies for the slow going on posting here as of late.  Between a work, real life and a vacation, it’s been difficult to carve out the time to write.  But alas, things look to be freeing up so I’ll be back at it more regularly.  I know; music to your ears.

Have you heard? A few pharmaceutical companies (and one oil company) have recently stepped into a healthy dose of crisis situations.  As is always the case, the response to those crises has been sliced, diced and pureed in every way imaginable.  The majority of industry pundits have been dissatisfied with the response of pharmaceutical companies in crisis situations and have pointed to their social media presence as proof of failed strategy.

I’m here to tell you it is not that simple.

In the midst of a crisis communications situation, there is a list 15 city blocks long of what a pharmaceutical company can’t say.  This is never more true than in the public eye of social media.  On the flip side, the list of things a pharma company can say when embroiled in a crisis is small enough to fit in your wallet.  So, all those calling for full transparency using social media are naïve.  I certainly would not suggest that a company should withhold pertinent information or intentionally deceive the public—but they simply cannot provide full transparency.  Why?  In many instances it’s illegal pending FDA review.  There is also a litany of legal considerations that put the squeeze on communications during a crisis. For example, no legal team at a pharmaceutical company would ever allow a public apology before all the facts have been sorted out.  In a legal sense, a public apology admits fault.  Fault implies responsibility and responsibility brings lawsuits.  It might seem callous, but that’s the reality.

Given the grim picture I have just painted, is there any hope for a pharmaceutical company dealing with a crisis.  Should they even be considering social media as a platform for handling a crisis and protecting their reputation?

While there is a long list of what you are not able to say during a crisis, you should be prepared to quickly say whatever is within bounds.  It sounds simple but too many companies get caught with their pants down under the assumption that a crisis won’t hit their companies.  A few well-respected brands would beg to differ.  You should enter a social media engagement expecting a crisis.  If you don’t expect a crisis then shame on you.  Knowing that a crisis situation may occur, you can then intelligently guess the areas where one is likely to arise.  Product recalls, disgruntled shareholders and adverse events seem likely to tip off a firestorm.  What are you doing to prepare for these circumstances?

Again, this is not about transparency for the sake of transparency.  A pharmaceutical company should not be taking to social media channels discussing specific adverse events.  But, it should be prepared to let the patient population know that they have been heard, the dialogue is open and they take the situation very seriously.  Pharmaceutical companies should also be prepared to offer additional resources.  Most pharmaceutical companies have case managers in their patient advocacy program—they should be at the ready during a crisis.  Top management should be visible and active.

There is a common misconception when it comes to crisis communications—that if done correctly, it is capable of solving the problem.  Regardless of how well you handle the crisis from a communications perspective, it still happened.  Crisis communications is not about fixing the problem, it’s about putting forward the human dynamic of a company—and there is no better way to do that than with social media.

Johnson and Johnson saw patients take to social media after the McNeil Healthcare product recall.  Sanofi-aventis stood by as a group of angry patients first created a fake sanofi page to voice their concerns and then took to the official corporate page.  Even Astra-Zeneca took a social media beating when a vendor it was working with inadvertently left a database open for public viewing that contained insights  from a social media listening program.  This succession of missteps has caused many a marketer to panic thinking all of the progress on the pharma social media front will come to a grinding halt.

On the contrary, I think each of these situations is a good thing for pharmaceutical social media. Certainly, product recalls and disgruntled patients are never a positive, but the impact it had on social media will only stand to move efforts forward in the future.

I know what you are thinking: how could realizing every executive’s worst fear of social media aide progress?  Because it made it real.

If there was one thing that has most hindered social media efforts it was disillusionment.  Disillusionment on the part of pharma executives that thought it could reverse poor brand images.  Disillusionment on the part of social media advocates that mistakenly believed taking to social channels was the key to languishing marketing efforts.  And most importantly, disillusionment on the part of both pharmaceutical companies and agencies that thought social media occurred in a vacuum—insulated from the mistakes of other parts of the business.

Welcome to reality folks.  Social media is not a silver bullet.  It doesn’t exist in some alternate universe where your businesses problems do not reflect on your social media presence.  And for heaven’s sake, social media does not sweep problems under the rug—it rips the rug clean off the floor.

This recent string of social media challenges for pharmaceutical companies was a good thing.  It will weed out the folks that are selling social media as THE tool that will reverse the image of the pharmaceutical industry.  It will dispel the notion that social media is immune to crisis and that a comprehensive crisis communications plan isn’t needed.

These challenges will make us better.

Don't let your social media strategy go up in flames.

Nobody ever said social media was easy.  sanofi-aventis is learning that lesson the hard way as its Facebook page has been the target of an onslaught of negative commentary from a patient named Shirley. 

Before I go any further with this post, let me first point out that I am passing no judgment on Shirley and what she has gone through nor am I condemning sanofi-aventis.  I fully realize that there is a heaping pile of information that very few people have access to in this case.  So again, this is not about criticizing Shirley’s actions; it is about evaluating what we can learn from this situation as outside observers.

First a quick synopsis: basically, Shirley is contending she was deceived about the side effects of cancer drug Taxotere—which she claims is responsible for permanent hair loss.  She goes on to indicate that after numerous efforts to get in touch with sanofi-aventis through traditional channels, she has taken her quest to social media channels.  If that is in fact the case, then sanofi-aventis has a bigger problem on its hands—a fatally flawed customer relationship management process.  Keep in mind, people don’t geenrally turn to social media as a first-line venting platform but your efforts on social media can bear the brunt of failures in other parts of your company.    

In this case, the target of her attacks has been the sanofi-aventis VOICES Facebook page (after posting it to a fake sanofi-aventis page that tipped its hand by botching the proper company branding—another post for another day).  She has also seemingly recruited her friends and family to join in the cause.

To sum it up: Shirley has hijacked a Facebook page to air her discontent with the adverse effects of a cancer treatment.  Pharma social media folks: we have a problem.

Given the situation that sanofi-aventis has found itself in, what can it do to course correct?  More importantly, how could it have better planned for such a social media calamity?

It is easy to point the finger at sanofi-aventis without understanding the dynamics of Facebook. Facebook itself has no advanced moderation functionality (again, a post for another day) if it is set up as an open group.  This means companies setting up a presence on Facebook as an open group are provided two options: allow open commentary or disable the feature entirely.  For some industries, that’s an easy decision, but for pharmaceutical companies the question is enormously difficult.  sanofi-aventis is not the only pharmaceutical company to allow open and un-moderated comments on its wall.  Johnson and Johnson has done the same and has weathered the storm during recent negative publicity events such as the Tylenol recall and a round of layoffs.  But this is different.  This involves the worst fears of every opponent of pharmaceutical social media—adverse events. 

So was this preventable?  Could sanofi-aventis have designed a social media strategy that would have prevented the firestorm that occurred?  Here again I feel it is worth mentioning I am not suggesting sanofi-aventis should have covered up Shirley’s claims.  Rather, I am suggesting that with better planning, those claims could have been directed to the right department and aired in the right forum.  I have been sitting on this since the news first broke, racking my brain to pinpoint where it went wrong and figure out how to prevent future missteps.  While I do think there were missteps, I’m not sure it was entirely preventable.  sanofi-aventis made the decision to allow un-moderated content.  Short of completely disabling conversation—this situation was not preventable.  However, sanofi-aventis could have taken some precautionary measures to mitigate its risk.  The other options with these types of groups would be to make them entirely closed off and not viewable by the outside world.  This allows only members to comment and see the content.  The group is not even searchable on this setting.  There is an in between that allows the administrator to approve all members, but the content is still viewable by all.   

Instead of preventing this from happening, what could sanofi-aventis have done differently to keep it under control?  First, there is some benefit to limiting the hours during which comments are permitted on Facebook.  For example, you can lock down the wall during the hours when there is no employee available to monitor commentary.  At least this allows a company to prevent inappropriate comments during off hours.  If they occur during office hours, they can be handled accordingly and directed to the right channels.  Of course, this does not prevent the situation, but would help to mitigate the risk.  In evaluating what happened here, most of the comments came during office hours.  It begs the question: what took so long to shut the wall down?  You can forgive one, but after the second comment, the wall should have been shut down entirely until further notice.  Now you have to be careful here.  It could certainly appear as though you are attempting to cover up information.  People that work in the pharmaceutical industry know that there are far too many risks associated with having a discussion like this in a public forum.  Upon shutting down the wall, sanofi-aventis could consider posting a message to the wall that indicates why the wall was shut down, that the compliant was being handled through appropriate channels and that once resolved it would be opened back up for discussion.  In doing so, you would effectively acknowledge the situation and not hide from it, but allow it to be handled in an appropriate manner.  

Another apparent misstep in this process was that there are no terms and conditions posted on the Facebook page of sanofi-aventis.  While this would not automatically prevent a user from posting negative comments, it would at least lay the ground work for the actions that would follow and would set a standard for all users to abide by.  It should also point patients to the easiest way to report adverse events.   

Finally, sanofi-aventis seems to be caught off guard by this situation.  It shouldn’t be.  Any company opening itself up to the risks associated with social media should have a crisis communications policy in place.  This policy should have pre-approved language that any approved administrator can use to handle an adverse event report, off-label usage discussion, etc…While you can never be prepared for every circumstance that develops, you can certainly put the pieces in place to act quickly and decisively.  

What this recent social media challenge has demonstrated is what most social media advocates have known all along—it’s difficult and there are risks.  That’s why as agencies we need to stop overpromising, neglecting strategy and following the shiny object.  There are risks associated with social media and no program will go flawlessly—but your response to challenges will say as much as your initial foray.  How will you respond?