That was a satisfying piece of information in the sense that I’ve long trumpeted the need for social media strategies focused on the Return on Health of the patient.  It’s always nice to affirm that you are not crazy.  It was frustrating because what I heard from the table was it was a need mostly going unmet. What became apparent to me during our dinner was that this is not a problem that can be solved by pharmaceutical companies in isolation.  Just like pharmaceutical social media engagement should not take place in a vacuum, creating a healthcare system where the patient is empowered to play a larger role in the decision-making process requires systems thinking.

Pharmaceutical companies can lead the charge in part because of their unique access to information but also because of their substantial sphere of influence.  Pharmaceutical companies have access to the best information available on treatment options, dealing with side effects and current research.  Like it or not, they also have pull on capital hill, with insurance providers, in the doctor’s office and with the patient.  Pharmaceutical companies must serve as the catalyst to empowering the patient.

But the process can’t stop there.  As agency people, we tend to focus our energies on swaying the folks that write the checks.  In order to truly empower the patient, we need to broaden our field of vision.  How can we expect the empowered patient to achieve a good outcome when doctors are incentivized to see more patients and not spend more time with patients?  What good is an empowered patient if she can’t find information on the latest clinical trials on her rare disease because search algorithms do not lend themselves to uncovering that information?  What’s the use of an empowered patient if doctors are not trained to take input?

I admit I am raising a problem far too complex for me to solve—something that requires brains far smarter than mine.  But I am smart enough to realize that pharmaceutical companies engaging in social media alone will not empower the patient—we need the collaboration of lawmakers, insurance providers, hospitals, doctors and patients.

Even with this complexity, it all centers on the patient.

(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.

I recently watched a video on the kitchen-gadget company Oxo.  While you may not expect it at first glance, Oxo is widely regarded as a world-class product design organization.  It’s the kind of company that routinely thinks of ideas of the: “why the heck didn’t I think of that variety?”  The video was on the company’s design philosophy and had a quote that struck me as particularly interesting: “We are a culture of nitpickers; we have to be to get it right.”

The idea behind the nitpicking philosophy is that every product-design decision is put through a firing squad of questioning.  Only if you try to poke holes in your own concept will you ultimately create the best product possible—no detail is too small.  Of course, most people when pressed would say they loathe working with nitpickers.  They slow down the process, obsess over small details and can’t see the big picture are the common complaints.  But in pharmaceutical social media, a healthy does of nitpicking might be just what the doctor ordered.

Let me explain.  Ask a pharmaceutical executive to describe a typical social media person and you will get something that describes a person long on creative juices but short on strategy and project management skills.  This results in an abundance of “big ideas” with little idea of how to implement those ideas or the business drivers that make that a reasonable course of action.  This creates false promises and failed programs.

A culture of nitpickers would approach this process differently.  Once a big idea is pinpointed, the next question is: “does this make sense given the goals we have (presumably) outlined?”  This would be followed by a series of detail-oriented questions that delve into the minutia of a social media engagement.  Should we allow comments?  If so, should they be pre-approved or in real time?  What will the terms of engagement be?  What are grounds for deleting a comment?  How will we handle adverse events or a disgruntled patient?  You get the picture.

Creating a culture of nitpickers is not about stifling innovation—just ask Steve Jobs.  Jobs is the Grand Poobah of nitpicking and few would accuse Apple of a lack of innovation.  It’s about marrying the “big ideas” with the “little details.”  Pharmaceutical social media is too often happening with only big ideas and no concern for the details.  Maybe it’s time we start acting like the company that invented rubber-handled potato peelers and become a culture of nitpickers.

According to research from Hubspot

These numbers are all well and good but my question is this: should we be judging social media success purely on the ability to amass a large following?

For the record, Hubspot makes no such implications in the post outlining the data, and instead merely presents the empirical data it has found.  But much of the chatter I’ve seen thus far in the dreaded pharma social media echo chamber uses this data to bemoan the lack of success pharmaceutical companies have had on Facebook.  Blindly interpreting data as a benchmark for success is a futile exercise.

For starters, did anyone actually expect the pharmaceutical industry to be higher than average when it comes to the fan base it has accumulated?  We are talking about an industry that is fighting long-held distrust, strict regulations and sensitive topics.  The hill is a bit steeper for healthcare companies than it is for the movie industry (the most liked industry according to a separate post).  Frankly, I’m a bit surprised that the pharma industry is that close to average.

The more important issue at hand is the idea that Facebook fans is an accurate measure of success in social media—particularly pharma social media.  I don’t buy that.  It should be part of the equation but it provides only a small glimpse into the success of your social media strategy.  In the pharmaceutical industry, we should be taking a closer look at the level of engagement of your established fan base, whether it is trending up or down and how active and vocal that community is.  These are all a blend of objective and subjective measures but provide a far more accurate picture of social media success.

The empirical data presented by Hubspot is useful in that it provides a top-level sense of the interest in pharmaceutical social media engagement.  What it does not evaluate is how long the group has been established, what purpose it intends to serve, what benchmark for success has been determined and how active the group itself is.  These are all critical factors in evaluating success in pharma social media.

Unfortunately, that conversation has continued unabated seven months later.  Debate is running rampant on who owns social media.  But my question is: who cares?

The constant debate about who owns pharmaceutical social media is not only useless chatter; it’s detrimental to the industry.  While an ad guy is selling a campaign concept and a PR guy is selling the idea of building a reputation—the pharma marketer is left scratching their head.  We often counsel our clients on clarity and consistency of message yet we muddy the process for the very people we are trying to convince.  I may not have learned much in school but one thing I do know is that confusing the buyer is not a recommended selling tactic.

So to all my cohorts out there on the agency side, who are we trying to convince—ourselves or the prospect?

Instead of making a decision based on the type of agency you are considering, I would encourage pharma marketers to focus on a different set of criteria.  Ask questions that cover:

• What is your process for setting strategy?
• What is the most compelling reason for us to be involved in social media?
• How will you handle a crisis communications situation online?
• What is the goal of our engagement on social media?
• How will you help me identify, create and extend the value of my content?
• How will you identify the appropriate audiences for me to engage with?
• How will you measure success during an engagement?
• What departments do you plan on getting involved internally (i.e. legal, IT, etc.)?

These types of questions and many more will provide you with better insight on the right social media partner.  It might be a digital agency, or it might be an agency like mine.  But if the debate continually focuses on who owns social media—they are not right for the job.

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.

Much of the pharmaceutical social media conversation has focused on the need for change from the market tactics of yesteryear.  The argument goes something like this: “agree or disagree, the pharmaceutical industry is one of the most distrusted and its public perception is overwhelmingly negative.  Why?  Fair or unfair, many point the finger at the barrage of DTC ads as a sore point.”  Using that logic, the strategy tends to be something to the effect of “change everything.”

It’s not all wrong.  I for one have been a proponent of pharmaceutical social media as a step in the evolution of the industry’s marketing.  No doubt, the pharmaceutical marketing has been evolving over the years to fit better with a business less focused on blockbuster drugs and mass markets and more concerned with areas of high unmet needs and building relationships.  So by all means, move forward with radical changes to the way you form marketing strategy, but don’t disregard your past entirely—you might miss a crucial lesson.

Today, Wendy Blackburn from InTouch Solutions reposted an article that she authored (originally ran in Med Ad News) focused on how pharmaceutical companies can take a more customer-centric approach to marketing (similar to my Return on Health concept).  Within that post, Wendy briefly mentions an interesting point: “patient support call centers have been around a long time. What’s so difficult about duplicating that experience online? Why not empower a corporate spokesperson to speak online on behalf of your company and your brand?”

This is an example I’ve used on occasion before: if pharmaceutical companies can trust call center employees to handle patient support functions, why can’t they replicate that process for an online team?  There are really only two (honest) answers to this question.  The first is that online platforms expose the companies to added risk and exposure to the FDA.  The issues are the same as what might be handled in a call center but when dealt with in a public manner, the feeling is that companies are being watched.  Call centers don’t face that challenge.  Second is a problem of scale.  Call centers provide a finite and defined environment.  The company can control (to some extent) the calls it takes in a day, the hours it receives calls and the process for responding.  The real-time nature of the Web makes this level of control impossible.  That’s really about it: too much scrutiny and not enough resources.

Yet, people tend to ignore examples of the past even if they have worked.  Call centers have worked in the pharmaceutical industry for the most part.  So here is what it comes down to: do you trust your call center employees more than your communications manager?

A Facebook page without interaction is nothing more than a Website.  A Twitter handle without engagement equates to an RSS Feed and a blog without open commentary may as well be a company newsletter.  The point?  Social comes first in social media for a reason. Far too many pharmaceutical companies focus on the latter and ignore the former.  The results can be disastrous in an age when executives are demanding quantifiable ROI and quick results.

The most value that healthcare companies can be derived from social media stems from connecting directly with customers (in the case of pharmaceutical companies: patients, doctors, healthcare providers, insurance providers, etc…).  This is where you will hear invaluable feedback on your product or brand, come to intimately understand the decision-making process for requesting a certain prescription, learn the types of information most valuable to the patient and earn the type of trust that creates loyal brand advocates.  Anything short of that is marketing as usual.

Sure, there are some additional benefits to establishing a presence on social media channels that can be achieved without being truly social such as search engine juice.  If you churn out enough content focused on the term “cancer research” you will probably rank higher in search results.  But what about all the other content organizations are churning out on the same topic?  Are you present in those conversations?  If not, you are missing an opportunity to extend your social media presence, provide simplified access to information and establish a new relationship with your company.  There are important touchpoints outside of your own social media presence that should not be ignored.

As a social media marketer, focusing on the tools perpetuates the myth that this is just a fad and purely tactical in nature.  Fads do not get a sizable portion of the marketing budget and tend to fizzle out in due time.  My advice: stop focusing on the “media” and start worrying about the social.

Of course, this level of content creation takes a commitment to social media that many companies might not yet be willing to make.  Who can blame them?  In addition to appointing some individual to monitor and respond to social media conversations, you now need to create engaging content within the boundaries of FDA regulations.  A significant time sink indeed, but one well worth the investment if done properly.

But in thinking about the topic, it occurred to me that this outlook on the involvement of pharma companies in social media is far too narrow.  Sure, it is easy for a pharmaceutical company to serve as an information broker.  But what about their role as a creator or energizer of patient support groups?  Is it even appropriate for healthcare companies to step into this area?

I realize this is not an entirely new concept.  Some companies have already done a solid job of connecting patients around  disease states.  But by and large, this is an area that pharmaceutical companies tend to steer clear of for a variety of reasons.  For starters, there is often an active and engaging online support group established.  Why disrupt the status quo?  In addition, pharmaceutical marketers have long had trouble defining their customer.  Ultimately, the patient is overlooked in favor of efforts directed at doctors, insurance providers, etc…

That needs to change.  For pharmaceutical companies to have any measure of success in social media it needs to focus on Return on Health and the patient.  This patient-centric view leads me to believe that a large part of pharmaceutical social media efforts in the past will be about creating and energizing patient support groups online.

Right now, healthcare companies are best suited to dispense information. In the future, they would have a better grasp on their patients and be best suited to provide a platform for support.

Forget about extending your brand, getting more prescriptions and enhancing your reputation (all of which will come by the way).  This is about providing a much-needed outlet to an often underserviced community.

There are two key takeaways from this report.  The first is that individuals living with a chronic disease are less likely to have access to the Internet.  According to the report:  “81% of adults reporting no chronic diseases go online and 62% of adults living with one or more chronic disease go online.”  The report goes on to indicate that this is an indication not of desire to go online, but of access to the technology required to go online.

The second key takeaway is that if all variable factors are weighted equally, individuals dealing with a chronic disease are more likely to go online in search of health information and far more likely to consumer user-generated content.

As pharmaceutical marketers, the obvious question is “how does this data impact my efforts?”  As I stated earlier this week, every social media engagement strategy should start and end with the patient.  The focus has to be creating better patient outcomes.  In order to move forward in that process, an understanding of the patient is paramount.  This study from Pew helps healthcare companies better understand the behavior of the patient.

The data supports the idea that social media is not a silver bullet.  The reality is a significant chunk of the patient population is not online.  Clearly, social media is not the right avenue to reach those patients.  Traditional forms of marketing (including PR) still hold relevance in reaching this segment of the population.  The Pew report states that the lack of access to the internet creates an information gap for patients that are not online.  Pharmaceutical companies should focus a piece of their efforts on bridging that gap.  As always, social media is but one part of a integrated marketing strategy.

The plus side of this report for social media advocates is that it confirms what we have always known—those patients that do have access to online content consume it voraciously.  Anecdotally I know this to be true.  My Mom battled Melanoma for 3.5 years and was constantly online looking for new research, treatment options and support groups.  In some small way, it helped her feel connected to a community and less isolated in her struggle.  That’s no small feat.  Social media remains a powerful platform to engage with patients, hear their feedback and work toward the lofty goal of achieving better outcomes.