There has been considerable discussion in recent times about ‘local’ versus ‘global’ engagement strategy, or whether there is some kind of mystical balance of the two. Earlier this year Creation Healthcare was pleased to facilitate seminars in New York and London with leading global pharmaceutical and healthcare companies, during which the constraints and opportunities of global healthcare engagement strategy were discussed.

Creation Healthcare are long-time proponents of setting aside time to define an overarching global strategy; we are therefore sometimes asked by new clients, “Do you really think we should have a global engagement strategy?”

This is a great question, to which we (almost) always answer “Yes”.

Some may say, “What about the local nuances?”; “What about the language challenges?”; “What about the regulatory variations?”; “What about the different technology constraints in each region?”; and so on.

We certainly do understand these issues. With 30 consultants all over the world Creation Healthcare is well aware of the challenges facing each territory, and we are constantly increasing our local in-country knowledge in order to make the best recommendations for our global clients. As much as we often encourage global strategy, we also know that it is absolutely necessary to have a local, tailored strategy to suit each individual territory or brand.

It is also true that at a global and companywide level, there are inevitably some common guiding principles that can bring continuity and consistency to the way an organization communicates, presents the brand personality, and ultimately engages with people – even on an international scale.

Incidentally, if you are skimming this article to find the quick-fix, ‘give-me-the-ten-tips’ commandments, you may wish to pull out now.

The reason for the title of this article is that it describes an approach, rather than a one-size-fits-all solution.

Let me explain using a ubiquitous metaphor. Most people in the world – regardless of their own personal religious belief, country of origin, or language – have heard of the so-called “10 commandments”. Indeed, quite a few people could list at least some of them from memory.

Interestingly, orthodox followers of the ‘Torah’ (as these books of laws are known) usually insist that there are actually 613 commandments all told, and that the 10 commandments are more of a ‘table of contents’ – a sort of cheat sheet for remembering the detailed laws and regulations.

Elsewhere, there is even a further distillation in to just two guiding principles. It is fair to say that in religious circles the 10 commandments have certainly permeated the human race over the past several thousand years, across millions of people in many languages and cultures.

We’ve found that this same concept also works for guiding an organization in healthcare engagement. Creation Healthcare maintains that it is possible to create ‘10 commandments’ which can be implemented globally, to bring new levels of (consistent, on brand) engagement.

Of course there really isn’t a single set of ‘10 commandments of healthcare engagement’ that would apply equally well to every company or organization, hence you will find no simple list here as a ‘take-away’.

Rather, each organization is uniquely different in its own right, with particular heritage, traditions, idiosyncrasies and ‘personality’. Therefore it makes perfect sense that each company should really develop their own global engagement strategy (and resulting 10 commandments).

Creation Healthcare can deliver a customized process to help you formulate your own global strategy 10 commandments; all you have to do is give us a call now.

On the one hand, physicians’ adoption of social media interaction with patients through the Internet is restricted due to legal and regulatory issues. On the other hand, patients seek trustable health information on the Internet and want to share their experiences and exchange information with peers. In a low engagement, low trust environment like the Spanish healthcare market, the www.vi.vu experience shows a path for interaction between users (patients or not) and professionals in a credible and safe way.

The network is open to health professionals and patients on a linking and question-and-answer basis. Each member can create their own network of professionals depending on the kind of information they are interested in. It is possible to interact privately but many of these conversations are archived publicly, enabling anyone with similar conditions to benefit from reading about them. Professionals also interact between them and exchange information.

Attracting professionals through reputation

Spain has a universal and publicly funded National Health System. Although in some regions the right for physician election exists, this is not the general rule. At least 25% of citizens have private health insurance to supplement the public offer. It is in this setting that physicians and hospitals or clinics begin to be conscious of the need to have a reputation among patients in order to be selected through the private insurance.

The www.vi.vu network offers professionals and healthcare providers a system for referencing and recommendation based on their professional profile and their activity in the network.

In the network, physicians act as mediators of information between parties. As Ignacio Parada – manager of the network – says, “they prescribe trustable and useful information”.

In this sense, the more active you are, the better indexing ranking you have in search engines (like Google) and the greater likelihood you have of obtaining a recommendation as a trustable source from patients and/or other professionals.

The network was launched last March in its final beta version and already has 400 professionals and thousands of users who share more than 4,000 links and 700 answers. Users and Patients join the network by invitation from professionals or by their own means.

Empowering patients

www.vi.vu permits any member to build his own team of professionals which provides useful information and counsel, either publicly or privately. This enables the patient to be in charge of his recovery process or to prevent any illness he could be exposed to.

Once the patients have acquired experience in an illness they can also be a trustable source of information for others and can upload or link any information they consider will help others.

Crowdsourcing information

The information traded in the network is already on the Internet. “There is no need to create new content when there are huge amounts on the Internet from credible sources”, says Parada. These credible sources are better know by health professionals. In some cases, the professional can refer to content created by the pharmaceutical industry or insurance providers. In this way, they have an  opportunity to send their information to patients. “But of course, they have to adapt it to the patient and sweep away any advertorial or message inducing to purchase of their products”, according to Parada.

www.vi.vu offers different services to health providers who want to carry out network projects with health professionals, such as talking to members on a daily basis in order to help them provide information in best manner. For example, many professionals have good articles about how to cope with a disease which might be better understood if translated into audiovisual media or supported by graphics.

Vi.vu aims to show professionals in the healthcare industry the opportunity they have through the network, to become trustable agents and gain credibility from the public. They think that the future of the network will come from the ability of the industry to participate, be a player and help the network to succeed in enabling all agents to benefit from the service.

They have a good number of clever ideas to develop the network further. For example, they plan to offer educational disease management programs or drug interaction databases. For now they prefer to consolidate the model, help professionals understand the importance of their online reputation and the vital role they can play in guiding their patients through trustable sources of information.

Social media is increasingly being used as a test-bed for conducting research with users, bringing them into the product development process as active participants and monitoring trends in user or client behaviour.

If you’re operating in a regulated healthcare environment, your social media participation might start as an information collation or broadcast tool rather than for direct engagement. There are numerous tools which can enable you to keep track of your competitors and measure user behaviour to inform your own marketing, engagement and product development strategies.

1.     Product and brand tracking tools

As a marketer, keeping abreast of the competition is an essential part of your job. They days of scouring press releases in trade journals, awaiting annual reports and attending far-flung conferences are in the past: today, more information than ever before is online and accessible about you and your competition and can be delivered direct to your desktop.

Ensuring you sign up for the relevant e-newsletters, Twitter feeds and Google Alerts for your competitors is an effective and immediate means of benchmarking how your own activity and profile compares with your competitors.  This previous article in Engagement Strategy takes you through the process of setting up alerts and information feeds. Users of social media can be quick to respond critically and publicly to situations and experiences, so tracking formal press along with conversational mentions allows you to monitor more effectively how your own and competitors’ brands are being discussed.

With the recent news that Google will be including social media in its search results, following on from the recent integration of Google and Microsoft’s Bing engine with Twitter into search results, considered management of brands and corporate profiles in online conversations and measuring responses will become increasingly significant in the development of the semantic web as user-recommendation interlinks with search engine functionality.

2.      Accessing research

Many search tools now make it easier to access research, articles and links to online resources archived by other users:

Academic research:

Google Scholar searches published academic research using weightings to rank publications based on how often they have been cited in other publications.

Mendeley, which describes itself as the iTunes for research papers, is a new service from Stefan Glänzer, the former Chairman of music search service Last fm.  It allows researchers to store together, search and cite easily all their research and connect with other researchers. Funded by the backers of Skype and Warner Music, this technology is not exclusively for the hallowed corridors of academia but is intended for wider roll-out to other research and enterprise sectors.

Enterprise search:

It’s likely that historic data you need to map longer-term trends may already exist in another department or site within your organisation. Enterprise search is a software solution to provide in-depth analysis to information within the enterprise, sourcing information from a range of internal sources including email, databases and intranets. It is a technical form of knowledge management for larger organisations, relying less on human cataloguing and gatekeepers and more on search parameters.  Enterprise Search is typically a high-budget, high-tech solution for large enterprises and knowledge institutes, however, lower-cost solutions using the easy usability and functionality of search engines are growing in popularity like Google’s Enterprise Search solution.

3. Bookmarking

Popular social bookmarking sites such as Digg, Technorati and Delicious allow professionals to catalogue their reading; these results can be made accessible to others or even integrated as feeds into a website or blog.  Social Mention allows search by keywords within bookmarking sites in addition to other social media tools such as blogs, microblogs and networks.  By storing research results as separate CSV/Excel files, you can perform analysis comparing responses from different platforms and also identify the key ‘thought leaders’ and influencers in your field.

4.     Tracking and measuring user engagement

Sentiment analysis:

As the web becomes more focused on person-to-person interactions, sentiment analysis has become a growing trend to analyse the quality of users responses rather than just tracking the volume of engagement through links or webpage views.  The Social Mention page above, left, shows how sentiment can be rated as positive, neutral or negative by analysing reviews, recommendations and a database of emotive keywords to determine the attitude conveyed in any communication.

Trending tools:

Many bespoke social media engagement platforms now provide sophisticated trend analysis tools which track the less easily measurable outputs of online engagement.  Free tools like Nielsen’s Blog Pulse allows you to measure blog trending topics in quantitative terms.  Likewise, Trendpedia allows the same with comparison charts of competitive terms, showing the market awareness and profile from online editorial and comment the brand or company is attracting, which can be converse to its actual market position:

In addition to social media, measuring queries with search engines can reveal how users are responding to or using your product.  Running a search on users questions relating to a medical condition shows a range of results:

Knowing patients concerns and how they choose to phrase them presents an opportunity, allowing the marketer to respond to these search terms with timely consumer information in the form of well optimised pages on your own website, driving traffic and increasing consumer confidence.

Telligent is a specialist social media platform which aligns consumer engagement with brand management.  It provides extensive analytics to track ‘soft’ measurement of engagement to prove ‘hard’ results from social engagement including measuring sentiment, levels of connectivity, productivity in internal groups and ‘hot topics’.

Partnering with other professional groups or sponsoring social media sites and services may provide access to a rich mine of engagement data.  Telligent’s current clients include the American College of Healthcare Executives, the American Psychiatric Association and the British Dental Association.

5.    Crowdsourcing research and open innovation

Crowdsourcing, engaging a community of people in a task through an open call, was a term first coined by Jeff Howe in a 2006 Wired magazine article.  Howe described how the National Health Museum in Washington, DC, sourced photos of pandemic victims from an exhibition from istockphoto using the ‘wisdom’ (or frequently just the footfall) of crowds to access and deliver affordable services.

Crowdsourcing also links closely with the idea of open innovation, a term coined by Berkley Professor Henry Chesbrough to describe how big corporations need to look outwards to buy in the latest innovations from smaller or more specialist businesses, a model now used by many technology companies including IBM and Google.

Some businesses are developing open innovation through galvanising and organising crowds of specialists. Edison Innovations have a web portal to identify new markets and innovations by tapping into ‘scopers’, the thorn-in-the-side of industry who always point out what could be done better.  The system stems from the belief that most market research is flawed and produces only constant ‘yes’ answers. It exploits the frustration of scopers and benefits from the wisdom of crowds (many who will participate just for the fun of it) which online technologies can harness.  From this pool Edison Innovations develop the idea and sells it to an established business or start-up on a royalty basis.

In a controlled DTC market, your crowdsourcing may be based around inter-sector exchange, connecting and learning from medical practitioners, journalists, researchers or other thought leaders in your field, tapping into both open and closed networks.

Open networks:

Linked In Answers is an open, global forum to pose questions to the world’s largest business network and to stimulate discussion and debate.  By searching against keywords specific to your specialist area and contributing to the discussion, this could help to diffuse criticism or influence opinion about your brand whilst supporting the industry.  It’s a perfect way of flexing your muscle as a thought-leader, in conjunction with a blog or other engagement strategy.

Don’t forget the deceptively simple Twitter Search tool for engaging with, and monitoring the comments of, other thought leaders or influencers in your field.

Closed networks:

You can conduct research with specific users through closed groups using social media networking sites such as Doctors Hangout, but avoid the temptation to hard sell: observe and interact but respect the informality and ethos of the network, as those engaged in conversations through specialist networks or in groups within social-based networks like Facebook are not going there to be sold to in the first instance.

If you are conducting research, online survey tools such as Survey Monkey and Survey Gizmo allow you to create a quick and simple online survey which can be easily analysed and segmented.  For closed groups, password protection is a feature of Question Pro.  Participation levels and quotas are hard to achieve for robust research but it can allow for a quicker frame of response to single-topic, immediate issues, and you may be surprised to find out how many people are interested in taking part. People are more likely to respond if they feel their views are being taken into account to progress innovation and development, and they can access the results at the end of the survey to benchmark their own experiences with their peers.

There are many online tools to conduct market research, but the measurement and analysis can be time consuming even when the tools themselves are free or low-cost so usage requires a strategic approach.  If you would like to talk with a digital strategist you can contact us to find out more about how to effectively use these tools and services.

Picture the scene: An enthusiastic communications executive presents a report to the organisation’s leadership team, and in a particularly favourable light explains how successful this new initiative has been. A few eyebrows are raised around the table, and various questions put forward about the impact in the marketplace. One by one, all eyes flicker towards the ex-MD, now Chairman of the Board, who finally asks the inevitable question; “Well, that’s all good news… so how does this affect our bottom line?”.

Every effective leader is concerned with the financial implications of new products, new systems, new staff, new partner arrangements, new technology, and any other new innovation as it is introduced to an organisation. Has this activity produced an improvement in efficiency, an increase in revenue, an increase in profitability? Conversely, has it only created a new cost centre? Has it created positive brand experience? Has it changed public perception?

The times they are a changing

The 21st Century has already ushered many new developments to the fundamental operation of organisations in healthcare and government. The Internet, broadband connection speeds, software services, and trends such as social media, have provided a new foundation for communication models that have seemingly emerged overnight, forever changing the expectations of ordinary citizens.

Whilst creative agencies, marketing departments, public relations companies and media buyers, are all touting the benefits of platforms such as Facebook, Twitter, Blogging, and community building, very few are actually able to demonstrate the kind of measurability that actually represents  something tangible to those in the boardroom. That is to say, real return on investment. Not an arbitrary number of ‘hits’, or ‘visitors’, or ‘bounce rate’, or ‘followers’, or ‘OTS’ value, or any other ‘marketing speak’ for that matter.

No, at the purest level, most leaders want to know about the resulting pounds and pence, dollars and cents. What did it cost and how did it achieve business objectives? Is the strategy behind the initiative working profitably? Does it need refinement? Is this a loss-leader? And so on.

Avoiding the question

Most digital agencies and marketing departments have a gamut of statistics and web metrics they can use to present the apparent ‘impact’ of an initiative. Very few seem willing to answer the fundamental boardroom question in hard currency. They would perhaps rather present their arbitrary numbers and hope that through abstraction, the consensus will be general nods of approval.

Bear in mind that their goal is to show that the work they have done for you has produced positive results, was worth the money, and you should therefore hire them for the next assignment. Do they necessarily care about the truth as much as you do?

Generally a creative agency’s greatest strength lies in their ability to be creative and not necessarily in displaying the kind of rigour and attention to detail that may be required by economists, statisticians, accountants and CFO’s.

It is consequently not uncommon for: a web-design agency to be reporting on how successful the website is; a search-engine optimisation company reporting on how successful the SEO activity is; a media-buyer reporting on how successful online advertising is; a PR company reporting on how successful the PR has been; and a social media company reporting on how successful the social media has been.
This is a fundamentally flawed approach, and may explain why so many executives are simply in the dark about what is really going on.

The truth is that the tools exist to tell the story accurately, but the effort required to check and double-check and to verify with more than one measurement means, can lead to some providers simply avoiding reporting in terms of tangible ROI. Additionally, agencies and marketing departments are often not really paid to produce an accurate assessment – this is a ‘value-add’ that they provide to justify their involvement. Not to mention that it is in the best interests of any external agency to present any results in a favourable light. In which case, how much ‘value’ has been added?

This situation makes it very difficult for executives to make an informed strategic decision about how to move forward.

Appointing an independent auditing team

Consider your internal accounting department. You may well trust their work, and be proud of their accuracy in reporting and meeting deadlines, yet you will always insist on appointing independent auditors to look over the accounts to ensure that you have the complete picture. It is the audited accounts that you will sign and submit for the record.

It is therefore imperative that executives and senior management insist on knowing the granular impact of their organisation’s digital media initiatives in financial numbers, and ideally through independent auditing. Bear in mind that this may require a certain level of transparency around cost centres, revenue streams, sales pipelines, and other traditional accounting mechanisms. Perhaps this kind of information is not suitable for external agencies, in which case you will need to establish effective cooperation internally to produce meaningful insight, or assign an independent contractor with appropriate non-disclosure agreements in place.

Until the important work of reconciling digital engagement initiatives with financial indicators is complete (one way or the other), it is impossible to accurately ascertain true return on investment, or indeed the ultimate impact on the bottom line.

The bottom line – quick tips

Here are some quick tips for executives looking at the bottom line impact of social media or digital engagement initiatives:

1. Set clear strategic and financial objectives that agencies and marketers will be held accountable for
2. Measure everything, and appoint independent audits of internally and externally produced reports
3. Insist on a financially based return on investment analysis – if it isn’t tied to your accounts, it may just be hype.

If you would like to increase your insight about social media engagement and the bottom line return on investment, contact us and speak to one of our consultants.