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.

Earlier this year I wrote about how language barriers are creating a new digital health divide and I suggested that the single biggest barrier to successfully connecting patients online internationally is language. On the one hand, the Internet has broken down many boundaries and has changed the geography of healthcare, uniting patients and healthcare stakeholders all over the world so that people are not constrained by information available in their own country alone. Yet on the other hand, language has become an even greater barrier as it separates people into groups – the advantaged or the disadvantaged – based on the information they can access.

I concluded that innovation is required, and offered some ideas about how to tackle language barriers in healthcare engagement. Now, in this report, I explore some of the innovative solutions being developed that are transforming healthcare engagement, improving access to healthcare, and literally saving lives by breaking down language barriers.

Solving patient-clinician language barriers

In the United States, over 34 million people speak Spanish as their primary language at home. When it comes to providing effective and reliable healthcare to this Spanish-speaking population, it is in the face to face encounter between physician and patient that any language barrier becomes critical.

I spoke with Dr Martha Bernadett, Executive Vice President at Molina Healthcare, a leading national healthcare provider in the United States, about the challenges of ensuring effective healthcare communication amongst non-English speaking communities in the US.

“It’s in the patient-clinician face-to-face encounter that patients gain the most important information and have the most important interaction,” says Dr Bernadett. “All other non-face-to-face interactions are trusted in a secondary manner, compared with the face to face encounter with a nurse or physician. After that is any written communication that the patient might take home, that they use to convey to family members what happened at that encounter. Those are the two critical elements in healthcare delivery where you don’t have as much margin for error.”

Molina Healthcare focuses on enhancing the relationship between patients and physicians, enabling them to communicate effectively with each other. Dr Bernadett told me that matching physician and patient language is an important aspect of the work they do. Where language matches or bilingual healthcare professionals are not available, interpreters are used for face-to-face encounters. Pre-translated documents also play an important role in efficient and accurate cross-language interactions.

Automating patient-physician interaction

Meanwhile, new technologies for automating translation are emerging and have been used successfully in healthcare. Staff at Bayshore Community Hospital in Holmdal, NJ, communicate with Spanish-speaking patients using an automated spoken translation tool that listens to a sentence in English, translates it to Spanish and speaks the Spanish sentence to the patient.

I spoke to Dr Mark Seligman, President and Founder of Spoken Translation whose product, Converser for Healthcare, is the innovative tool used by the hospital to engage patients in their own language and I asked him what makes the product reliable enough for use in a medical environment.

One of the keys to the product’s effectiveness, as Dr Seligman demonstrated to me, is ‘back-translation’ which confirms to the original speaker in text, what the translated text looks like when translated back into its original language. Through this innovation, it is easy to identify whether the context of an English word with multiple possible meanings has been correctly understood. If not, the correct meaning or inference can be specified by the user before the correct translation is spoken by the tool.

In the example below, the ambiguous meaning of the word ‘right’ in “Your right knee is broken” is clarified by selecting the correct meaning:

This is certainly an effective tool for reliable, context-sensitive translation that is making a real difference to areas including patient safety and compliance. The tool includes pre-translated compliance tools such as an informed consent form.

“Consent becomes a stronger thing when you can know and prove what you have said in a foreign language”, says Dr Seligman. The tool retains a transcript of conversations so it is possible to review exactly what was said. This opens another possibility for the future – the integration of transcripts with electronic medical records. Dr Seligman hopes this will be achieved next year.

“The challenge [of integrating with electronic medical records] is organisational rather than technological”, says Dr Seligman.

If this is starting to sound a little too much like a move towards fully-automated medical interactions, Dr Seligman is quick to reassure that Converser is not trying to replace human interpreters.

“Human minds, human hearts, human cultural understanding is irreplaceable.” says Seligman. “We’re not trying to replace humans. Converser will always work along with human interpreters.”

Emerging applications for automated translation

I asked Dr Seligman about the potential application of Spoken Translation’s technology into digital engagement channels such as social media. He explained that this is where he started out in the mid-1990’s, working on automating chat translations and it is certainly something that he hopes Spoken Translation will return to in the future. The company has a vision for applying their technology of today to live, verifiable, chat translation:

Spoken Translation’s vision of the future: live, verified chat translation

Other innovation in the pipeline includes server-based technology that would allow Converser to be used from portable and mobile devices. Dr Seligman hopes this will be available for iPhone and Blackberry during 2011.

Purpose built automated healthcare translation

During my research for this article, I was pleased to learn from TAUS, a think tank on translation strategies, about customized machine translation systems (aka automated translation) which are designed for use in specific sectors. This is in contrast to Google translate which can be unreliable for specialist areas such as healthcare. These customized engines are trained using database of previous translations from a specific industry and include features to ensure consistent use of terminology. The result is better quality, more accurate translations.

Just such a sector specific solution is used by the Pan American Health Organization (PAHO). Their system was originally developed in the 1970s, and today covers all combinations of English/Spanish and Portuguese and is being used daily for 90% of all PAHO’s translation needs, as well as by 75 clients. Another example is a Danish customized machine translation provider, Languagelens, whose purpose built solutions are used during clinical trials by pharmaceutical companies. Whilst human translators are needed to ensure that the final text is up to the high quality needed, the use of such customized automated engines drives down the cost of translation, increasing the amount of translation that can be done, and speeds up time to market.

TAUS also told me that it is possible to create automated engines rapidly when needed – within three weeks of the recent crisis in Haiti both Google and Microsoft added Haitian to the list of languages supported by their automated engines.

Real-time translation crowdsourcing

As automated translation technologies are deployed into healthcare environments, other innovative approaches to solving the automation challenge are emerging. New York, US based SpeakLike has developed a process that is enabling social media engagement to take place across 37 languages. Sanford Cohen, SpeakLike’s CEO told me that they were looking for a solution to enable real-time chat amongst people speaking different languages.

“We explored machine translation and found it was not good enough for our needs,” explains Cohen. “So we thought, ‘if machine translation were perfect, it would be integrated into everything we use – it would be in our email systems, in our chat systems, and in our content  management systems; but it’s not. But why can’t we have something that can be integrated into everything we use, with good quality translation?’ That’s when we started looking at crowdsourcing.” Cohen says this idea was how SpeakLike started:

“We got a large number of translators on our system, and users could send in a request when they needed it, 24/7, and then whatever translators were available or logged in first would provide the translation.”

The first application of the process was live chat, and in a 2008 beta SpeakLike demonstrated live, real-time chat between three users speaking English, Spanish and Chinese. This technology was implemented by PETLinQ, a provider of radiology imaging software management tools, to enable their user base of 71,000 doctors to collaborate in their own language.

After experimenting with the physician-patient interaction, where a dental reconstructive surgery in New York could support its worldwide patients pre- and post-surgery via international chat, SpeakLike started to develop other applications of the process. The translation platform was expanded to integrate with email, website content, and social media applications.

Today, a Twitter connector automates the translation of tweets, enabling either a single, multilingual Twitter feed or separate feeds for each language. Meanwhile, for bloggers using WordPress, a plugin automatically posts translated content into languages selected by a content author.

SpeakLike’s system is designed to manage the end to end process, automatically notifying translators, managing translated content, and publishing based on user options.

Cohen told me of a customer who was previously waiting typically for two weeks to have website updates translated into nine languages, but their content was out of date within four days. By integrating SpeakLike into their content management system, they were able to publish translations within less than 24 hours.

Responding to international health crises

The potential for transformation that can be achieved when people from different countries collaborate to solve healthcare challenges is exemplified in the work of international aid organisations such as Médecins Sans Frontières, where healthcare specialists from around the world work together in response to a crisis. But when the international team leaves an area of need, local physicians are often left without access to the international knowledge pool that exists during an aid mission.

Murdo Bijl, Founder and Executive Director of Health Connections International, saw this situation first hand when working with Médecins Sans Frontières in the former Soviet Union. The experience inspired him to set up an organisation focused on facilitating and promoting communication between professionals through multi-lingual exchanges of information. Health Connections International operates on a non-profit basis and focuses on improving responses to the HIV, tuberculosis and drug use epidemics in developing countries and resource-poor environments.

The organisation’s online knowledge and information sharing platform has been designed to allow healthcare professionals across the globe to share their experiences and exchange information, quickly and easily across multiple languages.

Healthcare professionals register as members of My Health Connections and can ask medical questions in their own language. Most questions are then manually translated and labelled by subject area (such as HIV/AIDS, treatment, medication) before being routed to an appropriate expert to be answered. Once answered, the response is translated back into the language in which the question was originally asked. It’s a laborious process but the result is a rich and growing knowledge base accessible in multiple languages.

MyHCI includes a growing, multilingual expert medical information knowledge base

I spoke with Murdo Bijl about his vision. He told me that in the proof of concept that has been running since April this year, 600 unique questions and answers have been posted. He said that as the number of questions and answers continues to grow, the knowledge base will be able to provide the answers to most commonly asked questions:

“There will be a moment when the knowledge base will have enough information for people to find the answers to their questions. Then all the questions will be translated into Russian, Spanish, Arabic and Chinese. Right now we have 500 Q&As online, translated into Russian.”

Supporting hard-to-reach healthcare professionals

In Kyrgyzstan and Tajikistan, local ‘focal points’ have been set up to bring Health Connections International’s service as close as possible to those healthcare professionals who may not have access to the Internet. As Bijl told me:

“We work with the medical academies and the ministry of health in the countries where we operate. They create their own knowledge centre in the capital city, with small focal points throughout the country which are equipped and manned by local physicians.

“In Kyrgyzstan and Tajikistan, we have twenty four ‘focal points’ on the premises of the ministry of health’s facilities, such as an AIDS centre or tuberculosis clinic, where local doctors who may not have access to the Internet can take their questions.”

Bijl says that the online model has allowed Health Connections International to continue to support medical professionals when other more traditional methods and have been unable to:

“What we’ve seen in Kyrgyzstan is that when many organisations had to halt their programmes because of political unrest and violence, we had an increase in user traffic. So even in political unrest, the work goes on.”

But Bijl is not content to stop at the existing online solution. He is already exploring new channels to increase the reach into low-income countries using mobile technologies.

“The next step for us will be to use mobile technology. 3G is virtually everywhere now in the low-income countries where we operate.”

Global collaboration

Amidst these examples of innovation in translation, TAUS supports the translation industry and aims to help the world communicate better through better translation, actively encouraging collaboration, sharing of knowledge amongst stakeholders and open innovation.

I spoke with Rahzeb Choudhury, TAUS’ Operations Director, about their vision for collaboration between translation organisations. He told me about the TAUS Data Association, a collaboration platform for sharing translation data, where Molina Healthcare is one of 40 founding members. This non-profit organisation provides an open platform for sharing translated texts into a single shared database which is a key enabler for experimentation and innovation, providing open access to language resources to help train better customized automated language solutions such as those used by PAHO and Languagelens.

The resulting repository of translations currently contains 2.6 billion words in 315 languages, including a giant corpus from the European Medicines Agency. The benefit of such a platform for healthcare (or any industry) can be seen by searching for a medical term in the free language search engine.

A glimpse of what is possible

From face to face physician-patient interaction in the United States to crisis response in the former Soviet Union, it is encouraging to see innovators establishing approaches and technologies that are breaking down barriers and achieving successful multi-language healthcare engagement. There is much still to be achieved, yet the examples here provide a hopeful glimpse of what is possible.

I am grateful to TAUS for their support in researching this report. My thanks are also due to the following:

Health Connections International
Molina Healthcare]
SpeakLike
Spoken Translation

How healthy is your digital engagement strategy? World-class ‘olympian’, or ‘gasping for breath’? We’ve put together a quick and fun tool for you to self-diagnose the health of your digital engagement. Just answer the seven questions below and see how your score adds up.

We recommend that you take this simple self-diagnosis check whether your focus is on product development, policy, corporate communications or marketing, and whether you are in prescription-only or over-the-counter medicines, medical devices, patient treatment or care. You will discover just how healthily you and your organization are engaging through digital.

A healthy digital engagement strategy allows you to connect with patients, healthcare professionals and other health stakeholders in a way that is relevant to each of them, and to achieve results aligned with business goals. Not only that, it allows you to discover which activities achieve the best outcomes so that you can continually improve effectiveness.

7-Step Self-Diagnosis

Simply answer these seven questions, and add up your score. Each question is worth up to 2 points. Find the closest response and score yourself accordingly. It’s entirely subjective and just for fun, so you can keep it to yourself or feel free to tweet me your score or comments (@EngagementStrat)!

1.

Who are the key stakeholders you want to engage? Patients, carers, healthcare professionals, government? Do you have a strategy in place to engage each of them online?

Award yourself between 0 and 2 points:
(2) I know all stakeholder groups and we have strategies for engaging each of them online.
(1) I know who our stakeholders are, and we connect with some of them online.
(0) I don’t know whether our stakeholders are online.

2.

Are your digital engagement activities and campaigns aligned with specific business goals? Are you able to measure the extent to which these goals are being achieved through digital activities?

Award yourself between 0 and 2 points:
(2): I understand our business goals; we have digital engagement strategies closely aligned with them. I am able to identify digital outcomes and their contribution to specific business goals.
(1): Our digital activities are designed in line with business goals, but I am unable to identify specific business goals that have been achieved through digital engagement.
(0): Our digital campaigns are not set up to demonstrate results against business goals.

3.

Is your digital engagement strategy an integral part of a broader business, communications or marketing strategy? Are you integrating digital engagement with your offline marketing or engagement activities such as advertising, sales, policy activities, clinical trials?

Award yourself between 0 and 2 points:
(2): Our digital engagement strategy is fully integrated with our business, marketing  or communications strategy. We plan for the online impact and opportunity with every offline activity and do not operate ‘digital strategy’ distinctly from non-digital engagement.
(1): Some planned integration exists between our online and offline engagement activities.
(0): We have a digital strategy that is completely distinct from our other engagement, marketing and communications strategies.

4.

Thinking about your key therapeutic areas, do you know what topics or words Internet users in your territories are searching for? And when they do, do you know what they find?

Award yourself between 0 and 2 points:
(2): We proactively analyse search activity and keywords around our key therapeutic areas, and I know what online resources we compete with for Internet users’ attention. We have a strategy to use search to connect with the right people at the right time.
(1): I know who are competitors are online, but we do not proactively analyse search behaviour or develop strategies based on search.
(0): I do not know what people search for around our key therapeutic areas or what they find when they do.

5.

If your digital engagement strategy includes a website, do you know how and why people find the site? Have you included clear goals you want visitors to achieve, and are you monitoring user journeys that achieve these goals?

Award yourself between 0 and 2 points:
(2): Our websites have clear outcome goals, we track user journeys and use this information to improve outcomes.
(1): I have access to key analytics data for our websites, but I am not able to align this data with tangible outcomes or goals from user journeys.
(0): We do not measure user journeys on our website.

6.

Is your approach to social media proactive or reactive – are you deliberately starting social media conversations, or listening and responding? Whichever approach you choose, do you have a plan in place to monitor and respond to social media events in a timely way?

Award yourself between 0 and 2 points:
(2): I know why we use social media; we engage in dialogue and we have an approved plan in place for managing conversations and outcomes. We are able to identify the results of social media engagement in terms of business goals.
(1): We use social media to connect with people, but we do not proactively listen to conversations outside our chosen channels of engagement.
(0): We use social media channels to make announcements; or we do not get involved with social media.

7.

Think about internal stakeholder engagement. Are your colleagues from legal and medical departments envisioned about your digital engagement strategy? Are you talking with company employees about social media and how to use it responsibly, in professional as well as personal capacity?

Award yourself between 0 and 2 points:
(2): Colleagues across all relevant departments understand the role of digital engagement in achieving our objectives, and we have a clear policy on social media engagement that colleagues understand and find helpful.
(1): We work with colleagues in different departments to plan proactively for social media engagement.
(0): We do what we have to, to gain approval from legal and medical colleagues before launching digital campaigns.

How did you score?

OK, add up your scores from the above and see which category you fit.

11-14: Olympian

Congratulations! You have pioneered, envisioned colleagues, and have a healthy approach to digital engagement. You understand that it’s a competitive environment, and you have measures in place to engage in a way that is continually relevant to stakeholders. You are achieving demonstrable business results, and you know exactly why.

You already know that in the world of digital, new platforms for engagement constantly emerge and user behaviour is unpredictable. When you need a partner who you can trust to give you independent advice about keeping your digital engagement strategy in top shape, contact Creation Healthcare. Like you, we care more about your outcomes than your digital agency.

6-10: On the mend

It’s likely that there are some areas where you are very strong. Your overall digital engagement health might be hindered by one or more areas of weakness. You probably know what needs to be done to change things for the better and you are close to having a digital strategy that delivers continually improving results.

By addressing those areas you know need work, you will move on towards Olympian level. At that point, your digital engagement activities will enable you to compete effectively online, achieving planned outcomes against business goals. To get you to that next stage, you might want to speak with an independent consultancy who can help you to make those improvements. Contact Creation Healthcare to discuss how we could help.

0-5: Gasping for breath

First, the good news: from the questions above you will probably have identified the areas you need to focus on to improve things. From a healthcare point of view, you are either in very poor health, or you are newborn – just starting out in digital engagement.

Look at the areas where you scored lowest, and select one or two to focus on. Don’t try to change everything at once. When you feel that you need extra help or advice, Creation Healthcare will guide you through the steps to healthy digital engagement. Contact Creation Healthcare at any time for a confidential discussion.

If you would like an ally in the ever-changing world of healthcare engagement, or a second opinion on your self-diagnosis, talk with Creation Healthcare.

On the day that we announce the winners of the Healthcare Engagement Strategy Awards 2010, we will be launching an international seminar program where you can learn from the very best healthcare engagement in the world.

The seminar program kicks off in San Francisco on 26 January 2010, followed by New York on 12 February. European dates follow, with  London on 15 April.

San Francisco

Hilton Union Square, San Francisco
26 January 2010

Reserve your place now, or download a brochure for Healthcare Engagement Strategy 2010, San Francisco.

New York

Hilton Times Square, New York
12 Fenruary 2010

Reserve your place now, or download a brochure for Healthcare Engagement Strategy 2010, New York.

London

Hilton Trafalgar Square
15 April 2010

Reserve your place now, or download a brochure for Healthcare Engagement Strategy 2010, London.

Come to London and save £150

The London event will be an extra special opportunity, following the day after we are running the SMi MasterClass in Social Media for Pharmaceutical Companies. If you’re booking both events, we’ll give you a booking code that will enable you to book the Healthcare Engagement Strategy 2010 seminar at a price discounted by £150. Contact us to find out more.

The Healthcare Engagement Strategy 2010 seminar program is just part of our international speaking and conference schedule for 2010. To find out when we’ll be in your area during the year, see our events schedule.

It’s new, it’s very shiny, and it could be yours when you nominate for the Healthcare Engagement Strategy Awards.

In January 2010, we’ll be announcing the best healthcare engagement activities from 2009, in the Healthcare Engagement Strategy Awards. We want to know who, or what, has made the biggest difference in healthcare by engaging people.

If you’re on Twitter, you can tell us who we should consider for recognition simply by tweeting a nomination using hashtag #hesawards and the word nominate. And when you do, we’ll thank you by entering you into a prize draw to win an iPod touch.

Who or what should I nominate?

Healthcare engagement is happening all around you – on websites; in social media applications like Facebook, Twitter, blogs, or Youtube; through mobile applications; and offline too of course.

Think about hospitals, physicians and healthcare professionals, communicators, healthcare companies, government initiatives, charities, whatever or whoever you think has made a positive difference to healthcare through engagement activities during 2009.

Nominate to enter the Prize Draw

To enter the Prize Draw, simply send a tweet containing the word nominate and hashtag #hesawards.

Your tweet may nominate an individual, campaign, organization or tool for recognition in the Healthcare Engagement Strategy Awards, or you might simply be spreading the word about the Awards and the Prize Draw.

So for example, your nomination tweet might look something like this:

I nominate X for #hesawards

Where X is your nomination. It might be a website, a campaign, a project or programme, a hospital or facility, a company or charity, a person – whatever or whoever you want to nominate for a Healthcare Engagement Strategy Award.

Even better, tell us in your tweet why you’re nominating them!

You can read more about how to nominate here.

Enter the Draw just by spreading the word!

Don’t know who or what to nominate yet? You can enter the Prize Draw right now just by mentioning the word nominate and #hesawards. So why not spread the word using any of the sample tweets below to link to this page?

#hesawards: Nominate or spread the word using Twitter and you could win an iPod touch http://bit.ly/61Yb7M

Nominate best healthcare engagement for #hesawards and you could win an iPod touch http://bit.ly/61Yb7M

When you nominate a healthcare campaign / strategy / person / organization for #hesawards you could win an iPod touch http://bit.ly/61Yb7M

Win an iPod touch when you nominate for #hesawards http://bit.ly/61Yb7M

More about the Healthcare Engagement Strategy Awards

You can find out more about the Healthcare Engagement Strategy Awards here. Or, try one of these links:

Announcing the Healthcare Engagement Strategy Awards

Momentum is building for the HES Awards

HES Awards: The International Judging Panel

How to nominate for the Healthcare Engagement Strategy Awards

HES Awards: Your questions answered

Prize Draw Terms

1. The Prize Draw is operated by Creation Interactive Limited, a company registered in England & Wales number 3543711.

2. Entries for the Prize Draw will be comprised of those Twitter users who have tweeted at least once before the Deadline with a valid tweet. Valid tweets must contain the word nominate and hashtag #hesawards.

3. The Deadline for Entries is Midnight, GMT, on 31-December-2009.

4. The Winner will be selected from Entries at random by computer, after the Deadline for nominations.

5. The Winner will be announced by Tweet sent from @EngagementStrat

6. The Prize is an iPod touch 8GB

7. The Winner must provide a name and shipping address for the Prize, within 4 weeks of notification. The Prize will be shipped to the Winner’s address.

8. Employees of Creation Interactive Limited, including Associate Consultants, and their direct family members, may nominate or spread the word but are not eligible to win the Prize.

As nominations for the best in healthcare engagement come in thick and fast, we’re being asked various questions about the Healthcare Engagement Strategy Awards.

Who’s eligible?

The completely open nature of the Awards means that they’re literally open to anybody or anything that is engaging with others, to achieve health outcomes. That might sound a little vague, but we’re expecting to discover some new things through this process.

This approach is based on Creation Interactive’s ‘Discovery’ methodology, which looks at healthcare engagement starting with a completely open mind in order to discover insights that shape effective strategies.

So far, we’ve received nominations for websites, people, healthcare and pharmaceutical companies, patient organizations, movements, Twitter users, and we’re sure there’s much more yet to come.

Who’s engaging whom?

We hoped that the Healthcare Engagement Strategy Awards would get even more people thinking about engagement in healthcare. And already, this is happening. In fact, we’re being asked about engagement – who is engaging whom?

This is exactly the kind of question we hoped you’d ask. There are so many players in the healthcare arena – healthcare professionals, regulators, pharmaceutical companies, medical equipment manufacturers, government, industry associations, patient advocacy groups… and, of course, consumers, carers, and patients!

Now here’s our thinking: successful healthcare engagement should ultimately improve the health or lives of ordinary people – patients, carers, and/or consumers. Of course, to achieve that goal requires many components of communication and engagement. So for example we might see nominations for strategies around clinical trial recruitment, public health awareness, healthcare professional knowledge sharing, patient communities, or effective healthcare product communications. That’s just the tip of the iceberg though – we really don’t want to constrain your imagination when it comes to nominations.

Ultimately, I’ll come back to the basics: Where do you see successful engagement between parties in healthcare, that is achieving positive health outcomes? Nominate that now!

Is there a list of nominees?

Nominees are coming in literally by the minute, and we’re expecting that to continue right until nominations officially close at midnight on 31 December 2009. That’s one reason why we decided not to publish a list of nominations.

The other reason comes back to the open nature of the Awards. We want you to keep an entirely open mind when you nominate – not to be constrained by existing nominations.

However, we’ve had a fair few questions about who’s been nominated so I have mentioned a few by tweet, to get you thinking. Just search Twitter for #hesawards.

What if I nominate something or someone that’s already been nominated?

We’re really happy to receive duplicate nominations– in fact, receiving multiple nominations for the same activity, person or strategy will tell us something about its reach and influence.

Note that multiple nominations will not count as ‘votes’ as such, but we do encourage you to show your support for existing nominations. See ‘How to nominate for Healthcare Engagement Strategy Awards‘ for more details.

What categories can I nominate for?

You might already have guessed that the open, ‘Discovery’ nature of the Awards nomination process means we decided not to restrict you to specific categories.

In my view, this approach should be obvious really, and I wish more Awards were judged on an open basis like this. But it requires a whole new way of thinking.

In the ever-evolving, always-discovering world in which we live, I believe we must keep an open mind if we are to learn new things quickly.

It’s a way of thinking that is already natural to some elements of the healthcare industry – in my first interview with Johnson & Johnson’s Marc Monseau about the JNJBTW blog, he spoke about the way the blog’s audience was defining itself:

“After doing this for a year, one of my biggest surprises was that the people who read the blog are not who I originally thought they would be — they are not just members of the media or healthcare bloggers — but include doctors, nurses, employees, competitors, retirees, supporters of J&J and detractors. It’s that the audience — and this is important — the audience is defining itself — which is different from how we’ve looked at the world in the past.”

How do I nominate?

To nominate for an Award, simply tweet @EngagementStrat, include hashtag #hesawards in your tweet, and tell us what or who we should be considering.

For more ideas about nominating by tweet, see ‘How to nominate for Healthcare Engagement Strategy Awards‘.

How many nominations can I make?

Nominations are unlimited – you may nominate as many entries as you would like to.

Can I support an existing nomination?

Yes, we encourage you to do so. See see ‘How to nominate for Healthcare Engagement Strategy Awards‘ for more information.

Is there an entry fee?

No, there’s no entry fee! It’s completely free to nominate entries – just send a tweet (see ‘How to nominate for Healthcare Engagement Strategy Awards‘ for more information on how).

This means you really can nominate any piece of successful healthcare engagement, right now. We want to hear from as many people as possible – so far we’ve heard from industry insiders, PR companies, agencies, professionals, and patients. Keep those nominations coming!

When and how will Award Winners be announced?

The winners of Healthcare Engagement Strategy Awards will be announced first in January’s edition of Healthcare Engagement Strategy e-journal which will be published and distributed on Tuesday, 26 January 2010. Results will not be released via Twitter until after the e-journal has been published.

To make sure you’re first to hear the results, subscribe to the e-journal for free at http://engagementstrategy.com.

Who will be selecting the winners?

We’ve put together an international Healthcare Engagement Strategy Awards judging panel, selected from Creation Interactive’s team members in Australia, Mexico, Spain, the UK and the USA.

Find out more about the International Judging Panel.

Where can I find out more about the Healthcare Engagement Strategy Awards?

We’ve written a few articles that will tell you more about the awards. Try these for further reading:

Announcing the Healthcare Engagement Strategy Awards

Momentum is building for the HES Awards

HES Awards: The International Judging Panel

How to nominate for the Healthcare Engagement Strategy Awards

Or, to see the latest tweets around the hashtag #hesawards, check What the Hashtag or search Twitter for #hesawards. And join in the conversation!

More questions?

Go ahead and ask! Tweet me @EngagementStrat or email me.

Finally, thanks for your support. And don’t forget to keep nominations coming in by tweeting @EngagementStrat with #hesawards.

When we announced the Healthcare Engagement Strategy Awards a few weeks ago, we hoped that we would start a conversation about where the really effective engagement is happening in healthcare.

We’ve been discussing effective engagement in healthcare all year through our Healthcare Engagement Strategy e-journal, but now we wanted to hear more about your ideas. Where have you seen the best outcomes from healthcare engagement during 2009?

And you certainly have been sharing your views! We’re excited to see nominations coming in thick and fast, and with them, some real encouragement from healthcare companies and communications experts.

So, thanks for your encouraging Tweets, your nominations, and for spreading the word. Together, we can help celebrate the achievement of real health results through engagement.

A different sort of Award

We hoped that the Healthcare Engagement Strategy Awards would mark a different approach to recognising effective engagement. We wanted to create something entirely open.

So, no predefined categories to constrain nominations, no awards entry fee, in fact not even a formal awards ceremony to speak of. We wanted nominations from people who have experienced the benefits of a healthcare campaign, or who have actively engaged on health issues.

Nominations keep coming!

We wanted to encourage the international healthcare community to get involved in nominations – and you certainly have! Nominations have come in thick and fast via open Tweets and Direct Messages, and by email.

Find out more

And with the dialogue, you’ve told us you want to know more about the Awards. So I’ve published a few additional resources that will hopefully inspire you to get involved and nominate entries.

You can find out more here:

Announcing the Healthcare Engagement Strategy Awards

Healthcare Engagement Strategy Awards: Your Questions Answered

HES Awards: The International Judging Panel

How to nominate for the Healthcare Engagement Strategy Awards

Keep up your support: you’re making a difference!

Every time you tweet with #hesawards, you continue to encourage innovation and a focus on real outcomes from engagement in healthcare.

So don’t forget to keep spreading the word to help us uncover the most effective healthcare engagement in 2009. Nominate (another) entry by tweet with #hesawards, or simply spread the word by tweeting this, or a variation:

Nominate strategies, campaigns & people for Healthcare Engagement Strategy Awards: Tweet @EngagementStrat with tag #hesawards

The Healthcare Engagement Strategy Awards judging panel is made up of selected members of Creation Interactive’s international team from around the world, with specialist experience in healthcare and digital engagement.

Alan Bowden, Australia

Alan Bowden studied in Cardiff and London, UK, and has since had an extensive international career in healthcare marketing and communications. His international work has included coaching global industry teams based in Asia, and customer research in the biotechnology industry in the USA, UK, and internationally. Based in Australia, Alan is a member of Creation Interactive’s Associate Consultant team.

Daniel Ghinn, United Kingdom (Chair of the Panel)

Daniel Ghinn co-founded Creation Interactive, the engagement strategy consultancy in 1998. Today he is the consultancy’s Director of Digital Engagement, Healthcare & Government, and editor of Healthcare Engagement Strategy e-journal, which is read by business leaders and communicators in the world’s leading healthcare organizations.

Pedro González, Spain

A qualified physician, Pedro’s extensive career in healthcare has spanned both agency and client-side roles in Marketing and Corporate Communications. With past roles in Pfizer and Aventis, Pedro is no stranger to healthcare engagement strategies. Based in Madrid, Spain, he is a member of Creation Interactive’s international Associate Consultant team and is currently working on international engagement projects for a major pharmaceutical client.

Paul Grant, United Kingdom

Prior to joining Creation Interactive in the UK in 2006, Paul Grant worked in the Australian and Pacific Rim region with global healthcare brands including GlaxoSmithKline, Merck Sharp & Dohme, and Boots Healthcare. Today, Paul is Creation Interactive’s Head of Strategy Implementation and is responsible for the deployment of successful engagement strategies in healthcare and government.

Nancy Lugassy, United States

Nancy Lugassy has an extensive track record in government and private sector digital engagement campaigns. Her experience in the healthcare industry includes health and wellness initiatives and consumer research whilst working with Nitro, SS+K and Grey World Wide in New York. Today, Nancy is a member of Creation Interactive’s Associate Consultant team based in the United States.

Verónica Tapia, Mexico

Verónica Tapia’s most recent role prior to joining Creation Interactive’s Associate Consultant team was as Innovation Manager with AstraZeneca in the UK, where she led a pilot and subsequent roll-out of an online engagement resource for healthcare professionals. She will be judging the Healthcare Engagement Strategy Awards from her family home in Mexico before travelling back to the UK in the New Year.

I’ve already described how the unique nature of the Healthcare Engagement Strategy Awards means there are no predefined categories, no entry fee, and no long-winded nominations. In fact, we’re primarily encouraging nominations by Tweet.

At its simplest, tweet @EngagementStrat and mention #hesawards

So, how should you make an effective nomination? As with many aspects of the Awards, the answer to this is something that’s becoming clear as we take this journey together and nominations come in. A simple nomination might look like this:

@EngagementStrat I nominate [A] for #hesawards

…where [A] is someone or something that deserves recognition – such as an organization, or a Twitter user, a strategy, a campaign name, or a web address.

Or, why not help us out by telling us why?

@EngagementStrat I nominate [A] for #hesawards because [B]

…where [B] is all the reasons why (or as much as you can fit into the remaining characters in your tweet!)

Feel free to tweet more than once, if you would like to tell us more. Tweet about results, impact on patients, and strategies. So for example you might tweet like this:

#hesawards [A] achieved [C]

Where [C] is the outcome or results of engagement.

We’re also seeing people add their support or comments to nomination tweets. A supporting tweet might look like this:

I agree, because [D] RT @… I nominate [A] for #hesawards because [B]

…where [D] is your additional reason why.

We don’t mind at all if you tweet a nomination that’s already on our radar. Multiple nominations and mentions won’t count as votes as such, but your tweets will help us to build a picture of the nomination and its influence, reach, and effectiveness.

Finally, I should say that you don’t have to mention @EngagementStrat in your tweet, but you must include hashtag #hesawards.

And don’t forget to keep spreading the word to help us uncover the most effective healthcare engagement in 2009. Simply tweet this, or a variation:

Nominate strategies, campaigns & people for Healthcare Engagement Strategy Awards: Tweet @EngagementStrat with tag #hesawards

Last week, 12-13 November 2009, saw the FDA’s ‘Public Hearing on Promotion of FDA-Regulated Medical Products using the Internet and Social Media Tools’. This was the long-awaited opportunity that pharmaceutical marketers worldwide had been waiting for, to engage in dialogue with the FDA about how the Internet has changed medical marketing.

The FDA public hearing in Washington DC

The last time the FDA held a hearing of this nature was in 1996, and with the rate of change in the way that the Internet is used, it was clearly about time that the pharmaceutical industry and the FDA has some constructive dialogue.

Not that the hearing included much dialogue. Packed with 69 presentations over two days, the FDA panel’s comments and questions were kept to a minimum. TheFDA’s formal response is expected to come next year.

v-Fluence’s Shea Johnson argues that investigating potential adverse events is a drain on time and resources

Earlier this year, we reported on the FDA’s warning letters about Google advertising to fourteen pharmaceutical companies and analysed the impact of regulation online. This action by the FDA signalled the start of things were changing in the FDA’s approach to the Internet and sparked a call for greater clarity about how pharmaceutical companies should market themselves online. According to both Google and Yahoo! at last week’s hearing, the effectiveness of pharmaceutical keyword advertising in the USA immediately dropped after the FDA warning letters as companies felt unable to provide enough information to encourage consumers to click through.

But the big issue wasn’t simply about reducing advertising effectiveness. Pharmaceutical marketers wanted to know what they could or could not do within the boundaries of regulation. The primary concern was that the boundaries were unclear.

A US-only impact?

Now, if you are a pharmaceutical marketer outside the USA, under a different regulatory regime, you might wonder what all this has to do with you. After all, the vast majority of the rest of the world does not operate a direct to consumer (DTC) model like the USA does, so many of the pharmaceutical social media campaigns that we’ve previously covered might seem irrelevant to you.

But the important lessons so far about the FDA hearing are not really about the specifics of FDA regulation or the DTC model for marketing medicines.

After all, the primary concerns amongst pharmaceutical companies about regulatory requirements, as cited by Johnson & Johnson’s Marc Monseau in a blog post about the hearing, are around the requirement to report any side effects that people may experience whilst taking medicines (a form of ‘adverse event’), and to ensurethat they do not promote their products beyond what is covered in their approved product label (promoting ‘off-label use’). Now, if you are outside of the USA, aren’t these amongst the primary regulatory issues that affect your online marketing too?

The Internet knows no boundaries

Of course, unlike regulators the world over, the Internet rarely discriminates on the basis of geographic boundaries. So if you are outside of the USA, what the FDA allow or do not will affect health consumers in your territory too. For example, whilst you might operate in a non-DTC environment where you cannot market your medicines to patents, those same patients in your territory may be engaging with your US-based colleagues’ social media marketing campaigns and discussing medicines.

And if you think that’s a bad thing, consider the alternatives: if an Internet user searches for one of your medicines and does not find a legitimate product website anywhere in the world, what do they find? In many cases, unapproved pharmacies offering to sell potentially fake medicines without prescription to unsuspecting patients (and that’s another story altogether).

One of the biggest difficulties in establishing clear regulatory guidance is in making sure that regulators understand or are advised on the technicalities of the Internet and social media. Unless regulators understand, for example, that in online encyclopedia Wikipedia, any member of the public can edit an entry, how can they decide who should be held responsible for its content?

It was clear that all speakers over the two-day FDA hearing understood the need for regulator education, for the vast majority of time was spent elaborating on how important the Internet is for healthcare and on how social networks work. This resulted in much repetition but I would imagine that most members of the FDA panel left the hearing with at least a better understanding of social media.

Clear guidance is needed

The big challenge for the pharmaceutical industry worldwide is uncertainty about how it could and should interact using the Internet and social media. This issue was raised by many of the speakers at the hearing, including Eli Lilly’s Michele Sharp, who asked the FDA to take into account the unintended consequences of either providing no further guidance to the pharmaceutical industry or of imposing too many restrictions. Either approach, she said, would keep the industry silenced on the sidelines.

Sharp said that to date, Lilly has avoided significant interaction with healthcare professionals and patients about products in social media forums, largely because of lack of clarity in understanding the FDA’s expectations as to how Lilly could participate and comply with FDA requirements.

Accountability must rest with content creators

Not surprisingly, speakers widely agreed that creators and publishers of information should be held accountable for the information that they create, control or promote including sponsored content. More importantly, it was widely felt that companies cannot be held accountable for information that they do not have editorial control over.

Safety information

In print advertising of medicines, much space is taken up in displaying important safety information required by regulation. This is one of the challenges faced in online advertising and one of the issues picked up in the FDA’s warning letters earlier in the year.

Various solutions to this were proposed, including suggestions that providing safety information just one click away should be allowed. There was, and no doubt will be for some time, much discussion about the pros and cons of this suggestion.

A new keyword ad format?

Not a company to miss a commercial opportunity, Google presented their proposal for a new ad format which it hoped would allow pharmaceutical marketers to advertise within FDA regulations.

Other ideas from presenters included FDA-approved Twitter hashtags, an FDA-approved logo, rich media advertising to allow lengthy information to be displayed in small spaces, processes for determining accountability, and a plea for a simple set of ‘can-or-cannot do’ rules.

Will anything change?

So after two days of talking, what is likely to change? The hearing may have helped the FDA gain a better understanding of the confusion pharmaceutical marketers are faced with regarding regulation and the Internet, but I have a feeling they knew something about this already.

One thing is almost certain: by the time the FDA make any ruling following the hearing, new platforms will have emerged that raise new questions and uncertainties – and of course, opportunities! Will the FDA be able to regulate in such a way as to cover any unforeseen platforms and digital media channels? I hope so, but I doubt it.

So what’s the big lesson? That nothing has changed. We’ve recently published interviews from pharmaceutical company social media communicators – Johnson & Johnson’s Marc Monseau on Twitter and Pfizer’s Bengt Mattson on his Swedish blog Ansvarsblogg – and both said that the platforms have not changed the basic rules of communication.

Untapped opportunities

In my experience, there are still huge untapped opportunities for those pharmaceutical marketers around the world who will carefully take measured steps in social media and the Internet. Yet the constraints of regulation are too often used by some as an excuse for poor engagement strategies.

Whatever changes or clarification emerge from the FDA or any other regulators worldwide, one thing is certain: regulators will not tell you how to do your pharmaceutical marketing effectively. I recommend that you continue to innovate, taking well planned, strategic steps to engage stakeholders. And speak with healthcare engagement experts at Creation Interactive about how our Discovery Methodology can help you achieve success in what is destined to remain a highly regulated healthcare marketing environment.