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.

The Global Fund to Fight AIDS, Tuberculosis and Malaria describes Born HIV Free as one of the most ambitious campaigns of its kind. Its aim, to mobilize public support for the work of the Global Fund and for a world where no child is born with HIV by 2015, is huge.

The Global Fund manages funding of US$ 19.3 billion for more than 572 programs to fight AIDS, Tuberculosis and Malaria in 144 countries. Endorsed by governments and individuals as diverse as Ban Ki-moon, Bill Gates and Bono, the Global Fund is currently saving 3,500 lives every day and 1.3 million lives every year.

Founded in 2002, backed by the United Nations after a call from Kofi Annan for the creation of a global fund, the organisation is unlike others in the United Nations family. When I met John Busch, Manager Online Communications at the Global Fund’s headquarters in Geneva, he told me that the organisation had a vision to use the web from the start.

And it shows: with a total staff of 600 people, The Global Fund employs a team of nine people dedicated to online communications. That’s 1.5% of the entire organisation. So when the organisation says this is one of the most ambitious campaigns of its kind, it’s no wonder that digital engagement is embedded deep into the strategy.

Integrating channels

It’s not all about digital. With films produced by Oscar-winning creative team H5 and featuring music by Amy Winehouse; a special video by actor and director Vincent Pèrez featuring Carla Bruni-Sarkozy; collector’s items produced by Tiffany & Co. and Jean-Paul Gaultier; a live concert by Paul McCartney in London’s in Hyde Park; and events around the world, the campaign is well resourced with assets around which to build engagement.

The campaign’s goal is for people to show support for their country’s contribution to the Global Fund by signing up on the campaign website. It’s important, because The Global Fund relies primarily on public funding, so it is not asking individuals to donate money. And in October this year, UN Secretary-General Ban Ki-moon will chair a meeting of donor countries in New York where they will pledge financial support to The Global Fund for the next three years.

The Born HIV Free website features a call to sign up in support

Engagement with the campaign takes place across all major social media platforms: Twitter, supported by Twibbon; Facebook; and a dedicated Youtube channel which has received over 13.5 million views to date.

Spreading the word

To encourage sharing on social media and internet platforms, the website makes available downloadable spreadkits of campaign material: logos, banners, photos, videos and facts. Meanwhile, each social media platform utilised includes plenty of opportunities to share and link with other channels. Over 31,000 Facebook users have ‘liked’ the Youtube Channel.

Born HIV Free Youtube Channel

With so many places to connect with the campaign, it would be possible that some Internet users might not make it back to the campaign website to sign up in support. To ensure that opportunities for support are not missed, a separate sign-up mechanism is included on the Youtube channel, whilst a Facebook Cause has already captured over 47,000 sign-ups directly from Facebook.

Multi-language engagement

The campaign’s reach is also strengthened by its use of multiple languages – the website is available in English, French, German, Spanish and Italian; as is the Youtube channel which switches instantly between languages. Language-specific Facebook pages add thousands of followers in Spanish and French, and even the campaign spreadkit includes logos and banners in five languages.

This is a great example of a strategy that builds on a compelling cause with powerful creative assets both offline and online, doing so in a highly effective way through the integration of complimentary digital channels that truly engage and direct users to clear, measurable calls to action.

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

As part of a strategy to increase global capacity, Creation Healthcare is pleased to announce a new location for its London office.  From 1^st August 2010, the company will be moving to improved premises with greater capacity.  The new address will be:

Creation Healthcare
90 Long Acre
London  WC2E 9RZ

Telephone: +44 (0)207 849 3167

This move follows the recent opening of a new office in Tokyo, as part of Creation Healthcare’s commitment to continually support clients located around the world with the expertise they need in local markets.

With a global team of 30 consultants located in 12 countries, Creation Healthcare is ideally placed to advise international clients about healthcare engagement strategies with the benefit of local cultural and language insights.

Creation Healthcare’s Co-founder and Director of Digital Engagement, Daniel Ghinn, explains why London is so important for a global consultancy:

“We’ve been in London for over twelve years now, and having travelled all around the world working with healthcare clients, I’m convinced that this City is the best place in the world to run a global consultancy from. With easy access to North America and Europe, we’re also well placed to connect with Asia, supported by our new Tokyo office.”

Some of those to whom I’ve said many times before that Creation Healthcare doesn’t do industry awards, might be surprised to learn that together with Pfizer we have just been awarded ‘highly commended’ at the Communiqué Awards 2010 for our digital strategy to change online behaviour in Real Danger, Pfizer’s campaign to tackle counterfeit medicines sold online from illegal websites.

Being awarded ‘highly commended’ by the Communiqué judges for this award was very special and the whole team at Creation Healthcare is proud that the digital strategy has been recognised.

But before you start to wonder if I’ve sold my soul and forgotten all those things I’ve said in the past about industry awards, let me explain: my frequently-voiced ramblings about awards like these have been on the basis that whilst much excellent work is often recognised, it is usually for what I believe are the wrong reasons. Great creative ideas, innovation, fantastic production, and even a campaign’s reach are all very admirable (and have been consistently highly awarded) but too often we find ourselves asking “so what?”

When Creation Healthcare is planning strategies with clients and their agencies we frequently find ourselves asking what can be uncomfortable questions about outcomes. To us, healthcare engagement is nothing without tangible, measured results against clear goals. Opportunities to view, website visits, social media reach and such measures are all well and good but we want to know – and we help our clients to discover – the actual impact of a campaign or strategy against goals that make a difference.

For Pfizer’s Real Danger campaign, the end goal was about changing the behaviour of consumers online. Knowing that consumers had been engaged at their point of risk, re-envisioned, and that they had taken tangible steps reflecting behaviour change as a result. In the end, up to 85% of people polled on the campaign website said that they would change the way they buy medicine online. Up to a quarter of visitors engaged further with campaign partners and accessed resources to help them change their behaviour.

Pfizer’s Real Danger campaign has been well awarded in many areas but I’m excited to see it gain recognition for these tangible outcomes online. It takes real guts and vision for a pharmaceutical company to put a digital engagement strategy at the heart of a campaign, and all credit is due to the Pfizer communications team for making it happen. The results speak for themselves… and the ‘highly commended’ is an added bonus!

“This house believes patient care will be enhanced through pharma’s involvement in social media“. So read the title of the debate I was invited to take part in at the PIPA Annual Conference 2010 on 5th July.

I was especially excited to take part in this debate, not only because of the opportunity to participate alongside an excellent panel of experts on the subjects of pharmaceutical companies, social media and regulatory affairs – Andrew Spong, Klynn Alibocus, and Sam Temple-Scotton. Even more so because the debate was hosted by PIPA, the Pharmaceutical Information and Pharmacovigilance Association.

In their own words, ‘PIPA is the professional organisation for individuals who are involved in the provision and management of information and those involved in the fulfillment of regulatory requirements relating to drug safety‘. In other words, the debate was hosted by regulatory, medical information and pharmacovigilence professionals. The fact that such an organisation placed this important topic on its Annual Conference agenda is an indicator that the questions being asked by pharma about how to engage through emerging two-way channels such as social media are being taken seriously.

At Creation Healthcare, one of the most enjoyable, if sometimes challenging aspects of our work is when we get to bring together internal stakeholders from across a pharmaceutical company – communicators, marketers, legal and medical colleagues, to develop healthcare engagement strategies embracing emerging channels. And from my experiences of this I know that amongst visionary pharmaceutical companies it is possible for these colleagues to strategise proactively together to achieve real health outcomes through innovative use of social media and other emerging channels.

Sarah Dunnett, Senior Medical Affairs Manager at Baxter Healthcare and PIPA President, chaired the debate and asked for a pre-debate vote. 42 conference delegates agreed with the motion (albeit some with caveats) whilst 21 disagreed, to at least some extent.

Not one to miss the opportunity to encourage healthy discussion about healthcare and social media, Andrew Spong kicked off the debate, playing devil’s advocate as he argued against the motion and highlighted some favourite objections including adverse event reports.

I followed with a brief outline of seven examples of pharma’s involvement in social media, outlining how each example demonstrated the potential for enhancing patient care. I included some of my favourite examples such as Johnson & Johnson’s Health Channel on Youtube, UCB’s partnership with PatientsLikeMe, Boehringer Ingelheim’s sponsorship of a Tudiabetes video, and AstraZeneca’s engagement with healthcare professionals through doctors.net.uk.

Sam Temple-Scotton then supported the case against the motion and pointed out that pharma is struggling to keep up with the level of change in digital channels.

Finally Klynn Alibocus made some excellent points about the breadth of ways in which pharmaceutical companies can enhance patient care through social media, drawing the debate away from marketing to consider other areas including clinical trials recruitment.

In the discussion that followed between the panel and PIPA delegates, some key issues were debated including trust, transparency, responsibility, stakeholder partnerships, business process change, and resourcing. Many of the most challenging issues were raised and debated. From my perspective, there was general agreement about points including:

• Pharma is generally mistrusted and this makes social media engagement difficult; but social media might play a role in enhancing trust through transparency
• Given the amount of discussion taking place by patients using social media about health issues, pharma has a responsibility to get involved
• Regulatory constraints make it difficult, but not impossible, to plan proactive engagement
• Avoiding adverse events reports by not listening to social media conversations is not the answer
• Successful social media engagement may require changes to the way pharma operates

Finally, a post-debate vote revealed the extent to which we had convinced PIPA delegates: after all the discussion, just 39 delegates agreed to any extent with the motion – a reduction of 3 – whilst 23 disagreed. On the face of it, it appeared we had done more to convince pharmacovigilence colleagues not to support pharma’s role in social media! But all in all I believe the debate was healthy, timely and relevant and I hope will encourage some of the PIPA delegates to take a proactive approach to working through some of the challenges with colleagues in their businesses. I am still reassured that 63% of pharmacovigilence professionals believe pharma’s role in social media will enhance patient care.

I understand that a more comprehensive report on the debate will be published in PIPA’s journal, PIPELINE. In the mean time, feel free to tweet me with your comments at @EngagementStrat.

Creation Healthcare, the global healthcare engagement consultancy, will open an office in Tokyo dedicated to serving healthcare companies in Asia on 1st July 2010.

The launch of the Tokyo office is part of Creation Healthcare’s strategy to continually improve its provision of global strategy with local insights and implementation.

Creation Healthcare’s consultancy activity in Japan will be led by Chris Earnshaw, Ph.D. Chris has lived and worked in Japan for 35 years and has spent much of that time consulting to major pharmaceutical companies on product positioning, branding, and regulatory compliance in the Japanese healthcare market.

Daniel Ghinn, Creation Healthcare’s Global Director of Digital Engagement, said:

“Our new Tokyo office provides a local presence from which to lead our work with pharmaceutical and healthcare organizations in Asia.

”

With thirty consultants based around the world, Creation Healthcare’s Asia office makes it the best placed consultancy for worldwide and Asian pharmaceutical and healthcare organizations who want to improve the effectiveness of their communications, marketing and digital engagement activities.

“Creation Healthcare in Tokyo will not only support clients in Japan and Asia, but will also improve the effectiveness of our international strategy development for global clients in Europe, the United States and the rest of the world.”

Creation Healthcare’s Tokyo office is located at:

Creation Healthcare
Shinjuku Park Tower 30th Floor
3-7-1 Nishi-Shinjuku
Shinjuku-ku
Tokyo
163-1030
Japan

Telephone: +81-3-5326-3000
Email: tokyo@creationhealthcare.com

Creation Healthcare’s global headquarters in London can be found at:

Creation Healthcare
53 Chandos Place
London
WC2N 4HS
United Kingdom

Telephone: +44 (0)207 812 6474
Email: london@creationhealthcare.com

If you live or work in Japan, or have visited the country, you will know it is a nation of contrasts. This is as true when it comes to online healthcare communication as anywhere else.

On the one hand, much of Japan’s healthcare communication is highly conservative. Yet in the midst of this, some Japanese pharmaceutical companies are becoming world leaders in developing patient-focused corporate websites.

Whilst the corporate websites of many pharmaceutical companies outside of Japan are primarily focused on content for investors and media, Eisai Co, Japan’s fifth-largest pharmaceutical company, has developed a highly consumer-centric website. In a regulated environment, direct-to-consumer marketing by pharmaceutical companies can be a sensitive subject, but for Hiroshi Kaihatsu, Manager, Business Strategy & Planning at Eisai, focusing on the consumer was essential.

“We must use the right words and terminology for consumers”, said Mr Kaihatsu at Marketing Excellence Japan 2010 last month. “This is not the same language we use for physicians.”

For Mr Kaihatsu and his team, the key to this was the development of an imaginary ‘persona’ around whom the website could be built. Following an extensive consumer research process, the persona was defined as an ‘ordinary’ lady; a healthy mother, the key family influencer. Her father has senile dementia; her mother has osteoporosis. She is fashionable, teaches flower arranging, and is 46 years old.

Eisai’s research process explored the magazines the persona reads, and the way she uses the Internet. Consumer interviews revealed that she checks the Internet for health information, although she is not a specialist in medical terminology. She likes to use the Internet to find out things she wants to know. Her favourite search engine, according to Eisai’s Japanese consumer research, is Yahoo!.

Eisai’s consumer persona features prominently on the website home page

The result of Eisai’s persona development is http://eisai.jp, featuring images of the persona around whom the website has been designed and a unique ‘Wellness Finder’ which was inspired by Amazon to direct consumers to relevant content based on their website activity.

Whilst the whole website experience has been designed with the consumer in mind, the home page’s Wellness Finder is a particularly innovative health information tool using consumer-centric language. On first appearing, the tool suggests a range of health-related terms such as ‘pain’, ‘stomach’, ‘pain’, ‘shoulder’, ‘fatigue’ or ‘osteoporosis’.

Eisai’s unique Wellness Finder tool

When a consumer clicks on a term, a series of related words is displayed. So for example, clicking on a term such as ‘pain’ updates the Wellness Finder to show words that will help narrow down a search for information, such as ‘neck’, ‘throat’, ‘stomach’. A further click on ‘stomach’ narrows down suggestions further and offers terms including ‘nausea’.

The Wellness Finder constructs relevant search terms through a simple process

With each click, the selected search term is added to a search query to return relevant information from the Eisai website.

Placing the Wellness Finder health information tool at the centre of user functionality has resulted in a website that is able to provide relevant health information to consumers easily and intuitively.

Eisai’s Wellness Finder’s provides relevant content based on simple user selections

What can others learn from Eisai’s website and Mr Kaihatsu’s experience? Getting the right information in a relevant way to consumers is a challenge that many pharmaceutical companies have yet to overcome. For Eisai, there was certainly a lot of work to achieve the new consumer-focused website. The work of mining and indexing the extensive content using specialist tools, and planning and designing the user experience around the persona, were only possible because of a culture that focuses on serving the consumer. As Mr Kaihatsu put it when describing Eisai’s 365-days-a-year call centre operation:

“Our call centre operates 365 days a year. Why? Because our patients don’t have a holiday from being a patient.”

Whilst Eisai’s corporate website does not cater for every health stakeholder – it is in fact just one of thirty websites operated by Eisai in Japan, including a search-based clinical website for doctors – its place at http://eisai.jp reflects the value placed by Eisai on putting the patient at the heart of its online communications.

If you would like to develop a strategy for engaging consumers in a relevant way about health matters, Creation Healthcare can help. Contact us in Tokyo or London to find out how.

In recent years, the world has witnessed the emergence of China as an economic driving force. At the same time, the emergence of social media has dramatically changed the way people use the Internet worldwide. How about social media in China? Do Chinese people use social media as much as anywhere else in the world? Since Facebook, YouTube, Twitter and many other services are banned in China, what are their local counterparts? This article provides a snapshot of the current social media landscape in China.

Since it has been made available to the Chinese population, the Internet is not only used as an information tool but also as a powerful communication tool allowing netizens to easily interact between each other. Nowadays, although the Internet penetration rate in China was only 28.7% at the end of 2009 (source: China Internet Network Information Center), this percentage represents around 384 million Internet users, 90% of them benefiting from broadband access and 30% accessing the web from their mobile devices.

Taking a closer look at the most visited websites in China (via the Google Adplanner 1000 most-visited sites on the web list), we notice that web portals like Sina, Sohu or QQ rank among the favourite sites. Dominating the local Internet market, Chinese portals offer a wide array of social media services, from forums, instant messaging, blogging, photo and video sharing, to free email addresses and comprehensive social networks.

BBS – Forums

One of the most popular forms of social media in China, BBS (Bulletin Board System, or online forums) is also the oldest as it was launched in 1994. We can find it either integrated within classic websites or portals (Comsenz being the biggest China BBS software provider), or on dedicated websites such as Tianya. Differing from classic social networks where browsing content often requires logging in, BBS is a popular destination for Internet users to browse free content, and to engage in conversations anonymously. Used by 30% and more of Chinese Internet users every day, BBS can be considered as the living heart of social media in China offering great snapshot of the vox populi, despite frequent abusive use of it.

Blogging

Another popular form of social media used in China is blogging. From a Western perspective it may be interesting to learn that Chinese people do like sharing their ideas and feelings online. Thanks to local web portals offering easy-to-use blogging features, at the end of 2009, an impressive 57.7% of Internet users had a blog or micro blog and two thirds of them have updated it at least once in the last 6 months. Increasingly used by companies, celebrities or organizations, blogging will also benefit from the functions of micro blogging such as instant messaging or mobile phone texting. For traditional and micro blogging services, Sina controls most of the market (featuring many celebrities and high profiles) hosting both the most important blogging service in China through its dedicated portal and the most important local Twitter competitor, Weibo.

Instant Messaging

As a strong online habit of Chinese Internet users and accepted in many local companies for employees, instant messaging (IM) is also one of the first widely used social media services in China. In fact, 52% of China’s Internet users go online to use instant messaging. Microsoft is the most successful provider, as 93% of Chinese people using IM services have a Windows Live Messenger (MSN) account. The Chinese counterpart to MSN is powered by Shenzhen-based company Tencent and named QQ (a name derived from the main competitor at the time – ICQ). Launched early in 1999, the company went public in 2004 and serves (figures vary according to different sources) around 80% of those who use IM in China.

More importantly, QQ defined and is still defining a whole part of China’s Internet culture, inspiring a new form of language quickly adopted by younger generations. Internationally, Tencent launched QQ versions in different languages like English, French and Japanese.  Except in South Africa where the service met a brief local success in the mid 2000’s, QQ is mainly used outside the country by Chinese expatriates, students or members of Chinese communities to communicate with their friends and relatives back home.

SNS – Social Networks System

With an estimated 124 million users at the end of 2009 (source: China Internet Watch), Social Networks System is playing an increasingly important role in social media in China. Although most users choose a social network according to the number of their known friends, colleagues or classmates, the main purpose for joining such networks is entertainment. Among the top social networking sites, Tencent (QQ) Qzone ranks first, with 388 million registered users. Formerly known as Xiaonei, Renren defines itself as the largest online community website among universities and copying the Facebook model (opening from students to all) now counts an estimated 120 million members. Focusing on young professionals, Kaixin001 has seen a rapid growth thanks its popular gaming platform and now claims around 75 million users. And among the many other networks existing on the Chinese market, Wealink is an interesting LinkedIn counterpart, becoming popular among white collar individuals.

Video

Watching videos is one of the favorite activities of Chinese Internet users. 90% of them admit actively watching videos online and 58% having already uploaded content (source: Universal McCann wave4). User-generated content accounts for 30% of videos posted on these websites. The recent ban of YouTube (March 2009) did not have much impact as local websites like Tudou, Youku or Ku6 already have strong audiences. Moreover, these websites are teaming up to develop common technology standards. Some of them have been granted the broadcasting rights for the FIFA 2010 World Cup, and they are now considered as fully integrated TV networks. In the near future, video will certainly play a more important part in social media strategies in China as it is easily embeddable within social networks and benefits from an attentive and avid audience.

Conclusion

Whilst this article provides a brief introduction to social media channels in China, there are some specific online platforms in China that would deserve further study including online gaming, wiki (such as Hudong, as Wikipedia is blocked in China), search marketing (Baidu benefiting from Google’s withdrawal), rating websites ( such as Dianping), photo sharing, and online music.

Understanding the unique way in which the Internet and social media are used in cultures and nations around the world is key to effective healthcare engagement. Creation Healthcare’s international team of consultants, located across the globe and supported through offices in Tokyo and London, allows us to partner with healthcare companies and organisations that want to develop global and regional strategies based on local insights.

At the recent Marketing Excellence Japan 2010 conference, I caught up with some of the pharmaceutical company speakers and asked them about the unique aspects of pharmaceutical marketing in the Japanese healthcare environment.

In this video interview, Brent McCain, Head of Marketing Excellence for sanofi-aventis K.K in Japan, and Gabrielle Pastore, Managed Markets Brand Director with AstraZeneca, share some of their experiences in the Japanese market.

Outlining the importance of Japan for a global pharmaceutical company, Gabrielle Pastore points out that Japan is the second-largest market in the world for pharmaceutical companies, and it continues to grow.

Pastore says there is an opportunity to bring Western market research techniques such as unique focus groups to Japan, to understand what drives prescribing. But she says that bringing new ideas can be challenging:

“Japan is an island, and they are very happy with the way they do things here. To bring ideas and change is a significant challenge.”

Brent McCain highlights the enormous number of Japanese patients who are not only accessing the Internet, but also creating content. He says that this provides a real opportunity for pharmaceutical companies to carry out market research, and also points out that this means changing the perception of the role of the Internet in pharmaceutical marketing:

“The role of the Internet is going to become a little bit different from what we thought before… it’s going to be a lot more about learning from social media and the Internet than it is about getting our message out to customers …that’s where we’re going to get insights.”

Creation Healthcare’s new Tokyo office opens 1st July 2010. Contact us if you would like to speak with a specialist about healthcare engagement in Japan or globally.