Slaying the digital beast

Recently, I did an interview with MedicinMan on digital technology, its applications in health care and its adoption by the pharmaceutical industry. The interview, published earlier in MedicinMan, is reproduced below:

Q : What exactly is digital?

Digital technology is an amazing system whereby information (words and images) are stored in the form of code. This enables unimaginably vast amounts of information to be compressed on small storage devices that can be easily preserved and transported. Digitization – or converting information to code- also quickens data transmission speeds. This technology has transformed how people communicate, learn, and work.

It is quite understandable how folks confuse between what is digital and what is not. Largely that’s because they just use the term digital and do not suffix it with either ‘marketing’ or ‘technology’. While ‘digital marketing’ is a new buzzword at least in pharma, ‘digital technology’ is not. Digital technology has been used in phones (landlines) since the 1980s, when the newer models (portable phones versus the old black telephones) were introduced. In the 1990s, digital technology enabled satellite television to enter Indian homes with a variety of 24X7 content instead of the boring, fixed time single channel DD. In the wider context, digital technology transformed information (as libraries digitized books), the airline industry (as more sophisticated air monitoring systems came into vogue).

Once we understand what ‘digital’ and ‘digitalization’ means, it is easier to understand that this is the process and everything else is the channel. Social media sites such as Twitter, Facebook and LinkedIN have used digital technology to create platforms for engagement over the internet. The amazing part of these social media outlets are that unlike traditional media such as newspapers and TV news channels, online sites do not create any content of their own. They merely provide platforms where it is easy for the layman to create his/her own content and engage with like-minded people from around the world. This is called user-generated content where users actually generate the content instead of the website. A more formal example is Wikipedia.

While social media is about humans interacting with machines (computers, mobile phones etc), the Internet of Things (IoT) uses digital technology to make machines interact with machines and humans. This is how a device on your hand can tell the app in your phone how much you walked or ran this morning. Or your laptop at office can switch on the coffee maker at home so that hot coffee awaits you as you drive in. Or the dashboard of your car can inform your doctor if you had a hypoglycemic attack and an accident. This is fascinating stuff and you can imagine how endless the possibilities with digital technology are. IN our business of selling medicines, the applications can be massive and can change the way disease is managed and treated.

Q: Is digital like a photocopier that is used by all the functions in a company or is it something only for the marketing and sales functions?

“Digital” – if it refers to technology – is used by almost everyone in a company. If you’re using a laptop or a phone or a scanner, then you’re using digital technology. However, if this refers to using digital channels to market your product or an activity to support your brand, then this is largely the domain of the marketing and sales team. The success of a digital campaign, in my opinion, is when it steps out of the domain of a marketer. Of course, the concept and execution still stays with them, but if colleagues in office don’t engage with the activity, or if the online campaign is too doctor-focused, then we aren’t leveraging the power and the reach of the medium.

I think it is also very important to understand that digital never drives strategy. It is always the brand strategy which decides the channel. Does a leave-behind piece or a visual aid decide the strategy of a brand? Of course not. They are just tools that a marketer uses to achieve an overarching brand objective (like create higher brand awareness amongst a specialty of doctors). It is the strategy of the brand that decides on which tools you want to use. It’s the same with digital – these are just channels or tools that one uses as one deems fit. I have always been amused when brand leads come to me and say “I have a Facebook strategy”. You can’t have a facebook strategy. You have a brand strategy. Using Facebook or not using it depends on that strategy.

Q : How can digital lead to better engagement with doctors and patients?

Digital technology allows innumerable options to engage with doctors and patients. As you would know customers engage most effectively with organizations or products that solve a pain point or what we call as an ‘unmet need’. One of the larger ones in health care for quite some time is ‘information asymmetry’ or the lack of availability of information that can be easily understood for patients or care-givers. This prevents them from understanding their choices and making informed decisions. Websites like iodine.com attempt to bridge that gap.

 Some other pain points are when patients want to consult another doctor to take a second opinion. This is very different from ‘doctor shopping’. Again there are websites that allow such discussions. Today finding the right doctors, setting up appointments, using mobile/digital prescribing and having medicines home-delivered through online orders reduces costs (makes it easier, sometimes cheaper) for health care transactions.

All this is possible through the use of digital technology. Pharma may not probably play in all those spaces. Yet, in its core area, pharma is making major changes to its operating model to wrap it around the possibilities that digital tech creates. Globally, there is a move to use big data to glean sharper and more relevant insights into patient and doctor thinking and behavior. There is also a realization that the industry must move away from monologues or ‘pushing’ information to engaging in a conversation or creating a ‘pull’ for information. This engagement of course will be required across all the possible channels (omni-channel) and must occur almost in real-time. No customer will wait if he/she receives an auto-response saying “Thank you for your email, you will receive a response from us in 7 working days”. Those days are long gone!

Considering the constrained environment that the industry operates in, it is little wonder that pharma is taking so long to institutionalize these changes. However, stellar examples in digital engagement can be found from companies such as Pfizer, BI, AZ, J&J, GSK and some more. These convince me that the industry is surely headed in the right direction. In the future, I think we will see more tie-ups and collaborations to create better and user-friendly products. That will make health care democratized (of the patient, for the patient and by the patient) in the true sense.

Q : How well prepared are professionals in terms of skill levels to facilitate digital adoption by companies?

Not much at the moment. There is too much of entrenchment into the traditional style of operations. We see human capital being built up within organizations but it is too focused on execution at the moment. There is limited play of digital natives within executive teams where decision making lies. That’s probably why we rarely see brand managers or business heads evolving their plans to wrap around the massive opportunities that digital creates. There is no ‘new-orbit’ thinking at the moment and therefore we see pdfs of visual aids on iPads, aspirations to create mobile apps (with little understanding of what end that will achieve) and 2-hour long CMEs distributed over web streaming platforms, once or twice a year. This belies little or no understanding of either the medium or the consumer of such content. This is the typical “monologue” or “push” mode that pharma is so comfortable with.

One could argue that reverse mentoring can help move understanding up the chain, but like most things that try to defy gravity, such initiatives rarely gain altitude. I am waiting for the day when pharma hires a CEO from a tech company. Someone who is told, “We are in the health care (not pharma) space and we need your help to do better in the new age economy.” That will be the day.

Q : Any good examples of digital adoption by pharma - global and domestic?

There are quite a few examples that are isolated (brilliant iPad campaigns or SM engagement etc.) but I want to focus on a couple of them. One of them is the “Don’t turn your back on it” campaign by Abbvie. This is for lower back pain and it is phenomenal in its omni-channel presence and the way it is being executed. I do not know the result of it, but I am sure it is good. Another such campaign in India is the “Knowledge Genie” project that Abbott rolled out in India a few years ago.

There are definitely many more such examples, but the reason I picked out these two campaigns are because of their distinct uses and I think there are lessons here for us. The Abbvie campaign is a glocal one – designed and created by the Global team but executed by individual markets. This shows a great alignment of the ‘go-digital’ spirit through the entire breadth of the organization. This is a brand-oriented campaign.

The Abbott India campaign is different in the sense that this is a doctor engagement campaign and not a product/brand-oriented one. Both these are long-term engagements that require a tremendous amount of capabilities and alignment within the organization and therefore worthy of mention.

Q How useful are platforms like Docplexus, Curofy and others to Clinicians? 

This is a tough one for me to answer considering that I am neither a clinician nor a part of these platforms. However, I think the need for such platforms exists in terms of a neutral discussion forum for doctors to exchange ideas and to network. Recently I saw another such platform which advertised its USP to be “pharma-independent”. Of course, this may be done to differentiate this platform from the others who engage pharma; but I see a lesson here.

 If pharma not participating in such platforms is considered a boon, then there is something seriously wrong. The industry which has to be an enabler of such initiatives is considered unwanted. It’s a shame since it signifies how wrong we have gone with our understanding of our customers’ needs and wants.

Who are the others new players in healthcare - what do companies Practo signify for healthcare?

There are many new players and it excites me tremendously. When Sergey Brin famously said that health care is ‘over-regulated’ he expressed the angst of millions of people amongst who are hundreds of innovators. I was afraid that these words from the co-founder of Google would scare off many of them. Fortunately, it hasn’t.

I have been fortunate to have the opportunity to coach a few startups in India and the energy, enthusiasm and never-say-die attitude that these youngsters have is just phenomenal. It is such a refreshing change from my day job.

“Startups” - as the new entrants in the space are referred to – are run by very smart youngsters who have identified “white spaces” in the health care arena. White space is jargon for an area in the sector that has a potential (and lucrative) customer pool but nobody to service them. To illustrate that, take the example of knowing the right doctors to meet when there is an urgent medical need. While this was a very obvious unmet need, the established players (hospitals, doctor organizations or pharma) did nothing for years. It took one determined youngster to begin a company that specialized in that area and then built around that core proposition.

This is what companies like Practo signify for healthcare. These companies have the potential to disrupt the health care space. They can create efficiencies in processes that established players have little incentive to reform. If and when they do that, it won’t be very pretty for the incumbents. We are seeing start ups all across the value stream – from data analytics to R&D, clinical trials, manufacturing straight up to managing the end-user experience. Almost every area in health care is looking at potential disruption. How soon will it happen? Only time will tell.

Q : Will tech products like Uber and Ola mean a better deal for doctors and patients? How can pharma partner with such players?

This has been a fascinating question and one asked quite often. To elaborate on your analogy – Uber and Ola are aggregator organizations. This means that they use digital technology to bring a cab to a customer. The beauty of the model is that they neither own the cabs, nor are the drivers their employees. In health care, the likes of Practo bring patients to doctors and the likes of Nightingales bring doctors to the patients.

While on the face of it, it seems like a good idea to have a service of bringing additional patients to doctors, this hasn’t really gone well with doctor organizations (who protested their members advertising on a website) or with the govt who cannot get themselves around to regulate these new-age services. To answer your question specifically – any program or company that reduces transaction costs for consumers to seek health care of their choice is definitely a better deal for everyone.

Since pharma still focuses on pushing its pills, and will continue to do so for the foreseeable future, I think what it can seek to benefit from these tech players is Big Data. Many of these companies over time will accumulate information on the beliefs and behavior of health consumers. Pharma can glean out great insights from that information. Now whether the tech players will want Pharma to monetize that information or want to do it themselves will be interesting to see.

Q : Is there an increased understanding of digital by Indian Pharma? How do you look at digital adoption by Indian Pharma?

Oh yes of course! Adopting digital channels to engage with doctors has picked up rather well in India as it has around the world. I am aware of some very interesting things that Indian pharma is doing on this front.

When we speak of adopting digital, there are two ways in which I would see it - the first way is to evaluate the use of content across channels. I would be very impressed to see content created and customized for multiple channels. I think this has a lot to do with understanding the functionalities and the scope of each channel and how that helps to promote the chosen story/message.

The second way to view digital adoption would be to see if content across multiple channels carries the same message or storyline. Most often I see messaging created for Twitter being quite different from Facebook which is itself far removed from website banner adverts. It would seem odd to customers if they’re unable to see the same message or connect the dots when they view that content over different channels. This, in my opinion, is quite key to superior engagement of digital technology. Of course all of this stems from the broad strategy for the brand/company.

That said, its great to see marketers finally accept this technology for its scope and power. One must experiment with it to learn how to use it best.

Q : Is there is need for education in digital adoption by way of workshops and what should these workshops focus?

Education is always useful. It helps to know what the industry is doing at large. Of late, I have noticed that fewer pharma managers are skeptical about non-pharma examples and this is a very encouraging trend. Earlier, I would see people rejecting any great example from non-pharma without understanding that the principle is more important than the example. The change means that pharma managers are opening up their minds and this augurs extremely well for the industry.

I don’t think workshops on digital technology would work in isolation. Since technology only adds further scope to engage with doctors and patients, the workshop should examine marketing plans to see if they have really built in the use of technology to optimize results. Ideally this exercise should happen a few weeks before the marketing team begins to work on their brand plans. If they understand the technology available, its functionalities, scope and results it can bring, I am sure marketing managers will understand better how to use it in their work.

 These are my personal views and do not represent the views of my employer.