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The leader in healthcare professional digital collaboration solutions
1
and New Solutions Factory
Lance HillCEO & Co-FounderWithin3, Inc.
Natanya WachtelManaging Partner
New Solutions Factory
A Brief Tour – The Online Discussion Healthcare Landscape
2
BASIC SOCIAL MEDIA
H E A L T H C A R E P R O F E S S I O N A L S
The Evolution of Online Healthcare Discussion
3
BASIC SOCIAL MEDIA
• Widespread personal & professional use
• Wild wild west – little vetting of participants,
content, and attribution
• Security / liability weaknesses prevent many
types of HCP discussion
A Brief Tour – The Online Discussion Healthcare Landscape
4
BASIC SOCIAL MEDIA
“FACEBOOK FOR DOCTORS”
SITES
H E A L T H C A R E P R O F E S S I O N A L S
• Owned by private companies generally with
advertising-based business models
• Improved vetting of participants, content, and
attribution
• Lack institutionally-owned content
The Evolution of Online Healthcare Discussion
5
BASIC SOCIAL MEDIA
“FACEBOOK FOR DOCTORS”
SITES
A Brief Tour – The Online Discussion Healthcare Landscape
6
BASIC SOCIAL MEDIA
“FACEBOOK FOR DOCTORS”
SITES
H E A L T H C A R E P R O F E S S I O N A L S
ORGANIZATION-OWNED SITES
The Evolution of Online Healthcare Discussion
7
BASIC SOCIAL MEDIA
“FACEBOOK FOR DOCTORS”
SITES• Owned by healthcare organizations using
purpose-built online discussion platforms
• 100% vetting of participants, content, and
attribution
• Audience correlates to organizations’ reach
ORGANIZATION-OWNED SITES
A Brief Tour – The Online Discussion Healthcare Landscape
8
P A T I E N T S
The Evolution of Online Healthcare Discussion
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BASIC SOCIAL MEDIA
“FACEBOOK FOR PATIENTS”
SITES
ORGANIZATION-OWNED SITES
A Brief Tour – The Online Discussion Healthcare Landscape
10
P A Y E R S
The Evolution of Online Healthcare Discussion
11
BASIC SOCIAL MEDIA
“FACEBOOK FOR PAYERS”
SITES
ORGANIZATION-OWNED SITES
None Active
A Brief Tour – The Online Discussion Healthcare Landscape
12
BASIC SOCIAL MEDIA
“FACEBOOK FOR DOCTORS”
SITES
ORGANIZATION-OWNED SITES
L I S T E N I N G , U N D E R S TA N D I N G , E N G A G I N G ?
P A T I E N T S
H C P s
P A Y E R S
More Connections = More Expectations
Fundamental changes in healthcare customer behavior
Interactions between all customers and all treatments options are starting earlier,and are oftentimes never ending.
New multichannel behavior patterns demand a new strategies, better customer insights, more actionable segmentation, and plans that not only leverage new channels, but understand customer channel consumption habits.
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Uses new online
channels and new
communication tools
Trusts in advice made by online acquaintances
Tends to make choices based on information found online vs
offline
Wants to provide
feedback about the
product and customer service
Expects better customer
experience
Reads and creates
reviews, blog posts
Seeks support to connect with like-
minded peers
Unlocking potentialby unlocking the secrets of human behavior
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Behavioral Science, Blended with Marketing Best Practices to Garner Predictable, Measurable Results
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R E S O U R C E S
K N O W L E D G E
B E L I E F S
What knowledgeand skills are
needed to make decisions?
Which resourcessupport decision-making?
What are the attitudes and beliefsthat prevent or motivate actions?
Engaging External Stakeholders –
Patient and HCP Case Studies
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Case Study # 1 – Inflammatory Bowel Disease Circle
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Discovering a Focus on Several Key Themes
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ANTIBODIES
SWIT
CH
ING Insurance
RESTARTINGRefractory
TRANSPLANT
Mo
nit
ori
ng
Combo therapy
PSCC
om
plia
nce
PREMEDICATION
Dose escalation
Role of surgeon
Volumetric analysis of IBD Circle posts, Q1 2016—larger font indicates more mentions
“Diffusion of Innovation” model (Rogers, 2003) may help us understand how opinions form
The five main factors influencing adoption of an innovation:
Rogers, Everett M. (2003). Diffusion of Innovations, Fifth Edition. New York, NY: Free Press
Model Factors Implication for Manufacturers
Relative Advantage: Degree to which an innovation is seen as better than the product it replaces
Perceived product strengths will be closely evaluated against known anti-TNF strengths
Compatibility: Consistency of the innovation with the values, experiences, and needs of potential adopters
Adopter “style” will drive uptake of the new drug, thus the importance of attitudinal segmentation
Complexity: How difficult the innovation is tounderstand and/or use
Discussions about when to use the productand premedication suggest complexity may be an issue
Triability: Extent to which the innovation can be tested before a commitment to adopt is made
Anti-TNFs could blunt product usage by improving physician and patient access and competing on cost
Observability: Extent to which the innovation provides tangible results
Published case studies and peer dialogue, are critical
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Why are IBD Circle Physicians Focused on Asking Expert Questions and Sharing Clinical Challenges?
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The IBD treatment landscape is currently framed with uncertainty—thanks to new drugs and new approaches to managing treatment risks
HCPs hoping their expert peers have practical clinical experience that can shed light on specific clinical challenges not being widely addressed by literature or pharma
Intrigued by product, but not sure when to use
Unclear when to optimize dosing vs. switch treatments
Comorbid conditions complicate therapy selection
Surgeons, patient compliance impact decision-making
KEY POSTING DRIVERS
Case Study #2 – A Patient Journey
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Summary:
• Severe chronic condition
• Brand team looking for better understanding of the patient journey
• Working with a group of patient ambassadors on various activities
• Some ambassadors enrolled in an ongoing clinical trial
• Original Plan – 1:1 InterviewsP A T I E N T S
Case Study #2 – A Patient Journey – GROUP 1
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17 Ambassadors
2 Moderators
5 Observers
Patient 4Nevada
Patient 2Patient 3California
Patient 17Illinois
Patient 7Patient 8Florida
Patient 9Kentucky
Patient 1Colorado
Patient 6Missouri
Patient 14Patient 15Ohio
Patient 13Massachusetts
Patient 12Rhode Island
Patient 5Texas
Patient 10Patient 11Virginia
Patient 16Wisconsin Moderator
Massachusetts
Patient Group 1Ambassador
Moderator
Case Study #2 – A Patient Journey – GROUP 2
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Patient Group 2
19 Ambassadors
2 Moderators
5 ObserversAmbassador
Moderator
ModeratorMassachusetts
Patient 7Florida
Patient 14Patient 15Ohio
Patient 17Patient 18Patient 19Illinois
Patient 3Arizona
Patient 8Kentucky
Patient 12New Jersey
Patient 13New York
Patient 1Patient 2Colorado
Patient 9Patient 10Patient 11Pennsylvania
Patient 5Patient 6Tennessee
Patient 4Texas
Patient 16Wisconsin
Case Study #2 – A Patient Journey
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Case studyConsumer relationship building coupled with adherence improvement
Case Study #3 – When Too Much ‘Patient Support’ Helps No One
The Challenge:
Though large-scale efforts existed, uptake and engagement were extremely low among all patients and care-partners. There was a clinical need to improve health consumers’ ability to comprehend and use health information to reduce chances of hospitalization and mortality risks.
The goal to reduce non-adherence, ensure refills occurred before expiry, and improve educational tools’ effectiveness was coupled with a desire for the brand to make deeper and more intuitive connections with their rather large database of consumers.
26
A Framework for Multichannel Engagement, Behavior-Change
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• Pay attention to EVERYTHING• Establish a Unified Presence• Foster Engagement vs Dissemination• Content Derived from a Framework• Actionable Measurement and Analysis
Define What Can be Changed
• Identify key learning questions across the patient journey and how they tie to brand business strategies
Define How to Measure
• Determine tracking requirements, reporting timeframes
• Determine KPIs, digital and diagnostic metrics
Implement Plan
• Design research surveys for measurement studies, Rx Data
• Implement tracking and studies
• Identify opportunities for optimization
Using Science, Data to Ensure Healthy Behaviors are Supported
Our applied behavioral marketing lens allowed us to develop a content
strategy and framework for deployment that drove medication
adherence across channels, including the brand’s 350,000-member
CRM program
28
Self-Regulatory Skill BuildingSelf-Affirmation TheorySelf-Determination TheoryBehavioral Skill BuildingSelf-AffirmationMotivation TheoryMotivationRelatedness
The Results
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Post audit and opportunity assessment yielded a restructuring and consolidation where overall engagement metrics increased dramatically
Metrics included not only comparisons to baseline for clicks, downloads and registrations, but also included adjudicated co-pay card registrations, product expiry dates and missing data added to existing database
Deployed surveys, longitudinal tracking and 3rd party Rx-lift analysis which yielded not only and increase in overall TRx, but a short time-span for average refills and annual rates for average LOT
Case Study #4 – New Data from Phase III Clinical Trial
30
The Situation:Important new data from a key clinical trial released, expected to have broad implications for healthcare professionals across the US
The Challenge: How can we quickly understand opinions, impact, and needed next steps around this critical information?
The Strategy: Engage physicians, nurses, and DOs from around the country on the data results via an online discussion platform
Case Study #4 – US Regional Engagement Structure
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Atlantic Region5 Advisors
Northeast Region6 Advisors
Midwest Region6 Advisors
Southeast Region5 Advisors
South Region5 Advisors
Northwest Region8 Advisors
Southwest Region8 Advisors
7Regions
41Advisors
2Moderators per Region
Online Discussion Platform
32
Case Study #4 – Quantitative Results - Cumulative Data
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0
50
100
150
200
250
300
350
Midwest Southeast Atlantic Northeast Southern Southwest Northwest
Region
1715total advisor comments
342Pages of written
feedback
1
6
Tota
l Co
mm
en
ts
42average comments
per advisor
1073average words
per advisor
6 advisors 5 advisors 6 advisors 5 advisors 6 advisors 8 advisors5 advisors
Case Study Deconstructing the Doctor-Patient Disconnects
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Case Study #5 How Assumptions (by all Stakeholders) May Lead to Suboptimal Care
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The Challenge: Increase understanding of the way low patient health literacy, due to a range of factors, has a measurable impact on health outcomes for a life-threatening disease.
Medication errors and adherence challenge rates were higher than average, and feedback from HCPs indicated there was room for improvements, to drive better clinical outcomes.
Educate and train partners to successfully develop content, tools and service programs that better meet health literacy principles for better clarity of communication and serve all customer and patient needs.
HCPs Were Not Aware of the Size of the ‘Miscommunication Gap’
In Product ATUs (HCP Surveys of Attitudes, Trial and Usage), HCPs reported high rates confidence in their patients’ understanding of the treatment instructions.
In patient research, patients reported a marked ‘over-reporting’ to their HCPs for understanding and confidence. This in part was due to a fear of looking ‘foolish’. ‘Shame’ or ‘fear’ were also not expressed, but strongly felt.
36
Most People Cannot Fully Understand Healthcare Communications
50% of Americans read below 8th-grade reading level
Disease State # Of TacticsReviewed
AvgGrade Reading
Level
Range of Reading Level
Breast cancer 91 9th 6th – 15th
Hemophilia 54 10th 2nd – 17th
Rheumatoid arthritis 42 12th 9th - 19th
ADHD (Attention Deficit Hyperactivity Disorder)children and adults
85 12th 6th – 17th
Multiple sclerosis 41 10th 6th – 14th
MDD (Major Depressive Disorder)
86 12th 6th – 16th
Diabetes 105 11th 5th – 19th
Total/Average 504 10th /11th 6th – 19th
Sources: Center for Health Care Strategies, Inc. What is health literacy? http:/wwww.chcs.org/publications3960/publications_show.htm?doc_id213119. Health Agency and evaluation of patient education communications materials across multiple disease states and channels, 2007-2014.
Institute of Medicine. Health Literacy – A Prescription to End Confusion. Washington, DC: The National Academies Press; 2014
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What Can Be Done?
38
Many studies show there is an independent connection between health literacy and health outcomes, including:
• Emergency department use
• Hospitalizations
• Self-reported physical health
• Lowered depression risk
• Mortality
An authentic approach to understanding disconnects that may occur, leads to finding actionable solutions. These solutions not only improve patient and caregiver/care partner understanding and health outcomes, but also may strengthen relationships between patients, HCPs and treatment teams
Questions?
39
Lance HillCEO & Co-FounderWithin3lhill@within3.com
Natanya WachtelManaging PartnerNew Solutions FactoryNatanya.wachtel@newsolutionsfactory.com
BASIC SOCIAL MEDIA
“FACEBOOK FOR DOCTORS” SITES
ORGANIZATION-OWNED SITES
Case StudyHelping brands develop content and services that HCPs actually want, will use
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As HCPs Need to do More With Less Time, Deciding ‘What’s in the Bag’ is More Critical Than Ever
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Help identify and rationalize the most impactful opportunities for a brand struggling to differentiate and capture the interest of physicians and other HCPs in the treatment team
Propose concrete opportunities that deliver the ‘biggest bang for the buck’, based on the landscape. Only focus on that which will most likely drive customer action
Ensure real-world, growth-minded strategy guides tactical development, both short-term and long-term
Our Approach: Leverage, Layer Multiple Sources of Insight
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ASSESS AGAINST
Customer Impact
Strategic Alignment
Resources Required
Ease of Implementation
GATHER INTEL
Social media mining with health psychology
Stakeholder interviews
Literature Searches, primary research
MODEL
De-identified behaviors and campaign data
Feeds
Predictive
Modeling
Analogs
Try to Focus on the ‘Most Actionable’ barriers and motivatorsTry to Focus on the ‘Most Actionable’ barriers and motivators
Avoiding a common pitfall
Many assessments fail to filter
out ideas that can be
reasonably put into action
Strive to ensure that
opportunities are specific,
feasible (financially,
practically), and within the
brand’s control to be
considered as useful by
physicians
43
Specific
Within Our
Control
Feasible
Action Oriented
Understand Workflow, Treatment Paradigms and Unique Styles and Engagement, Behavior Shifts are Possible
44
After the audit and opportunity assessments were complete, the reframed content, tools and services were deployed with an uptake of 4:1, and Rx Lift reported in less than four months post-relaunch
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