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Healthcare Agency Roundtable 2017

Written by: | andrew.humphreys@medadnews.com | Dated: Friday, December 1st, 2017

 

Executives from 2017 Manny Award winners/finalists and other healthcare communications agencies participated in this Q&A forum of industry topics.

 

Med Ad News: How are your organization and clients implementing and optimizing patient engagement strategies?

Dana Maiman, CEO/President, FCB Health: Patient engagement is not a one-size-fits-all and neither is our approach to implementing and optimizing strategies to support patients. Lately, we’ve been building adaptive, needs-based engagement models. The foundation of which is a behavioral strategic framework. The steps to this approach involve uncovering the patient insights and needs that ladder to desired behaviors and business objectives. This leads to a unique, patient-informed engagement strategy. What we’ve noticed is that … Whether the business objectives are focused on disease education, branded conversion, or adherence and advocacy, the engagement strategy becomes the team’s mission for how all our tactical elements come together into a seamless, engaging experience for all stakeholders.
a. The key to successful patient engagement programs is to make the tactics relevant at the individual patient level. To achieve this relevancy we use a “mass customization” approach. Our process starts with gaining insight into the patient journey and the motivators and barriers for health behavior change we aim to create. Next we analyze variations in patient demographics, attitudes, clinical profiles, and media and technology use, with a goal of creating a segmentation strategy to maximize patient homogeneity. Then we create the engagement plan, based on decision rules or a predictive engine, that delivers highly customized, profile-driven engagement tactics.
b. We simplify deployment of these tactics by using variable content templates. Deployment of tactics varies in timing, messaging, language and marketing channel depending on each individual patient’s profile and analytics, including experimental design when appropriate. We are experts in preparing MLR submissions in an easy-to-understand format so that clients and reviewers can embrace this approach.
c. We optimize results by setting up test and control groups to identify the most successful interventions, then implement the proven tactics.

Sonja Foster-Storch, President, GSW-North America, part of INC Research/inVentiv Health: Our approach to optimizing patient engagement starts with our ability to understand the Patient Journey® and what is occurring at critical moments that can impact what a person is experiencing. In order to be effective, we go beyond the surface to develop engagements that are part of an individual’s journey and provide value based on how that user wants to interact in that given moment. By understanding the motivations and behaviors of the patient, we start to think how we can build engagement through customer experience marketing efforts. At GSW, we utilize our predictive marketing and data science team to help us understand the most optimal solutions that will create our multi-channel marketing efforts and how we help our clients implement patient engagements that help impact their lives and desired outcomes. Our efforts are monitored and optimized over time by completing our strategies to be successful through our measurement teams. This overall approach of incorporating data science and measurement into the development of our engagement strategies ensures we are meeting patients’ needs of making every moment matter.

Faruk Capan, CEO, Intouch Solutions: Think about the experience you have with your favorite store – one of mine happens to be Amazon. They have what I need; they provide excellent service with no surprises; they even predict what I will be interested in. I can re-order household supplies just by saying a few words to Alexa. Even their marketing isn’t interruptive, but instead seems to suggest exactly what I am looking for when I am looking for it. I engage with Amazon repeatedly because the whole experience is positive and seamlessly connected. This is the model we’re building for our clients and their customers – one that is service-oriented, integrated, predictive. The old way just won’t work. Patients expect and deserve more.

Amar Urhekar, President, McCann Health Americas: Patient engagement continues to be of critical importance for both our agency and our clients. As the market continues to evolve to value based healthcare, with consumerism becoming a driving force, patient engagement is becoming even more critical. It is not enough anymore for a patient to just be knowledgeable. Knowledge must lead to greater engagement in order to drive optimal outcomes.
We partner with our clients and apply social science techniques to fully understand our target patients’ motivations, needs, and behaviors across the healthcare journey. This allows us to develop appropriate strategies and solutions to drive favorable change. One solution we’ve developed is our proprietary ARULETM framework, which ensures that we design communications that are Appealing, Relevant, Usable, Learnable and Easy to act on. ARULETM is currently being validated up against some of the most rigorous health literacy frameworks, and is being vetted by several industry experts, and our team members out of Columbia University Mailman School of Public Health. Doing this allows us to facilitate a more even-sided dialogue between patients and HCPs that ensures that both stakeholders understand what is being said, and its implications on health outcomes. This level playing field makes it easier for doctors and patients to connect with one another on a human level, creating an exchange of empathy.

Drew Desjardins, Executive VP, Chief Strategy Office, Dudnyk: Rather than diving into a tactical conversation, I’d like to focus on how we create relevant dialogue to fully engage with patients. For years, Pharma has applied a very simple formula in its approach to talking to patients – portray patients in marketing materials who reflect the aspirations of a typical patient. That’s why we see lots of patients at rooftop parties, picking out vegetables at roadside produce stands, and running with their dogs along beaches – after all, who wouldn’t want that? But when it comes to rare diseases, it’s essential to fully understand the dreams, fears, and expectations of patients so we can communicate with them in meaningful ways.
Mapping patient journeys is not new; Pharma has been doing this for decades. But it’s not enough to just chart the buying process. Sure, the transactions are important. But what really matters is how patients think based on a combination of “hard wiring” and environmental factors to make decisions and, ultimately, how they feel about those decisions after they’ve been made. At Dudnyk, we find it incredibly valuable to overlay the HCP journey onto the patient journey to help us understand when and how information is being shared, but then we push even further to understand the impact of conversations between HCPs and patients. Often, we find out from these conversations that there is very little alignment between the HCP’s goals and the patient’s expectations and aspirations, particularly in rare diseases.
Our solution is to create strategies that reflect on the understanding of both parties and to bring those insights to light in communication that creates shared empathy. When we work with clients and market research partners, we push to ensure that we’re unlocking insights that will help facilitate a more effective conversation between HCPs and patients. By our mapping insights and not just the journey, these learnings can be incredibly powerful and can have a profound effect on changing ingrained physician mindsets and behaviors. Sometimes, it can be as simple as figuring out the right words or phrases that a patient can use to be better understood by their doctor while preparing the HCP to listen for those words to create a stronger connection. Other times, it may be more important to create messages that reinforce patient/HCP dialogue and serve those who can affect real change.
We’ve had significant success with this approach when working with clients. And the bottom line is that when HCPs and patients truly understand each other and communicate effectively, everyone wins – including brands.

Eileen Yaralian, Executive VP, Director of Strategic Services, DDB Health:

Treating patients like shoppers rather than influencers:
Gone are the days where patients unequivocally trust and adhere to physician direction. Patients are becoming more educated and are more capable of being their own advocates. With unlimited access to information online, patients can often “shop” for both diagnosis and treatment options before even visiting a physician. When they show up to a physician’s office, they have often self-diagnosed and already have a request for treatment in mind. Recognizing the evolving role of the patient has reinforced, for our agency and for our clients, the importance of providing clear and accessible information to patients and prospective patients when and where they need it.

Targeting individuals rather than patients:
People with a shared disease are more than their condition, and a lot can be learned about these people as individuals by understanding their online behaviors. Pharma is beginning to use big data to target specific patient segments based on online activity. Leveraging our Omnicom Health Group network, we have the ability to provide our clients with hyper-targeted engagement plans and execution. Hypertargeting allows us to create an emotional connection with patients based on their individual profile and position along their disease continuum.

Leveraging the extended reach of healthcare:
Patients are relying more and more on non-traditional ways of accessing healthcare, and we’ve taken notice. With our clients, we are beginning to explore non-office-based opportunities to engage with patients, encourage screening, and drive education. The role of retail pharmacies as healthcare advisors has grown tremendously in the past few years, and many patients regularly rely on their local pharmacists for information and advice. Physicians are extending their own reach, as they are now incentivized to utilize some form of telemedicine to improve quality of care for their patients. Non-traditional channels are beginning to offer new opportunities for pharma to engage with patients, so we are exploring it for some of our brands.
Nadine Leonard, Managing Director & Executive Planning Director,
Heartbeat: Pharma brands seem stuck in an engagement approach that is one-size-fits-all and one-way. And patients have been forced to accept it, despite the incredibly personal nature of healthcare decisions. But they won’t put up with it from pharma for much longer, as other industries are setting expectations by delivering services that are highly customized and often on-demand.
So, Heartbeat is using data and technology to enable a more human and personal connection between patients and their medications – capturing symptoms, choosing the best treatment, ensuring its effectiveness, etc. And then, wherever possible, closing the loop by getting this information to the physician to help shape current patient treatment, as well as the HCP’s future decision-making.

Jonathan Pepe, VP, Director, Engagement Strategy, The Bloc: The advent of the attention economy has signaled a significant change in consumer behavior; as such, campaign volume and targeting alone are not enough to get the message across. Today’s patients expect a solution that is directly tailored to their individual needs, one that solves a fundamental challenge for them, all while respecting their time and attention. As a result, we focus our efforts to deliver a whole experience to a customer experience at the precise intersection of brand opportunity and customer utility. Truly, now is the time to champion partnership over promotion with our customers.

 

Med Ad News: What can the healthcare industry do to combat the opioid epidemic?

Christopher Tobias, PhD, President, Dudnyk: One of the biggest things the healthcare industry can do to combat opioid addiction is to help change focus from emphasis on law enforcement to one of education and support. Addiction is a disease and those that suffer from it deserve compassion and access to harm reduction and other support programs that are not currently embraced in this country. This epidemic touches every rung on the socioeconomic ladder and invades every type of household, yet it often seems that those addicted to opioids are treated as society’s “disposable people.” Yes, opioid addiction is dangerous, life-threatening, and destructive to each individual and family affected, but simply assuming the only cure is abstinence is as outrageous as telling a diabetic patient on day 1 that they can never have sugar, bread or pasta again. Only through the full appreciation and acceptance of addiction as a disease, along with the acceptance of appropriate medical steps, can we help escape the grip of this growing epidemic.
Not long ago, psychiatric illnesses, such as depression and anxiety, were not considered to be medical conditions, but rather situations in which people just needed to “ snap out of it” or “cheer up.” Likewise, many feel opioid abuse is something that can be easily stopped, if only an addict could pull him or herself together. The truth is, the opioid epidemic is incredibly complex, multifactorial, and in need of an approach that takes into account treatment advancements that have been shown to be successful in other areas of the world. A recent TEDMED talk by Mark Tyndall introduced a compelling first step toward combating the opioid epidemic. He worked for 11 years at a harm reduction clinic in Vancouver, Canada using an evidence-based public policy approach. His clinic focused on safe injections and reduction in spread of illness, as well as aid in rehabilitation. This approach differs tremendously from our current stance on prohibition, punishment, and denial. Our healthcare industry can affect change by using the tools we so often harness when educating professionals and patients on certain diseases. By supporting a comprehensive platform of appropriate education and awareness, we can work toward creating the compassion, empathy, and caring that this disease deserves. When we stop pointing fingers and laying blame, we can focus on recognizing the value of every human life, regardless of the disease they are fighting.

Andrew Gottfried, President, Entrée Health New York: It really depends on where you locate the problem. While the source of the issue takes many forms – eg, overprescribing, the pathology of substance abuse, and the diversion of prescription medications – we think it’s critical to also consider how organized customers can help curtail this epidemic. That’s why we support our clients in working directly with ACOs and health plans – above brand – to stop the flow of inappropriate prescriptions at their start. And that’s also why electronic health records are such a great resource for educational efforts at the organizational level.
Anti-abuse technology takes many forms, and EHRs still may be a bit downstream from the original issue. Sequestered opioid antagonists, bound directly to opioid agonists, are an elegant molecular solution to the abuse of crushed pills. We’re excited to see what comes next in the area of pain management.

Barry Schmader, Chief Creative Officer, Elevate Healthcare: The opioid epidemic is real, and we can argue all day about how we got here, but the truth is the medical community can’t stop the flood of illegal and black-market fentanyl and cheap heroin that is flooding into this country. It seems at this point, we don’t have an opioid epidemic as much as an overdose epidemic.
Despite how we got here, the solution suggested by some to stop prescribing opioids altogether is absurd. Opioids are the best tool pain specialists have to help manage chronic pain, and any consideration of limiting their prescribing by credible, medical professionals is wrong minded, and reactionary. That said, there are some things the medical community can do, and has already done, to help stem what many feel may be the origins of the initial path to heroin and illegal use – over prescribing of legally obtained oxycodone and hydrocodone.
First and foremost, education for physicians, patients, and caregivers about the risks of opioids – even legally prescribed ones for legitimate medical conditions – has been key to stemming the over prescribing issue. The medical community has already taken some important steps to help combat their contribution to the problem. One real solution is the increased data that comes from statewide or national monitoring programs that provide information on patients’ opioid prescriptions, so that physicians can actually see if this patient has been “doctor shopping” or has had many previous opioid prescriptions – before they prescribe. This helps to identify patients who are abusing.
Secondly, the voluntary reductions in the number of opioids prescribed at each prescription, and the increased limits on the time a patient can be on opioids is helping. This is more or less the result of increased education and awareness for physicians and for patients about the risks of long term, or high-dose opioid use.
Finally, and perhaps just as important as education and prescribing limits, the key thing the healthcare community can do is to endure the unfettered and mandatory access to naloxone. Many medical authorities, from the AMA to the CDC, are recommending that naloxone be co-prescribed with every opioid. This single practice can help protect patients who are taking opioids for legitimate reasons, and also help protect families of patients who have opioids in the home. The widespread adoption of naloxone as a co-prescribed agent with opioids can help stop the overdose epidemic, and making naloxone available to anyone at risk is a key step.

Barbara LePetri, MD, Senior VP, Director, Medical & Scientific Services, The Bloc: As both a doctor who treated “pain patients” and the daughter of someone who suffers from chronic back pain despite multiple surgeries and device implantation, my plea is that we don’t forget about the patients who suffer intractable and life-altering pain. We need to provide these patients pain relief options beyond the currently available options. To do this, I think two overriding beliefs need to be adopted.
First, pain is a disease in and of itself. While we can attempt to correct the underlying condition with physical therapy, weight loss, and so on, let’s not forget the patient is in pain and that, physiologically, pain can beget pain. If a patient with a bacterial infection has a fever and feels miserable because of this fever, do we tell them “let’s just wait for the antibiotic to start working?” Why treat the pain patient any differently?
Secondly, we need to think “beyond the pill.” Not all pain therapies require a prescription for a pill or an injection. Nonpharmacologic treatments such as nurse-delivered training in pain-coping skills have been shown to improve patient-reported pain. While effective, they are labor intensive to deliver. The healthcare community should look for opportunities to leverage current technology platforms to deliver cognitive behavioral therapy to a much larger group of pain sufferers.

Boris Kushkuley, Executive VP, Multichannel Marketing and Consulting, Intouch Solutions: Previously, the opioid problem was considered a crime or moral failure, then a disease that needed to be fought medically. But we have to focus on the core of the problem: overuse of opioids as a painkiller in medical practice. While the United States represents just 5 percent of the world’s population, it consumes approximately 80 percent of the global supply of opioids. Physicians, health systems, payers and medical associations must focus on establishing standards of care that look at long-term outcomes and implications of using opioids as a key component of treatment protocols. It is everyone’s responsibility to consider the health, social and behavioral results of trigger-happy prescription practices.

Amar Urhekar: The opioid epidemic is no doubt currently one of the largest public health issues and has risen to that of a national health crisis. While tackling this issue requires a multidisciplinary approach ranging from policy to public health, the healthcare industry can and must do more to educate and engage patients and their healthcare providers.
One possible solution is to build a model where a percent of the earnings associated with each prescription go to a national program. For example, partner with middle and high schools to deploy a nationwide mandatory educational program to create a movement that echoes those of the past, such as safe sex and drunk driving. Imagine launching the initiative with an influx of opioid disposal locations around the country sponsored by pharmaceutical companies.

 

Med Ad News: How is the industry best leveraging VR/AR to create memorable brand experiences?

Bruce Rooke, Head of Ideation, Fingerpaint: We are a bit like expectant parents: somewhere between promise and delivery. We’ve watched others have really awkward children, like the first “AR” with QR codes. Then, we saw the demanding kids of VR who insisted that we pay full attention to them with their enclosed goggles and immersive worlds.
Now we marvel at the ultrasound visions of perfect offspring: HoloLens glasses and ARKit (and especially the precocious child prodigy of Magic Leap!). We can already picture animated MOAs bouncing across a physician’s desk, injection training through the virtual devices of iPhone Xs, and overlays of text explaining what that strange mole on my arm might be. Our due date is next year.

Bill Drummy, Founder & Chairman, Heartbeat: The VR/AR opportunities that excite me the most are ones that heighten empathy for illnesses and medical conditions. A great existing example of this, although not for an Rx product, is Excedrin’s “Migraine” AR experience. For pharma, the richest place to replicate this is with healthcare providers and diseases states where the patient’s suffering might not be fully appreciated. To experience the feeling of near-suffocation of a COPD patient, or the paralyzing pain of rheumatoid arthritis, can be extremely effective in raising doctor understanding of the urgency of the problem, and thus, the urgency of a more effective solution.

Sanjiv Mody, Founder & CEO, PIXACORE, and Kevin Ungaretta, Program Manager, Marketing, PIXACORE: In the past couple of years VR has enabled brands to engage its customers more intimately than any other medium. From HCPs and internal staff, to patients and caregivers, VR has been leveraged by brands to educate the masses on a wide range of topics. These immersive, distraction-free experiences drive a better understanding of complex diseases, mechanisms of new investigational treatments, and interactive visualizations of vital data sets. All of which can be vividly experienced from a patient’s perspective while simultaneously promoting empathy and the learning of new skills in a penalty-free, high-retention environment.
When the right content, the right approach, and the right execution converge, VR as a medium has proven to be unparalleled in its ability to captivate an audience. Additionally, experiences with interactivity allows the user to participate in near-limitless ways which, in turn, substantially increases the impact VR can bring to a brand.
Having a measurable barometer, the impact of VR is undeniable. AR, on the other hand, has yet to be fully explored, tested and measured. Transporting and immersing the user into a virtual world to accomplish empathy or learning is irreplaceable, but availability and simplicity continue to block its widespread adoption. Despite AR being in its infancy stage, the use cases are already outnumbering those of VR, especially in terms or reach.
AR being intrinsically more scalable, will be used for real-time, real-world training and reinforcement to demonstrate the best use of actual products along with their features, benefits, and potential risks. Field and technical support teams will have AR at their disposal, at all times, to guide them through almost any task or scenario.
AR and VR are complementary mediums that have had, and will continue to have tremendous success in the industry for the foreseeable future. The challenge for the brands will be to identify experts who can guide them along the entire journey. If and when these mediums are applicable, it is imperative to build experiences that meet business objectives, and ensure the end-user has a positive brand experience.

Wendy Blackburn, EVP, Intouch Solutions: This technology is really just now coming of age as we’re seeing more practical applications in healthcare. This year, Intouch developed In My Eyes for Regeneron, an AR/VR experience designed so that healthcare professionals and caregivers can experience first-hand what it’s like to live with certain retinal diseases. The goal is to illustrate the important role the sense of vision plays when navigating everyday situations, and the challenges that come with vision impairment. It’s an empathy engine, if you will. We’re finding that the approach is really resonating, because the brand goals and the technology are a great fit. That said, there’s admittedly been a lot of hype around AR/VR and, certainly when you experience it firsthand, it’s difficult not to get excited. I’ve even heard some people predict AR/VR will replace the rep’s iPad – but that’s taking it a bit far. The trick is to focus on the strategy or the problem you’re trying to solve first – not the technology. Sometimes VR/AR will be a fit for your brand, sometimes it won’t.

Nicole Brandt, Multi-Channel Planner, Dudnyk: Virtual or Augmented Reality (VR/AR) can create memorable experiences for brands to offer patients, healthcare providers (HCPs) and caregivers. This can be accomplished through a story-telling format and like most strong marketing tactics, requires in-depth knowledge of customer attitudes, beliefs, and behaviors. Information consumption preferences are another important element for a successful VR/AR initiative.
Initial AR/VR projects included immersive experiences within the human body to demonstrate mechanism of disease or mechanism of action of drugs. These early projects created memorable experiences by engaging senses not activated by traditional means. Healthcare professionals who were intrigued simply by the technology walked away from the interaction with much more – a greater appreciation of the disease or therapy.
As marketers have become more adept at leveraging the technology, AR/VR is gaining traction as a means to create real-life experiences that can give a voice to patients to communicate with caregivers or HCPs. However, the real promise of the platform lies in its potential to provide a unique medium for reducing time to diagnosis in rare diseases and creating empathy for patients among HCPs.
The use of VR/AR can provide insight for an HCP who has limited time to engage in meaningful conversations with patients. This can be particularly true in rare disease categories by serving as a powerful training tool that can accelerate recognition and connection of disparate symptoms often mistaken for other more common diseases. With over 7,000 rare diseases identified, imagine how powerful a tool could be that could help doctors to more easily identify, diagnose, and begin treating these patients!
Moreover, within the rare disease category, VR/AR can create unique and compelling ways to connect HCPs with the daily struggles patients are experiencing. This in turn can positively impact physician attitudes toward caring for these patients and even create brand advocates. The promise of VR/AR appears to be limited only by the imagination of the marketers who are leveraging the platform and ultimately may prove to be an incredibly powerful tool not only for creating memorable brand experiences, but also for enhancing care and improving lives of patients.

Megan Fabry, Executive Vice President, Director of Channels and Innovations, DDB Health: While the majority of virtual and augmented reality experiences in pharma have been limited to MOA presentations at conferences and events, brands have an opportunity to tell more immersive stories, drive better understanding of disease and treatment, and create experiences that leave a profound impact on the user. Practically speaking, VR/AR offers an immersive tool for education and entertainment. But how boring is practical! There are literally no boundaries to how the industry can use VR/AR to make memorable experiences.
Want to help a caregiver “experience” the pain and disorientation of a migraine? Or allow young treaters to understand what it’s like to live as an elderly patient? Or help hospitalized children “go home” for a little while? You can. And, with the launch of iOS 11, iPhone users can seamlessly access augmented reality directly from their phones, opening up a huge opportunity for pharma to create cost-effective programs. So now, instead of limiting VR/AR to conferences, brands can deliver immersive MOA experiences to patients and help them understand the progression of their disease or how a drug works in their body without the need for an expensive headset or hardware other than their phone.

Seth Perlman, Head of Digital, ghg: The industry fares best when it avoids “Fantastic Voyage”-type VR experiences taken from an MOA video. While I understand the temptation to reuse 3D assets from an MOA clip, the “wow” factor rarely lasts beyond the initial impression. The most memorable brand experiences are those that demonstrate efficacy – of a drug, device, or a behavior – through an emphasis on the “reality” in augmented or virtual reality, particularly with chronic or progressive conditions. Consider a patient with RA increasingly unable to grasp a glass of water in VR as the disease progresses untreated due to non-adherence, or a physician seeing inflammation overlaid on his own joint in AR in response to speed of diagnosis and treatment decisions. These experiences feel immediate and consequential – not just escapist.

Dan Chichester, Chief Digital Officer, TBWA\WorldHealth: Even at this still nascent stage, VR and AR risk becoming “gee whiz” buzzwords – “How do we get this shiny object attached to our brand!” By all means, let’s fight against this. The compass points in the right direction, no matter where you stand in the 360-degree surround, so long as it’s pointed to a simple question: What specific insight or objective does virtual reality or augmented reality address and how does it uniquely address the problem?
The potential to have real effect is so great. “Preventative Care VR” could demonstrate to a health-risky individual what their life will look like if they continue down an unhealthy path. VR’s immersive world can be a whole new way for healthcare providers to connect with emotions and change decisions. “Informed AR” can grant patients x-ray vision to view inside themselves and see exactly how a drug works in their biology. This goes beyond simply visually captivating, but can work on a level of trust, putting individuals at ease with what they’re being asked to put in their body. (From an HCP POV, AccuVein is doing a version of this with their device that maps veins over the skin to pinpoint and ease IV injections. And at TBWA\WorldHealth, we are leveraging AR to demo the innovative mechanisms of some of our device clients, helping HCPs see the difference “in” their own bodies.)
Entering into a virtual or augmented space is bigger commitment than just glancing at a brochure or watching a video. In most cases, for the time being at least, we are asking people to strap a brick to their face: let’s make sure it’s worthwhile. As VR and AR move beyond their video-game style origins – journeys of discovery in somewhat preprogrammed environments – let’s embrace the potential of multisensory experience. We will need to learn the tools and opportunities of a new type of storytelling that not only looks good, but is intuitive – and respectful – to our audience and the heightened levels of information and sensation we will be surrounding them with and asking them to invest themselves in.

Prodeep Bose, Executive VP, Growth & Innovation, The Bloc: Let’s just admit at the outset that AR/VR is pretty much at the peak of the hype cycle, particularly as it relates to the use of headsets for brand promotions. There are certainly many gimmicky uses of the technology to present MOAs to doctors and display data in 3D at marketing booths, but they’re more of an experiential enhancement than a game-changing experience. One of the most impactful experiences using headsets is in virtually assisted surgery; for example, Medsights Tech that is developing augmented reality glasses that overlay 3D ultrasound imaging to assist in precision tumor removal. And for patients with phobias, PTSD, or motion instability, there are fascinating uses of AR+VR such as MindMotion PRO, which is approved by the FDA to bring 3D virtual environment therapy for neurorehabilitation.
That said, when we consider the core of what this technology is about, its simulation. And what is simulation good for? Empathy. Especially when combined with touch, pressure, smell, temperature, AND an immersive visual space, this is a powerful platform for creating empathy through simulation of many disease conditions. VR/AR has a distinct role to play in advocacy and awareness and perhaps a use that will be readily embraced by well-funded pharma initiatives rather than non-profit advocacy groups. But companies like Viscira are hopefully evolving solutions beyond writing code for Unity platforms that power headset-based experiences to a fuller sensory immersion that can support such scenarios.

Dana Maiman: We have seen incredibly useful applications of VR particularly around education, but the most memorable brand experiences we’ve seen are those that create empathy around a disease state. VR can transport you to another world and let you walk a mile in another’s shoes.
AR is just becoming mainstream with the release of ARCore and ARKit. Early applications are exploratory and often whimsical, but we’re particularly excited about AR experiences that are synched with people / places / things in the real world. You can create remarkable experiences when you play one off the other.

Sonja Foster-Storch: We’re very excited and currently experimenting with Apple’s new AR library ARKit. They have really opened a world of new possibilities in making their iPhone and iPad devices the world’s largest AR platform overnight. Traditionally, we’ve seen AR experiences happening in trade shows and congresses but with such a platform available on millions of devices overnight we expect to see brands embracing it more and more in the consumer space.
Regarding VR, we think that the immersive environment it provides is perfect to help brands build empathy, because it allows you to literally put someone in the shoes of a patient or caregiver. In 2016, we used VR to allow healthcare providers to experience what it would be like to come to consciousness in a busy restaurant after a seizure. This debuted at the AES conference and is still in use around the world today. Many people step away from that experience with a new understanding of what their patients are dealing with every day.

Amar Urhekar: We’ve seen some spectacular uses of VR/AR, and the most notable ones are those that create and nurture an emotional connection between brand, condition, and experience. For example, allowing HCPs, payers, and pharmacists to relate more empathetically with a patient’s ‘hard-to-explain’ symptoms, such as in migraine or epilepsy, by letting them experience those physical symptoms in a virtual setting.

 

Med Ad News: How are agencies and clients using Artificial Intelligence (AI) to dramatically change business and using chatbots to become a viable customer service channel?

Randi Baerson, Executive VP, Director of Client Services, Entrée Health New York: Reimbursement and patient support have historically been very labor-intensive processes, with quite a bit of room for human error in patient hub enrollment, health and medicine coverage lookups, medication starts, and adherence follow-up. But AI has advanced to the point that we can use it to help patients and office staff navigate the reimbursement process, fill in complex forms correctly the first time, and generally streamline the process to help them get the answers they need.
The advancement of AI is timely; specialty products come with an expectation of reimbursement hub support, and the personalized approach is important for patients and office staff. That’s why many of our clients are now considering adding AI as a new way in for their products.

Harry Stavrou, VP, Digital Services, HCB Health: Machine learning has been changing various industries for years now, including the healthcare and pharmaceutical industries. While advances in AI are shaping the future of product development, treatment options, and reimbursement models, they are also changing the way organizations create and deliver content for improved brand recognition and ROI.
Entering vast amounts of data into an AI framework such as personas, journeys with clearly defined conversion points, custom content, and KPIs allows for the delivery of relevant material to more receptive customers. In turn, monitored customer interaction with this material allows machines to learn and more accurately predict behavior, further honing the delivery of relevant content at the right phase of the customer journey. All of this helps clients, agencies, and other content developers be much more efficient with the types of material they create, limiting subjectivity and reducing development time.
Similarly, various chatbot solutions allow for round the clock customer communication and patient support. Opt-ins open the door to practical, brand-centric services such as proactive, scheduled SMS or voice based adherence tools that build brand equity and trust over time. Chatbots themselves can be built on simpler, decision tree based platforms or can be paired with AI which would import customer inquiries into its platform and be ready with an appropriate response the next time it was asked that question.
Needless to say, this is an interesting time for healthcare and pharmaceutical industries. Shaping its evolution is up to us.

David Sakadelis, VP, Technology Group Director, Heartbeat: AI and Machine Learning are poised to reinvent how patients and consumers access information. Channels such as chat and voice are emerging as viable replacements for the destination site or “pull” model of engaging and servicing consumers. It only takes observing a child interacting with Amazon’s Alexa to realize that the “zero interface” model will soon become a daily method for accessing information, as well as dramatically shift the marketing messages and business models we know today.
Chat bots are a branch of this concept. By combining chat, voice, facial recognition and/or patient data, bots can deliver more personalized messaging and right-content/right-time support. Patients willing to entrust bots and AI with their health information have the opportunity to experience more fruitful and informative interactions around their wellbeing. Recent studies suggest this level of trust among consumers is already very high – some cases even claiming patients are more willing to share private health information with a bot over their physician. This form of engagement is ripe for healthcare marketers to deliver brand messaging in new ways. At Heartbeat, we’re developing our own AI bot to act as the brains behind the connected patient ecosystem – we’re calling her “HeartBot”.

Chris Millsom, VP, Digital Strategy Director, ghg: Intelligent systems exist along a spectrum of capabilities, from those that act (rules-based systems like cruise control in your car) to those that create (eg, Google’s “Deep Dream”). Generally, artificial intelligence systems used by agencies and clients for healthcare communications exist on the lower end of that spectrum, just like chatbots.
Having developed AI-powered platforms for several years here at ghg, we use the technology to affect 3 main areas that usually stand in the way of improved outcomes:
1. Enhancing the customer experience
2. Enabling users to access data previously inaccessible
3. Allowing the uncovering of insights that were previously unavailable

Of course, chatbots fall into this first realm, enhancing the customer experience (they’re relatively simple to build compared with other AI-powered systems). A recent study showed that chatbots outscore apps in every perceived customer benefit (from 24-hour customer service to quick answers to simple questions). In fact, chatbots come in second in preferred communication channels (behind face-to-face contact). Finally, a study by Senesely showed that up to 20 percent of RN time is saved when triaging patients use chatbot-like systems.
Therefore, it is not surprising we’re seeing agencies and clients using chatbots in the following ways:
• As a supplement or replacement to traditional branded or unbranded educational FAQs
• As part of more traditional CRM systems that allow customers greater flexibility in getting answers to questions they need
• As a precursor to customer-service or rep conversations
• As an easy way to cross-utilize content and functionality (with the rise of vocal interfaces)

Facebook announced they’d reached over 100,000 Facebook Messenger bots earlier this year at F8, and I anticipate this number to grow even faster with the recent announcement of integration of these bots into brand websites, thereby extending their reach beyond just those on the social platform, and providing an even greater range of potential applications for solving client and healthcare challenges.
When it comes to larger AI-powered solutions, they’re generally built in order to solve the second and third problems outlined above. A great example of this is Pfizer Oncology’s use of IBM Watson to enable easier access to a wealth of data about metastatic breast cancer (mBC) for physicians, payers, patients, and advocacy groups. At the same time, this solution enables us to derive insights from what people are looking for as it relates to gaps in care, and understand how gaps in care are changing over time. This can be viewed here: www.breastcancervision.com.
Ultimately, the potential applications for AI-powered solutions are vast, but it comes down to identifying a viable business need, and the underlying data and knowledge source for that data, in order to make these applications successful. We must be careful to select the right business need that can be solved with AI, and then select right AI solution for that business need.

Bob Pearson, Vice Chair & Chief Innovation Officer, W2O Group: We are just learning how to adapt AI to healthcare, and specifically to the agency world. We are currently focusing on machine learning. We are teaching software models to identify the right people, language, content and outlets that matter to shape the conversation of a market. We are building new alert systems that are trained on what is “normal” so we can see what is abnormal in close to real time. For us, this application of AI is normal business.
For chatbots, we do analysis for brands on how counterfeiters promote fake drugs. We can how our clients how a chatbot network works, ranging from how they create fake people, how the network content, what type of ecommerce models they use and how to protect one’s brand. AI is accelerating the usefulness of the algorithms and models we have been building for years.
In addition, we can use AI to supplement clients’ call centers to help answer patient or physician questions, to address common frustrations and enhance the customer experience in healthcare. As AI comes into its own for the customer experience, though, we will be leveraging the technology to create a truly tailored customer experience based on very specific customer needs that we will identify through analytics.

Paul Balagot, Chief Experience Officer, precisioneffect: If you ask patients how they feel about the level of customer service in the healthcare space, you will likely encounter a high degree of frustration. Doctors are pressured to maximize throughput and see and treat patients more efficiently.
This dynamic unfortunately leaves many gaps in the field of patient support. This was underscored most recently at the AMA co-sponsored Patient Experience Summit, where the theme was “Empathy by Design” and had a distinct focus on “exploring innovative ways to create and sustain a human-centric environment.”
However, even with the advancements in AI and Affective computing (which is a field of computer science focused on developing human-computer interactions that can recognize and respond to human emotion), there exists the ability to close the patient support gap by enabling human-like, supportive encounters that can scale and aren’t reliant on human intervention.
Enabling this technology requires multiple disciplines to ensure the patient receives sound, accurate and empathetic guidance. We have prototyped a number of different experiences using AI and look forward to their commercialization.

Dana Maiman: There is a lot of hype surrounding Artificial Intelligence so we focus on proven use cases such as employing chatbots to improve the Human-computer Interface (HCI). The promise of digital tactics has always been that we can have a conversation with a brand, and chatbots literally enable that experience. If done properly, they remove friction and allow consumers to access information and services with breathtaking speed.

Sonja Foster-Storch: The AI field itself is in its infancy, and we’re still figuring how to best take advantage of it in the marketing world. We’re currently using it to predict ROI on various ad placements and automate our a/b testing based on performance, but in the future we can see AI giving numerous recommendations. Chatbots, either through Facebook or basic SMS texting, will continue to be more and more sophisticated in the types of tasks they can complete for you. They’re popular because they embrace users in the ecosystem they’re already familiar with – why download an app for a specific task when I can just send a Facebook message or a text? We’ve helped launch projects where chatbots are doing everything from recommending nutritional information to activating patient savings cards.

Wendy Blackburn: The digitization of everything, combined with exponential advances in processing speed and data storage have made it possible to store and analyze quantities of data never before possible. We’re moving from historical measurement of marketing, to real-time, to predictive and even prescriptive. Our data scientists are getting into some very exciting applications of using this data. For example, machine learning is dramatically improving our profiling, targeting, acquisition and retention, well before we even measure a program’s end results. We’re applying advanced algorithms to predict how payers will behave – if they will cover or drop a drug – even if they don’t know yet what they’ll do. We’re implementing chatbots to build relationships through conversations, tips and updates that are custom to a patient’s individual situation. There’s a little bit of an over-hype factor here, but behind the scenes, most people would be surprised by how much is actually happening in this space already.

Amar Urhekar: Chatbots have evolved immensely since their introduction in the mid-90s. They have come from heavily scripted interactions, to having the ability to recognize natural language and react in real time, ultimately creating a satisfying experience for the user. Cognitive interfaces like Google Assistant, which uses their Deep Mind AI platform, and those accessing deep learning systems like IBM Watson, are beginning to change the way customers interact with retail brands like The North Face and Macy’s, by understanding the customer’s motivations and meeting their needs.
For pharma, the applications of AI are endless, and the best of use cases will be those that truly solve human problems through ecosystem-inspired solutions. The healthcare ecosystem, with its many diverse stakeholders, has grown increasingly difficult for consumers to navigate. A brand can harness AI and predictive analysis to create truly scalable, personalized solutions to guide and coach patients through the complex healthcare ecosystem.

Megan Fabry: AI and chat technologies aren’t new, but their application in healthcare is finally beginning to take shape – and marketers are taking notice. Chatbots offer real-time, on-demand customer support services that can help patients and office staff facilitate processes such as booking appointments, managing prescriptions, and navigating complex prior authorization and insurance issues. Luma Health, for example, offers users a tool that can automate referral outreach and prompt patients to self-schedule. Their reminder system delivers customizable messages that patients can engage with, and even includes HIPAA-compliant ways to share test results, images, and insurance information.
Pharma brands are also embracing chat technologies to create more dynamic interactions on brand owned web and social sites. For example, instead of launching flat FAQ pages that require users to hunt and peck for the information they’re seeking, brands are beginning to embrace virtual assistants to help patients better understand how a drug works, side effects and dosing regimens, as well as drive enrollment into support and adherence programs. The chatbot is even making its way into online advertising. Watson Ads has developed banner bots that allow users to ask questions via voice prompt or simply by typing directly in the banner. Responses range from text to video to downloadable materials available directly within the ad experience.
Non-pharma healthcare brands are some of the greatest adopters of AI, using the technology to help patients better articulate their symptoms and predictively manage compliance with medication and lifestyle modifications. For example, Your.MD has branded itself as an AI personal health assistant, prompting users to ask healthcare-related questions, then serving up relevant responses. The service also helps users find doctors, pharmacies, and other healthcare services directly related to the problem or situation being discussed with the bot.
Looking to the not-too-distant future, AI-powered chatbots will drive more open channels of communication between patients and healthcare professionals, and other stakeholders such as payers. Their ability to help provide information and address user needs in real time provides a valuable service that can promote better health for a wide variety of patients.

Dan Chichester: While Stephen Hawking and Elon Musk may be right in their consideration that a true Artificial Intelligence (AI) will have a healthy disregard for our collective sub-cognitive species, the potential of AI to help ourselves up to the point of machine sentience is encouraging. Computer based learning and problem solving is moving from the back-end and is now taking hold – even taking the virtual hand – of patients, caregivers and health professionals. Contextual intelligence can help to collect, organize and advise on care.
Sensely’s “virtual nurse” is helping patients engage in real-time dialogue that can benefit their long-term disease maintenance via AI-informed risk assessment, education, insights – even advising if it’s time to go to the hospital. (Sensely is a platform TBWA\WorldHealth and Omnicom Health Group are already bringing forward to clients for pilots and real-world engagements.) Enlitics technology can interpret medical images 10K faster than the merely human radiologist, proving 50% better at calling out malignant tumors with a false-negative rate of zero. iCarbonX plans to combine data from bodily fluids and environmental/lifestyle factors to create an AI-powered “digital you” that can tailor wellness programs and prescription meds. The biggest caution is the human factor: our tendency to misuse technology before we understand it. With machine smarts that can truly deliver better patient outcomes, let’s never settle for simply a more clever chatbot.

Jonathan Pepe: By and large, our clients are just beginning to understand the impact that AI signals for our industry, but many companies feel any meaningful implementation would be cost prohibitive or that it lies outside their core competencies. At The Bloc, we feel that there is an untapped opportunity to implement AI at scale to significantly augment HCP workflow, ultimately leading to the creation of a new channel of communication in healthcare. And all while staying true to the mantra of “tailored customer experiences” that offer direct value to our consumers. As far as bots are concerned, we are seeing increased interest in using bots to augment consumer-focused campaigns, offering virtual “white glove” service as part of patient engagement and support programs. This is going to be a major industry trend, and it certainly will be interesting to see how both of these technologies continue to develop.

 

Med Ad News: Where do you see the future of personalized medicine heading?

Steve Hamburg, Managing Partner and Chief Creative Officer, Calcium: Personalized medicine is heading to a far brighter future full of promise, driven by our understanding of the human genome and the genetic basis of virtually all diseases and disease processes. So, as the science advances – as molecular biology advances and reveals new insights and information about individual human genomes, we will be able to create individualized or personalized therapies that are tailored to the specific genetic and biological needs of individual patients. In retrospect, we will view our current age and the previous age as being eras of what might be called imprecise medicine as we grow our ability to create medicines that are responsive to the specific genetic and biological hallmarks of any given individual.
The key question, of course, for those of us in the business of marketing pharmaceuticals is, how will this transition to personalized medicine affect our role? And the answer, I believe, is that there will still be a foundation of common ground or shared experience in disease classes and in drug classes. There will still be a foundation of meaning and relevance to message on a broad scale. In other words, the brand imperatives will still be shared by a large number of people, and therefore, brands can still stand for meaningful and singular things even as sub-messaging or sub-targeting can occur for patients whose needs may be more particular or specific. I don’t think marketing will atomize or completely fragmentize because there will still be enough critical mass of shared disease experience and shared need for effective therapy on which a brand message or architecture could be built.

Eric Densmore, VP, Account Director, AbelsonTaylor: The concept of personalization is abundant in all facets of our lives. From technology that allows our homes to welcome different family members with personalized lighting, music or temperature, to the internet’s somewhat creepy ability to display banner ads of the mountain bike on my laptop after I was looking at them on my phone. But no where can personalization make a greater impact than in medicine; stakes don’t get much higher than creating a customized treatment to cure a patient who otherwise had a slim chance at living.
Many efforts have been made to personalize medicine, but having had the good fortune to help a manufacturer bring a gene therapy to market, I’ll focus there. Mind-blowing fact of the day: it’s estimated that the cost to sequence a full human genome will cost less than one dollar by 2025 (https://www.genome.gov/sequencingcostsdata). At that price, gene sequencing is likely to become as routine as a standard clinical workup blood test. However, genetic information, unlike a blood test, isn’t prone to daily changes and goes further than simply collecting information such as Hg & O2 levels. New advances in medicine will try to integrate this genetic information with other data to create new insights into a patient’s overall health. Think of genetic sequencing as mining for coal. By combining the information and linking with other data sources, we process that coal into energy.
While the potential for good is real, could this actually result in the de-personalization of medicine? A therapy developed from a patient’s own genes to cure a disease is, by definition, personalized. But what if so much focus is put on matching patient data to treatment data that we start thinking about patients more as data and numbers and less about them as people? Will genetic sequences be combined with real time clinical measures (such as MRIs, blood tests, etc.) to have artificial intelligence spit out a diagnosis and treatment plan? Can you envision hearing Amazon’s Alexa saying: Patient 7E496 has leukemia and their genetic profile suggests treating with Product X. As marketers, we may need to work even harder to keep the focus on the patient, keeping top-of-mind the person behind the sequence. Every advancement comes with a new set of challenges, so let’s do our best to help keep the person in personalized.

Kathleen Nelson, PhD, Chief Scientific Officer, Elevate Healthcare: More and more, there is a shift from a therapeutic paradigm in which a treatment is expected to work for everyone with few exceptions, to one in which a patient’s individual make-up helps determine the treatment that is the best fit specifically for him or her. Although the trend to personalized medicine may be slower than originally predicted, it is evident.
Examples of personalized medicine can be seen across the therapeutic spectrum. From preventing adverse effects, such as the hypersensitivity reaction seen in some patients when treated with abacavir; to helping clinicians determine the best dosing for their patients, such as recent advances in understanding the genes that are largely responsible for inter-individual variability in response to warfarin; to predicting the likelihood of a patient developing certain illness, such as breast/ovarian cancer when the genes BRCA1 or BRCA2 are present; to evaluating how genetic make-up influences treatment effectiveness, such as HER2/neu testing for trastuzumab therapy for breast cancer. The latest example of personalized medicine is the breakthrough development of CAR-T therapies in which a patient’s own immune cells are modified to attack and kill cancer cells in the patient.
As our knowledge of diseases and advances in technology continue to grow, so will the identification and treatment of patients based on their own unique characteristics – in large part because the benefits of personalized medicine are broad-based. As NIH Director Francis Collins commented, “Personalized medicine is empowering.” Patients will receive safer, more effective treatments. The pharmaceutical industry will be able to develop better therapies more efficiently. The cost of healthcare may well be reduced as fewer patients receive therapies that provide no benefit or have serious adverse effects.
While personalized medicine is currently more common in cancer care, it is only a matter of time before this paradigm shift emerges as a dominant force in other therapeutic areas that affect large numbers of people, for example diabetes care.

Megan Hall, Executive VP, Creative Director, Copy, Entrée Health New York: With an increasing ability to personalize medicine comes an increasingly complicated set of payer policies designed to ensure that only patients who will benefit get access. What today we call a “hub” will become even more important, and will probably look very different from the standard set of support services we’ve come to expect. The hubs we help design and market today are light years beyond where they were even 8 years ago at Entrée Health.

Nancy Beesley, Partner and Chief Strategic Officer, HCB Health: I see two key words here: Precision and Predictive. Personalized medicine will take the shape of the consumer world – developing solutions based on customer needs and preferences to solve a specific problem. We think of precision medicine as targeted therapies for a specific patient group, but I consider the broader definition of custom therapy delivered to the patient the way they want it. This is probably the most exciting frontier in medicine. It puts the patient back at the center of everything – where they should be.
Predictive is the other word that personalized medicine will evolve towards. We use data to inform us constantly about how an HCP or a patient has behaved in the past. What is so much more insightful is using our extensive access to data to routinely predict how a customer will behave in the future. We can use information to predict not only behavior, but also from a clinical perspective – what will work and perhaps what will not. Controversial, yes but also very exciting.

Emily Poe, Global Practice Leader, Healthcare Communications, W2O Group: Predisposition to disease through tissue-specific gene activity – that is, tailoring treatments not just to a specific gene or mutation, but to which tissue the variant is located in the body. Researchers are already using data from the Genotype-Tissue Expression (GTEx) international project consortium to associate risks to complex genetically associated disorders like schizophrenia, CV and diabetes. We are now able to see how certain genes are turned on and off at a tissue level through expression quantitative trait locus (eQTL) analysis, and understand that this impacts a person’s risk of a disease and which tissues are most relevant to a disease. This, for example, may help determine how the microbiome may impact diseases in other areas of the body, and therefore may help us to create personalized prevention or highly personalized treatments.

Eileen Yaralian:

Patients understand and take ownership of their own healthcare:
Already, patients are able to access a huge set of data regarding their own health by tapping into labs that map chromosomes and detail health risks, such as 23andMe. Patients can add this information to their own health records in order to inform future treatment needs. However, personal health records have yet to take off on a broad scale. Challenges today include patient willingness to manually upload their health information and technology issues merging it all into one place. Automatic synching of records will be critical to making this a reality, and many tech companies are exploring solutions. The opportunity to connect and aggregate their own health history improves continuity of care and reduces redundancy among health care providers.

Personalized healthcare will be proactive, rather than reactive:
Today, we think of personalized medicine, rather than personalized healthcare as a whole. That’s because it largely comes into play in response to a specific diagnosis. In the future, personalized healthcare will become the driver of preventive care. Based on the genetic profile of individuals and aggregation of big data that many organizations are compiling, predictive analyses across populations will be able to identify individual risk for a disease or condition. Individuals will be able to opt for preventative measures that may improve their long-term outcomes.

Personalized medicine will move beyond oncology:
Many oncology patients today are being treated by their molecular profiles first, rather than their disease. This year, we saw the first drug to be approved by molecular biomarker rather than tumor type. However, personalized medicine has largely been isolated to the oncology world and spread little to other categories. We anticipate this changing over the next decade, with more and more identifying markers of diseases being discovered. Manufacturers are encouraged by payers to provide biomarkers to better predict treatment response, which will fuel continued exploration.

Dana Maiman: Personalized medicine is a large umbrella term encompassing a lot of different changes that are impacting how physicians and patients agree to treatment decisions. The first is a better understanding of how drugs will work in individual patients. Particularly in areas like oncology, matching drugs with patients who have no only specific biomarkers in their tumors, but genetic signatures involving multiple genes will become increasingly important for helping oncologists match the most effective drug with the patient who needs it. The opportunities for pharma to play a role in facilitating that guidance are only starting to come to light, with companion diagnostics to new oncology therapies moving from “nice to have” to “required” for many new product launches, and for reimbursement.
Another big area of personalized medicine that’s gaining ground is shared decision making. As patients are becoming better informed, and categories are becoming more crowded with therapeutic options, treatment decisions are moving away from the paternalistic “doctor knows best” model to an engaged discussion between patients and physicians to help figure out what the best treatment option is for that patient and their lifestyle. And it’s not always about efficacy and safety – other factors that have traditionally been discounted like quality of life improvements, method of administration, and dosing frequency are suddenly becoming front and center as patients have gained a voice in the management of their illnesses. Through marketing initiatives to patients, physicians, and other health care professionals, pharma now has a chance to help inform all stakeholders in the decision making process about what matters to them.

Sonja Foster-Storch: What if we had the ability to treat one patient, one condition, one challenge, with the right dose at the right time to help cure their disease? Sounds daunting, almost impossible, right? Well, that’s just what personalized medicine is trying to do. Simply put, the future of personalized medicine, if executed correctly, has the ability to significantly change how our industry understands, responds, and treats patients, and may revolutionize the practice of medicine at an incredible rate.
We are all amazed at the craze about data, information, and our own personal information that we collect on our health – but what does it all mean? What is it good for? What will it do? What if it allowed the medical world to truly understand what his or her main objective was – to treat you, the person, the individual, on a personal level versus what we do today, treat everyone with the same (or similar) process? Personalized medicine may have that ability; the potential to remove the trial and error and to focus on a specific patient and a specific treatment factor. With more information, we can understand that each individual’s body and diseases are different, giving us the ability to personalize our approach based on large sets of data that can then be tailored and targeted to treat that specific individual. Innovation, technology, speed, sharing of information: all of these are potential assets to help understand that individuals are made up of different compositions and respond differently to treatment based on patient populations, response data or even genomic makeup. Sounds great, right? But not so fast – while there may be technological and innovative advances in diagnostic tests and data, there remain many barriers within the industry that have slowed the predicted advancements over the years. Things like policy, legislation, pricing, access, etc, all add complexity to what seems like a simple answer. Personalized medicine should happen fast – I mean, who thought we would all have our phones in our pockets as a key element of how we live our lives?

Amar Urhekar: While personalized medicine is emerging as the new paradigm for disease prevention and treatment for complex health conditions such as cancer, the true potential is just starting to be realized across other conditions. The healthcare industry is beginning to demonstrate a commitment to this emerging area of medicine that will advance innovation in diagnostics, therapeutics, devices and overall health.
The focus on personalized medicine will continue to grow in importance and commitment among numerous key stakeholders, including the government, research institutes, academic centers, pharmaceutical industry, patients and caregivers. We expect to see companies mine online customer behavior, social media consumption and posts in order to create medicines that meet their specific needs. Study protocols will be designed to meet such end-points, and along with marketing and user-generated content insights, product labels will be more developed by just as much what consumer define as their greatest pain points, ultimately expanding to new indications.
Once intelligent technology gets incorporated into treatment, we can learn about how that particular medicine relates to that particular person. The fusion of technology and medicine will open up a new definition of personalization. Most recently, a wearable sensor patch made by Proteus Digital Health is part of the Abilify digital pill study. This is just the beginning of how personal data can inform future innovations.
From a pharmacy perspective, personalized medicine will enable patients, pharmacists and prescribers to better manage and prevent adverse events and help improve patient outcomes.
Additionally, personalized medicine can help lead more creative and faster patient recruitment into patient registry and clinical trial networks. Accelerated priority review will become the norm for candidate drugs that offer major advances in treatment or provide a treatment where no adequate therapy exists. The time goal for completing a priority review is six months, but a well-prepared submission with strong evidence, and a commitment on the part of all of the parties involved can enable the review to be completed, and the drug approved in half that amount of time.

Boris Kushkuley: For decades, we experienced a curious dichotomy in healthcare. On one hand, diagnosis was highly personalized through the use of clinical tests and patient feedback along with physician experience and analytical skills. On the other, treatment options were somewhat limited and relatively generic. Not anymore!!! Today, genetic testing that leads to targeted treatment like RNAi-based medications, immuno-oncology or CAR-T are starting to truly redefine the way physicians treat diseases. We are at the dawn of new era when ailments are matched and highly personalized for patients, and treatments are uniquely engineered for their conditions.

Prodeep Bose: Genetic medicine is typically the epicenter of any discussion around personalized medicine. And rightly so, given that the basis of personal medicine depends, to a great extent, on sequencing one’s genome. Diseases with single genetic variations such as cystic fibrosis, sickle cell anemia, or muscular dystrophy have been the foundation of genetic medicine; however, personalized medicine goes beyond the treatment of simple genetic mutations. Complex diseases such as depression, Alzheimer’s disease, and hepatitis C have a genetic component, but the primary realm of personalized medicine involves the environmental conditions of age, alcohol consumption, and weight. This requires a broader view of personalized medicine that encompasses preventive medicine, personalized disease monitoring, and treatment choice. The role of genetics is still critical. For example, Helix’s DNA test decodes your genome to report on whether you should avoid lactose, whether you have an inherited risk of cholesterolemia or diabetes, and can customize weight loss plans. AliveCor has a digital device that can record your own EKG using thumb pads and your iPhone for an ongoing personal record that is far more likely to discover abnormalities than an annual visit at a doctor’s office. Mindstory and Parkinson’s Voice Initiative are several current startups that claim they can use smartphone voice data to diagnose post-traumatic stress disorder, identify patients who might develop psychosis, and spot early signs of manic episodes in patients with bipolar disorder. There is even an effort to deliver therapy via a chatbot on Facebook. On the treatment choice end, the field of proteomics, the discovery of biomarkers and understanding of molecular and cellular mechanisms, and the development of bio-informatics for data interpretation, pattern recognition, and predictive analysis are shaping the future of therapeutic innovation. It has been noted that proteins constitute the bulk of therapeutic targets accounting for more than 98 percent of drug targets. In short, the realm of personalized medicine is multi-faceted, and what will deliver tangible value in terms of health economics and outcomes tends to suggest proteomics over genomics, as well as personalized monitoring and intervention over personalized drug discovery. But then again, each breakthrough in a disease category reshapes its future.

 

Med Ad News: How are your agency and clients promoting gender equality in the workplace?

Ed Mitzen, Founder of Fingerpaint, and Bill McEllen, Head of the agency’s Saratoga Springs office: Fingerpaint has a comprehensive approach to promoting gender equality in the workplace. As an agency without titles, it is somewhat challenging to evaluate pay scales between men and women. However, our CFO has developed a system and regularly analyzes our employees’ salaries to ensure that we are not discriminating based on gender, and our analysis holds true to that. Above and beyond this, nearly 50 percent of our senior leadership team is female, which is an intentional move on Fingerpaint’s part. We believe diversity on this team ensures that the best interests of both Fingerpaint and everyone employed by us are equally represented.

Steven Michaelson, Founder and CEO, Calcium: When promoting gender equality in the workplace, the way to lead is by example.
Regarding our clients, the considerable majority of the executives we interact with are women, across all levels of management, the brand managers and decision makers. And in fact, the CEO and founder of one of our largest clients is a woman, though women in general haven’t made the same inroads into pharma c-suites as they have into the next-step-down levels of management.
As for our own agency, gender just isn’t something we actively think about. Two of our six managing partners are women, three of five senior leaders, and probably two-thirds of the total staff are women. It’s not that we aren’t aware of the challenges of gender equality out in the wider marketplace, or the value of supporting it – it’s just that we’ve been so focused from day one on finding and supporting the best talent that things like gender or race or any of that really never came up. We don’t need to go out and advocate for gender equality or more women in the workplace; our own leadership structure and roster of employees makes that case on its own.

Jennie Fischette, President, DDB Health: As a female lead of an agency, I’ve recognized that I am in this position because others thought of diversity and the value it provides. Recognizing diverse perspectives means thinking in a broad manner from the start and ensuring that diversity is present at the table rather than a check of the box after decisions have been concluded. I firmly believe workplace equality translates into better decision making, creativity, and innovation, which leads to a better product for the client and is indicative of the brands we represent and the success of our agency overall. Period.

Jennifer Matthews, President and Managing Partner, The Bloc: As a certified woman-owned agency and with 58 percent of our leadership team being female, we’ve reaped the rewards of gender equality at The Bloc for quite some time. Founding Partner Susan Miller is a legendary industry force and shaped the agency with a relentless focus on attracting the best talent, be it female or male, from the very beginning. That being said, we do recognize that women can benefit from mentorship and sponsorship on a more intimate level. While we invest in training and programs, we’re proud that most of our initiatives are grassroots/ground up – coming from women inspired to make a difference across departments and levels.

Nina Manasan Greenberg, Managing Partner, Executive Creative Director, Entrée Health New York: I’m proud to say that 4 of our 5 executive team members at Entrée Health New York are women. But let’s be clear: we’re committed to diversity of all sorts. To be successful, I think you have to live this commitment every single day in at least 3 ways:
1. Hire well, then train well. We believe in feeding the talent pipeline and then supporting the education of all our people, in the ways that each of them need to grow.
2. Be aware of cultural biases, actively work to undo them, and embrace difference. Frankly, we have a pretty strong nerd culture at Entrée Health, which means we hire smart people with incredible potential, and assume that everyone here is a learner. And we’re lucky; the nerd predisposition tends to support diverse opinions.
3. Your structure has to support your goals. Our merit-based structure insists on the development of each individual coming up.
It’s not enough to just take on bias deliberately. That’s why we’re proud to actively support MAIP. (And we’re proud that one of our ACDs, Natasha Aswani, was honored as one of 6 MAIPers to Watch in 2016.) As well, our pro bono work with Queer Health Access helps us live our mission: we think it’s critical for people to have access to the healthcare they need.

Annemarie Armstrong, Executive VP, Director of Client Services, Dudnyk: Promoting gender equality stems from our core values. Chief among them is “believe in others.” We fundamentally believe in treating each other with dignity and respect. And this plays out at Dudnyk each day. We work to create a rich, open culture where we value the contributions of everyone – no matter your role, title, gender identity, who you are, or where you come from. If you don’t have a healthy inclusive culture to start with, I think it’s hard to promote gender equality. It rings hollow.
An equality culture isn’t only about acceptance of women. Promoting equality is also about making sure that we provide equal opportunities for professional development and career growth, regardless of gender. We want people to build their careers here, and that means giving them opportunities to learn and be challenged by new assignments. And again, it ties back to a core value of ours – “keep learning.”
Recently, Dudnyk paid for almost 20 team members to attend the Pennsylvania Conference for Women. It was a day full of rich discussion, inspiring speakers, and a lot of fun and bonding. It gave us each an opportunity to step away from the day-to-day demands of our jobs. We focused on ourselves as individuals and had time and opportunity to think about what inspires us to “be our best “(another core value).
Keynote speaker Carla Harris, veteran business leader and author of Expect to Win: 10 Proven Strategies for Thriving in the Workplace, spoke about an awareness of what leads to success in the workplace. “Recognize your power and own it,” she said. “If you were invited into that environment, that room, that conversation – then you deserve to be there. Never question it.” I was struck by that fact that women at Dudnyk don’t question that they deserve to be here. We have arrived! It’s a healthy culture, with values that are lived every day, and a supportive team environment that has laid the groundwork for that kind of confidence.
In my experience, a values-driven culture embraces gender equality as the norm – because it’s the right thing to do. But it makes good business sense too. In one McKinsey study, gender-diverse companies were found to be 15 percent more likely to perform better than their competitors. I see this benefit not only at Dudnyk, where more than 50 percent of our team members are women, but also in organizations we work with. Women are well represented in leadership positions throughout these companies, and they are confident and empowered in their roles. I walk the halls of our clients’ organizations and see initiatives supporting diversity and inclusion, and it’s not by happenstance. We work with some of the most innovative biotech and pharmaceutical companies in the world, and they know what we know – a healthy, inclusive environment is critical to business success.

Carolyn Bartholdson, Chief Human Resources Officer, Omnicom Health Group, and Ayaunna Bibb, Human Resources Manager, TBWA\WorldHealth: At Omnicom Health Group (OHG), our agencies pride themselves on a meritocracy. This meritocracy has manifested itself with strong representation of women across the network. In the US, 61% of our works force is comprised of women. This is consistent as staff advances. We have the same representation of female VPs (61%). At the most senior level (SVP, EVP, President, CEO), 56% of the positions are held by women. As an OHG company, TBWA\WorldHealth’s Leadership Team is comprised of 80% women.
Sharon Callahan, CEO, TBWA\WorldHealth and Chief Client Officer, OHG, spearheaded an OHG-wide effort highlighting International Women’s Day 2017 with a focus on the contributions and impact that women have in advertising. In 2018, we are launching an unconscious bias training effort to our entire agency to dispel myths and shake out gender misperceptions.

Kristi Veitch, Executive VP, Human Resources, Intouch Solutions: One of the great things about Intouch is that equality, diversity and inclusion (of people and of thought) have been present since day one; so we don’t have a lot of hard-core equality “promotion” programs, as it’s already ingrained into our company culture. Specific to gender equality: women outnumber men at Intouch (60/40 ratio across the entire company) as well as across our leadership team (VPs and above) … and those Intouchers who prefer to remain gender neutral/fluid find us to be a safe place to work where they can be themselves.

Nadine Leonard: An interesting fact about Heartbeat is that our staff – and the agency leadership team – has consistently been 60 percent+ female for its nearly 20-year history. I’ve always enjoyed the mentorship and camaraderie of our ‘female force’, but this question forced me to really think why it has been this way. Naturally, having female leaders has led to women being supported, championed and promoted. But beyond that, I keep coming back to the same reason again and again: we’re really a meritocracy. It’s never really mattered someone’s age, their race, their gender…when we’re interviewing or reviewing performance we’re just thinking ‘are they good?’ I recognize that the female leadership that has always been at Heartbeat benefits the meritocracy-approach. And if that wasn’t the case, we might need to be more intentional in that approach. Call it luck, chance, or planful, but for us the core philosophy upon which our business has been shaped and grown, has worked. Practically, Heartbeat has career path models that document what ‘good’ likes like for every role and that’s what the staff is assessed against. So, with ‘good’ having no gender-orientation, you end up with a staff that is well-balanced.

Dana Maiman: FCB Health is committed to the diversity of people and thought. We’re fostering a culture that is inclusive, promotes mutual respect, and maximizes individuals’ full potential to ultimately benefit our employees, their families, our clients, vendors and shareholders. We lead initiatives such as #CreativityInColor, “Here Are The Women,” and co-sponsor panels like “Their Truth,” to tackle the issues of diversity and inequality in advertising.
As our agency mantra states, we’re Never Finished, and the fight for equality is far from over. We’ve made tremendous progress in recent years, and have built a global leadership team that is over 50 percent female. But we’re not stopping there. Our local office leadership teams have more award-winning women in leadership roles than any other global agency network, and have been named Matrix Award winners, Industry People of the Year, Women to Watch, and top creatives – all across the network.
In 2016, we began offering up to 6 weeks of paid family leave for both men and women to care for newborns, promoting gender equality at home and ensuring women have more support as they transition back into the workplace after having a baby.
FCB is a sponsor of the 3 percent conference, which focuses on increasing the number of women in creative leadership positions. Our Chief Creative Officer is a “manbassador” and dedicated to ensuring we are providing opportunities for women to advance to all levels of creative
We’re proud of the numerous roles women play throughout our global network. Diversity and equality are two key parts of our culture, and we will continue to grow and thrive with a diverse and passionate group of individuals that will never stop benefiting our clients, vendors and shareholders.

Sonja Foster-Storch: Creativity is born out of thinking differently. You need to build and maintain a dynamic and diverse workforce of people with unique backgrounds and expertise that sparks new ideas and groundbreaking work. We excel at this and have created a collaborative and open environment where people are free to share their thoughts and challenge one another to arrive at the best outcome. This only happens when we reflect equality in all parts of our company, including our decision-making process in hiring, compensation, and corporate initiatives. It is imperative that the environment in which we work also represents the targets we are trying to reach. As a woman in a senior leadership position here at GSW, I will continue to lead by example, and this goes across gender and diversity. One of the reasons I came here was because the people I interviewed with – women and men – have a shared philosophy of respect and we will continue to inculcate that throughout our agencies. I also seek to align with clients who share this same mindset and have been fortunate to work with agency and client leaders who share this same ethos.

Amar Urhekar: We’re very proud that 50 percent of McCann Health’s North American Senior Leadership Team are women. And in 2018, we plan to launch an “Authenticity Program” specifically focusing on helping women executives find their authentic voice in the workplace.
Additionally, six women from McCann Health participated in the IPG IDEAL Leadership Training Program, a highly regarded,12-month business leadership development program for high performing, senior-level, diverse employees and their managers.
Other IPG/McCann Worldgroup Diversity & Inclusion and Gender Equality programs that McCann Health participates in include:
Diversity Scorecard Presentations + Toolkits to measure and monitor representation, hiring, and promotion of women and people of color, while also providing relevant guidance and possible solutions to improve.
Unconscious Bias Training Workshops: In-person workshops to further knowledge and awareness about the subject and how it can influence our personal + professional lives.
Free the Bid: we joined the movement and pledged to #FreetheBid , a non-profit initiative advocating on behalf of women directors for equal opportunities to bid on commercial jobs in the global advertising industry.

Emily Poe: W2O and our CEO/Founder Jim Weiss, have made it part of the firm’s mission to focus on equality, inclusion, quality work, client service, empathy and diversity. This foundation has contributed to a strong female representation across the firm (63 percent) and in leadership (3 of 5 operating company’s leaders are women, as is the head of W2O EMEA). As part of this, we review pay practices regularly to ensure parity based on role. This too has supported an open, honest, idea-oriented, and respectful workplace. We’re proud to say that as of our most recent review, virtually all roles demonstrated pay parity (some even show higher pay for women vs men).
That said, we – and the industry – have much more to do as it relates to ethnic diversity. That’s why we teamed up with the LAGRANT Foundation (TLF) to foster diversity in healthcare communications. The W2O Group LAGRANT Fellowship in Healthcare Communications is a first-of-its-kind paid internship in healthcare focused on diversity, inclusion and will create new opportunities for emerging talent who may not have considered our industry as a viable option for them. The program places ethnic minorities pursuing careers in healthcare communications in one of our offices to get first-hand experience in the industry. The goal is to engender more balance, provide different perspectives, and enhance authenticity within communications.
As we move into 2018, we’ll be implementing new strategies that promote inclusion and social accountability (in hiring and promotion) to bring greater transparency and continue to move the needle for W2O and the industry to ensure continued gender parity and foster greater ethnic diversity in our workplace.

 

Med Ad News: Some industry sources say technology is beginning to eliminate the need for prescriptions typically used to treat medical conditions such as diabetes, hypertension and obesity. For example, a recently published study documents how a mobile app is lowering blood pressure and reducing weight for adults fighting hypertension and prehypertension. This is reportedly the first study ever to prove consumers can lower their blood pressure using a mobile app. What impact would this type of technology have on the pharma industry?

Jay Carter, Senior VP, Director of Business Development, AbelsonTaylor (Twitter: @jaycarterrxads): Mom and Dad payed a lot for my pharmacy school education. Ever since then, I’ve been pretty fussy about making evidence-based claims. I believe that there’s probably some promise for mobile app use for diabetes and obesity. The apps today might work a bit, too. However, to suggest that apps are eliminating the need for prescriptions for these diseases is more than a stretch. A quick literature search validated my thinking that the jury is still definitely out on the question of apps for common diseases like diabetes, hypertension, and obesity (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4978862). In fact, I would suggest that this topic, with hype, could turn into “fake news.” Apps are limiting in their scope, don’t involve health care professionals enough, and could encourage people to think that miniscule efforts are enough to help them. Every segmentation of patients with diabetes consistently suggests that only about 17 percent of patients with the disease are willing to work at it … and if they do, they are the ones with lower A1C scores and weight loss.
Want to address diabetes, hypertension, or obesity for real? Make an appointment to see, and listen to, your doctor!

Garth McCallum-Keeler, Managing Partner and Chief Strategy Officer, Calcium: The results of studies like this speak as much to the importance of empowering and engaging patients as they do to the “replacement” of prescription drugs. Today’s patients expect to have ready access to their “digital self,” be it health monitoring data through apps or other support systems – they expect themselves to be surrounded with easily accessible help and information to guide their understanding and decision making. So we as marketers have to be prepared to meet those expectations, with whatever technological tools may be utilized.
Of course, doing that isn’t as easy as just saying so. There’s a clear tension in the use of technology for patient support – on one side there’s the Silicon Valley thinking, “Let’s give the user whatever s/he wants – since it is the person’s data and they have every right to it,” and on the other side there’s the FDA/regulatory department thinking, “Some of this is complicated stuff, we shouldn’t trust the patient too much. That’s why we have healthcare professionals.” So no matter how far the technologies go, collecting and “releasing” patient data is always going to be a balancing of that tension.
As technology and health data on the self become more ubiquitous, developing mechanisms to encourage or increase the dialogue between the HCP and the patient becomes critical. No health support app/data aimed at a patient audience should ever exist in a vacuum; it should always operate in the context of the patient/HCP relationship.
Finally, we as marketers should always remember that many of the disorders our brands treat have multiple components that influence the course and severity of the condition – some physiological, some psychological, and some psychosocial. Data aggregators and apps are certainly not at the level of replacing drugs, but they may cause more introspection and discussion regarding the ways forward for treatment, focusing as much on what the individual can do as much as the drug.

Peter Agliardo, Senior VP, Group Creative Director, DDB Health: At its core, the emergence of “digital therapeutics” represents a digital extension of what doctors have been telling their patients for years: “Eat better, exercise more, stop smoking,” but with the added benefit of real-time data that allows the digital provider to continually improve and customize the product. Although venture capitalists are betting hard on this technology playing a replacement role, it’s still not clear how supplemental or supportive it will be. What is clear, however, is that this will alter the conversation between pharma companies and patients. Pills and devices will no longer be the only show in town, and therefore, will not be the only technologies influencing the way a health product engages with a patient. These new technologies will influence the dialogue, and patient expectations for suppliers of health will naturally change.
So what’s a good pharma company to do? Proactively partnering with app companies to enhance the performance of their own pills and devices is an obvious first step. They may also need to develop more meaningful relationships with patients post-prescription to address the patient’s evolving needs. They should also look to invest more in data from real world outcomes, as positive data will help their products maintain high value in the eyes of payers and patients alike.
In the future, while the phrase “there’s an app for that” might not be a part of a doctor’s regimen to treat something like breast cancer, it is likely that young women may use an app to lower their breast cancer risk, or at least catch it early. Which means that by the time pharma companies enter the conversation, they’ll need to speak a similar language in order to be heard and trusted.

Nick Bartolomeo, Digital, Media & Analytics, Fingerpaint: Mobile health (mHealth) has the potential to make a big impact on the pharma industry but, in my opinion, only as an add-on to prescription medications. I don’t see mHealth competing with pharmaceuticals as of now, but rather supporting them to better improve health outcomes – and they have a few challenges to overcome first. Currently, many clinicians have concerns over the validity of mHealth apps, especially in the cardiovascular category, where many pulse and blood pressure monitor apps have been shown to be clinically inaccurate. Another challenge is the age-old issue facing all health interventions: patient adherence. Research tells us that it is still extremely difficult to get patients to simply remember to take a pill each day. Certainly the same challenge will apply when we try to get them adhere to an mHealth app.
In order for these supportive tools to show real-world results, we will need to design them to be as seamless and hands-off as possible. The good news is that companies are working to make this happen with such products as Apple’s Care and Health Kits and Amazon’s Echo. Apple has built a framework for developers to more easily build apps that interact directly with the iPhone and its built-in Health app. Amazon Web Services too is partnering with tech and healthcare companies to increase Alexa’s skill set. With the direction these companies are heading, the possibilities are immense.

Faruk Capan: Digital medicine is slowly but surely coming of age, and the next few years will sort out which technologies and players will be in it for the long haul. I am personally most excited about the promise of the combination of a traditional treatment plus a digital one. Intouch has experience here – one of our apps was tested in a clinical trial in combination with traditional treatment and a wearable, and use of the app showed significant improvement in patients. The key is to make the technologies ultra-easy to use, ambient in nature, and integrated into the patients’ life and broader treatment plan. I believe we’ll be seeing more and more impact on our industry from digital therapeutics, and the pharmaceutical companies that are paying attention and partnering now will be more competitive in the future. In the end, digital therapeutics will be an aspect of treatment, but it won’t be the only and it won’t be the panacea.

Barry Schmader: Technology that assists people in addressing health issues isn’t a new idea. Devices offering biofeedback mechanisms have been around for years, and the benefits of AR and VR in helping patients to control or adjust their environments to help manage certain diseases is fairly well documented. But as far as a mobile app replacing or eliminating a prescription? That’s a stretch. This hasn’t stopped mobile app developers from making wild claims, with many implying that a smart phone could actually be a medical device.
Just take hypertension for example. There are over 200 apps claiming to be able to help patients manage their hypertension. At best, these apps are intended to help with adherence to a medicine regimen, or assist with weight loss, or help monitor dietary intake, or in some cases, act as monitors to take blood pressure readings with your phone. Unfortunately, none have a claim that can be supported by an actual well-controlled trial.
A 2015 study published in the Journal of the American Society of Hypertension analyzed 107 mobile apps relating to high blood pressure.
Seventy-two percent of the apps could track indicators such as a patient’s blood pressure, heart rate, salt and calorie intake, and body mass index. Thirty-seven percent offered general information on high blood pressure, and 22 percent provided tools to help patients take their medications via smartphone features such as notifications or alarms. Only 3 percent of the 107 apps were developed by a healthcare agency. Fourteen percent of hypertension apps available on Google Play claimed to be able to measure blood pressure and heart rate when the user’s finger was placed on the phone screen or camera – but none had any documentation of medical validity.
The study also reports that although these apps made medical claims without providing proof, they received up to 2.4 million downloads by smartphone users, the highest number of downloads among all the apps dealing with high blood pressure.
Another study, reported in the May 16, 2016 issue of JAMA Internal Medicine, followed 85 people who had their blood pressure measured by the Instant Blood Pressure app, which was available for more than a year before it was taken off the market in 2015. The iPhone app, which cost $4.99 to download, required users to place the top edge of the smartphone on the left side of their chest and their index finger over the device’s camera lens. When the study participants measured their blood pressure, using both a traditional instrument with an inflatable cuff and the Instant Blood Pressure app, there were wide variations in the readings. The results showed that the app underestimated higher blood pressure. As a result, 78 percent of people with high blood pressure who used the app were falsely led to believe that their blood pressure was not in the hypertensive range.
So while in theory, apps could potentially help with lifestyle and dietary changes that could conceivably lower blood pressure over time, the only real benefit of any of the apps was to help patients manage high blood pressure by sending text messages as reminders to take their medication.
Ultimately, while these apps that offer a monitoring method sound like a good idea, it seems their best application so far, at least, is to help with medication adherence. We all agree that even the most diligent patients are noncompliant with their meds a percentage of the time. So, in terms of eliminating a prescription, it’s a pretty big claim that as of yet, has not been demonstrated. It seems at least so far, that the excitement over hypertension apps is mainly hype.

Paul Balagot: As the field of digital therapeutics expands and gives patients other options from having to “medically manage” their disease through pills or injections, this creates the potential for a dynamic shift in how pharma companies pursue their clinical development programs. Clinical programs singularly focused on molecule development will need to be reevaluated to include technology-based solutions. We see some of this happening already in clinical trials and we only see that trend continuing as tech giants look for ways to both collaborate with pharma and disrupt the industry.

Seth Perlman: While it’s a bit of a stretch to say that technology is “eliminating” the need for prescriptions, it’s fair to say that non-pharmacotherapeutic treatment options present huge opportunities for the pharma industry. Most of the advances in this space are being made by startups and health-tech companies, and for good reason: it takes much less time to get to market if you don’t need biological R&D, molecule development, long gaps between trial phases, and manufacturing facilities. These companies obtain funding based not on their potential to transform health, but on their ability to acquire data about patients. Pharma, on the other hand, is already funded, and has access to a wealth of resources that can help it deliver software-as-medicine solutions to market much more quickly, and at a lower cost than its traditional development business. Innovation groups, or CoEs, would do well to investigate bringing even a low-risk product to market as an exercise in applying traditional QSR/GxP to software – remember that the FDA has already signaled its receptivity to digital health solutions by pre-clearing firms and eliminating oversight in some cases.

Andrew Gottfried: There’s a lot of promise in new healthcare technology. But if this technology isn’t covered by traditional payers, I’m afraid the benefits will be reserved only for the “haves” among us. That’s why it’s going to be critical that we work with payers to ensure that access to these advances in healthcare is available to everyone.

Nancy Beesley: Any technology, whether it’s a mobile device or a class III implant that serves patients in the quest for compliance is a good thing. We have to give patients back the empowerment to take charge of their own health. Only then do we begin to chip away at the epidemics of obesity, hypertension and diabetes. These diseases require a patient to be an active participant in their fight. Pharma companies need to embrace this, as it truly “takes a village” to make a meaningful change for these conditions. If anything, I think we would see Rx’s go up – folks become more engaged in their health and wellness, they are more likely to be compliant. It’s a win/win for everyone.

Prodeep Bose: Digitally enabled behavior change platforms such as Omada Health should force every pharma company to ask itself whether it sees its business in terms of volume or value. Omada Health reports 30 percent risk reduction in diabetes, 16 percent in stroke, and 13 percent for heart disease. This is good news! These reductions mean that in combination with drugs, the net effect will be a far better outcome for patients. And clinical trials must incorporate such services when measuring endpoints, thereby making support platforms part of this new model for pharma products (Digital medicine = molecule + monitoring). The fact that some part of the trial outcomes can be attributed to behavior change is less relevant if pharma is to be held accountable to value-based pricing. In investment terms, there are two areas: discovering the molecule and investing in outcomes. In order to achieve this, the issue today may be more of a lack of imagination than a regulatory barrier. If pharma thinks its business is selling more pills then it will see behavior change platforms as a threat, but if it views its business as making people healthier then it will embrace this as part of the ‘product’.

Emily Poe: Digital health truly has the power to positively impact health. It’s an exciting area and one that the pharma industry should be, and in many cases, is working to understand how to best incorporate into their model. That being said, we know there are many other non-medical strategies to address chronic conditions such as type 2 diabetes, hypertension and obesity. Unfortunately, there still remain ever-increasing numbers of people living with these often preventable conditions.

Nadine Leonard: Over the past few years, the healthcare industry itself has been rebranded and relaunched. For decades, we’ve been focused on “scientific breakthroughs” and “treatments.” But, now the resounding themes are “outcomes” and “wellness” and “prevention.” If we’re being honest with ourselves, it should’ve been about those things all along. But now that the narrative has broadly shifted, eyes and ears are turning to big pharma to see how they react. Will they continue to “make drugs for sick people” or will they make an obvious move towards creating products and enabling processes that improve human health?
The hushed worry is that they won’t be able to support their business model economics while also promoting wellness and prevention. But who says they have to choose? Pharma companies would be smart to jump headfirst into partnering with technology and lifestyle solutions and pushing them as treatment complements. Why? Because humans are, for better or worse, human. Just as medication adherence is a trouble spot for pharma, adoption and prolonged interest is a trouble spot for tech solutions (like apps and wearables) and lifestyle changes (diets and exercise). Each element should be part of a solution, rather than the feeling that there has to be or will be a single magic bullet.

Dana Maiman: As a physician as well as medical director in pharma advertising, it is amazing to see how mobile lifestyle apps have enabled patients to manage common primary care conditions such as hypertension and obesity. Patient engagement with their treatment plan is key to improving outcomes and ultimately, helping patients live longer. Many of the disease states that I remember struggling to treat as an internal medicine resident, such as hypertension, diabetes and obesity, now have more treatment options than ever before coupled with more sophisticated technologies for tracking and monitoring by both HCPs and patients alike. This has allowed for pharmaceutical companies to focus on developing targeted drugs for more complicated therapeutic categories such immune-mediated diseases, oncology and less common/orphan diseases, to name a few. The pharma industry is also embracing technology as a complementary tool to help patients (and their HCPs) manage conditions – from reminders to promote medication adherence to real time tracking of symptoms and now even basic lab chemistries – this information allows for optimized use of pharmacologic therapies.

Amar Urhekar: Technology generally allows a holistic oversight to how patients manage their care and can be fundamental in ensuring progress. However, the question should not be “what is the impact this type of technology would have on the pharma industry”, but “how is pharma going to learn to use technology to co-manage the benefits patients receive when taking their brands”.
If they expect to grow, pharma companies must learn to see themselves as true healthcare solutions providers, as opposed to pill manufacturers. Coordinated treatment solutions, those combining medication(s), technology, and behavioral changes, will serve to provide better customer experiences, improving outcomes. Pharma needs to leverage its rigorous testing methodologies and principles, to help drive effective health tech application applications.
Working with our pharma partners, we have created apps to show patients how to use their product, manage the patient’s disease state, help to stay on treatment and then monitor it so the app can keep the patient’s doctor informed, and ultimately show ways to balance their disease with their lifestyle. Never before have these patients been able to have such an informed conversation with their doctor.
Co-managing care with technology will require a cultural and behavioral switch in how things are done currently. Positive patient outcomes in many chronic conditions are generally a result of more than one approach to care. So, we believe the bigger win will not come from an app. It will come from understanding the rich data that comes from monitoring performance that enables continuous improvement.

 

Med Ad News: Facebook is experimenting with letting brands study people’s posts and comments (users’ identities are withheld) on the network in an effort to better inform their marketing. This is the first time that Facebook is making it possible for advertisers to mine what users post. What are your thoughts on this?

Erin Byrne, CEO, ghg: Social media is a place where people can be themselves, get information on a wide range of issues, and have conversations on difficult-to-discuss topics. With more than 4 million health support groups on Facebook alone, these discussions can prove a rich source of information that could lead to significant insights. Marketers can study this information to make their content more actionable. We support this. However, marketers are also obligated to view social-media content cautiously, recognizing that findings are directional, not necessarily factual, given we know people sometimes varnish their social profiles for appearances’ sake.

Michael Schreiber, Executive VP, Executive Creative Director, DDB Health: Whether you consider this ability invasive, or even creepy, there’s no question that it is inevitable. This reality already exists on Twitter where posts are public and a simple search will return all the accounts discussing that topic. Assuming that it can be accomplished in a HIPAA compliant way, which is probable given that people are proactively posting their status, it is an invaluable tool for pharmaceutical marketers.
A tool like this will lead to ad targeting at a group discussing a topic with highly tailored messaging. For instance, ads could be served to thousands of people who are discussing their specific disease state.

Dina Steinfurth, Executive VP, Director of Strategic Services, Entrée Health New York: Whether it’s Facebook or any other company mining consumer data, one really interesting use of this technology is the targeting of cost and coverage messaging to patients based on the content of their posts. Someone who posts about what their grandkids are doing will get a very different message from someone who posts about her job, or his college acceptance, even if the ages of those posting are withheld. And for people who post the kinds of personal stories that imply they’re having trouble making ends meet, we might serve up a “$0 copay” message to them.
At the same time, stripping users’ identities also allows us to gain information about how people are behaving without the risk of infringing on HIPAA rights. And it may make us far better at true social listening. I’d like us to think more broadly than individual therapies or disease states, and start listening to what, precisely, people do and don’t understand about their healthcare coverage, and where they need help.

John Canevari, Senior VP, Director, Digital Experience, The Bloc: As social media participants become more and more used to the idea that their data are being “utilized” for market research and targeting purposes, the idea that Facebook is now doing something similar will quite likely trigger a momentary temper tantrum rather than a long-term concern for users. Think back to the congressional clamor over display ad targeting circa 2011 and the move by advertisers to reveal the targeted use of ads with the AdChoices icon. Absolutely nobody cares about this now, and nobody takes the time to opt out. Essentially, users have caught on to how targeting works online, and they don’t necessarily make distinctions between Facebook, websites, or mobile ads. So long as my security is not compromised, I’m good! Millennials, being digital natives yet security concerned, understand this difference inherently. Users in 2017 now know, for instance, that when they search on a particular subject, the follow-on display advertising is geared towards their preferences. Like it or not, it’s relevancy, and we’re growing used to it. At the core, it’s no different from the relevancy back in the 70s of advertisers understanding that a population of males was driving home in their cars after a day’s work; those advertisers would target that demographic via radio at the right time. This is the exact same construct with the exact same use of human nature – and we get used to it. In my view, marketers will use these data from Facebook and eventually other entities to refine their targeting, and users will benefit by having more relevancy infused into their daily lives.

Garth McCallum-Keeler: Data mining from Facebook is an inevitability – soon, it will be included in every brand’s standard set of data. The question is, how are we going to use the data? And how trustworthy is it? We would be wise to keep in mind that Facebook is just a modern incarnation of what the sociologist Erving Goffman called “The Presentation of Self” – it’s the modern dramaturgical stage for people to present themselves to other people in the way that they wish to be perceived or believe others wish to see them. So an awareness of that sensibility when analyzing any data mined from Facebook will be critical. The differences between a public persona and private beliefs and behaviors may be quite significant – and sorting those differences out will be a non-trivial exercise requiring considerable behavioral expertise. So, Facebook data will have utility, but it should only be used in combination with the many other data vectors that are available to us today, many of which come with considerably less inherent potential bias.

Nancy Beesley: I think we are going to have to get comfortable with our data being watched, analyzed, and then used back at us. The first time I was “retargeted” while browsing the web – the shoes I had eyed the day prior were now calling again to me in my FB feed – I was a bit uncomfortable. But let’s face it, social media is opt in – and users should know that nothing they post is not for public consumption. If privacy is a concern, then FB is not for you.
This data will serve important functions – first, to help analyze what is important to people which is the key to any good marketing strategy – finding the emotional hook that is so often the basis of decision making. Secondly, it will help predict, based on social interactions, how they might behave in the future which is a key component personalized marketing strategy.

Nadine Leonard: We’ve been mining social media and online communities for insights for over a decade – it’s the 21st century focus group. So, as patient and caregiver discussions are increasingly taking place on Facebook-hosted communities, this enabled access to their thoughts and concerns means our set of useful, candid data grows – leading to more insightful solutions that forge a human connection between patients and pharma.

Dana Maiman: It’s a golden age for data science. We’re not only collecting reams of data in native digital formats, but powerful tools are emerging that leverage Machine and Deep learning make it easier than ever to find relevant consumer insights. Access to data will become a key offering as long as platforms can navigate privacy issues.
Depending on how Facebook implements this policy, we see it as an opportunity to gain more insights about target audiences. Using AI and machine learning, we believe we can mine profiles, even if anonymous, to understand more about how consumers would be likely to make decisions. If the access is granted at a granular enough level, even if anonymous, we believe that we can map personality traits to an audience that can better inform our messaging approach.

Amar Urhekar: This is a smart move for Facebook that will help them become more relevant to healthcare, and play a more significant role in their communications plans. This will provide a great feedback tool for honest reactions to communications, medicines, and general health trends.
Several of our partners are already starting to mine both Facebook and LinkedIn. They’ve been digging into demographics, user preferences, searching types of practice, in types of market, looking at specialties, reviewing groups they belong to. The collection of all this these data helps to paint the picture of who these people are, which will help us when we’re trying to figure out what will drive traffic to websites, etc.
On a larger scale, we’re understanding who these people are interacting with, how they are interacting with them, where they are getting their information from. The more data we have for marketing, the better off we are. It allows for a much more pointed ability to target those we need to reach. In turn, pharma has a responsibility to provide the most credible, and relevant information to its customers.

 

Med Ad News: How is your agency currently implementing social media such as LinkedIn to improve business relations?

Bob Palmer, CIO, HCB Health: Developing a successful social media strategy for a business requires several key elements: choose the platform that most efficiently achieves your business goals; provide constant and active monitoring and posting of relevant content; and strive to make the content as sharable as possible. That doesn’t necessarily mean that content should be purely promotional, but interactions should be both proactive and reactive across a spectrum of subjects that capture and hold your audience’s attention. As opposed to non-business-related or “recreational” social media, when it is used as a business strategy it’s important to not waste users’ time with unfocused subjects and discussions. At HCB Health this activity is directed by a very proactive social media expert, Sophia Liu. And like every good social media strategist, she has a keen sense of content strategy.
Although HCB Health has a social media presence on other channels, including Facebook, Instagram, Pinterest, and YouTube, we have found that LinkedIn and Twitter are by far the most useful channels for our purposes. With a growing roster of 1,800 followers, we’ve found that LinkedIn in particular is an important resource because of its business and professional focus. When a user is on LinkedIn, generally he or she is searching for content that will benefit him or her professionally. A good rule of thumb is that if content isn’t worth sharing, it isn’t worth posting – which is the essence of a good social media strategy. A “Like” isn’t nearly as useful as a share.
LinkedIn has a number of new tools and infographics that are designed to promote a business. A new feature is “Benchmark”, a tool that compares HCB to other healthcare agencies. A number of windows on the LinkedIn HCB page give company stats, including employee distribution by discipline, headcount, new hires, etc. While these features are of interest to some parties – perspective clients, for example – they are not the drivers of a coherent and effective social media strategy. Also on the HCB LinkedIn page is content that would be of interest to almost anyone involved in health and wellness. The use of video is important, making the content dynamic and engaging. Topics include recent awards; posts and blogs on a variety of subjects; digital thought leadership events, both past and upcoming; re-posting of articles written for online and print magazines; recent studies and articles from industry publications; a comprehensive market survey on what clients want from their agency; recap videos from our experiences at SXSW; and a wide variety of other topics of interest to our core audience. The use of LinkedIn Pro also feeds relationships through InMail, a tool available at a monthly cost that allows connecting with people not normally within your network. Whenever an individual uses InMail, the message should contain a link to the LinkedIn business page.

Lisa Tamborello, PHR, Executive Director, Human Resources, Elevate Healthcare: Social media, especially LinkedIn, has become an integral part of our recruiting efforts. For Elevate, LinkedIn gives us a platform to establish our company’s mission, vision, and services but more importantly showcase our culture and our community. It gives us the opportunity to make a good first impression with individuals including those that may be outside our network.
We use the update feed to share marketing and employee activities, and use the other LinkedIn tools to tap into active candidates, but more importantly, passive candidates. Through InMail and other LinkedIn features, we can fine-tune searches to access pools of talent that best match our needs. In most cases, our success rate in finding the right candidate is much higher and more focused using social media tools, than traditional “help wanted” ads on job boards.
For potential applicants, LinkedIn and other social media outlets give a snapshot of our company’s culture and a means to better understand our position within our industry.

Jessica Corcoran, Copy Supervisor and Content Strategist, Dudnyk: Even before the Microsoft acquisition at the end of 2016, Dudnyk recognized the importance of LinkedIn as part of our social media strategy. Within our overall strategy, each network has a specific target audience and purpose. We have found that LinkedIn is the ultimate cross-section of our 2 primary target audiences – potential new client partners and new hire prospects.
Through LinkedIn, we are able to raise brand awareness, easily share thought leadership material, and showcase our agency’s culture. Some of our top performing posts include acknowledging employee anniversaries and sharing thought leadership articles. Additionally, LinkedIn makes it easy to share agency news, such as industry award nominations and wins, and announce the availability of new career opportunities.
Because LinkedIn is a professional tool and uses a resume-style profile, it means we are able to use sponsored content to target an even more focused audience. For example, when we launched The Unifying Effect earlier in 2017, we sponsored a post that drove users to a blog post about the new branding, targeting pharmaceutical and healthcare professionals with certain titles. This allowed us to ensure that the right message was getting to the right audience at the right time.
The updates to LinkedIn over the past year have only supported our goals. The addition of searchable hashtags allows us to group our content with similar posts, using words and phrases our audiences are interested in. Plus, the updates to personal profiles, such as photo editing, updated navigation, and the overall interface, mean that more people are using LinkedIn more regularly – increasing the number of impressions and engagements our posts receive.
Finally, as a company page, our reach only goes so far. An integral part of our strategy is to encourage engagement from our employees. As they like, comment on, and share our posts, it increases our reach and opens up our content to an even broader audience.

Kristi Veitch: LinkedIn is still the #1 social media platform for connecting with – and recruiting – top candidates across all levels of talent. And our people take an active role in sharing relevant stories about Intouch through their LinkedIn networks in order to help affirm a desire to work with us – as a client or as an Intoucher.

Sonja Foster-Storch: It’s no secret that social media has fundamentally changed the way we connect and share information. At GSW, we see social networks as instrumental vehicles to further engage with our audiences, whether it is clients, prospects, employees, or industry peers. Our social brand channels allow us to tell our story, converse with stakeholders, celebrate milestones, and share career opportunities. When used properly, social channels have the ability to engage us in meaningful dialogue and create powerful relationships.

Emily Poe: We have long appreciated the power of LinkedIn for our own networking and reputation building efforts, as well as for those of our clients. At W2O, we continue to use LinkedIn as a platform to share our thinking to other industry decision makers and thought leaders. We encourage our teams act as W2O brand ambassadors externally and invite them to share our LinkedIn content within their own networks, to both foster recruitment in a market always tight for strong talent and support business development efforts. In the past few months, LinkedIn has increasingly become a priority for clients who are focused on attracting and retaining the best of the best for their firms.

 

Med Ad News: What are your predictions for the healthcare industry in 2018 and beyond?

Kerry Hilton, Partner and CEO, HCB Health: The convergence of digital life and pharmaceuticals will continue to accelerate in 2018. With the FDA’s green light that allows Japan’s Otsuka Pharmaceuticals to implant a chip inside Abilify to monitor compliance, the race will be on to leverage this new technology. Developed by Proteus Digital Health, the chip sends a tiny signal when ingested and then tracked through a patient’s app. This is just one example of how individual patient data will continue to explode in the coming years. The “digital patient” is an opportunity to better diagnose, treat, and manage a medical condition if that data is properly put to use, thus the rise of pervasive AI in the healthcare universe. In the coming years we’ll see even more innovation around connectivity via 24/7/360 monitoring. The “digital patient” will simply be a “digital human” that needs treatment.

Carolyn Morgan, President, precisioneffect: The industry has been touting a “patient-first” model for quite some time. And while this is more an ongoing commitment than a trend, I do think we will see an uptick in focus from brand teams on patient experience – particularly with regards to adherence and compliance. This is good news for patients and caregivers. Things like run-of-the-mill HUB services, generic email campaigns and brochures should no longer constitute a great patient experience.
First, we need to dig deeper into patient journeys and unique behaviors to understand how an individual’s experience can be improved through customized and valuable touch points and services. Then, through segmentation and technology, we can dramatically improve not only that critical first 30 days, but also the ongoing relationship with the brand and its stewards.
To be successful, content and experiences should match patients’ varied needs. Everything ranging from insurance, therapy administration, psychosomatic support to nurse support, mentoring, patient community and ongoing disease state information needs to be available in all of the ways patients and caregivers would like to consume them – phone, online, voice assist, AI, in-person.
Some brands are doing this exceptionally well today, but they are few and far between. We think this next year will see a big leap in what “patient-first” care really looks like.

James Talerico, Managing Director & Executive Creative Director, Heartbeat: I foresee more and more emotion coming into our HCP marketing and communications. The reality that treatment decisions are influenced by emotion and prejudgment, as much as protocol and practice are undeniable, and creative marketers are making note.

Laurie Bartolomeo, EVP, Creative Director, Dudnyk: I think one of the most meaningful advancements in health technology in the years to come will be in the development of accurate, widely accessible disease screening tools that will allow physicians and patients to detect diseases before symptom presentation and give patients the best chance at positive health outcomes. We’ve already seen tremendous strides in both metabolic and genetic testing that have enabled proactive treatment approaches to many cancers and other illnesses. These technologies that were once only theoretical are now being refined and put into actual clinical practice.
Now, the challenge is for our society to catch up to our science. How can we educate and raise awareness of these diagnostic advancements and ensure their accessibility to patients and physicians in as many areas as possible? Imagine the implications of commercially available, affordable, pre-symptomatic detection of degenerative diseases and what that could mean for patients, especially in rare disease and oncology communities. No matter how rare the condition might be, every person deserves access to knowledge that could lead to life-altering or even life-saving interventions. Our challenge is to keep pushing for progress that will ensure these exciting advancements in science and technology reach real world patients in meaningful ways.

Brian Reid, Managing Director, Media & Engagement, W2O Group: 2018 will be the year where patient frustration with the health care system – and the way health care is financed – moves from the edge of the discussion to the center. This will be driven by the dramatic, if under-recognized, move to shift costs to patients via high-deductible health plans, co-insurance for
high-priced specialty drugs, and hospital billing practices. Tensions will rise among various parts of the health care ecosystem.
However, the same set of forces will also prompt more collaboration as various stakeholders look for ways to improve care and lower costs without undermining the incentives required to continue innovation. Value-based approaches and well-funded partnerships designed to change patient care will begin addressing the most dysfunctional elements of the system, enabled by regulatory reforms that encourage market-based solutions.
Scientifically, continued innovation, including in the area of cell therapy, gene therapy, RNAi and immune-oncology combination treatment escalate the focus on pricing and value and force difficult discussions about strategies to balance dramatic short-term budgetary impact against long-term cost savings.
Across geographies, pricing transparency pressure will continue to increase, value frameworks will be front and center, and access challenges will cross borders as reference pricing and international collaborations increase.

Erin Byrne: Back in the day, most of healthcare was reactive. You’d get sick, call the doctor, follow the doctor’s orders, and hopefully get better. Then, with the dawn of the information age, power began to shift from the provider to the patient. Thanks to Dr. Google, people can now become proactive in managing their health.
In 2018, as we move into the experience age, we are progressing from being proactive to interactive, and things are about to get wild. Digital will be everywhere, and health will become so enmeshed in our everyday lives, that we will no longer think about it as a distinct separate category. Technologies like mobile monitoring devices, smart objects, and artificial intelligence will travel with us, integrating seamlessly into the way we live. We will use technology to create experiences that meet our needs with the right message, at the right time, in the right way, tailored just for us. This has amazing potential to truly transform our experiences and maximize health outcomes.

Bill Drummy: Beyond 2018, I believe the industry will finally fundamentally break from its age-old commercial model of selling their products through a series of discrete pipes: the clinical pipe where we talk to HCPs about the efficacy and safety of our products; the patient pipe where we stimulate the ultimate consumer of the product to have a conversation about a solution to a problem they may or may not be aware they have; and the financial pipe through which we (increasingly) make the economic case for a drug to financial decision-makers in hospitals, group practices and systems of care. This is not a sustainable model, as the changes in the nature of healthcare delivery, driven by the ACA and other pressures, is going to force us into a more integrated, holistic conversation about the value of medicines, across all of their attributes: clinical effectiveness, quality of life enhancements and overall improvement in outcomes and reduction in costs. This will force the ‘health improvement industry’ to tell their customers a coherent, integrated story that addresses the value of their products and services across all the dimensions that matter. There will no longer be armies of sales reps deployed to the HCP frontlines, while we carpet bomb DTC commercials on the citizenry. Instead, it will be precision-targeted yet more multi-dimensional campaigns delivered with a holistic understanding about how these solutions will improve patient outcomes. As an industry, we have never done this before, so there will be an awful lot to learn, and unlearn.

Nina Manasan Greenberg: Sure. We’ve been hearing about the rise of the consumer as payer for years. In 2018, we’ll see more enrollment in high-deductible health plans than ever before. So the consumer has become a true financially driven healthcare decision maker.
Andrew Gottfried: At the same time, the health system itself is on the rise. Individual physicians have already fled en masse to groups. Smaller medical groups are joining in with larger health systems. Follow who’s holding financial risk, and you see that consolidation will continue to be a trend for some time.
Nina Manasan Greenberg: I can’t help being obsessed with the idea of Amazon entering the healthcare world. They’ve changed the retail market tremendously; why not retail pharmacy? And the moment they decide to get in, they will either quickly become the biggest PBM in the United States, or they’ll change the way PBMs do business. At once, they can disrupt purchasing models as we currently know them and lower costs tremendously.

Michael Schreiber: As in all industries, technology will play an even greater role in healthcare in 2018 and beyond. Technical breakthroughs are already yielding astonishing developments in molecular engineering and gene editing.
Thanks to developments in these areas, there’s a whole new world of pharmaceuticals ready to explode. Soon enough, CRISPR-Cas9 gene editing technologies will allow scientists to edit genetic material, ostensibly eliminating certain genetic diseases.
More practically this year, technology will catch up with big data and allow patients greater control of their personal health information. Technological breakthroughs that decentralize data will provide missing pieces for an integrated and high-value system of digital health records.

Wendy Blackburn: We are at a crossroads in the history of healthcare. We’re moving from treating illnesses to preventing them wherever we can, from after-care to advanced wellness. As a result, we’ll see a large difference in the healthcare needs of the Boomer generation versus Millennials and beyond. And we’ll see payer strategies follow suit. Pricing will continue to be a focus as stakeholders seek unique solutions such as money-back guarantees and other models borrowed from retail and CPG. We will see companies not historically specializing in healthcare make major moves – Apple will do something with its wealth of health data; Amazon will capitalize on the pharmacy provider opportunities it sees before it. Healthcare will continue to become more and more digitized – sadly, at the risk of losing some of its humanity. Pharma communications will become smarter, more automated and integrated and, as a result, will slowly move toward a more positive experience for patients and providers.

Boris Kushkuley: Medicine used to be semi-science, semi-art. The physician was a magician at the center of this ‘show’. In the coming decades, we should expect AI and Big Data to completely redefine the role of clinician. AI-driven diagnosis, based on much more detailed genetic tests, coupled with the ability to sift through years of long-term clinical-outcomes data gathered from billions of patients will provide much more reliable treatment recommendations. Patients will enjoy better results with less side effects. The big question, though, is what that will mean for physicians. Will they become as obsolete as drivers in the age of driverless cars? The answer is probably “no,” but it would be presumptuous for me to claim that I know the answer.

Nadine Leonard: Point of Care is the big MUST for 2018 – and not just a “media buy” that puts some of your assets in a waiting and/or exam room. We’re recommending our clients build holistic programs that really connect those micro-moments during a healthcare appointment/hospital stay, bringing patients & HCPs closer together in healthcare decision making – bridging their knowledge and interests for a more productive dialog. This can be in a practitioner’s office or in a System of Care where outcomes are equally important to patients and the System’s financial health. My prediction is that if a brand isn’t engaging here, and doesn’t in 2018, they’ll unquestionably be behind the competition.

Sonja Foster-Storch: For the eighth year, inVentiv Health Communications and GSW will release our very popular trend reports, read by thousands across healthcare and marketing. Over 200 collaborators from across the global enterprise of INC Research/inVentiv Health Communications contributed to the report, sharing clues, observations, and individual stories about the changing experience of health and healthcare.
In 2018, we expect to see intriguing new mindsets in key segments of patients, including those disloyal to physicians, disengaged by new divides, and a significant new group finally leaning in. Fundamental shifts will continue to change the systems these patients seek care in, including specialty pharmacies being snapped up by PBMs, a sharp decline in people choosing to parent, a new focus on retail providers, prevention bringing an age-old conversation about compliance back to center stage, and accelerations in ultra-rare disease diagnosis. Those shifts and more are changing the experience of health and healthcare. We’re seeing more people finding medicine in the comforting glow of their screens, a new push to support “elder orphans,” data-driven nudges, and home delivery of just about everything health.
These predictions and more will be published early in 2018. Look for them on http://inventivhealthcommunications.com/how-we-think/report/2018-trends.html

Amar Urhekar: While the healthcare industry continues to evolve and become more complex, key impactful trends will gain more traction in 2018, including:
• Value-Based Care: The shift from volume to value based healthcare – with a greater emphasis on quality, patient outcomes and cost containment – will continue to grow. Key stakeholders, such as organized provider groups and providers, are beginning to assume varying degrees of financial risk. Pharma companies offering biosimilars will take the first leap to accelerate VBC.
• Integration and Consolidation: There will be a push toward vertical integration of health plans and PBMs – as seen by the recent CVS and Aetna merger discussions. Additionally, there will be continued acquisitions of provider groups resulting in more integrated care and stronger geographic dominance. In addition to M&As, we may see a spurt of healthcare systems creating their own insurance plans. This will all be more likely if Congress repeals the laws preventing insurance companies from selling across state lines.
• Home Is Where The Medical Care Will Happen: Advancements and growth in key areas of health technology including, telemedicine, electronic health records and system integration, mobile apps and wearables will mean more virtual physician-patient interactions.
• Data and Analytics Demystified: Health data is so pervasive, but uncoordinated and mysterious. Machine learning and cognitive systems have advanced so we can finally get meaningful insights from our data. One example, of the endless applications of this data, is predictive modeling such as identifying high risk patients for disease progression and complications.
• Consumerism’s Child – Accountability: While patients become increasingly informed, engaged, and empowered in their healthcare decisions, they will also be more accountable for their health. It’s possible that we will see patients paying custom premiums based on their health and habits. Something as seemingly as supermarket loyalty cards and credit card spending could be analyzed to predict risk for disease based on what they are spending their money on and be charged an extra healthcare premium because of it.
• Power to The Payer: Health plans and PBMs will continue to increase control of drug and healthcare access, while shifting costs to the patient.

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