End of the beginning

Dear Readers,

This week’s post marks the last I will write as an assignment for my graduate social media course at NYU.

I began this blog as a required assignment, choosing a topic relevant to both my career and social media. Little did I know this would force me to think more strategically about topic consistently discussed by healthcare PR and Marketing communication innovators.

By researching what to post each week, I have closely followed the latest and greatest in the big pharma-on-social-media conundrum. I’ve watched how pharmaceutical companies engage digitally and how they don’t. I’ve also watched how patients respond to different approaches, and how they don’t. Having one ear pressed against the glass of my Healthcare list on Twitter has already helped me inform recommendations to my teams  (back to the Groundswell). I have become a hoarder and sharer of all things healthcare digital media and truly couldn’t be more excited about it.

It is inspiring to watch how healthcare communication innovators have already begun to ice pick up the slippery slope and make come impressive progress. Likewise, spotting untapped potential and thinking strategically about incorporating digital media is inspiring.

Though what we do in Public Relations is fast paced, challenging and stressful (just being honest) it’s also the perfect blend of analytical and creative thought. To me, that’s just plain fun.

So, with the close of this class (my favorite thus far in the program since I’m already being honest), I’m greeting the end of the beginning of my health socially love affair, not the end.

Until next week,


Happy beginning! I took this at one of my favorite spots in Seattle, Golden Gardens, Summer 2009


CASE STUDY: Facebook & Adverse Events

In my first post I addressed, “FDA communication regulations,” as being a deterrent for pharmaceutical companies engaging on social media outlets like Facebook and Twitter. One of these guidelines is Adverse Event (AE) reporting. Here are the basic AE facts:

  • The FDA defines an Adverse Event as, “any undesirable experience associated with the use of a medical product in a patient.”
  • The FDA’s Adverse Event Reporting System (AERS) is the digital  database for the post-marketing safety surveillance program of all approved drug and therapeutic biologic products. The FDA uses AERS to monitor for new adverse events and medication errors that might occur with these marketed products.
  • Adverse event information should be reported to the FDA if the drug company has knowledge of these four basic elements:
  1. An identifiable patient
  2. An identifiable person reporting the event
  3. A suspect drug or biological product
  4. An adverse experience or fatal outcome suspected to be due to the suspect drug or product

Though these four basic characteristics are outlined, the FDA lacks specific guidance on the subject of Social Media engagement.  The most recent FDA draft guidance on responding to unsolicited requests for off-label information mentions social media, but it still does not address the handling of adverse events reported on social media sites (Drug Safety Alliance, January 2012).

It it interesting to watch how different pharma companies are currently addressing this without specific guidelines from the FDA. I’d like to take a look at Merck’s Facebook Timeline Homepage, (which I think is beautifully done) where the company has taken a direct approach to managing AE reporting by clearly drawing attention to policies for its Timeline users (see the red box below).

The “Adverse Event Reporting” tab encourages users to report their AEs to the FDA hotline, providing users an outlet to discuss their AEs while also providing an example of the company’s obligations to the FDA.

“In order to monitor the safety of Merck products, should any of your comments mention an adverse event to a Merck product, we encourage you to report this to Merck’s National Service center at 1.800.672.6372. We may be required to contact you for further information. You may also report any adverse event directly to your healthcare provider or to the U.S. Food and Drug Administration (FDA)” -Merck Facebook Timeline

Merck then expands its recommendation of reporting AE’s to a specific policy directly asking users to refrain from mentioning Merck products on its TimelineIt acknowledges open communication on social media, but  again cautions that it will act on its own legal obligations if necessary.

“Merck respects the rights of individuals using social media to voice their views and opinions. However, within our social media channels, we reserve the right to remove comments that are considered inappropriate, off-topic, abusive, or being used to promote and solicit for third-party sites, initiatives or products. We ask that you please respect the following guidelines for our page:

  • Please refrain from mentioning Merck products or products from other companies. We reserve the right to remove any comments that reference a product.
  • Comments or posts that are factually inaccurate or misleading, are spam, inappropriate, violate another’s copyright or intellectual property, use profanity or are defamatory will be deleted.” -Merck Facebook Timeline

So, do I think that this is an effective engagement tactic? I suppose the answer is not that simple. Let’s break it down.

  • Pro: This tactic communicates openly and honestly with the company’s Facebook users about its obligations.  Honesty and transparency are essential to social media communication.
  • Con: I also think that any attempt to control user content in social media rather defeats the purpose of the platform. In this instance, this tactic may inadvertently dissuade some users from talking on the company’s Timeline at all as it  will remove inappropriate content. Isn’t responding effectively to dissenting voices the best way to gain credibility? Visibly removing negative voices can remove some company credibility with them by censoring in lieu of response.
  • Pro: On the other hand, however, I’m aware of the mire the company will be left forging when it is inundated with posts about AEs that it is required to report.  This tactic does actively manage risk.

What do you think readers? Does this tactic turn you off? Do you think its admirable and courageous? I would love to hear your thoughts!

Doctors go digital to help patients

Have you been to the doctor lately that whipped out an iPad to show you your x-ray kind of  like this?

By kanteronsystems via Flickr

I, for one, have. My dentist of 23 years back home in Seattle, who I insist on continuing to visit when I’m home at breaks despite living in NYC for two years now, surprised me this past winter when he  — in the same breath as boasting about his brand spanking new AARP card–  showed me my x-rays, reports and records on one of the iPads he has in each exam room.

Atlanta Dr. using our EMR via iPad

By Practice Fusion via Flickr

Doctors, just like the rest of the now digital world are realizing the merit of incorporating digital assets into everyday tasks. They can see patients, take phone calls, and answer specific questions with files at their fingertips via an iPad or smartphone.

Digital healthcare technologies to support healthcare have reshaped medical record keeping and communication with  electronic medical records, practice management systems, mobile health apps, and online medical journals. This process hasn’t been  just another byproduct of the groundswell either. In 2007, the European Commission launched the Lead Market Initiative for Europe designating ‘eHealth’ as one of the focuses, leading Europe and the US alike in understanding the importance of digital technology working seamlessly with the physical world. One doctor quoted in an article by CBS Boston, said he uses his iPad for everything from prescribing medication to educating patients about upcoming surgeries.

As Suchitra Menon of Healthcare Engagement Strategy contends the internet has also forced the healthcare industry’s communication hand with, “[the] rise [of] patient-centric healthcare, where patients are an active participant in the healthcare delivery process.”

“Patient-centric,” digital healthcare has taken particular form in prevention and lifestyle apps. According to data revealed by Float Mobile Learning:

By drchrono via Flickr

  • 40% of doctors believe that using mobile health technologies such as apps that monitor fitness and eating habits can reduce the number of office visits needed by patients.
  • About 88% of doctors are in full support of patients monitoring their health at home.
  • There are more than 10,000 medical and healthcare apps available for download in the Apple App Store, making it the third-fastest growing app category among iPhone and Android users.
  • 80%  of doctors  use smartphones and medical apps.
  • Physicians are also 250% more likely to own a tablet than other consumers.


Some medical providers are even giving consultations virtually via Skype and FaceTime. For example,  RingADoc, is a startup telemedicine service providing on-call doctors 24 hours a day via phone, smartphone or tablet. With a phone call or digital face time, patients can renew a prescription or get a suggested diagnosis from specific symptoms as fast as they can press the call button.

To answer some of the questions I posed in my first post, I think that all of this information arms pharmaceutical companies with a huge opportunity. By creating apps or other digital systems to access information about products and programs, doctors can easily read pharma companies’ materials and even more easily share them with patients. Being so widely used, Health and progress trackers are another great tactic to reach patients directly. These apps promote the sustained success of a  healthy lifestyle while taking specific drugs, provide patients with additional resources and foster meaningful direct relationships between pharma companies and their target markets.

Changing media environment: what it is

Social media has indisputably changed the media landscape everywhere. Companies have begun to see that they have an incredible tool in social media at their fingertips, allowing them to reach their stakeholders directly.

The PR industry itself has had to change its approach to engaging media. As Steve Rubel, executive VP for Global Strategy and Insights with Edelman, summarizes there has recently been a “dispersion of authority,” in which  the power to shape media conversation has moved away from a few big players, to many smaller ones. The effect of this dispersion is that we now have four different spheres of media, three of which exist on the internet. 

Rubel outlines these as the following:

  • Sphere 1: Traditional media, which includes newspapers, radio, television etc. These mediums allow for little if any audience interaction.
  • Sphere 2: Tradigital” media is a bridge between old and new.
  • Sphere 3: Social media where anyone can say anything they want at any time.
  • Sphere 4: Owned Content. i.e. corporate websites and the like, where every business can act as a media company for the purposes of promoting themselves.

The key to all of is this how sphere 4 not only makes it’s way into that center sphere, public engagement, but how it helps influence the other 3 spheres. The voice of a company’s owned media,  must remain consistent in the other spheres for companies to ensure that the message they want a key audience to hear is heard.

Q: How can this message be heard?

A: First by the companies’ responses digitally to their key audience, and then by following digital promises with physical action.

Q: Who is that key audience ultimately in healthcare?

A: Patients.

Take  a recent example from the press on Tuesday of this week. A study released in the UK by researchers at Imperial College London examined 10,274 ratings submitted on NHS Choices in 2009 and 2010 about all NHS hospital trusts  in England (i.e. hospitals to the US English speaker). They found that hospitals with better patient ratings tended to have lower death and readmission rates. Hospitals rated by patients as being cleaner have lower rates of MRSA infections.

In this instance social media worked against hospitals with poorer reviews and naturally in favor those with positive reviews as it provided a direct and immediate method of exposing the truth of performance. Social media does, however, also present an opportunity for hospitals to engage their patients directly and improve the public’s opinion of their performance.

Are the hospitals still missing this opportunity?  I would contend, yes. Chelsea and Westminster Hospital began to use Facebook by creating their own page in late 2011. Patients were receptive at the page’s inception  posting thank yous and accolades.  Did the hospital take this opportunity to speak with their patients and continue the conversation?

The last post was from October, 2011.

Why does healthcare need social media?

photo courtesy of http://bit.ly/pSGu3P

Mobile healthcare app downloads are predicted to top 44 million this year, and patients increasingly turn to social media platforms for peer advice and support.On the physician side, tech adoption continues via mobile platforms and integrated EHR solutions. Pharma marketers have done a respectable job of reaching these distinct audiences. The next step is to fully leverage the power of digital and social to maximize the most important dynamic of all—the doctor/patient relationship.– by Chad Latz on MM&M.com


The healthcare industry has been slower than most to join the ranks of organizations that engage their customers directly through social media conversations. This is largely due to two sets of regulations that protect patients: HIPPA that protects a patient’s right to confidentiality and FDA communication regulations that assure prescription drug information is truthful, balanced and accurately communicated. Penalty for breeching either of these federally mandated sets of rules is severe– $$$, loss of business, or even jail time.

So, why enter any communication situation that isn’t completely controlled with that much at stake? Well, many pharma companies and healthcare providers think this question is rhetorical. With this blog, I will explore the other side of this proverbial coin, and answer to this million dollar (pun intended) question.

In my opinion, the simple answer is that if healthcare and pharmaceutical companies don’t join in the conversation, they may no, they will end up excluded.

How, do you ask? And why is this important?

Social media is, of course, a form of communication that can potentially– as all others–be abused. More importantly, however, it has great potential to promote more candid provider-patient, provider-provider and patient-patient communication and ultimately help improve awareness and general health (Great point, Colin Son!).

This kind of open and honest communication between consumers and healthcare professionals (I lump more than just doctors into this; drug reps, nurses, dentists, consumer health product sales people, pharmacists…) provides countless opportunities for not only happy & healthy consumers, but ultimately more revenue for the companies. And what corporation would complain about that?

Sweeping claim? Maybe. Proof? Keep reading my blog to read my support!