Launch of #HCSMUK 16th March 2011

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If you are reading this post you will undoubtedly be aware of the highly successful and for me, inspiring #HCSMEU tweet up that takes place every Friday at 12.00 UK time.


The vision for #HCSMEU is stated as follows:

'To drive forward the adoption of social media across Europe in order to improve the quality, access, value and effectiveness of health care delivery to patients.'

There have been a number of local branches of this core group that have sprung up over the last year. with the intention of augmenting the central #hcsmUK vision with a more specific and in depth discussion about issues affecting a specific geography.

I feel that the UK could benefit from a 'local' #hcsmUK group, meeting every 3rd Wednesday of the month at 12.30 UK time for one hour. I think at this stage, and as only one voice it would be wrong to state a grandiose mission statement for the UK affiliate. However the vision I have is that we can discuss the impact social media and broader technological innovation has on the UK healthcare landscape.

Although the issues facing healthcare and incredibly universal, there are some very local UK issues that spring to mind immediately. Just a few examples could include:

1) The NHS and it's use of modern communications and new media, the IT 'project' (RIP) and the broader issue of EHR in the UK, NHS reform etc etc.

2) The e-patient in the UK and how this has/will/is affecting patient advocacy. .

3) The pharma landscape, regulation and working within the ABPI.

There are, I am sure, many better examples than this we can get our teeth stuck into.

For #hcsmuk to work however it is I feel essential that the broadest possible stakeholder group for healthcare  is represented in the discussion. This obviously means the NHS community, patients and patient advocacy, science and research, , pharmaceuticals, agency both medcomms and creative design, advertising and of course media (in all its guises).

In short everyone is welcome and everyone has an important voice and part to play.

More info about how to submit questions to follow in a separate place to this blog.

Hope this makes sense to people and of course comments and suggestions very welcome, both here and on twitter @hcsmUK or @alex__butler

The first #hcsmUK is scheduled for Wednesday 16th March 2011 at 12.30 GMT.

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On Liberty (or the problems of writing an internal corporate social media policy).

I have a passing interest in philosophy. Actually I am really quite interested. I even read philosophy on holiday and listen to the (very good) ‘philosophy bites’ podcast when driving. This makes me quite dull to sit next to at a dinner party but you might wonder what relevance it has to social media.


As you can imagine, saying you have an interest in philosophy in commercially led organisations is not encouraged. Like turning up to a meeting of ‘The League Against Cruelty To Animals’ and stating a mild amusement for bear baiting, or a bit of a thing for bull fighting.

For those who are still reading, it is very relevant for anyone set the task of developing internal social media policy.

Most people recognise that it is essential for a modern business to have a code of conduct, guidance or policy that sets out organisations expectations of the individual employee regarding their use of social media. This is as much to protect the employee as it is to safeguard the business against breach of confidentiality or damage to the reputation of the organisation.

The truth is that the expectations of any employer have not changed; it is just the amplification of new media combined with the ‘permanency’ of the self publishing model that have inexorably raised the stakes.

If somebody got drunk at a private party 20 years ago and started shooting opinions from the hip regarding the ‘immoral’, corrupt’ ‘hateful’ company they worked for, this wasn’t good, but there was no real damage done. A bit different if these opinions are posted on twitter and Facebook. There have already been examples in pharma of disparaging comments being placed on forums regarding competitor products.

This is where John Stuart Mill comes in for me. Mill was a nineteenth century philosopher who caused something of a storm with his 1859 work, ‘On Liberty’. In essence this work supported the moral and economic freedom of the individual from the state, an exploration of the struggle between authority and liberty.

I believe social media to be a great democratising force in society. There are already fantastic examples of people fighting authority through their use of the ‘personal’ web to affect great good for themselves and society at large.

A company does not own somebody’s opinions; they have a right to a personal life.

In the modern world this should mean the right to express their personality through individual platforms and through communities. This is expressed by Mill as the freedom to publish opinions, Very basic free speech. What we now understand as the freedom of assembly was expressed as "freedom to unite”, very relevant in the age of the social web.

However, as Spiderman knew only too well, with great power comes great responsibility. Mill shocked many a Victorian sensibility (usually a good barometer for many people still working in pharma companies) with his assertion that people should have a right to tastes and pursuits deemed ‘immoral’ by society at large. Only, however, as long as these pursuits do no harm to others.

Personal responsibility encouraged through education is the only sensible option for a modern pharmaceutical company. They need employees to be active in social media to help set the company up for the next decade, it is only through practice that you can fully appreciate the necessity for self moderation.

For those companies who do not allow use of social media at work it looks like a steep learning curve. You may as well ask students not to drink too much and avoid casual sex. You could try, but I would leave this to certain daily newspapers.

Should you company have a head of social media? ...Well maybe yes, but not for long.

I am afraid I have a confession to make. I often google myself.


Now this is can be seen as a form of egotism, self importance and possibly even a bit delusional. No, I do not think I am very important. However for anyone who works regularly with the media and especially with a specific focus on social media, this is an important thing to do.

For any other regular ‘self searchers’ out there I am sure most of you will be haunted. Either by another more successful individual (for me a Dallas stockbroker, a photographer and even somebody who works for the ‘government’), or by something you said or were reported to have said.

These comments always defy the laws of natural search to linger towards the top of your page while the feature interview you gave to the New York Times languishes on google page 4.

The thing that most haunts me on my virtual shelf is a comment I made while on a panel discussion in Berlin in March 2010. I made the pronouncement that we should not aspire to ‘Social Media Managers’ within pharmaceuticals. The point was supposed to be challenging. It is a philosophical position I still stand by.

If we separate digital from marketing, social media from communications we make a step backwards. In principle both broad digital strategy and social media need to be intertwined and embedded in the organisation. Only then can we develop fully integrated functional plans. Only then can pharma fully embrace the fantastic opportunities that the new conversation presents.

There is a small problem with my argument however; I have just become a Digital Strategy & Social Media Manager. Right. Well I have three obvious choices.

One, try and get the offending comment removed from google and then continue as normal. Nothing to see here, move along.

Two, admit to a road to Damascus conversion (around the time I was offered the job) and spend the next 12 months chastising organisations who do not give enough importance to the difficult and essential role of developing and managing social media engagement.

Three, admit that in the perfect world I was right but that in very complex and conservative corporate environments, we sometimes need someone to enable multiple functions to develop aligned strategy. Someone to empower people to engage on their own terms.

I am going with option three.

The truth is that being the first company to launch this platform, the first brand to do disease awareness through this channel or allowing negative comments on this website are all interesting distractions from something far more important. All of us who work in pharma understand that the challenge is more about corporate behaviour.

If as an organisation you believe in really listening to people, understand that criticism can often be more valuable than praise and understand that listening is not enough. You need to be seen to listen, it needs to be public. If you really believe this then twitter, Facebook, Youtube are easy.

If you believe that we do have tremendous value to add to patient support and education, although not as a single source, asset sharing will not be a problem.

I could go on. The important thing is that the company *gets* it.

So do people need a Social Media Manager? Probably, but they need to work themselves out of a job in 12-18 months.

Come back in a year and a half and I will be trying to remove another comment from my google search...

Heroes and villains or the smokescreen of regulation

When framing a story for the media it is well known in the communications community that a successful piece must have a number of components.

First we must have the challenge, the mission at the heart of the narrative. We then need a hero, the shining figure at the centre of the action battling for the force of good against, well evil, obviously.

For this we need a credible villain. They are probably more important to the success as the hero themselves. In our lives we often secretly find ourselves emotionally drawn to them, whether we are watching a Hollywood blockbuster or a simple TV soap. This is because the truth is often more complex than it appears.

Maybe this explains why recently I have begun to think that for those of us responsible for pharmaceutical company engagement in social media, regulators have become the evil smokescreen.

This is often a displaced complaint against our own medical and compliance teams, people we should have carried with us.

They have become the Lex Luthor to our creative Superman, the Cruella Deville to the large community of marketing and communication's cute Dalmatian puppies.

Unfortunately the truth is much more complex than this.

The Health 2.0 revolution is now too important for any of us to make excuses. The latest 'Cybercitizen' survey from Manhattan shows that across Europe patients are flooding into health communities to find information and support.

This engagement ranges from the cosmetic to people managing a chronic long term condition such as Diabetes. The highest level of engagement (70 to 80%) is from people caring for a loved one with Alzheimer's or Cancer.

On top of this nearly three quarters of health care professionals regularly use online communities to help them better manage their patients health.

It is absolutely essential that pharma takes its place in this discussion and steps up to its responsibility to provide the high quality information and dialogue it is capable of. Not only to help health care professionals support and add value to their patients (50% would like to recommend websites and communities to patients) but also to directly speak with our end users. The patients who now represent the new KOL's.

The real challenge of the new media revolution does not depend on changing the regulatory environment. There are two sacrosanct guiding principles that underpin the ABPI code of practice in the UK: One is that we must not promote prescription only medicines to the public and the second is that we protect the safety of patients by collecting adverse events.

If we get our objectives right we can tackle both of these head on.

This definitely depends on a change of corporate behaviour that is more open and engaged with patients language and concerns. If you will allow a moment of platform gazing there are a few examples of things we can do right now.

People do not enter a social network in order to be sold something and I am sure that most patient forums would not appreciate a pharma medic jumping into the conversation to request more information on a possible AE, or to put a poor unsuspecting blogger straight about a products efficacy profile.

If we get the objective right we can add value through twitter, placing a human face on the company-not pushing company brand or product. We can develop disease focused communities on Facebook where we have the credibility and the relationships.

Even more important is overcoming the obsession with adverse events online and developing real world data programmes. This will not only enable us to open a new channel to understanding the safety of our medicines but could also enable a more focused form of patient support.

Lets stop blaming other people and start to put patients and health care professionals at the heart of our communication strategy.

Patients the genuine key to Market Access, not a NICE to have.

Market Access has become the most important strategic pillar in pharma and with this the most overused business cliche.

When you look at the focus, experience and expertise of most Market Access teams in the UK it is not difficult to see who the important stakeholders are; Health Technology Appraisal and the dreaded 'Payor' (is it just me who hates this term?).

In order to look like we are tackling this key challenge we have developed a whole new KOL landscape based around 'commissioning'.

This translates in the field as forcing our pre and post marketing messages on overworked 'Prescribing Advisors' and 'Medicines Management' (both hilariously ironic job titles that could come straight out of 1984). If we are lucky we get to work with more senior, genuine commissioners.

It is very difficult in these circumstances to communicate the true value of our medicines to society and even harder to translate this into the dramatic personal impact this could have on someones life.

Unfortunately it often means high level sales teams renamed and re-skilled, interacting with cynical under informaed NHS Management and Pharmacy Staff who should be ashamed of their respect and understanding of the pharmaceutical industry in the UK.

The funny thing is that in the new environment the most important people to Market Access are the patients and carers themselves. How many MA teams have the expertise to deal with that? Because of the understandable focus and talent set to work on HTA, they are often not even on the radar let alone part of a strategy.

The explosion in new media has completely changed the way we interact with each other and the world around us. The NHS has always managed resources through Demand, if people did not know about a drug or service then their local GP wasn't going to be the one to tell them about it. Google, Facebook, Twitter, PatientsLikeMe has changed all of this.

If you are not getting the best treatment then you will know about it and probably do something about it.

NHS, Nice, SMC and AWMG have one thing in common, they are scared to death of the patient voice.

Bring on the new world, I would not want to be the one telling a person caring for a loved one with Alzheimer's they are not worth the investment in new therapy, or crushing new hope in a patient dying of cancer.

The Real Social Media Question for Pharma

There is a tremendous amount of discussion at the moment about how trust is now the key to corporate reputation. That is fine. The trouble is that you can't buy trust. Even more frustratingly it is about behaviour and communication over a long period of time, i.e. there is no quick fix.

Trust is something that has frustrated and fixated the pharmaceutical industry for years. The latest Edelman Trust Barometer suggested that about 53% of educated top quartile participants trust pharma-thank God for bankers and the insurance industry.

The ABPI is currently engaged in a very laudable project called VITA (Value, Innovation, trust and Access). A part of this Trust stream has involved engagement with stakeholders through social media. I obviuosly support this development, I just have one problem.

Developing a twitter presence or constructing a facebook page is not a strategic objective. I wish people who are desperately trying to catch up with the social media revolution (like an elephant on roller skates) would stop talking platforms and start thinking about what actually lies behind this dramatic change in communications-open and transparent dialogue.

If you don't change how you listen to your customers or stakeholders and you continue to push out the same messages, hoping you won't get any difficult questions, you have completely missed the point. "How can we develop a presence on twitter while minimising the risk?"

The risk that people may start to understand how important their opinions really are?

If large pharma can hide behind regulation and good practice to subvert the social media conversation and remove any interaction that is uncomfortable, we will do even further damage to our industry. An industry I am proud to work for.

I was pleased to have been involved in the Q&A document being produced by the PM Society for the PMCPA, outling recommendations for the pharmaceutical industry in digital media. We have to understand as an industry that control is dead, the next great challenge is to have influence. If not, how can we be a force for good in the future?

When people care, they want to be part of an interactive community. If people want to ask about what really constitutes value in medicines? why we have withheld clinical data for a differential marketing positions? Or how much money we have given to the recent Haiti disaster? We should make sure we have a good answer.