June 2010 Digital Pharma Newsletter

Dear Reader,

This marks the second edition of The Digital Pharma Newlsetter, and we are very pleased that you have chosen us as a source for your pharma news. As director of the Digital Pharma event series, I encounter many varying opinions about the most effective manner in which pharmaceutical companies should engage in interactive marketing. Our innovative contributors ask not only how, but also why the industry should embrace this strategy.

This issue brings together some interesting looks at these vital questions, starting with our chairmen of Digital Pharma East, Shwen Gwee and Dr. Bryan Vartebedian. Shwen invokes the all-important concept of listening in his piece: "Listening Should Not Replace Market Research, but It Should Seriously Be Considered as an Important Supplement", and Dr. Vartebedian follows by raising the question: "Who Owns the Social Health Conversation?". Viscira CEO Dave Galuzian goes over key factors that should be considered when developing and deploying effective interactive programs, and AstraZeneca's Elizabeth Sozanski asks how we define our communications in "Is Marketing Still Marketing?". Janssen Cilag's Alex Butler argues that marketers have a newfound responsibility in the digital age, while Diabetes Activist Allison Blass suggests that patients are unwilling customers and must be communicated with accordingly.

From all of us at ExL Pharma, have a fun and rewarding summer!

P.S. You are welcome to submit a written piece to be considered for an upcoming issue. Please send your articles to Jason Youner, at jyouner@exlpharma.com.

If you have any questions or suggestions, please let me know.

Best,

Jason Youner

Editor, Digital Pharma eNewsletter

Director, Digital Pharma event series

ExL Pharma

10 Things You Should Know About Social Media

Basically, it's just a list of thoughts and ideologies that I feel are important — but often overlooked — fundamentals of social media that I have come to learn and understand over the course my time and involvement in the social media culture. Those of you who have heard/seen some of my recent presentations will recognize these 10 ideologies, as I've added them to the end of my talks of late.

1. It's NOT a magic pill or the holy grail
2. It will only serve to amplify — not rectify
3. It humanizes your corporate brand — act like a human
4. It's a commitment — not a campaign.
5. Your biggest investment will be your time and resources
6. It does not replace face-to-face — it enhances and supplements it!
7. Time to stop convincing — time to start compelling
8. Bring booze to the party — don't be a mooch
9. Empower your audience — and earn their trust
10. Set Expectations Xplicitly!

While some (all?) of them may seem rather cliche, I do think they speak to issues that are often lost in the hype when people think about social media. And more than at any other time that I've heard many of these issues brought up, these ideologies rang most true to me during the closing un-conference session at the recent Digital Pharma conference (read about it here and here), where many of these topics were brought up, discussed, mulled around, and ruminated. So here's a bit more detail for each one:

#1 It's NOT a magic pill or the holy grail
The problem with getting caught up in the social media hype is that we sometimes forget: It's NOT the answer to everything. It won't solve all your problems or turn your mediocre product/marketing into something that it isn't (see point #2). For more, read Tara Hunt's "Your Social Media Strategy Won't Save You" presentation from the 2009 Web 2.0 Expo in NYC.

#2 It will only serve to amplify — not rectify
Again, social media isn't going to save you if you have bad staff, bad marketing, bad product, etc. IN FACT, it's quite the opposite. Be prepared for an amplification of the perceptions of what already exists...Good OR bad. If you want a positive amplification, then you need to work for it and put effort into what you're doing to make it better. It's about genuine, authentic responsibility and relationships with your customers. Not just another sales pitch.

#3 It humanizes your corporate brand — act like a human
A big part of social media is turning cold corporate walls into warm blooded humans. Humans that connect. It's a very different medium and culture from traditional media, so instead of trying to squeeze the square social media peg into the round traditional hole, think about what you're trying to achieve. Don't just take the traditional "corporate voice" and copy-and-paste it into your social media channel — a sales pitch or a speech doesn't belong in a conversation. For more, read Chris Brogan's great post on "What Human Business And the Social Web Are About".

#4 It's a commitment — not a campaign
This is another one about NOT treating social media like we do traditional media campaigns. The long-drawn build up to launch is not where the hard work and big efforts come in to play. It's AFTER launch that you really need to put a lot of work and nurture the initiative; monitoring, reviewing, responding, adjusting, etc. See David Armano's great diagram and blog post for more insight.

#5 Your biggest investment will be your time and resources
As mentioned in #4, it's not just a one time deal and, just like in any relationship, the biggest effort happens AFTER you meet. The build up before the meeting was just a preface to the hard work that makes any commitment or relationship really work. So make sure you plan for the resources that are required for the post-launch activities ahead of time! There's no sitting back and waiting to see how a relationship turns out.

#6 It does not replace face-to-face — it enhances and supplements it!
I believe one of the biggest misconceptions that exists about social media is that it's about a bunch of geeks online all the time, conversing through Twitter, Facebook, and other social networks. However, what many people fail to realize is that social media actually drives and multiplies the opportunities for face-to-face interactions. Look at all the tweetups, meetups, podcamps, foocamps, unconferences, etc, etc. that surrounds new and social media. We love meeting the people we meet online. The technology that drives social media just ends up being a conduit for human interaction and in turn propels us to want to make real world, face-to-face, human connections!

#7 Time to stop convincing — time to start compelling
OK, so this one's borrowed from the summary of Web MD's 2009 Health Forum. It's about doing those (sometimes intangible) things that your customers will feel compelled to tell others about in a positive way. It's not about occupying a "new category" for your brand in the mind of your customers. It's about connecting with their hearts and bringing them value, trust, and authenticity.

#8 Bring booze to the party — don't be a mooch
Another borrowed statement... This one is a slightly altered version of something I once heard Chris Brogan say: "Bring wine to the picnic". Basically, this really speaks to the need to start thinking about what value we bring to our customers. Ask not what they can do for you (and your profits), but what you can do for them. Create value for them and they will thank you for it...And sing your praises.Ties in very closely with #7.

#9 Empower your audience — and earn their trust
This follows on from #8. If you really want to do well with social media, you need to give your customers the ability to amplify your positive value in their lives. Just look at the Obama presidential election "Social Media Toolkit" (PDF link to Edelman whitepaper) for the many ways that the audience had opportunities to raise their own voices, share it with others, and evangelize their party. However, it's important that you need to earn your customers trust first, before asking them to do anything. Remember, #8 — bring value first. Otherwise, they will have no reason to sing your praises.

#10 Set Expectations Xplicitly!
Finally, I end with the idea of setting expectations with your customers (I purposefully left off the "E" on "Explicitly" — makes for a better acronym ;-) ). This is probably the single most important thing for any corporate entity engaging in social media, especially if there are limitations for how a social platform has to be implemented, due to legal/regulatory issues, etc. By first telling your customers what to expect, you have transparently allowed them to understand the framework that you are working in. See the JNJBTW, GSK's "More Than Medicine", and AZ's "Health Connections" blogs for examples of their frankness about their approach to blogging within the regulated pharma industry. Don't let the purists or trolls make you think that social media is an all or nothing activity (see my comment on that here).

Shwen Gwee
Founder
Social Pharmer and Med 2.0 Blog

Can Google's improved algorithm lead to better patient web accessibility?

In anticipation of Bing's launch in late May 2009, Google began to revamp its search algorithmto positively impact the following:

Speed
The speed of search results matters to search engine users. If results take too long to download, users will go elsewhere. Why should this matter? Search marketers spend money where they know quality traffic resides. A high abandonment rate of the search engine could lead marketers to believe that quality traffic resides elsewhere. This would motivate marketers to move spend in favor of a quicker alternative.

 
Relevance and Accuracy
In my view, these attributes are the most important elements of a search engine's usefulness.
Accuracy: An intelligent search engine should provide in its top results a list that closely matches whatwas entered into the search bar.
Relevance: In late 2009,Google launched a real-time search featureto reportbreaking news. Thisis possible because of the creation of newer search technologies and ventures with multiple players, such as Facebook and Twitter.

Below are acouple of search engine examples that highlight these attributes:

Google Example:

Bing Example:


Inthe example "healthed group" was typed into both Google and Bing; you'll notice the search engines rankedequally on accuracy with the first listing being the official company website. However, Bingfared better on relevancy; it's second listing was HealthEd's Twitter feed.

Indexed Volume
Google is expected to increase the volume of indexed Web pages as a result of its recent revamp. This could increase availability of Web pages in the search engine results pages (SERPs).

With many of these changes either under way or expected to happen within Google (which owns more than two-thirds of the search engine market share), here are the key areas that Web marketers should focus onin developing a digital strategy for patients (from a search engine perspective):

• Web site content—Contentthat is relevant to the site's core message is essential. Choice and emphasis of keywords within the body and title of the pages also are important.
• Meta title and description tags—good ones increase site relevancy and improve standings in SERPs.
• Site/page download time—currently Google places little importance on download time. The best digital assets will be those that achieve a compromise between faster download times and better creative delivery.
• Fresh and updated text—in the new version of Google, recently updated Web siteswill rank higher in the SERPs than those Web sites that haven't been updated for awhile. Therefore brand marketers should start thinking about getting additional Web content pre-approved through med/legal, embargoing it, and posting it throughout the year.
• Quality links—Web sites that are similar to own-product sites will receive greater weighting, irrespective of Google Page Rank.Example: news article linked to pharmabrand.com in PR Newswire will receive a lower ranking than those linked to pharmabrand.com in, say, Quality Health.
• Social media—thanks to partnerships, Facebook, Twitter, YouTube, and blogs are being mined by search engines to provide real-time search results. The powers of blogs, search engines, and social media Web sites are finally converging.

About.com conducted a study in June 2009 in which patients were surveyed online about their behavior post diagnosis. Almost 65% of survey participants stated that they would research the disease state, treatment options, and specific pharma brandseither viasearch or specific health Web sites, such as WebMD, Quality Health, and Real Age.

An increasing number of pharma brand marketers are now focused on patients and their Web usage. As marketers, let us help our patients be more engaged participants in their treatment process and provide them with up-to-date, relevant information in a medium that is a popular choice for many.

Abel Rajan
Director of Strategic Services, Analytics
HealthEd Group

Who Owns the Social Health Conversation?

Meetings centered on social health are becoming popular. Everyone wants a piece of the pie as the demand for face-to-face dialogue grows. But this raises an interesting question: Who owns the social health conversation? In other words, who decides where, when and what to talk about? And who speaks? Who, after all, is in charge?

Online no one owns anything. Everyone has the stage. Your platform and reach are determined by your credibility. But the relationships and power positions that evolve in the virtual world may not extrapolate to the real world. There are different forces in play.

Offline, ownership of the message is more complex. Meetings need physical space, podiums and perspiring pitchers of ice water. Someone has to put the money down to rent the space and let everyone know it's going to happen.

And the reality is that in an 8-hour meeting only a limited number of people can stand at the podium. An agenda must be set. Those who set that agenda control the direction of the conversation during that brief moment in real time. So meetings are biased by those who create them. There's no way around it.

As the online health conversation grows and extends to the real world, expect ego and politics to become more evident in the struggle for attendees.
Who will run the most relevant meeting for social health? Will there ever really be a SXSW of health? Is TED the model? Does the social health consumer only want unconferences? And who are the real thought leaders in this space?

In the end the market is smarter than the crowd. I believe remarkable, innovative content and format will determine where the smartest people convene offline.

Bryan Vartabedian (Dr. V), MD FAAP
Physician & Social Media Activist
Baylor College Of Medicine/Texas Children's Hospital

Executing Effective Digital Strategies for Your Brand

Whether you are a pharmaceutical salesperson clambering to get a face-to-face meeting with a doctor, or a pharmaceutical marketer implementing a new eDetail program that hopefully will stand out in the physician's inbox, the need to devise creative, integrated ways to reach your target audience has become paramount. Although the pharmaceutical industry's sales force numbers continued to decline in 2009 — almost 60,000 jobs lost through October of last year compared to roughly 44,000 jobs lost in 2008 — there are still plenty of salespeople out there trying to reach high-prescribing physicians However, in an environment with increasing barriers to entry to doctors' offices, pharmaceutical marketers are looking for new and inventive solutions to make their sales force more effective.

In addition, the growing acceptance and adoption of new technology and electronic communication by healthcare professionals has increased the need for pharmaceutical companies to leverage alternative channels to reach their targeted audience. "The Internet and other new media channels are becoming increasingly important ways for myself and my colleagues to stay current on new developments in patient care," says Dr. Anthony Padula, a leading rheumatologist in the San Francisco Bay area.

According to Manhattan Research, the number of physicians who use the Internet and other technology to access pharmaceutical, biotech, and medical device information has grown 23% since 2004 to account for almost 90% of the total U.S. physician population. Devices such as the iPhone and the iPad will make it even easier for physicians to retrieve online content. In fact, one of the areas that saw the most significant growth during the past year is mobile with 64% of physicians now owning smart phones.

Dynamic interactive and new-media solutions are a way for pharmaceutical companies to get physicians' attention and to have their product messages stand out in an increasingly crowded space.

There are many different types of solutions including interactive sales aids which provide a way to blend scientific imagery, video, and interactivity to visually illustrate and support key selling messages. Interactive case studies can incorporate a range of new-media content like video segments, animation clips, and actual patient scans, as well as high-end graphics.

eDetailing has become very popular with pharma marketing managers who give it some of the highest ratings for impact and value as compared to other traditional marketing tactics like direct mail and email messaging programs. Even 3D disease state and mechanism of action (MOA) animation development has become so advanced that some of the leading interactive companies are using Hollywood special effects that resemble those seen in a Pixar production.

Not only are there myriad new- media tools being used, but there are also multiple delivery channels. Gone are the days when direct mail was the primary option for reaching a healthcare practitioner. Product information is being delivered via the web, email, smart phones, and PDA's. In fact, given the rapid adoption of smart phones used by doctors, effective interactive programs typically integrate a mobile device component whenever feasible.

Clearly, there are many possible tactics and sorting through them can be daunting. While entertainment value is important, there are many other key factors that should also be considered when developing and deploying effective interactive programs for your brand.

Dave Gulezian, President & CEO of Viscira, a leading provider of interactive and new-media solutions for the life sciences industry, will be speaking on this subject at the upcoming Digital Pharma West conference on June 30th. Dave will take the conference attendees through some of the top do's and don'ts in interactive marketing as well as touch upon the ways in which to develop new-media programs for the greatest impact.

Noël Ashekian
Marketing Communications Manager
Viscira

Is Marketing Still Marketing?

As someone who has been fortunate enough to spend significant time in both Marketing and Public Relations, I have often been asked to compare the contrast those two related disciplines. One of the key distinguishing features was the way in which media presence was obtained—was it paid? or was it earned? And what was the measure of its impact.

Those of you who've been in PR will easily recognize the following question: How can you prove that the earned media you hope to get is worth the money we are spending on the XYZ campaign? To address it, we often turned to our key unit of measure—words per inch. Since with earned media, one could never be certain how much of our material (if any) will be taken up, nor which angle will be applied by a given editor or reporter, running story "miles" seemed to be as good of a measure as any to demonstrate how much of the earned media we actually...earned.

In marketing, although the price tag was usually discussed more clearly upfront, paid media--whether it's advertising seconds on primetime TV, a billboard in New York's Penn Station, or a half-page ad in a popular weekly magazine—it ultimately boiled down to practically the same: How many "inches" or "seconds" did it take to build brand loyalty, and how much did it cost to place it in the spot where your audience was most likely to see it?

Today, the distinction between the world of marketing and the world of PR is rapidly disappearing. With the proliferation of social media, PR has become marketing, and marketing has become PR. Any Facebook reader can "become a fan" of a promoted product—whose placement within the portal is by no means cheap—thus multiplying the value of the ad through what essentially is an earned media concept.

According to a recent report by The Nielsen Company, most "earned impressions have the highest level of impact" as a result of Facebook users "engaging with an ad." They conclude that "the key to success for marketers is creating a mix of social impressions that incorporate both paid and earned media."

Additionally, marketers have to learn how to deliver their message in a very limited space. No words per inch. Fewer 60 second or half page ads. Things have become compressed, and a marketing message must be brief, almost vacuum-packed, if we want anyone to notice.

In the age of social media, it's no longer just about paid TV spots in a national network or a half-pager in a key newspaper or weekly magazine; it's about earning loyalty directly from the customer. So instead of viewing instant customer feedback as a loss of "marketing control," let's see it as a way to earn customer relationships. Isn't that better than earning media column inches in the past?

Elizabeth Sozanski
Senior Director Marketing Strategy
AstraZeneca

What High School Politics Can Teach Us About Social Media

Lately, we've seen Twitter labeled as the latest "shiny new object" for brands making an effort to adapt to the online world in which customers are increasingly in control. While the examples of innovative uses of Twitter are interesting in that they go beyond simple push messaging many brands have misguidedly adopted, pharmaceutical marketers have additional legal and regulatory implications to consider. They also have the additional challenge of products for which the customer base may simply not care to engage in conversation with a pharmaceutical brand, or even respond to the brand at all.

Despite these challenges, some companies have taken a novel approach. Consider AstraZeneca's @AZhelps, a Twitter account that plays a unique hybrid corporate-brand role that exists in addition to @AstraZeneca US, the company's public relations and news account. Twitter is proactively monitored for brand mentions on behalf of all AZ products. Once located, @AZhelps responds to the tweet author with a PRC-approved response directing the author to call the patient safety 800-number.

While PR and customer service (such as @AZhelps) are important functions in social media, they are largely applicable only to the corporate side of companies. For brands, social media presents a different challenge altogether. At its core, social media is a conversation that takes place among people in order to derive value from one another. For a brand to take part in this conversation in a meaningful way, it's essential that the brand first understands the conversation that is already taking place.

Consider an analogy: It's your first day at a new high school. You want other kids to like you and talk to you. You want to be part of the "in" crowd and you want to make a good first impression. You see a group standing together, and you walk up to join the conversation. Now, there are several ways you could do this, but only one of them will be beneficial for your social life.

You could walk up to the group without introducing yourself, start talking about a topic that's not relevant to them or the conversation already taking place, refuse to respond to any comments or questions, and then ask them to be your fan. Seems silly, right? There are a whole slew of brands out there and a disproportionate number in the pharmaceutical sphere that have exhibited this precise behavior and then been surprised at the backlash in social media or the lack of fan requests and followers.

Consider a company that opens a Twitter account, provides no information as to why the brand is there, disables the option to comment or follow the brand, doesn't respond to any other conversation going on around them, and then proceeds to blast messaging that has little relevance to anyone but the brand. There are countless examples like this out there on Twitter and Facebook.

Now, if you wanted to actually make some friends in this scenario, you would likely walk up to the conversation, introduce yourself, and then listen. Really listen. To absorb the nuances of the conversation and identify who the popular kids (read: thought leaders) are on each topic. You might then begin to add valuable on-topic commentary to the existing conversation. Finally, after you've integrated yourself into the group and have proven to be a knowledgeable and considerate participant, you'll earn the right to introduce your own topic of conversation as long as it's interesting your friends. The group will likely find it relevant and engage with you. They might even tell their other friends about you.

Given this scenario, it's important to ensure that you're ready to listen and respond to what your customers have to say, both positive and negative, before embarking into the world of social media. The organization should be prepared to devote resources in the form of time, financing, and personnel to support social media efforts. It also means modifying the traditionally-sluggish regulatory process that will allow you to respond to customers in the short time frame that is demanded in social media.

Finally, the most important thing to remember about engaging with your customers through social media is that it's about them, not your brand. Be transparent and responsive, and provide frequently updated content that your customers truly value, not simply material that supports your brand messaging. This is not the place for push marketing. Listen first, and ensure that you're planning to participate in social media because your customers want you there and because you can provide value to the ongoing conversation, not because it's the "shiny new object" of the moment.

Sarah Larcker
Director of Strategy & Analysis
Digitas Health

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 heart 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' from Manhattan shows that across Europe patients are flooding into health communities to find information and support.The 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.

Alex Bultler
Communications Manager
Janssen-Cilag, UK

Patients Are Not Willing Consumers

When you think about marketing, you think about selling a product. Most of the time, this product is something that is desirable. Perhaps the new Apple iPad or a fast car or the latest It bag. These things are cool, they're hot, they get people talking.

But nobody really likes medicine. No one chooses to get sick and require medication, whether it's for one week or the rest of their life. No one sees a commercial for the latest FDA approved drug and think, "Man I wish I could get my hands on that!" Patients are unwilling customers. They purchase products they have no desire to have using money they have no desire to give away.

Medicine is necessary. Products created and provided to us by pharmaceutical companies are necessary. There is no question about that. When I was diagnosed with type 1 diabetes at 8-years-old, I had very little understanding of how pharmaceutical companies would play a role in my life. As a child with diabetes, my world was still wrapped up in things like Girl Scout meetings, family vacations, and sleepovers. I spent much more time worrying about whether or not the girl with the nicer clothes liked me. My health was important to me, but it was handled by the superior knowledge and understanding of my parents.

That wouldn't last forever, though.

Although I literally grew up on the Internet (I created my first AOL screen name when I was 11 years old), I didn't discover true social networking until I was a senior in high school. Although I was familiar with Instant Messaging with my schoolmates and using the Internet to research homework assignments, my contact with people that I didn't know was limited. As the Internet grew more interactive, so did the ability to connect with people outside of my little community.

It may feel to some like it happened slowly over time, but for me it feels like a rapid progression. One minute, I am the only person with diabetes that I talk to on a daily basis and the next day, I have at least fifteen people who I share stories with on a chatroom that I eventually went to work for when I was 17. From there came forums, chatrooms, blogs, Facebook, Twitter, and patient-created social networks like TuDiabetes. Now I barely go an hour without hearing about a person with diabetes (PWD) sharing a struggle that I am also having or receiving countless messages of support and comfort.

Whereas before, I was limited to the information my doctor or diabetes educator could provide me about new medications or medical devices. Sometimes I would hear about someone who tried the latest It device, but it was usually a "friend of a friend" situation. With social networks, I had direct access. No matter what I wanted to know, I could find someone who had been there. The other PWDs in my social network became my new sales reps.

A few weeks ago, someone tweeted about why the diabetes community seemed to be so strong in social networking. Personally, I think there are a few contributing factors. First is time. People with diabetes have been using the Internet to communicate for as long as the Internet supported the function. Second, I think that certain diseases or conditions so strongly affect a person's day-to-day physical and mental faculties that it is only natural that we would reach out to others. A disease like diabetes is like an anchor on the mind, dragging it down again and again, with only our own strength to keep it from completely stopping us in our tracks. With social networks, we work together, as a team, to help those who are particularly struggling to keep themselves afloat.

Lastly, diabetes is unlike most diseases in which the primary decision maker of treatment is not the doctor. Of course, a person with diabetes is surrounded by a team: an endocrinologist, a diabetes educator, a nutritionist, an ophthalmologist, perhaps even a podiatrist or countless other specialists. But after the education has been done, and the patient goes home, there are often months before the patient returns to the doctor. Thus, the day-to-day care involves juggling a dozen factors over which we only have control over a couple. Diabetes is a mysterious disease, and one that often can only be understood through experience, which means we often rely on others who have slowly uncovered its mysteries.

The medication and devices we use can also be best explained by the people who use them. It's really no different than going to Yelp to get a restaurant recommendation from someone who has actually eaten the food. Doctors and sales reps might know how the medication should work, and sometimes we even encounter sales reps with the same disease, but even then, there's only so much they can say. That's where patients come in.

I have always believed in a holistic relationship in healthcare. Patients need to listen to their doctors, doctors need to listen to their patients, pharmaceutical and biotech companies need to listen to patients and doctors. We are all pieces to the puzzle of healthcare and our knowledge and experiences are extraordinarily valuable. No patient wants your product, but they do want it to work. There is no shortage of patient experiences online, and while I sympathize to the challenges of adhering to FDA regulations (I too work in healthcare communications), there is no question that if you want to understand what your patient is going through, all you need is Google.

Allison Blass
Blogger
Lemonade Life

Curation - The Next Trend in Social Health

The next trend in social health may be medical curation. Published health information is expanding at a rate that none of us can really understand. Yet despite this embarrassment of riches, access to reliable, actionable information for patients is variable. Search is a dubious avenue to health information.
So where is a patient to turn?

The answer may lie in health curation. Curation is the active and selective collection of content. Curation is not search. Curation is not aggregation. Curation is not automatic. Curation isn't a 4-hour workweek scheme.

Curation requires a capacity to separate the reliable and accessible from the rubbish. In health it this would seem to require two elements 1) expertise in the area under curation and 2) clear understanding of the needs of the reading patient. E-patients can't do it alone. Doctors can't do it alone.

While health aggregation portals are a dime a dozen, I can find few examples of health curation done right. I have concerns about the potential influence of pharmaceuticals in some of the sites I reviewed.

If you do nothing else read Steve Rubel's landmark post on the matter. He doesn't mention healthcare but the concept would seem to represent the critical missing link in the future of health literacy.
As Rubel reminds us, demand will never scale to match supply. The future belongs to those who can help address the attention crash.

Who will create the definitive collection of the infosphere's greatest health content?

Bryan Vartabedian (Dr. V), MD FAAP
Physician & Social Media Activist
Baylor College Of Medicine/Texas Children's Hospital

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