Archive Page 2

#HCSMGLOBAL

Heads up: I’ve written a post for #HCSMGLOBAL on the global information and communications technology (ICT) gap. #HCSMGLOBAL is the grass roots umbrella organization for regional #HCSM chapters who meet, discuss and influence the healthcare conversation on the social web. If you are connected with healthcare in any way (be it professionally, or maybe as a patient or a carer), I urge you to join the conversation in your location:

#HCSM (US)
#HCSMCA (Canada)
#HCSMEU (Europe)
#HCSMLA (Latin America)
#HCSMAsia (Asia)
#HCSMANZ (Australia & New Zealand)
#HCSMEUFR (France)
#HCSMES (Spain)
#HCSMUK (UK)

Look forward to chatting with you at #HCSMEU (@hcsmeu). We meet on Twitter at 1pm CET every Friday. Just search for #HCSMEU.

SXSW feature: The secret life of behaviour change

I was fortunate enough to attend the South By SouthWest Interactive conference (colloquially ‘Southby’ or SXSW), which benefited from a health ‘track’ that focused on innovation and digital in healthcare.

At the event, I attended a number of panels and I would like to share my notes on some of the panels here. So, I want to talk about a solo piece from
Aza Raskin (@azaaza), founder of the startup Massive Health, who talked about how consideration of feedback loops can help change patient behaviour with regards to lifestyle choices and disease self-management.

Feedback loops
Raskin maintains that the secret to changing behaviour is to examine and change these feedback loops associated with health behaviour. For example, a morbidly obese person is likely to be very aware that their condition will have a serious negative impact on their health, and so dieting and exercise to reduce weight/BMI/waist circumference is very important to avoid stroke or myocardial infarction or all the diseases that obesity is a risk factor for. However, we all know that dieting and exercise are very difficult to start and even more difficult to maintain on a long-term basis.

Cake
He uses cake as a good example of a feedback loop in action:
A person sees one piece of cake and knows that they shouldn’t eat it, however if they do eat it, there is no immediate consequence (possibly other than guilt or sticky fingers). This demonstrates that people do not consider the cumulative negative effect on health that the cake contributes to, and therefore this cake is part of a long-term feedback loop with consequences way off in the future. The same with cigarettes – smokers know that a cigarette will essentially shorten their life, but those consequences are at the end of the life, not at that moment.

So, it is clear that long feedback loops do not encourage ‘good’ behaviour and, therefore, there is a need to find a way to make it easier for people to adhere to good behaviours for the duration of that feedback loop, either by creating shorter feedback loops (giving often or instant feedback to people on how well they are doing) and/or rewarding people for modifying their behaviour.

Marshmallows
To illustrate the idea of rewards for behaviour modification, Raskin described an experiment where young children were presented with a marshmallow. The children were told that they could eat the marshmallow now, however if they waited without eating the marshmallow, they would get a second marshmallow on the researcher’s return (thus the promise of two marshmallows – an exciting prospect for a 4-year-old!). Although the original study was investigating the effect of age on the development of delayed gratification, the point Raskin was making was that the children who waited rather than eating their marshmallow modified their behaviour in order to gain a benefit/reward.

Amusing video of something similar that Raskin showed:

Oh, The Temptation from Steve V on Vimeo.

I think this gives food for thought (possibly not marshmallows), as if we can apply this rhetorical theory into the programmes that we produce and find a way to make it work, this could have a great positive impact on patients lives.

Right about Xoom and iPad 2

Last week I predicted Apple would drop the price of the iPad for the launch of the iPad 2. Looks like I was right, as Apple have announced a £100 reduction in the price of the original iPad in the UK, with other countries receiving similar reductions.

Whether this is for clearing stock of the iPad or a more permanent offering remains to be seen. However, this does support my predictions that the Motorola Xoom will not be considered over the iPad, or even the iPad 2 in a pharma salesforce or hospital environment.

Motorola Xooms itself in the foot?

I was pretty excited about the announcements before and during the Mobile World Congress in Barcelona last week. Android was the star of the show, with many many manufacturers showing off hardware that uses the operating system. Forefront in the hype was the tablet-specific iteration, called Honeycomb that will be available on many of the new tablets, a couple that are creating buzz are:

LG Optimus Pad (formerly called G-Slate):

Samsung Galaxy Tab 10.1 (10-inch version of the existing Tab)

These tablets will be available for consumer and enterprise use later in 2011, however, more imminent is the Motorola Xoom, which will be the first tablet running Honeycomb available.

It looks fantastic, and represents a viable alternative to the iPad for both detailing duties and for use in a hospital environment. In fact Android, being an “open” platform, means that you don’t have someone like Apple meddling in the types of app that can be produced for the tablet, making it simpler to manage, produce and approve specific apps for specific tasks. In addition, pharma companies and hospitals can have control over how the user interface looks and feels.

The problem with the Xoom is twofold: No Flash integration at launch. Admittedly, this is a minor problem, as Flash is promised for a few months’ time. However, the major problem is the cost of the thing. Even assuming the retail price of $799 can be beaten by bulk purchase, this still leaves the Xoom on a par with its (currently) only rival in the 10-inch category, the iPad – a very well known and trusted device, and I expect that, given the choice based on cost, 90% would go for the iPad.

It also gets worse, rumour has it that iPad 2 announcement will be days away (March 2 anyone?), and if the iPad 2 is launched soon, you can bet that the price of new original iPads will drop significantly, as we saw with the iPhone 3Gs when the iPhone 4 was launched. This leaves Motorola in the position of having an untested device, with a completely new and unfamiliar operating system at a higher price than the iPad. Which will be a problem.

Aside from this, Pharma companies and institutions looking to leverage tablet devices should maybe think about waiting for the choice of devices, as I thought you would also like to see what else is out there too in terms of tablets:

HTC Flyer – a 7-inch tablet that controversially uses a smartphone version of Android and has a stylus

RIM PlayBook (BlackBerry) that runs on a new operating system and is intended to link up with the BlackBerry

HP TouchPad – uses WebOS, developed by Palm (remember them!)

Will bandwidth capping/throttling scupper Mhealth?

I love the idea that you could fire up an app on your smartphone and check your health records, or if you are a physician, you can peruse the drug interactions for HIV medications on your iPhone. the healthcare ‘mobile revolution’ appears to be starting, and mobile healthcare is predicted to be very big starting 2011 and I myself have predicted that mobile health will play a larger role in 2011 too.

Of course, this all depends on the uptake of smartphones (and tablets, if you consider them to be a mobile device) by patients, as well as the commitment to infrastructure by healthcare providers and authorities. We know Pharma is interested (My agency are currently developing several apps ranging from dosing calculation tools to e-detail aids on a number of platforms), but my main worry is whether our efforts will be scuppered by the one variable no-one seems to be talking about: The telecoms companies.

Let’s look at recent news in the industry – there have been reports of mobile providers throttling bandwidth (Virgin Mobile in the US is the most recent to announce this). In addition, mobile providers are reducing the amount of data that can be used in a particular plan. Even last year in the UK, for instance, all the large telecoms companies were offering ‘unlimited’ mobile broadband packages (with a fair use policy of up to 500MB or 1GB of data a month). Significantly, there was little enforcement of the fair use policy. Fast forward to today, where T-Mobile are the latest to announce that they are essentially abolishing the fair-use policy and introducing a hard cap on data usage (500MB/month), above which punters would need to pay an extra £5 per 500MB per month. This follows similar rules introduced by Vodafone in late 2010 (which was handled appallingly with regards to how they communicated this to customers, by the way).

So here begs the titular question: Will bandwidth caps/throttling scupper mobile health?

Consider data-heavy apps, sharing images, streaming video and other information. The telecos won’t pay to support this. Will healthcare infrastructure pay for physician apps? Will patients be happy to pay extra to access these?

Edit: 18 January 2011 – an another operator adds to the confusion. Sprint are to charge smartphone users an extra $10/month to account for data usage!

Balloon animals

A quick apology to readers of this blog. I really enjoy writing here, but the past month has thrown up a number of challenges.

One of these challenges is actually finding something interesting and, importantly, new, to write about. There are so many bloggers out there that I feel I would be doing you a disservice if I wrote basically the same stuff that others have already covered.

Social media is no longer new and exciting, and in the pharmaceutical sector at least, little has changed with regards to its use, other than the fact that pharma companies know more about it than before. Especially in Europe, where regulatory guidance is a long way off; don’t get me wrong, there have been excellent examples of innovative use of social media, however all the signs show that we are ‘over the hump’ of social media hype and are now, quite rightly, looking at it as a channel to be considered and utilised in an appropriate manner as part of an integrated plan. Not so much a bursting of the social media bubble, more a slight deflation so that we can make balloon animals (to overextend my mixed metaphor for appropriate consideration and usage of social media). Essentially in 2011, it is necessary for Pharma to bring social media into the Venn diagram and start using it appropriately.

What about the rise and rise of mobile and tablet healthcare with native apps (and in my opinion this is also something that is still overhyped and not rationally used as a tactic in an integrated plan, but I expect that to continue for the moment). I think Android will play a much larger part in healthcare as a platform with some major players bringing out Androidbased tablets in 2011 (with implications in terms of enterprise, cost and accessibility).

Let’s not forget the possibilities of near-field communications (NFCs), especially now that mobile handsets are starting to integrate this technology (notably Google’s upcoming Nexus S made by Samsung, which also inexplicably has no LED indicator or SD card expansion slot). This is something that will gain momentum in 2011, with possibly some good use coming of it either late in 2011 or more likely in 2012.

Now to a topic I’ve also been banging on in this blog about recently: integration, and I think actually this will be a key theme for the focus of my commentary in 2011 – integration of digital into overall healthcare strategy. We need to be savvy that digital must fit within our offerings in an integrated manner, and that we shouldn’t get overexcited about ‘the shiny’ (be it platforms or gadgets). I expect 2011 to be the year where the ‘bedding in’ of digital occurs, where we all go back from being ‘digital strategists’ to just ‘communication strategists’, because this is where the benefits for patients, HCPs and Industry lie.

I’m excited by the prospect of 2011 in digital. Happy holidays to you all.

Paul

Social media sharing for pharma

I probably don’t need to tell you that there has been buzz recently about the new FDA guidance on social media that is predicted to appear in this year Indeed, John Mack predicted that the guidance would be issued in sections, and he puts forward a theory that guidance on short-format or space-limited communications will be published first. Whether Mack is right or not, this issue will be discussed within FDA guidance, as it has a huge effect on how we currently communicate and share information about pharmaceuticals.

I’d like to examine the current situation from the social sharing widget/link point-of-view. For those who are unaware, social sharing widgets (such as ShareThis allow users to post up snippets of content from your website on to their social media space, for example share with a status update or wall post on Facebook. This will display a small snippet of information and this has implications because invariably these snippets use metadata from your site, which is not part of the content that the user reads – it’s hidden within the code for that page.

The problem? Illustrated by the widely-cited warning letter to Novartis on their use of a Facebook sharing tool. Metadata can be very short and therefore it would make creating this snippit with fair balance very difficult. So with this in mind, how are pharma companies using sharing tools on their sites? My experience when discussing this with clients is that they are not willing to risk being in breach of regulations, and the concept of social sharing tools on pharma websites, even non-promotional ones are quashed very early by regulatory departments, even if the metdata is crafted to remove any claims and can be approved in their own right.

Of course, enterprising companies are rushing to try to give pharma companies more control over their sharing options. For example, there is the Share, Send, Save widget from Intouch Solutions and the competing tool from Bridge Worldwide and ShareThis. Currently I can’t say I have seen these tools being used on pharma-backed sites at all, but at least these give options to allow users to share content with others whilst keeping more control over the information that is provided through these tools.

So the question is, will the new FDA guidance pave the way for additional social sharing tools, will there be enough guidance for Pharma to be confident about using this functionality, and will Pharma take the plunge into social sharing in a big way?

Let’s see what the guidelines say.


About me

Hi, my name is Paul Jacobs and I write the Medigital blog, as well as being the Director, Digital Strategy at Sonic Boom, a digital and social agency. I hope you enjoy reading my thoughts about the digital domain in pharma and medical communications/education.
Please note that opinions expressed in this blog are my very own and do not necessarily reflect those my employer, family or pets. Twitter: @PJ_Medigital
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