ephmra online conference papers 2020 · to accomplish the move to ‘responsible’ successfully,...

EphMRA Online Conference Papers 2020

Keep up to date by reading the summaries of all our Webinars and online Conference Papers since June.

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Contents

Contact usIf you have any enquiries, suggestions or feedback just email us: Bernadette Rogers, General ManagerEmail: [email protected]

A View of the Future: Covid-19 and Employee Resilience

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Powering Market Research: Bringing Secondary and Primary Data Together for Greater Insights

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MR Excellence Award Winner 2020: Making a Business Impact

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Pharma’s use of digital marketing is often poor. How can our insights make it better?

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Isolation Nation - Pharma’s role in shaping the new normal

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AI in Healthcare PMR - Smoke and Mirrors or a Future Staple?

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Partnering with Patients - How do we ensure true collaboration?

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Human vs. Machine: Who will win the battle for insights

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Patient Advocacy Insights from Ultra-Rare Disease Caregivers

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Tell them a story they can’t refuse

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China Forecasting - Primary Market Research in China, Market Access and Overcoming Other Challenges in Forecasting

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Culture in Healthcare: Developing Awareness and Competence

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AI in Demand Planning - How AI is NOT Changing DP

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Find your own WHY: How understanding yourself can lead to better professional development

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Looking at Data Differently

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EphMRA Online Conference Papers 2020

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EphMRA Online event - 2 June 2020

A View of the Future: Covid-19 and Employee Resilience

Speakers: Dom Boyd, Managing Director, UK Insights, Kantar and Mandy Rico, Global Director, The Inclusion Index, KantarDrawing on many different data sources including Kantar’s barometer, The Inclusion Index, Dom Boyd and Mandy Rico presented an overview of the realities of coming out of the Covid-19 lockdown situation and the implications for customers, products and employees in the move from resilience to a desire to return to normality.

Is Covid-19 creating a new normal for brands and employees?

Covid-19 is not just a disease - it is a disruption which is impacting all of our lives in many different ways and in doing so, it is creating a new normal. It is also revolutionising the relationship between businesses and employees.

The business crisis

The business crisis created by Covid-19 is a human issue and not just a talent issue. Over three-quarters of workers say that this pandemic is the most stressful period of their career. It is a time of heightened emotions and there are four scenarios that can play out: the close call, the panic attack, the recurring nightmare and the brave new reality. Whichever of these scenarios plays out will require change which is stressful for many people.

The social crisis

The new normal is not normal. The impact of social distancing, blended responsibilities (typically involving childcare and home-schooling), solitary social-ism and enforced introversion (e.g. the use of video conferencing) brings new emotions to the fore. Although there can be some positive emotions, such as around the use of video calls in which people can feel calm and secure, over half of the emotions experienced are relatively negative (i.e. panic, worry, fear, stress and anxiety). However, there is a positive behind Covid-19 in that it has been a catalyst for creating more caring societal values.

The brand crisis

The impact of Covid-19 is moving us from a ‘powerful’ cultural era to a ‘responsible’ cultural era.

• The ‘powerful’ era which began in the 1960s has focused on creating better ideas and products.

• This moved through to the ‘possible’ era which was about creating a better self.

• The last decade saw a ‘purposeful’ era focused on creating a better society.

• This has now moved into a sharpened sense of purposefulness which is ‘responsible’ and is about creating better behaviours and brands’ duty of care to their customers.

This movement to a ‘responsible’ era has profound implications for organisations as well as brands, with a mindset shift from selling to serving. Value creation in the future will be driven less through ads and more through acts. It will require a step-change in corporate behaviours and there will be less emphasis on messages and more on enriching experiences, both for employees and customers. The role of the customer journey will be elevated and there will be an operational shift from efficiency to empathy which will mark out the brands and businesses that are more successful going forwards.

The move to a ‘responsible’ era can also be seen as a shift from doughnut brands to wholesome brands, defined by:

• Being built inside out instead of outside in i.e. anticipating and satisfying the customer’s need for wholesomeness and strong values.

• Having no room for companies to hide with growth through demonstrating role-modelling positive behaviours which enrich society, employees and customers.

• The start point will be based with colleagues rather than the customer or culture.

• There will be more focus on the employee experience as well as the customer experience before the brand experience. This is a real turn-around for marketing which has traditionally looked outside for culture and consumers as a start point.

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The employee crisis

To accomplish the move to ‘responsible’ successfully, businesses need to bridge the trust gap. Research has found that there is a significant lack of trust among employees towards their companies in areas including disclosing health conditions, bullying and being made to feel uncomfortable in the workplace. Businesses must therefore bridge the trust gap by reacting with genuine empathy and reimagining the measures of success.

What are the watch-outs for companies - lessons learned from Kantar’s Inclusion Index

Kantar’s Inclusion Index allows companies to understand, track and monitor their own progress in how employees feel about working at their company. This allows leaders to develop and embed diversity and inclusion strategies across their company. It also enables companies to understand what it is like to work there in the context of inclusion and diversity.

Pre-Covid-19, the Inclusion Index focused on engagement, belonging, empowerment and perception. Globally, 36% of employees felt anxious in their jobs. In ‘vulnerable’ diverse groups, this rose to 56%. When looking at employees with pre-existing mental health problems, the number who felt anxious rose to 60%. Comparing other global sectors with pharma/healthcare, the differences were:

• Employees diagnosed with mental health issues: 15% (other) and 23% (healthcare/pharma)

• Stress and anxiety globally: 43% (other) and 55% (healthcare/pharma).

• Chronic fatigue: 35% (other) and 48% (healthcare/pharma).

• Lack of stamina: 19% (other) and 26% (healthcare/pharma).

While a sense of belonging was relatively high across all industries pre-Covid-19, there were clear differences between global pharma/healthcare and pharma/healthcare participants with mental health symptoms.

This all means that now more than ever, we have to understand how to support employees in times of stress and anxiety. Right now, we are seeing heightened levels of anxiety when people are thinking about their health and that of their families, as well as coping with their workload and the ‘new normal’. It is therefore more important than it has ever been to track employees.

We are in a global recession and it is documented that redundancy and other life circumstances brought about by a recession can trigger depression, anxiety and suicide. In the economic crises of 2007, this correlated to an additional 10,000 suicides in Europe and North America. It is therefore imperative that we track how employees are feeling. The Inclusion Index provides a way of letting employees know that inclusion and diversity are still high on the corporate agenda and that their feelings are being monitored.

Key take-outs: Leading inclusively during the new era and the new keys to success

• It is essential to communicate with employees and right now, over-communication is key.

• Trust needs to be enforced within an organisation.

• Communication needs to be delivered in transparent and empathetic ways.

• Proactively asking employees when and how they want to be communicated with will make them feel included in business decision-making.

• Covid-19 provides a unique opportunity for helping employees discover their own personal purpose.

• The growth mindset should be there to help employees thrive and flourish.

• Encourage staff to make use of their downtime by upskilling themselves through online training.

• Remember that everybody is struggling in some way, including leaders.

• Tracking how teams interact, the needs that they have and how these are evolving will provide important learnings that can be leveraged.

• Move from a doughnut brand to being a wholesome brand.

• Inclusion and diversity are business imperatives for growth underpinned by strong values and beliefs.

• Proactively share and celebrate examples of your employees embodying your company’s values. Shine from the inside.

• Covid-19 is a catalyst with positive elements that can help reshape your brands and build a more diverse and more inclusive culture with a stronger vision for the future based on stronger values and greater connection with employees.

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MR Excellence Award Winner 2020: Making a Business Impact

Convenor: Rachel Medcalf, Adelphi Research

Mobile: “Don’t Break the Data!”Speakers: Nadine Winter, Boehringer Ingelheim and Alex West, Instar Research

With an explosion in the use of mobile devices for completing market research surveys over the last five years, particularly in markets such as China and the USA where up to 40% of the surveys that are fielded are conducted using mobile technology, Boehringer Ingelheim (BI) worked with Instar Research to evaluate the impact of mobile device usage on market research surveys.

Business needs and research objectives

• The business needs identified by BI included:

• The impact on market research surveys if they were moved specifically to mobile devices.

• The considerations needed for any variants seen in the data.

• The degree of optimisation that needs to be factored in when using mobile devices and the impact this will have on the data that is seen.

A key objective was to evaluate device type (PC versus mobile) in terms of any potential impact on the data - the ‘platform effect’. It was also important to assess the impact of setting the same question up in different ways to optimise it for a mobile device and comparing this to the test group using a traditional survey to see if there was any data variance. A further objective was to explore how carrying out surveys on mobile devices potentially increases the engagement of physicians and participation rates.

How the research was conducted

The research was conducted in three stages.

1. A hypothesis testing exercise was run via a workshop which explored what BI thought the results were likely to be and how this might differ across the team. All of this information was then put into a survey design, picking up on perceptions of what the market research data might say, including differences, what the quality might look like and what the physician experience might look like. This provided an essential context for framing the deliverable and the storyline became more engaging as it sat within the context of what BI thought might happen.

2. The testing phase involved a scheduled tracking arm for one of BI’s brands which was split three ways with 120 healthcare professionals per arm involving:

• A traditional arm with a traditional grid layout.

• A mobile friendly arm, which took the same survey with slight tweaks so that it looked better on a mobile device while sticking as close to a traditional survey layout as possible. It involved scrolling up and down.

• A mobile first arm which was optimised for viewing on a mobile device, plus a modified survey layout and sequencing to work better for a mobile. It involved swiping right for yes and left for no.

Considerable effort was made to use a design that was a true enhancement of a traditional mobile survey. In running the study three ways, it was possible to isolate the impact of the device i.e. the ‘platform effect’. The impact of changing the way the question looked and whether there was any statistical variance in the data could also be seen. While the invitation to physicians did not insist that they completed the survey on either their desktop PC or mobile device as specified, there was a very high degree of compliance.

3. The project debrief involved a myth-busting exercise in the context of the hypotheses that had been developed and the myths that needed to be busted from the results obtained. A lot of the predictions, hopes and fears expressed in the hypothesis testing exercise turned out not to be true at the end. For example, although the survey layout impacted on consistency, there were similar completion rates and the fieldwork times were not improved. These were surprising findings for BI and they have provided a blueprint that can be overlaid on discussions about their mobile strategy to give areas for consideration and what they need to be mindful of if they go down this route.

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Key findings in order of impact

• The mobile trend is only likely to be one way.

• The device type impacts KPI performance, even when it is optimised for a PC versus a mobile device.

• The survey layout did not impact as far as the KPIs were concerned but there were significant differences in how doctors responded in terms of attributes and grid questions.

• Optimised survey layouts took longer to complete although the post-survey did not yield any complaints from doctors.

• All three physician groups said that they would be willing to participate in the future, even though one of the groups took noticeably longer.

• There were no differences in key fieldwork statistics (response rate, screen-outs, drop-outs and length in field were all the same).

Summary of strategic implications

• Piloting - make sure that the questionnaire is working as it should on both PCs and mobile devices to ensure that there are no significant differences in data collection or quality.

• Analytics - monitor surveys in terms of the number of completes on PCs versus mobile devices and include this as a banner point on all data tables.

• Reporting - for each study, there should be an appendix that clearly highlights that different platforms have been used to conduct the market research as well as key similarities and differences.

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Speakers: Georgie Cooper and Soumya Roy, Basis HealthBasis Health conducted a self-funded study throughout May 2020 which looked at both the short-term and long-term impacts of the Covid-19 pandemic on the healthcare system and healthcare professionals, as well as the role that pharma can play in supporting customers to shape and navigate the ‘new normal’.

Approach

The research was both a qualitative and a quantitative study.

The qualitative element involved around 20 healthcare professionals in the UK and US across a broad range of specialties i.e. not only those who have been involved in acute Covid-19 patient care but also those who are involved in chronic disease management. 60-minute telephone interviews were carried out and Basis Health spoke to those involved on an ongoing basis as part of an online diary in which they gave insight into their day to day lives. The healthcare professionals also took part in a number of creative exercises.

The quantitative element involved 200 consumers in the UK and US who took part in an ongoing tracking study for four weeks. Part of the discussion was around their interaction with the healthcare system and their thoughts and feelings about this interaction during the pandemic so far.

Results overview:

The emotional impact that Covid-19 has had on healthcare professionals in the UK and US

Healthcare professionals have gone through a host of emotions on a daily basis as a result of Covid-19. Typically, they feel out of their comfort zone through being in situations that they are not normally involved with, which can make them feel useless as a result. They have to make uncomfortable decisions, the results of which can lead to a constant internal debate as to whether these decisions were the right ones. They can also feel vulnerable, with some having had close colleagues and family members who have died of Covid-19.

Although this impact is very much felt by frontline workers, phenomenal adjustments have had to be made which have affected many other healthcare professionals, largely because the healthcare system has had to segregate itself. Hospitals have had to be split into two in order to manage Covid-19 patients while protecting the health of non-Covid-19 patients. Healthcare professionals who do not typically work in ICU have had to do ward rosters on Covid-19 wards and this may be a permanent move in some cases to manage Covid-19 patients full-time as part of their role. Likewise, healthcare professionals who are not involved in Covid-19 patient care have had to take on patients from their colleagues. They have therefore seen an increase in their caseloads to accommodate and manage shifts.

All of this has meant that healthcare professionals are united by uncertainty and apprehension i.e. moving from a sense of feeling quite comfortable and an expert in their field, as well as knowing what their day to day and work-life balance looks like, to a world where they feel overwhelmed and out of their depth.

Anxiety and distress are not limited to healthcare workers. The deterioration in mental health among consumers has also been pronounced, particularly with women and younger cohorts. Around a quarter or more of consumers in the UK and US report that their mental health has deteriorated. In the US and UK, this is particularly among 18-34 year-olds and among women (33% US, 29% UK).

When asked about specific mental health issues, consumers in the US are generally suffering from more anxiety and insomnia. In the UK, about half of the population reports some feelings of depression and alienation, with this being significantly higher among women.

While there is a feeling of anxiety and being overwhelmed among healthcare professionals, the study found some real positives. One of these is a sense of pride for working in a healthcare system and supporting the health of the nation at this time. There is also a real sense of camaraderie which is felt in the face of a much bigger national loss of confidence. There is a sense of security in working in a hospital that is doing the right thing when there may be question marks about some of the decisions being made on a bigger national level.


Isolation Nation - Pharma’s role in shaping the new normal

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How Covid-19 has drastically changed chronic disease management both in the short and long-term

Various models have been adopted to manage the splitting of Covid-19 and non-Covid-19 patients while also protecting the latter. In the UK, primary care “hot clinics” have been set up where patients can go before going to hospital. If they have showed Covid-19 symptoms, they have been able to see a primary care practitioner rather than having to go straight to hospital. In the UK and US in a hospital setting, some sites were deemed clean to manage non-

Covid-19 patients while field centres were set up to manage Covid-19 patients. Cancer care hubs were also set up to provide key focus centres to take referrals from other hospitals and ensure that continuity of care could be maintained.

The study showed that it is clear that the management of chronic disease patients has fundamentally changed because of the pandemic.

• There has been a decline in new diagnoses and there is the sense that there will be a second healthcare crisis post-Covid-19 which will be an influx of new diagnoses.

• There is a shift in how patients gain access to their medicines. Hospital pharmacies have looked at ways to ensure that they can deliver medicines straight to the patient.

• The majority of healthcare professionals are either at home delivering virtual consultations or they are going into hospitals to give virtual consultations. Therefore, face to face interaction with colleagues is severely limited. Team meetings have been cancelled or are held virtually. Virtual consultations are the gold standard approach to managing patients and only urgent cases have been seen face to face.

• This is also the case for diagnostic tests and ongoing monitoring. There is a need to make sure that patients do not come into contact with people and do not come into hospital unnecessarily. Diagnostic tests and ongoing monitoring are only done in essential cases.

• Only urgent surgery is ongoing and elective surgery has been cancelled. This is reviewed constantly to make sure that any surgery that has been cancelled has not become urgent.

• There seems to have been a shift in terms of the risk-benefits ratio with new initiations and switches. New treatment is being held off and not switched because it is riskier to switch treatment when the patient is unable to be seen or monitored on an ongoing basis.

There have also been some clear shifts in oncology, with treatment now only being focused on patients who are deemed fit and have curative intent. Treatment for other patients is either being delayed or decisions are being made to no longer continue it. Oral treatment is being favoured over IV treatment and immunotherapy is the preferred option to chemotherapy because it maintains the immune system for patients.

Virtual consultations have offered a number of key benefits for both healthcare professionals and patients.

• They are safe and convenient.

• Certain patient types are benefiting, such as younger patients who find it flexible and easy for them.

• Loved ones and family members can also be part of the consultations, offering support.

However, there are a number of areas for improvement:

• In the UK, the IT infrastructure has not always been in place and there has been a steep learning curve. Some healthcare professionals have needed to go into hospital to carry out remote consultations.

• It is difficult to gauge assessments visually and also to rely on body language. It is obviously impossible to see the patient if the consultation is done via telephone.

• Ongoing monitoring is very difficult.

• Accessing some patient types can also be difficult, such as older patients or those with mental illness.

How the future is looking uncertain but there is still hope

There are a number of anticipated long-term implications as a result of the Covid-19 pandemic:

• The need to minimise patient contact with the hospital environment. A number of healthcare professionals are moving to monitoring patients at home and are looking for solutions whereby they can keep patients at home but ensure that they can monitor them.

• Over half of patients said that they would like to continue with virtual consultations in the future i.e. there will be a shift in terms of how patients interact with healthcare professionals.

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• Healthcare providers are balancing the need to de-escalate the current measures in place while protecting the health of healthcare professionals and the nation. They want to support unseen chronic disease patients and reduce some of the Covid-19 rosters. They also want to protect healthcare professionals, preventing burnout and mental health problems, while managing the influx of new diagnoses and referrals and protecting against the fear of a second spike.

While they navigate through the next phase, healthcare professionals will have to identify which patients they see first, how they make sure they limit their interaction with patients, and how they ensure that they are sharing knowledge on the Covid-19 pandemic.

The role that pharma can play in helping customers navigate the new normal

Pharma company interaction with healthcare professionals stopped almost immediately at the outset of the pandemic. Moving forwards, there may be an opportunity for pharma to help customers navigate the next phase of Covid-19 and shift what has been a transactional relationship towards more of a partnership. There are particular areas where customers may need support:

• Patient materials that can help the patient identify themselves to a healthcare professional.

• Help with IT infrastructure issues around remote consultations, specifically if there is any technology that can help with visual consultations.

• Remote monitoring and technology that can assist patients in achieving this.

• Mobilising healthcare professionals within specific disease areas to share knowledge around patients in the Covid-19 world.

• The route of administration – subcutaneous and oral is preferred

Summary and key implications

• There continues to be a phenomenal professional and personal adjustment for healthcare professionals both on the frontline and beyond.

• Customer interactions and company and brand communications should reflect this context to make sure that they are relevant and optimise customer engagement.

• Desperation has driven innovation and remote working. Remote consultations are here to stay.

• The pharma engagement model needs to adapt as quickly as customers have adapted. Communications need to be fit to use in this new remote way of working.

• Market dynamism has been significantly impacted. New innovations and switches have dramatically reduced. Products with ease of administration and home monitoring solutions will be key and will have a longer-term advantage as remote working will continue into the future.

• There is a real opportunity and potentially a need for pharma to revolutionise the way it interacts with customers by offering specific and relevant solutions that can help to support them as we move into the next phase of Covid-19.

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Speakers: Vanessa Pott, Merck KGaA and Trishna Bharadia, Health Advocate and Patient Engagement ChampionDeveloping the partnership between the pharma industry and patients/carers was explored from different perspectives by Trishna Bharadia, Health Advocate and Patient Engagement Champion and Vanessa Pott of Merck KGaA, who both shared inspiration, guidance and real-life examples of what such a partnership can look like.

The importance of partnering with patients

Patients are more informed today than ever before and thinking of them simply as passive recipients doesn’t match their relationship with other industries and brands. They want similar experiences with their healthcare to what they experience in other areas of their life. This makes patient centricity increasingly important in all areas of the healthcare industry. Pharma companies and regulators are actively wanting to see greater patient involvement and by making patient partnerships an integrated part of the way that you operate, you will help your clients meet their patient centric objectives.

Involving patients will make your projects more relevant and targeted, as well as helping pharma learn about customer profiles and unmet needs. In the Covid-19 era, identifying unmet patient needs is ever more important because the healthcare landscape is changing rapidly. The pandemic has also presented the opportunity of turning many people into patient advocates. There is currently a great deal of positive interest in the pharma industry and this can be leveraged for greater patient involvement. Becoming known for being a patient-focused company can enhance a company’s reputation and the pandemic has shown that it is even more important to have your finger on the pulse of what the patient community wants and is thinking.

Collaborating with patients helps to create a more informed and activated patient community. This helps them to better manage their care and can help with better engagement with the healthcare system. It also creates greater interest from patients in what is going on in the industry.

Patient groups

The pharma industry often puts all patients together into a single group but not all patients are the same and the patient landscape is changing. There are three broad groups of patients, all with varying characteristics which determine how a stakeholder can interact with them.

• A patient by experience is somebody who knows about their own experience with their condition but little else about their disease or the patient community beyond that. The vast majority of patients are in this group.

• An expert patient is highly knowledgeable about their own experience of their condition but also about the experiences of others within their patient community and the issues affecting them. They are well informed and take an increasingly active part in their healthcare.

• A pro patient is an expert in their own condition and also in their patient community. They are able to look beyond to the issues that face all patients with chronic or systemic illnesses, such as health literacy, the drug development process and patient engagement. These patients are highly skilled and very knowledgeable. They are also often well connected with various stakeholders.

The skills, experiences, expertise and breadth of knowledge increases with these groups. Engaging with patients and patient advocates is different from engaging with patient groups and patient group representatives. They bring different things to the table but both are valuable. This needs to be considered when you are deciding how/when to engage with them.

What should you consider when partnering with patients/carers?

Consideration of a number of factors can help you ensure a successful partnership with patients.

• Staying within local rules and regulations is important as guidelines are often used as a reason for companies to say no. Vendors can play a key role in facilitating a change in culture whereby the rules and regulations are used as an enabler for fair and transparent collaboration.


Partnering with Patients - How do we ensure true collaboration?

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• You should think about your product lifecycle and when it would be appropriate to partner with different types of patient. Involving different patient groups will depend on the project. It is always important to ensure that patient involvement at any stage of the project is relevant and suitable for their skills and expertise.

• You should make it as easy as possible, both logistically and practically, for patients to partner with you. Virtual working often facilitates patient participation, as do flexible schedules and transparent timelines. A partnership needs to be open and there needs to be honest conversation about the objectives and potential hurdles.

• Transparency throughout a project is key and this includes outlining timelines and milestones where relevant and anything else which will make the patient’s participation as clear as possible. You should make it easy for patients to understand what is being asked of them and be approachable so that they feel comfortable to say if something isn’t manageable or if they don’t understand. Always remember that patients need to be able to maintain their independence.

How Merck has been partnering with patients

Merck has developed a range of different opportunities for working with patient organisations, patient advocates and individual patients in three core areas, while recognising that these groups are not the same and will bring very different experiences and expertise to the table.

Clinical trials

Merck has a forum called the Patient 360 which takes a holistic view of the patient community in the form of an insights exchange with senior leadership. Leaders from the patient community at large are brought together on an annual basis, with invitees being experts in their field who can guide Merck’s strategic leadership, strategy development, culture and mindset. Merck specifically involves patients who they can learn from and who can help them better understand the patient perspective, rather than people they are working with anyway. Senior leaders meet with patient representatives for up to two days to discuss top level aspects of the company’s R&D strategy. This translates into a multitude of projects, including the design of clinical trial protocols and in particular, the patient reported outcomes measure.

Merck increasingly partners with advocacy organisations in terms of education and clinical trial recruitment, as there are still many misconceptions and fears about involvement. In terms of practical trial considerations, a group of patients are convened on a specific day/time to work through practical aspects of the trial. Considerations include how they would like to be approached about the trial, how they will logistically get to the trial, what barriers might arise and whether they require any assistance. The increasing digitisation of clinical trials is an area that has been informed by direct feedback from patients.

Annual forum

Merck has an annual forum which brings together patient advocates in dedicated meetings, for example, around the impact of MS on women. Around 50 people are convened for a panel discussion, from which Merck translates the points raised into internal actions and a communications strategy, as well as resources developed by advocacy organisations who attended the meeting and learnings for different countries.

Ambassadors’ Programme

It is important for the culture of pharma companies to reflect patient centricity at their core and for this to be not just an empty commitment. Patient centric activities need to be part of a strategy and accordingly resourced, so that everybody within the organisation understands why they are significant. Merck’s ambassador programme involves patients representing various countries. The programme is externally managed and the ambassadors receive communications training so that they feel comfortable in answering questions. The programme is voluntary and the ambassadors come into Merck at different times, enabling employees to hear directly from patients how their lives have been affected. This can be heart-warming and inspirational for those attending.

Key takeaways

• Without the right culture and mindset, patient centricity is not going to go very far in a pharma company.

• Partnering with patients and carers is crucial in today’s healthcare and business environment. It is not just a nice to have. Projects get better when you have patients involved at the right time.

• Successful collaboration is about partnering with patients as opposed to merely engaging with them.

• We all have a part to play in changing the industry’s way of operating.

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Speakers: Alec Pettifer, suUAZIO and Al Triunfo, Mowat-Wilson Syndrome FoundationThe real-world impacts achieved through the successful collaboration between insights firm suAZIO and the Mowat-Wilson Syndrome Foundation were presented by Alec Pettifer and Al Triunfo, who shared their different perspectives on the project with particular relevance to the impact of the Covid-19 situation.

Background

suAZIO wanted to collaborate with a patient advocacy group for mutual benefit and to develop a patient engagement model.

Mowat-Wilson Syndrome is an extremely rare disorder. There are only about 200 cases in the USA. and it is extremely under-diagnosed. The Mowat-Wilson Syndrome Foundation was founded in 2013, with its Board comprised of parents and grandparents. Its mission is to help families that are affected by the syndrome, to raise awareness and to support research, but most importantly to provide family support. The Foundation is a close-knit group and is responsive, primarily communicating through social media, newsletters and word of mouth, as well as a biannual international conference and many regional events.

Objectives

suAZIO and the Mowat-Wilson Syndrome Foundation had complementary objectives.

• suAZIO wanted to develop a patient insight survey template and test this live with a patient community, sharing the results as a case study and thereby demonstrating their business capabilities.

• The Foundation was trying to better understand the unmet needs of its community. It also wanted to attract interest from the research community as well as improve its grant applications and fundraising opportunities.

Results

The collaboration resulted in an online survey which took about 12 minutes to complete. No incentives or honoraria were involved to engage with patients/caregivers and the survey was quick, easy to replicate and delivered immediately actionable results, many of which are particularly relevant in the current post-Covid-19 situation.

Better understanding the unmet needs of the Mowat-Wilson Syndrome community

While suAZIO had ideas about what they wanted to capture, the Mowat-Wilson Syndrome Foundation had considerable input into the types of questions asked in the survey and the close collaboration resulted in questions from both organisations being included.

Respite care was of particular interest to the Foundation and the survey found wide variance in its use. Only about 40% of the participants (caregivers) received any kind of respite care and the cost per month varied widely. This data now enables the Foundation to seek out those who need respite care but don’t have it, thereby meeting an unmet need in the community. This knowledge can also be leveraged in terms of expressing a specific need in fundraising and grant applications.

The rest of the unmet needs were assessed through a “select from the following” list in the survey. One of the most significant needs was that families were looking for information on the syndrome to share with physicians. They were looking for a handout and as a result of the survey, the Foundation has started work on a number of prototypes i.e. the data enabled efforts to be channelled in the right direction immediately.

Digital and mobile health apps were specifically asked about in the survey and it was found that few mobile apps were being used. Findings on the features that would be valuable in apps for caregivers will be important when the Foundation reaches the point of developing an app, but are also applicable to other patient advocacy groups.

Mobile health apps have taken on a new relevance post-Covid-19 as they enable people to access information. The survey identified those who are not engaged on these platforms who may be under-served at this time because they are not connected as much as others. A similar survey could also be used to discover new or novel unmet needs in at-risk populations for which underlying conditions such as autoimmune disease and diabetes increase the risk factors for Covid-19.


Patient Advocacy Insights from Ultra-Rare Disease Caregivers

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Attracting interest from the research community

The survey validated what the Foundation believed about its own responsiveness. It attracted 109 participants out of a population of around 200 and this was achieved in under 3 weeks through social media, its community newsletter and through the networks that each of the board members has built. The strong interest in participation demonstrated robust recruitment from a tight-knit organisation and could be accomplished because of the strength of the partnership between suAZIO and the Foundation and their complementary objectives.

Respondents were also asked specifically about their willingness to participate in patient- focused drug development and clinical research. The results showed a strong core of willing participants for patient-focused drug development, demonstrating that this was no longer based on anecdotal opinions from the board. Any sponsor organisation that now wants to engage with the Mowat-Wilson Syndrome Foundation knows that there is a core population that is willing to participate either in patient-focused drug development or clinical research. The caregivers were also asked if they would be willing to participate when given an increasing challenge level, such as having a conversation with a rep or taking part in a discussion group. As the challenge level increased, it was possible to see the percentage that dropped off in terms of their willingness to participate.

As we need to be more sparing of healthcare resources in the light of Covid-19, the relevance of the willingness to participate in research monitoring or survey research will become increasingly important with the need to keep people out of care environments if they are not in an emergency situation. The kinds of approaches and techniques used in the SUAZIO/Foundation survey can pre-screen those from a patient advocacy group who would pre-qualify for patient-focused drug development conversations or clinical research.

Expanding grant/fundraising opportunities

Specific objectives are essential when fundraising and the survey provided clearly documented evidence, enabling the Foundation to reach out for specific funds, such as for respite care. It can now demonstrate to researchers that it has a willing and active group in terms of participation and it has put the Foundation in a much better position moving forward to achieve the goals it needs to for its community.

Key takeaways

• The approach taken by suAZIO and the Mowat-Wilson Syndrome Foundation can be adapted to almost any patient group to meet the needs of the group and related sponsors who may want to have insights about patient communities whether they be rare, ultra-rare or any other kind.

• A quick and low-cost online survey template can gather patient and caregiver insights if there is close collaboration between an insights firm and a patient advocacy group.

• An involved and highly engaged community was discovered that can and will respond quickly to similar requests for insights.

• The package of information revealed by the survey can be shared with researchers and sponsors, putting the patient advocacy group in a much better position moving forward.

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Speakers: Julia Liu and Richard Goosey, Kantar Health DivisionThe opportunities presented by the dynamic and evolving healthcare environment in China were outlined by Julia Liu before Richard Goosey moved on to take a closer look at the challenges involved in forecasting in this market.

Policies

There are three key policies to be aware of in the Chinese healthcare market:

• Volume Based Purchasing or procurement is very important and will continue to be impactful into the future. It is organised by the National Health Security Administration which is a reimbursement authority and its main purpose is to cut the price of drugs with a guarantee of volume.

• Generic Quality Consistency Evaluation cuts the price of drugs while maintaining acceptable quality and supports Volume Based Purchasing.

• The National Reimbursement Drug List ensures the value of the drug and cuts the price. The Chinese government negotiates whether drugs can be covered in this list and while the list was previously very secure, this is no longer the case and a drug can now be de-listed.

Ensuring a value-based healthcare system

China wants to ensure a value-based healthcare system based on three key elements:

• Improving access to healthcare and quality for the Chinese people.

• Controlling cost and improving efficiency. The Chinese government has limited resources as a result of the country’s changing economic status and because of the evolution of healthcare technology. Spending on healthcare has increased and therefore there are policies to control the cost.

• Encouraging innovation, improving access and controlling cost. To ensure quality and efficiency, the government has to encourage innovation.

The impact of Covid-19

The Covid-19 pandemic is still ongoing in China, creating opportunities as well as challenges for the healthcare industry. Although it has slowed down wider economic growth, it has also accelerated digitisation of healthcare and enhanced public health. There has been a shift of channels and patients are now playing a bigger role in healthcare decision-making due to greater use of online platforms. AI is becoming even more important and the pandemic will also create opportunities for vaccines, IVD and private insurance in the future.

Implications for the healthcare industry in China

• Focus on value, not only the value of existing products but also at the R&D stage and the value of your services.

• Demonstrate to your shareholders the value that you claim and think about creating value for key stakeholders through marketing activities.

• Embrace new channels and approaches, such as AI, for your products.

• Build innovation into everything that you do.

Overcoming challenges in primary market research when forecasting for a new launch in China

The situation in China is changing very rapidly and forecasting is difficult because of a lack of certainty (“the certainty of uncertainty”).


China Forecasting - Primary Market Research in China, Market Access and Overcoming Other Challenges in Forecasting

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Challenges and opportunities

Forecasting is problematic in China for a number of reasons. The growth rate in medicine spend has been very high and was around 16% to 25% from 2009 to 2012. This has slowed more recently down to 4% to 9% from 2015 to 2018 and it is predicted to decline even further to 3% to 6% to 2023. However, in spite of this, the Chinese market is the third largest global market and the opportunities remain huge in that 22% of the world’s population is in China, but the country’s global healthcare spend is currently only 3%.

When it comes to forecasting, the focus is on the secondary tertiary care market and Tier 3 hospitals within this. Although they only account for 8% of hospitals in China, they account for 41% of patient volume. At national and city level, these hospitals are the most important because they tend to drive adoption and recommendations for drugs to be listed, although Tier 2 hospitals will become more important in the future.

Reducing uncertainty when forecasting

Demand estimation generally aims to quantify the expected uptake and overall potential for a new product and feed the results into a forecast model.

In doing this, the following need to be quantified:

• The size of key patient segments.

• The speed and size of uptake by patient type, country and respondent type.

• The patient share over time.

• The impact of core components of the TPP and how these impact uptake and patient share.

Understanding key patient segments in this rapidly changing market

• Start your research with a qualitative stage to reduce uncertainty. Outline who your primary target patient is and identify sub-groups of the target patients. This should be checked against your epi data and other syndicated sources.

• It is advisable to uncover access restrictions. This will affect your uptake curves or reduce the size of your target population. Be aware of formulary and line restrictions.

• Identify market facts and events that will need to be included in your forecast scenarios and that will change the uptake.

Reducing uncertainty in your forecast

A forecast project generally goes through a number of stages from estimating demand or preference share through to adjusting for overstatement, the estimation of order effects, model promotion effects and then overlaying the epi data.

China allows patient case records to be collected and this can really increase the robustness of estimating patient share. By recruiting physicians who are treating patients currently, details on the patients can be collected and the TPP can be introduced if it is an established market product. The patients are then introduced and asked if they will be treated differently with this product in the market. The leads to more reliable peak share raw data.

It is important to be aware of overstatement in China. Overstatement is a bias and China is second only to India in terms of overstatement.

Another way of reducing uncertainty is to include an analogue product in the forecast. This is really important in China and you should check the analogue against the six Ps - Product, Patient, Physician, Place, Payer/Price and Promotion - to see whether the analogue could be matched to the product you are launching.

Reducing uncertainty in terms of data quality

There are several important steps that can be taken to reduce uncertainty in terms of data quality.

• Always translate materials into Mandarin Chinese, as English is not used by doctors. English is only spoken by less than 0.01% of the population. It is also recommended that you back translate to check the quality of the translation.

• It is advisable to include verification questions and logic checks.

• Aim to do a soft launch and check the data and clean it. Using a TPP can be quite complicated. It is advisable to stop after 10% of the sample to check the answers.

• Recruitment can be very slow and extra time is often needed to be given so that you can check data for quality and allow for re-recruitment after you have deleted the speeders and cheaters.

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• Try to take respondent fatigue into account. Keep the questionnaire short and if possible, use gamification tools to make the questionnaire and study more enjoyable to the end.

• Be very mindful of the Cybersecurity Law which came into effect in June 2017. There were 15 enforcement cases in the first three months alone and the Law will stop your study and the processing of your data, with a fine of half a million yuan.

Summary of steps you can take to reduce uncertainty in China when forecasting

• Make sure that you talk to the payers.

• Understand what drives value and what the access hurdles are.

• Understand what proof will be required to enlarge the patient pool.

• Understand how physicians make treatment decisions.

• Understand how you can work on the clinical parameters to increase opportunities for your product.

• Understand the market and your sources of business.

• Try to use real-life patients to increase the robustness of your data.

• Make sure you understand why your forecast includes uncertainty and how you have minimised it.

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AI in Demand Planning - How AI is NOT Changing DP

Speaker: Dr Sven F Crone, Lancaster University Management School and iqast.deThe role of data in enabling AI in demand planning was the focus of Dr Sven Crone’s presentation, which included a case study on how Janssen has improved its forecast accuracy.

Background

AI is changing the world in many different areas of life but in spite of the hype around it, it is not changing demand planning in the supply chain context at the moment. It is nevertheless hailed as the ‘Holy Grail’ in demand planning forecasting for the supply chain as the demand grows for forecast accuracy and improved supply chain accuracy.

With traditional ways of programming, it was impossible to develop a code and the breakthrough came not with a regular code, but with an artificial neural network i.e. an algorithm that has layers and mimics the way in which the brain operates. This is a completely different approach to programming a code.

An image is shown which is learned and an output obtained. Rather than teaching it a code, pictures are shown which are broken down into pixels. Each pixel is then given a mean colour with a numerical representation which is fed into a network that does a classification. The algorithm learns the picture and therefore the next time it sees it, it is able to predict it better, based on a process of showing it thousands of pictures.

The success of AI technology has been driven by:

• The power of hardware which has grown exponentially.

• Exponential growth in the complexity of algorithms which are also growing exponentially in size.

• Datasets which have been growing exponentially because the algorithms are data hungry. Algorithms are now being trained to recognise everything from cars to pedestrians to movement. There is also exponential growth in the dataset size.

The need for data in Demand Planning

We are not ‘drowning in data’ but are ‘learning to swim’ at the moment. We therefore need big data in order to train algorithms that can handle image, voice and speech recognition.

There is a convergence of three drivers, all of which are driving predictive analytics:

• New algorithms.

• More Central Processing Unit (CPU) power.

• More data.

Historically, the datasets that were used to train exponential smoothing and AutoRegressive Integrated Moving Average (ARIMA) algorithms were based on air passenger data from 1949 to 1960.

However, if we look at the data that is available in industry today, three years of monthly data is mostly available i.e. today we have shorter data than the data which simple algorithms were based on in the 1960s. We have gone from macro to micro economic forecasting and when it comes to data storage, we are throwing away a lot of historic data. A survey on demand planning practices a few years ago found that 72% of companies only used 3 years of monthly data. They had lots of data sources but these were not consolidated in any way and most data was exchanged by email, making it not readily accessible. This results in clear limitations when looking at, for example, average seasonality patterns. There are also sparse data labels in industry and nobody builds up an annual demand signal repository to learn from unusual things.

There are therefore new algorithms and more CPU power but not much more data, although everyone is hungry for data in demand planning.

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Case study: Janssen - Creating big data from little data

Janssen has 145 brands and a total of 5,500 SKUs covering different therapeutic areas with different rules and regulations in the markets in which it operates.

Before 2013, there were multiple planning systems and in that year, they rolled out SAP APO worldwide which resulted in a reduction in forecasting error by 10%. Some tools were developed with forecasting model selection in 2015 and in 2016, they centralised with a demand planning centre of excellence. A team of analysts with the right tools, techniques and communication enhanced demand planning and they were able to leverage software tools and training to reduce forecast error further by another 8%.

At this stage, it was noted that there seemed to be a diminishing return on the effort invested in the forecasting and there was a need to further improve forecasting in terms of accuracy. To obtain more data for demand planning, it was moved from monthly to weekly to daily i.e. using the same data but not looking at it monthly quadrupled the amount of data available. The data could be disaggregated and also aggregated back to monthly data as there was still a requirement to forecast monthly data. Creating different aggregates of data resulted in more data and more effects. For example, if weekly data was available, it was possible to forecast more accurately by modelling particular events and this could then be aggregated from weeks to months.

It is important to recognise that it is not possible to see stock outs on a monthly level but you can see it weekly. You can then create a time series with a variable binary which creates additional data for newer networks to learn from. The more variables you introduce, the more you can anticipate weekly data.

In the Janssen pilot study, forecast accuracy increased by a further 10% and it reduced error by 10%. Although this was a time-consuming modelling approach that was only done on 8 items, Janssen is now looking at AI weekly forecasting with internal data, aggregating the forecasts up.

Summary

• Start building Demand Signal Repositories now because no system or algorithm can be leveraged until you have the data.

• AI is enabled by the three drivers of new algorithms, more CPU power and more data, but data is the core enabler. Therefore, focus on your unique data, not algorithms.

• Data in supply chain planning is often small because historic data is thrown away, historic events are not recorded and historic disruptions are not recorded.

• Focus on collecting your data.

• You can test AI in demand planning - low-cost pilot studies offer the opportunity to try new algorithms.

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Looking at Data Differently

Speakers: David James and Kris Barker, J&D ForecastingDavid James and Kris Barker of J&D Forecasting presented an initiative that was started eight months ago to explore whether the value of data could be increased in the context of forecasting through the use of technology and advanced analytics.

Objectives and approach

The objectives of the initiative included:

• Improving the efficiency of managing and manipulating the data.

• Making the data more transparent and more flexible so that it could be put into the correct format in terms of segmentation.

• Looking at whether machine learning can be used in this context.

The first step focused on existing datasets to see if they could be improved in terms of the ability to analyse and visualise the data. The second step moving forwards is involving the application of predictive analytics so that, for example, it is possible to be more descriptive and accurate about where a disease has come from and where it is going i.e. correlate the drivers of the disease.

Current data challenges

Data is often delivered in silos. Epi data is very cross-sectional and very disease-focused but clients are not really forecasting this way anymore and are often looking across diseases at comorbidities. The siloed approach to delivery creates a lot of work for clients to get the data into a format they can use, often involving considerable time and expertise.

A lack of transparency presents a further data challenge. There are many assumptions that need to be made before treating a patient population and these assumptions are not always transparent. If the assumption or variable changes going forward, you cannot adjust your epi data to take this into account.

The J&D initiative to date

J&D’s initiative has to date been achieved via two steps:

• Existing data has been formatted to make it more flexible and transparent. A big database was formed by creating relationships across the different data silos so the data could be manipulated more within the analysis.

• This database was linked this to a data visualisation analytics tool, giving the user the ability to analyse, interrogate and cut the data in any way they wished and more flexibly than before.

The initiative is ultimately about creating an underlying mass of data using technology that can work for you through interaction in a more efficient and user-friendly way. It enables the data to be interrogated however you see fit e.g. incidence, country or gender, with the ability to manipulate and drill down into the data as required.

Applying the initiative to Covid-19

J&D’s database has been created to give flexibility in how you look at the data, for example, going in via a biomarker and then looking at how patients sit in terms of the biomarker as well as the dynamic growth between each of the diseases. From this, it is possible to create reports and look at the cause and effect that one disease has on another.

There continue to be many unknowns about the Covid-19 pandemic. Although we don’t yet know what the incidence is across the general populous, it is known that there are certain age groups and certain comorbidities that have a higher risk of hospitalisation and mortality.

If you wanted to forecast Covid-19 within a hospital setting, you could estimate the potential patient population that you would be targeting. You could then run your analysis in terms of the impact the different waves have had on hospital mortality rates.

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If you were doing this traditionally with a standard epi database, this would mean taking lots of cuts from different epi reports and combining them. Within the platform, because the database has been created, the data can be analysed in different ways that are faster. This can enable you to control and interrogate the data in line with your needs.

Challenges

A number of challenges have arisen during the initiative so far, including:

• The biggest challenge is the data itself. In most situations, it is collected and siloed away and there isn’t necessarily the connection between a branch in one disease and a branch in another disease. Creating a database was very challenging, both to clean the data and make sure it is consistent and then to make it more three-dimensional so that a relationship could be linked across the data between patients and their disease as well as vertically across diseases. This takes a lot of analytical time to construct and restrictions remain on how the data can be manipulated because of how it was entered.

• Evolving the database and the relationships between the data so that analysis at different levels can become more sophisticated.

• Technological access and IT firewalls.

Summary and the future of data analytics

• This initiative has so far added a layer of flexibility to the data that was not there previously.

• It has created an ability to analyse the data in a much more efficient and effective way.

• It has also enabled greater transparency, for example, in what is driving markets and how they are evolving, as well as identifying patient groups so that they can be looked at from different perspectives.

Looking ahead:

There is clear value in creating predictive analytics, but the data needs to be more holistic with a lot of additional information and analysis.

Whether machine learning and AI can ever be applied to epi data is unclear because of the nature of the data. Epi data is often cross-sectional, very granular and not always particularly accurate. Running AI on this type of information would be a challenge and might initially only give you simplistic outcomes.

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Powering Market Research: Bringing Secondary and Primary Data Together for Greater Insights

Speakers: Tom Haslam and Magali Pullino, IQVIAThe benefits of taking a synergistic approach to primary and secondary data and how to put this into practice were discussed by Tom Haslam and Magali Pullino of IQVIA, who drew on case study examples to demonstrate how combining data sources can bring greater insights.

Strengths and limitations of primary and secondary data

Both primary and secondary data have their own strengths but also limitations which often mirror each other.

There has been an explosion of secondary data availability through, among other things, a greater number of government sources being accessible, data collected directly from patients via wearables and increased computerisation of previously held paper records. At the same time, we often do not have much insight on the decision-making process or how or why physicians do what they do. We can also have lots of different data, but there is often a lack of consistency between the data sources.

Primary data is fully customisable so if you don’t ask the question, you will not get the answer. However, there is often a recall bias which is inherent to Primary Market Research (PMR) as well as issues around the robustness of data.

Bringing primary and secondary data together means that the whole can be greater than the sum of its parts and it can provide a number of advantages, including:

• Better market understanding.

• More robust analysis.

• Higher credibility of results.

• A more customisable solution.

• Cost savings through not using one approach only.

• A reduction in your dependency on recall bias.

• The ability to address both the what and the why of a business question.

• The ability to address niche areas such as rare diseases. This is something that is often lacking from secondary data alone.

Examples of data being combined to create synergies and added value

Inform

Primary and secondary data can be combined in a way that one informs the other. The secondary data can inform the design of the PMR i.e. who are the most appropriate respondents and how can we reach out to them in the most effective manner.

Secondary data can also inform the design of a study. For example, doctors can be segmented according to their total prescription of a specific brand and their total prescription in general across the market. This can then be linked directly to a doctors’ database.

Supplement

If secondary data has very high coverage but not a lot of detail, it can be supplemented by PMR with greater detail but lower coverage.

Indication split is another interesting area for the combination of data sources and can help us understand patient dynamics as well as the business that is being driven by different teams. It is of particular use in the autoimmune biologics market where almost all of the 20+ products are licensed across different overlapping indications. There are many new launches and a lot of heterogeneity by brand, channel and country with no one size fits all approach that can be used. A three-level calculation was required by IQVIA and their approach used 18 different data sources, including PMR, to provide this information across the top 7 EU markets.

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• The first split was by channel i.e. hospital versus retail and how these channels vary by country.

• The second split was by specialty, using local secondary data sources that contain specialist information. In the hospital setting, this might be departmental data telling us the department that a specific patient is being treated in. In the retail sector, this could be longitudinal prescription data which is captured at pharmacies and allows us to see the specialty of the prescribing physician.

• The third split by indication is where PMR is used. While in IQVIA’s study it was possible to model some information off co-prescribing etc., the complication in this specific market meant that PMR was needed to ensure the most accurate picture available. In this study, PMR was run on an ongoing basis with a few specialties, making sure that patient records could be captured and incorporated within the calculation.

Combining data sources delivered the most accurate indication split per market.

• Sales data was extracted from IQVIA’s MIDAS database which ensured that the metrics were valid and consistent. The sales totals helped to link to other client data extracts.

• A specialty split was applied from secondary EMR datasets. These had already been projected and could therefore be directly applied. This led to high levels of coverage without the need to project the data to provide the speciality split.

• The indication split from PMR was applied which had captured results on treated patients across different specialties, including the specific brand that is used and the specific indication that has been used for each brand for its specialty. By combining these together, the proportions could be split out in order to provide the split by indication.

• Projection to patient totals per brand enabled sales, units and patient totals to be seen.

The reports that can be produced using this approach can be used for a wide range of purposes by clients, allowing them to construct brand plans, support robust performance monitoring and also forecast accurately.

Enhance

Traditional Healthcare Professional (HCP) segmentation has a number of drawbacks:

• There is limited scope for patient collection and there is a trade-off between the depth and breadth of information that we would like to capture and the HCP’s willingness to complete long surveys, particularly when it comes to complex markets.

• We may have to focus on highly tactical segmentation or more attitudinal segmentation. It is normally difficult to do both. We usually have to make a choice in the design phase as to which of these to focus on, rather than cover off both within one segmentation.

• It can be difficult to build a predictive model in a segmentation, particularly for launch products, to highlight the physicians who would be more receptive to them in the future. A lack of data can prevent a high level of predictability.

Combining sources generates a more predictive segmentation with a number of clear benefits:

• An in-depth assessment of attitudes is able to be captured via PMR and also actual rather than claimed prescribing behaviours. This comes through from the secondary prescribing data. It would not normally be possible to capture the same depth of information from actual physicians because there is a limitation on survey size and with historic information, any physician is going to be biased towards more recent results. By combining these together, it is possible to understand where those attitudes are leading to those behaviours. It is the link between the two that allows us to get into the deep detail by having the information all in one place.

• Enhanced segmentation supports strategic planning and implementation.

• The profiles that are able to be produced cover multiple aspects of HCP behaviour across.

· Potential - volume and brand adoption.

· Channel affinity - physician preference by channel.

· Personality types - demographics and attitudes.

· Prescribing behaviours.

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Looking to the Future

The Covid-19 crisis has highlighted that there are many more ways to engage with patients and each of these novel ways are much more likely to create a data fingerprint. There are now over 300,000 healthcare apps and over 340 different consumer wearable devices, providing a volume of data we have never previously had access to. Greater investment in analytics and data science means that it is easier to link these data sources together to produce a web of information that allows us to understand every different aspect of patient care.

As an industry, we are still at the early stages. Data and technology will really help to transform the way that we do market research and as we move more towards AI-driven approaches, it will help us to reduce effort and enable curated systems to answer questions that are being raised by clients. By the end of the decade, the majority of studies are likely to involve some form of secondary and primary data in order to answer questions. Real-world evidence will be more embedded as part of the information system, allowing more real-time availability of results and the potential for feedback loops where systems can be monitored on a more frequent basis than they are at the moment. The value of new analytics will be achieved over time as the volume of data grows.

Predictive and advanced analytics come into their own when a sufficient amount of data has been collected and we are able to produce statistically significant conclusions.

We also need data collected over a length of time. With leading KPIs, we need to be able to see the lagging results before we are able to link them together and initial pilots may not provide absolutely all of the answers you are hoping for. It can take a move into the production cycle for a particular offering in order to deliver the optimal value.

Key takeaways

A synergistic approach of combining primary and secondary data can bring you:

• Better insights, using a more robust approach that can generate cost savings and is fully customisable with increased credibility.

• Enhanced skills, with people who will be less siloed within an area of market research.

However, a synergistic approach is not necessarily the solution for every project. It is important to think carefully about the business question and what is the best way to answer it so that you can identify what is the best solution.

Areas you should consider include:

• Is my organisation structured in a way that helps and supports the collaboration between PMR and data experts? Running a systematic review in relation to all key business questions is the first step to moving towards a more holistic solution rather than a siloed solution.

• What data assets do we already have and what data do we currently have that could help answer this business question? Running a comprehensive review of datasets available on a regular basis will identify where the data exists and where there are gaps.

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EphMRA Online event - 1 July 2020

Pharma’s use of digital marketing is often poor. How can our insights make it better?

Speakers: Lucy Ireland and Beth Stagg, Hall & PartnersUsing insights as a critical element in digital marketing was the focus of a presentation from Lucy Ireland and Beth Stagg, who highlighted why this is now more important than ever for pharma.

Why pharma needs to optimise digital communications

Although some pharma companies are leading the way in providing effective digital communications, around 65% of specialists are not currently satisfied with pharma’s digital offerings. While the percentage of doctors using pharma websites to look for information is growing, there are a number of key reasons behind this level of dissatisfaction:

• The focus of much digital communication is often very sales-orientated, with a lot of the material originally coming from marketing teams. This approach can be a turn-off for doctors.

• There is often limited content that doctors find useful, as the content is what the pharma company wants to share, rather than what the doctor wants to hear.

• There needs to be a reason to go back to the website to learn new things i.e. content needs to be regularly updated.

• Many websites are poorly designed with bad navigation.

• There is a lack of awareness from pharma companies and no plan about engaging new users, resulting in few people finding the website.

The Covid-19 pandemic has created a wholesale shift in what doctors now expect from pharma companies and how they want to be communicated to. The majority of doctors are looking for much more digital engagement and a large amount of communication has changed to digital channels, although the sheer volume of material means that it needs to be tailored because of the risk of bombardment. There has been a big acceleration in digital patient education materials and doctors’ confidence has grown in the digital realm, although if you are not adding value to the physician relationship through effective communication, you may potentially damage the trust they have in you.

With the explosion of digital channels, there are many more ways to drive engagement and reach audiences. The competition for attention has never been higher - the question is how to stand out in the right way.

Insights and digital marketing

There is a critical need for insights that drive digital marketing which are underpinned by user understanding and don’t just focus on the tools and technology. If this approach is optimised throughout the whole digital campaign, the process will enable teams to develop the:

• Right offering at the right place via the right channel, where audiences want to receive the message.

• Right content in the right format in the right language that is going to connect and resonate with the audience, so that ultimately you can create the best possible experience for your customers which adds value to the audience and the organisation.

It is also important to think on both a micro and macro level:

• The journey on a micro level can be around a particular product i.e. how a customer reaches your website.

• It is also about thinking on a macro level at the broader journey you are wanting your customer to go on, from awareness through to advocacy. Whatever your campaign goals are, it is important to map out each stage of the process to understand the beliefs and barriers that are in the way in terms of messaging and communication to take them on the full journey. Thinking of the fuller journey can help to drive greater effectiveness but this all has to be underpinned by insights.

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Using new and existing sources of insights

Starting with the end in mind will help you to clarify:

• What you are trying to achieve.

• If this is this the right strategy.

• The behaviour you are trying to change with this plan.

• The insights which have informed you that this is the right approach.

Before considering the digital materials you might use, you should think about the early research and make sure that you are building a picture for your audiences from market understanding, customer experience and patient journey studies. The picture should focus on:

• Who your audience is.

• What matters to them and influences them.

• What behaviour changes might be needed, as well as the levers and barriers for driving change.

• Where and when you will communicate with your audience and what their digital journey or digital experience will be i.e. if you developed the website, would they find it and which channels are they using?

All of these areas should be built into earlier studies so that the information and answers are known.

Once you are into the planning phase of any kind of digital marketing, there are many different insight sources available. These include syndicated reports which are existing reports that are often bought by marketing teams in pharma companies. Search data and real-world data can also be very helpful and you can capture digital footprints via browser scraping, marketing databases and the mapping of channel use from secondary real-life sources.

Looking at some of these sources in more detail:

• Social media can give us a huge amount of information. AI is helping us to understand what language to use and what language your audience uses, as well as which channels to use, not just based on how many people use a channel but how your audience uses different channels and how you can mirror this. There is little point putting information into a channel that does not mirror your audience’s use of that channel. You can also look at who you can partner with to drive influence, as social and digital influencers are now very significant. This has led to the rise of doctors and patients who are quite often a very different profile from the traditional KOL.

• Search data is a fascinating area of syndicated data that can tell you which websites are most popular. The information sources that patients are finding are quite often American in origin and hence do not have the right indications and the right information for patients in a European country.

During this planning phase when you are thinking about the data sources, you should also start to think about the measurement needs, as you need to be able to see that the digital asset you are building is actually working. There are some inbuilt metrics that indicate:

• The number of people who are reaching your website.

• The number of pages they are they going to.

• How many people have acted on your call to action.

The conversion metric or behavioural change metric is data that you might need to collect completely differently and separately from the assets. It might be something that you want to put on your tracking to see whether behaviours are changing and whether people are going to your website. There are many data sources within pharma that can be mined to provide the conversion.

Designing better digital experiences

Within pharma, there are well established processes in terms of developing and testing campaigns, concepts, story flows and detail aids. As the pace of digital transformation evolves, we need to make sure that the development, testing and validation process for digital products brings users into the heart of the process.

A considerable amount of thinking goes into creating a successful user experience that enables you to easily achieve your goals. Good design is never noticed, only bad design. We want the user to put all their effort into engaging with the information and for them to feel that their needs are being met in a good way.

The key concepts when designing digital experiences are:

• Information architecture - how the information is structured. This involves creating a way to structure the information that makes sense to your audiences and enables them to find the information they need in a way that makes sense e.g. a site map.

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• User interface - the space where the user and the product interact. This is impacted by multiple factors including functional aspects, levels of interactivity and elements including visual design, layout and branding. Aspects that work well in one format might not translate to a digital interface.

• Usability - the degree of ease by which users can achieve their goals efficiently and effectively. This is critical because it is based on the end user and the testing should be done in an environment as close to the user as possible.

• User experience - all the above aspects build up into this. It is the overall experience of the person using the digital product.

If we plan user insight around each of these aspects, not just at the start and the end of the process but through an iterative process throughout, we can create user experiences that are more effective.

One aspect in healthcare that is critical is accessibility. When we are feeding into the development process, it is important that the product takes into account the needs of the user and that they are inclusive. For example, when designing for those with visual or cognitive impairments, it is critical that the end result is designed in a way that is going to work for them.

Bringing insights into the digital development process

There are five key areas to consider:

Discover - building an understanding of user needs and what it is we need to do to meet and fulfil the user and business needs. There is so much in terms of insights within organisations that can help to drive the understanding of what the aim and goal of the digital campaign is. Before moving into any stages of development, we need a real understanding of the users and their needs, including their technical specification. We need to understand ultimately what they will be using to access the materials.

Define - what is the strategy and the approach of this digital product, as well as what is it that it is going to bring to the audience, what are the goals and what is the information architecture and content strategy.

Design - developing the layout and interface design. This involves thinking how the visual identity comes through and how it comes together.

Development - taking it from initial low fidelity design to a working prototype before going into full build and coding. It is important to ensure that at all four previous stages, there has been input so that any further change can be minimised after going into full build.

Deploy - making sure that we have a fully tested, functional and working product before it is piloted, released and optimised.

Marry your needs with your audience’s interest

User involvement does not need to be costly or time consuming. It can be done on quite a small scale and be rapid. By creating with and not for users, you can save time and money throughout the process. It is about reducing your risks and increasing your likelihood of success.

Within pharma, it is important that the content has a balance between promotional messaging and marketing aspects, while being aligned with what audiences really need help with. You need to make sure that the language connects in the right way, the content is in the right format and it evolves over time, giving the user a reason to return and engage further.

It is important that you build content in a way that makes sense to your users and there are lots of different tools and techniques that can be used to involve users in terms of design and navigation. Developing interactive prototypes makes it easy to go from static design to something that is higher fidelity and truly interactive for the user. It can bring designs to life and help you get insight into the user experience, functionality, journey and flow. It will also enable you to uncover any issues and solve them before you go into build.

Key takeaways

• Learn something about your audience every time you carry out testing. Record this and keep it as a base of knowledge for the future, as there is always a danger that the same mistakes get repeated.

• Get involved from the start to inspire the right decisions. The creative team is often really keen to connect. Get close to them and tell them everything you know so that they set off on the right track.

• Get comfortable with the terminology and the technology - keep learning as it keeps evolving. To be at the table, you need to know the right language and be comfortable with it.

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AI in Healthcare PMR - Smoke and Mirrors or a Future Staple?

Speakers: Carolyn Chamberlain, Blueprint Partnership and Georgina Butcher, JanssenWhile consumers are leading the way in terms of the adoption of AI, healthcare market research has been slower in using AI to deliver additional value. In their presentation, Carolyn Chamberlain and Georgina Butcher took a closer look at the evolving use of AI in healthcare market research and what the implications are for agencies and clients, particularly in the light of the Covid-19 pandemic.

Approach

In January and February 2020, 60-minute telephone interviews were conducted with a variety of respondents both client and agency-side, as well as a few experts outside of the healthcare field but still with relevant experience. All of those interviewed had a strong interest in or experience of AI.

As a result of the Covid-19 pandemic, 15-minute follow-up interviews were undertaken in May 2020 with a subset of the original sample to assess how the landscape has changed since the beginning of the year and within just a few months.

The AI landscape

Companies adopting AI are seeing an increase in revenue and often a reduction in costs, not through a loss of jobs, but because AI is more effective. The fear of AI destroying jobs is probably unfounded but there will be a shift in skills, with an emphasis on investment in upskilling and training. An immediate impact on jobs is not anticipated in the future.

There is also considerable variation in AI capabilities within sectors and there is a gap that seems to be widening between AI high users i.e. those that have more than one AI capability embedded in their organisation and those who have fewer capabilities or who are behind in the learning curve. High tech continues to be the high performer in AI, outperforming all other industries. A large proportion of these organisations use more than one AI capability and this has been increasing year on year. The retail sector is catching up and is also quite high in terms of embedding AI capability. The pharma industry in general has a lower embedding of AI capability and has also experienced a drop since 2018. In pharma, the focus tends to be largely on physical robots, while in high tech, AI use encompasses machine learning, robotics, virtual/remote and natural language technologies.

AI is used in a variety of technologies including:

• Big data analytics.

• Facial recognition and eye tracking, which is beginning to be used more in healthcare.

• Chatbots, which are being increasingly used but are still fairly limited.

• Wearables

• Automated coding in terms of sentiment analysis and social media scraping

Perceptions and understanding of AI and technology in healthcare and market research

The telephone research found that respondents felt:

• A mixture of excitement, trepidation, and scepticism about AI. They are excited because they can see a lot of potential but there is also caution.

• There is potentially a lot to invest in and there is a concern about demonstrating value.

• There is oversell but a lot of curiosity and interest.

• There is confusion as to what AI means and a variety of understanding about what AI is and what it can deliver, from those who feel that it is conceptually so advanced that they can’t really describe it, to those who see a complete paradigm shift.

• There are varying degrees of comfort in healthcare market research. AI is still limited within healthcare and there is only a low proportion of clients who use it on an ad hoc basis. While it has been around for several years, it has not quite built up momentum yet and we are still not seeing a move towards full adoption.

• There is caution from the client side, while agencies tend to be more ambitious.

• More evidence is sought on the value of what AI can deliver.

• There is not sufficient evidence to fully understand how AI works or have confidence in it or how they are going to sell it internally.

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Future development

The expectation is for AI to have an increasing role in market research, combining great research skills and great interpretation with a technology component. AI has the ability to:

• Quickly analyse large sets of data to synthesise meaning with fast turnarounds.

• Integrate and triangulate multiple data sources. This was increasingly requested by the pharma companies who were interviewed.

• Enhance or validate insights, adding an extra layer of validity for clients.

Trust in AI will be built by validation. It will be important to understand and showcase to clients what technology can deliver i.e. the extra insights and value it can bring to central business questions. Clients will want to see both the evidence and the key benefits that AI can bring to market research. Agencies who provide clarity of thinking and embrace AI while showing the value it adds are going to be the winners in the future landscape. Specifically:

• The use of automation and technology will make tasks more agile and efficient.

• The automation of mundane tasks, such as analysing open ends and trawling social media, will hopefully attract a different level of talent to the industry.

Using technology alongside human scrutiny in a more agile and inspirational way will increase levels of engagement through new people and new thinking.

Drawbacks of AI use in market research

While AI offers clear benefits and advantages in healthcare market research, there are also some drawbacks which should be considered.

• In the pharma industry, regulations and compliance present limitations and barriers in how data can be gathered, stored and used.

• Agency and client perceptions are easier for distilling patient rather than physician data because of compliance and ethical hurdles.

• Applying AI to niche areas where the universe size is very small will be difficult.

Impact of Covid-19 on AI in healthcare market research

A subset of the telephone respondents was contacted in May 2020 to see what had evolved for them in the light of the Covid-19 pandemic.

Covid-19 is providing ever increasing quantities of data from new sources and it is clear that healthcare has had to adapt quickly. The pandemic has accelerated the adoption of AI and respondents cannot see a return to face to face interviewing for the foreseeable future, with a blended approach more likely going forwards. It is clear that Covid-19 has catapulted us into a new world, accelerating the interest and receptiveness for technology.

Summary

We are in unprecedented times and in the current economic climate, pharma companies are cautious about investing in digital and AI market research, at least in the short term. The onus is on market research agencies to step up and facilitate pharma companies to make a leap of faith using AI based on data. Agencies need to lead the way and validate the technology so that they are the change agents in the pharma industry. Likewise, pharma companies need to step up and be receptive to change. We need to talk about technologies and how we embed them alongside classical research approaches to augment and drive conversations with pharma companies.

In short:

• AI technology is here to stay and it is time to embrace it.

• AI will address the need for agility and efficiency without sacrificing quality.

• AI will deal with a huge amount of datasets and can power greater learning.

• Clients need to see the tangible benefits. They need full transparency to understand what AI is doing so they can accept it and sell it internally.

• Covid-19 has increased the necessity and receptivity to digital technology.

• Now more than ever, pharma companies expect agencies to provide validated, accessible, value-add AI solutions.

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Human vs. Machine: Who will win the battle for insights

Speakers: Hannah Mann, Day One and Shruti Malani, PY InsightsHannah Mann and Shruti Malani introduced a joint study which compared human-based research with machine-led research, looking objectively at what each approach has to offer and through this, what the future holds for market research.

The acceleration of technology-based research

AI is now reaching almost human levels of intelligence inside and outside of healthcare. AI-enabled systems are now better than humans at spotting data to detect and predict disease and AI can even work out the optimum treatment algorithms for patients based on their specific needs and biological make-up.

AI is going to continue to change and shape our future and all of this obviously has an impact on us in terms of the work we do and what we are useful for. A prediction that 1.8 million jobs will be lost by the end of 2020 due to intelligent machines may now be even higher because of the effects of the Covid-19 pandemic. Although jobs are being lost, AI is set to create 2.3 million new jobs, thereby creating $2.9 trillion for the economy.

The speed at which technology is developing has been accelerated by Covid-19 and we are now relying even more on it to help us communicate, socialise and work. It is also changing how the pharma industry connects with customers and the relative value of on and offline information sources. This would appear to be a permanent shift and it is unlikely that we will return to how things were pre-Covid-19. We therefore need new methods in market research to help us reflect this changing world and there are three clear advantages in using technology to help us achieve this:

• Faster decision-making. Market research has often been guilty of being quite slow and is now keeping up with the pace of decision-making more effectively.

• Fresher insights via access to new data sources.

• Better value, both in terms of good ROI and also time-saving.

Approach

Day One and PY Insights carried out an experiment to put human versus machine head to head to see how they compared. The aim was to take as pure a tech-only approach as was possible, pitched against a human approach using fully tried and tested technology, with the aim of assessing their relative value in providing meaningful insight.

The experiment’s focus was to illuminate the behavioural journey of women seeking fertility treatment, based on:

• Who they are in terms of context.

• Where they go for information.

• Which of their information needs are not being met.

• Which sources of information are most influential.

The fertility journey was chosen as the basis of the experiment because it was felt that it would be a true test of the different methods. Particular characteristics include:

• The early IVF journey is largely hidden and very private.

• It is drawn out over many months, if not years.

• There is a large online and offline component to it.

• It is also a very sensitive subject and people do not always reveal their true thoughts and feelings willingly in a one to one discussion.

PY Insights conducted the machine arm of the experiment, while Day One conducted the human arm. Gillian Kenny Associates (GKA) helped to recruit for both phases and a total of five women participated. The experiment was fully GDPR-compliant and the participants were told what data was being captured for what purpose and what was not being captured.

Day One conducted 30-minute discovery sessions, involving human to human detailed discussions which were largely retrospective and reliant on recall and memory. The sessions also allowed detailed responses as well as covering the on and offline journey in what was essentially a fully human-based process.

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PY Insights’ mission was to understand how the online journey evolved for women who are in IVF treatment. Technology enabled historical information to be gathered to understand the journey the women took over time. With limited human involvement, the journey was collected via laptops and phones.

Passive metering approaches were used to understand the participants’ natural journey in terms of how they found out about different IVF treatments without prompting them or giving them a task. The machine arm of the experiment required explicit permission from the participant with no automated process and if they agreed to take part, data was captured within one minute. The tool was uninstalled automatically at the end of the experiment and there was no lingering tracking which made the participants feel quite comfortable.

Each part of the process was assessed in terms of the following KPIs:

• Speed - how quickly could you get to the insights needed.

• Quality of the insights and therefore the business impact.

• Value and cost-effectiveness.

Results - Machine

PY Insights focused on:

• What the participants were looking for online.

• When (day and time) this happened.

• How their journey evolved over a week.

• What type of information they were looking at and how this evolved over time.

• The exact search terms that they used i.e. looking at their train of thought.

100% of the participants searched for a specific symptom or condition and they were very focused on their own personal search i.e. what is IVF for me and what are the considerations? Costs were a key concern, with over 60% of participants looking up details on what the financial impact of IVF might be for them.

Most IVF online activity was happening during the week and not at weekends. This suggests that couples look up information separately before discussing matters together - a finding that was confirmed in the human interviews. Searches generally took place in the early morning and afternoon.

The participants’ journey over time began with searches on healthcare sites but evolved into searches for online communities that provide real experiences i.e. sites that tell others about going through the process or specific conditions that people have had success with. They were looking for real experiences, moving from information gathering to an emotional element.

50 different search terms were seen among the 5 participants. This potentially provides a great opportunity for SEO and content-based strategy because you can see the information they may not be finding and what they are specifically thinking and searching. This can involve very complex terms and shows what is going through their minds, such as specific areas e.g. the age limit. Their journey is not always what we would expect it to be. Some of the search terms reflected their particular conditions and there were also searches for IVF treatment outside the UK.

For one participant, pricing was a particular concern and this was spoken about in their interview. They were concerned not just about what it looked like, but also how to improve the pricing issue by looking internationally.

Driving traffic through SEO versus specific brand properties showed how often they went to a domain directly instead of through a search. Domain activity can usually be linked to content as well, for example, Mumsnet succeeds through driving traffic by search.

Machine - business impact

There were four key areas of business impact from the machine-led experiment:

• SEO - it was possible to see exactly what people were looking for and therefore terms to optimise for.

• Content optimisation - it was possible to see the specific type of content participants were reading. This can give you information for developing content strategy. For example, two of the participants talked about the same condition because there isn’t much information available. This presents an opportunity that might not have been thought of.

• Persona building - this was not just based on demographics and claimed behaviour but looked at actual behaviour based on the journey taken and the things that participants did. This can help you to build a persona to start targeting different types of users.

• Investment guidance - making sure you understand the relevance of search versus brand in your industry so that you can maximise the results you get from the money you are spending.

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Results - Human

The 30-minute discovery sessions organised by Day One found:

• Why the participants search for information and the hopes, fears and emotions driving their searches. It might not be possible to get this level of information from just looking at cold hard data.

• Information gaps i.e. the identification of information needs that were not successfully met. Again, it might not be possible to understand this from the machine part of the experiment only.

• The value of each data source and the role and purpose of each source in decision-making.

• The relative influence of on and offline sources. Digital footprint mapping is not going to be able to provide this.

• The power of a story brought to life through emotionally charged quotes. Again, it is not possible to obtain this from just analysing the data.

The discovery sessions allowed participants’ stories to be explored from start to end alongside all the influences within it, not just their digital activity. All of the women visited a healthcare professional, in most cases a GP, as their initial point of contact. These consultations were largely very unhelpful and upsetting and could be a hindrance in terms of their getting IVF, an issue that could potentially be of significant interest to a client.

The sessions also revealed who the participants were in their journey with. They often carried out searches on their own, either because their partner was not as engaged as them or because their partner did their own separate search and then came together to discuss it afterwards. It can be quite a lonely journey for these women and this is why they look for other sources, including online, for support.

The participants also found that the IVF clinic websites can use language which is off-putting, very medicalised and very complicated. The websites assume a level of knowledge which these women do not have. This is powerful learning for any IVF clinic trying to attract clients.

In terms of the influence of different sources of information, the participants seem to end up at the back end of their journey looking at social media and influencers. It is here that they get their hope and success stories as well as the validation for some of the decisions they are making. They cannot get this from their friends and family because they are too embarrassed to talk about it.

Human - business impact

The four key areas of business impact from the human arm of the experiment were:

• Customer closeness - this approach brings the voice of the customer and human stories to clients.

• Persona building - this approach can build a detailed picture of the customer, not in terms of their digital behaviour but in terms of their context and their surrounding situation.

• Content optimisation - a human-led approach can identify which questions have been left unanswered i.e. unmet needs.

• Investment guidance - this approach cannot give as much guidance in terms of where to invest digitally but it can look at the balance of on and offline sources and how to invest across both of these.

How do both machine and human perform across the three KPIs?

Speed

• The machine approach can slow recruitment because you need to tell participants about the process and offer them reassurance which can take time. However, once they are recruited, you have instant access to their data and this can be analysed in days rather than weeks.

• The human-led approach is much slower and it can take weeks, rather than days, to recruit people, set up interviews and carry out the transcription and analysis.

Quality

• With the machine-led approach, the data is 100% accurate and participants cannot change it. There is no research effect and nothing is missed out. There is also no reliance on memory, although this approach can leave some questions unanswered.

• The human approach is not 100% accurate. In this example, participants were asked to recall journeys, some of which have taken a very long time and it is human nature to forget things. However, this approach can result in deeper exploration with follow up with questions where necessary.

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Value and cost-effectiveness

• The machine approach offers new data which is 50% of the price of TDIs.

• The human approach offers value in terms of understanding complex behaviours. However, it is double the cost of the machine approach.

Key takeaways

• All data sources are valuable. Machines will not provide all the answer and the two sources need to be brought together to get the full picture. Behavioural data provides the ‘what’ and ‘when’ with real accuracy, but traditional approaches provide the ‘why’ and the human story.

• Blend old and new for best results. Experiment and tailor the approach used in line with the specific objectives and use different data sources to broaden your world view. Work smarter rather than always taking the safer option.

• We need to embrace technology and what it can bring. Traditional market research methods are not always enough. Technology enables us to access people and data in new and more relevant ways. It can help us make sense of new and complex customer journeys.

• The Covid-19 pandemic has fundamentally changed business models. We need new tools to collect new data to help us better understand the impact this is having, how doctors are gathering information and the online sources they are using.

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Tell them a story they can’t refuse

Speaker: Erik Mathlener, Story ManagementThe power of story-telling in transforming presentations into effective and memorable communication was the focus of Erik Mathlener’s highly interactive webinar.

Why does story-telling work so well?

Our brain works in an associative way that wants to link new information it receives to everything that it already knows. This is also how a story works, based on scenes that are associated with each other. This therefore makes it really easy for our brain to absorb the story-telling process and to remember content.

A story is a tale about someone having an experience. It is always about a person and an event. If we present data, it is not necessarily about people and it is not necessarily about events, but a story always is.

The hormones cortisol, dopamine and oxytocin are critical elements in why story-telling works so well.

• Whenever we are in danger, our cortisol level rises and this makes us very alert and focused. When we are listening to a good story, there is something in it - possibly even danger - that is making us alert and interested.

• When we get emotional, dopamine is released. It makes us remember and learn things. In a good story, emotions are always involved.

• When we can identify with someone’s situation or emotions, oxytocin is released. It reinforces trust. When people trust you, they also know that everything you are saying might be true.

“A compelling story with an emotional trigger alters our brain chemistry, making us more trusting, understanding and open to ideas.” Dr Paul J Zak

The three story-telling secrets

There are three secrets to effective story-telling which will make audiences listen, be convinced about your content and remember your message so that they can retell it.

Make them listen

Audiences want to have a problem to solve. If they have something to think about and something they want to know, they are attentive and focused. Stories you can tell in healthcare could be about a doctor you have interviewed, the everyday life of a patient, your own work/process or the obstacles you have overcome. Data can also offer story-telling opportunities, particularly if it involves deviations and extreme results, as human behaviour always lies behind extreme data.

Story-telling in general needs less preparation, although if you do prepare, the story can be even more powerful. The story arc involves:

• Starting with a brief introduction and scene-setting before going into the problem.

• Telling your audience how you got out of the problem.

• The problem leading to the solution. Some people outline the problem and then quickly give the solution but this misses the ‘attention line’. This is the point at which everybody wants to know what is happening. Even more attention is created if the line goes up and down and the solution is not reached quickly.

If you want to get people’s attention very quickly, you could start with the problem and present it in one sentence, such as: “The moment I saw the data I knew we had something” or “I knew we had a problem”. It is important to give your audience something to make them curious.

Get them convinced

You need your audience to have confidence in you. You can achieve this through telling stories where the audience can see what you believe in, what you stand for or what your background is. Conveying your ambitions and doubts, talking about your successes and failures and showing your emotions will make you ‘human’. All of these emotions are universal to people and your audience will be able to relate to them. The more you step into the personal side of your story, the more that people will engage, while the safer you get, the colder the story will be. Try to go a little bit out of your comfort zone into something more personal, as identification creates trust and influence.

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Make them remember

Our mind is always making pictures of everything we see and hear. There is a message in any picture and by painting a picture, the message can become clearer for the audience.

Leaving a message in your audience’s minds

Story-telling is fun but it only works if there is an objective. By telling a story, we want our audience to listen, be convinced and remember the content, but we also want to leave a message in their minds.

• Write down the message i.e. the one thing that you want them to remember, take away with them and action. Write it down in 10 words, not half a page, so that people can remember it. You can also use it as a mantra in your presentation.

• Find the story which can include the message. It might be an image, an illustration of a moment in your research, or a problem that you overcame. You can use personal stories as an analogy or as a metaphor. These personal experiences are not hard to find but finding one and linking it to your message can take some time.

Key takeaways

• Stop talking data and start telling stories.

• Give your audience a problem to solve.

• Include something about your personal life in your story - this will help people to trust you and be convinced by you.

• Paint pictures to help your audience remember you.

• Clients might not be interested in your data but they will be interested in the insights and the message you have for them.

• It is professional to tell a story in a presentation. Stories are appropriate for all situations.

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Culture in Healthcare: Developing Awareness and Competence

Elina Halonen, Square Peg InsightBringing together relevant insights from cross-cultural health psychology, Elina Halonen looked at the impact of behaviours and cultural influences on healthcare and the doctor-patient relationship.

Why culture matters in healthcare

Culture is all encompassing. In a subtle but powerful way, it guides how we live our lives, what we believe, how we communicate, our habits and our tastes. It is also one of many factors guiding health-related beliefs and behaviours, with others being:

• The characteristics of an individual i.e. age, gender, life experience, physical and mental health.

• Educational background.

• Socio-economic situation e.g. social class, racism.

• Environmental factors, such as population density and infrastructure.

All of these factors play a role but in different proportions in different situations.

Culture and cultural difference are significant because most of what we know about human behaviour and health psychology is based on just a fraction of the world’s population (15%) from the US and a handful of European countries. These are what is known as WEIRD populations. This acronym, coined by researchers about a decade ago, describes the most commonly attributed people in psychology as being:

• Western

• Educated people from

• Industrialised

• Rich

• (From) Democratic countries

Many well-known psychological theories are based on these assumptions. Although the situation has become more balanced in the past ten years, a large number of theories in psychology are still based on the US or on countries that are similar to the US such as the UK and Australia. This leaves a huge range of countries we do not know very much about, even though they are of considerable interest.

Combined with this bias in our knowledge of the human mind, our natural tendency towards ethnocentrism means it is easy for us to unintentionally use our own standards, values and beliefs to make judgments about other people.

In healthcare, we have an additional issue which is medicocentrism, = ethnocentrism for the medical profession. Medicocentrism puts the focus on the disease or illness but not on the patient or the patient’s perception of a problem. Physicians are products of their own culture and may exhibit ethnocentric and medicocentric attitudes.

Defining health through a cultural lens

Health is ultimately about optimal human functioning and this is rooted to what matters to us in different cultures. Optimal human functioning is shaped by the society we live in, historical factors, the types of institutions we might have and other psychological processes which tell us how to behave. There is a lot of variation across different cultures in how people perceive health, what behaviours they think contribute to health and what they think about diagnosis and treatment options.

In western societies, the focus is on the absence of disease or sickness, which is the biomedical approach. In non-western societies, there are other approaches, such as psychosocial, biopsychosocial or phenomenological. The western approach assumes that the mind and body are independent and the mind can be ignored. The psychosocial approach assumes that the body and mind are connected and the phenomenological approach assumes other forces as well.

There are many things that we take for granted in the western world but which vary across cultures. They include time, control, mind, body, health and the self or person. In western-European cultural traditions, time flows from past to future. Time is a valuable resource that should be saved and used wisely because time moves in a linear way.

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In other cultures, time doesn’t flow forwards but flows backwards. This could influence areas that might be of interest for a research study, such as punctuality, delayed gratification or impulsivity and is something to consider if you are working in emerging markets.

Cultural dimensions that impact healthcare

The most powerful influence on our behaviour is the way we see ourselves. The way that we see ourselves and the assumptions that are tied to this lie underneath all the western cultural clinical concepts and what we understand as normal. They also influence how we see wellbeing, health and illness. If we are not aware how our western cultural tradition might influence healthcare and doctors’ assumptions, misdiagnosis and failed treatment might result.

There are distinct mindsets that shape western and non-western thinking respectively:

• The individualistic mindset (prevalent in Western countries): I know myself and I can easily tell a doctor what I want and need. I work towards my goals and want to improve all the time. I value freedom, being self-sufficient and having control. My health is my responsibility

• The collectivistic mindset (more prevalent in non-Western countries): I really want to be part of groups. It is very important to have harmonious relationships with close others. People close to me are an inseparable part of me. Happiness is not just about what I want as a person. My happiness is strongly linked to other people who are close to me and their happiness. I adapt myself depending on who I am with because of the desire for a harmonious relationship. Fitting in is important to me because it preserves harmony. My social roles are more important than my own needs. This is the collectivistic mindset and is more common in non-western countries.

Awareness of these two mindsets is important because the way we see ourselves shapes what we pay attention to – and if we pay attention to different things, we might also be living in different worlds.

This can be seen in the current attitude to wearing face masks during the Covid-19 pandemic. Masks are quite widely accepted in Asian countries, yet in the west there is a lot of resistance to wearing them. One big difference between eastern and western countries is that in the west, we tend to pay attention to the whole face, particularly the mouth, as a way of interpreting people’s emotions whereas people who have grown up in Asian cultures are more focused on looking at the eyes.

With the collectivistic mindset, the priority is that you maintain harmony in your life, and you pay less attention to your own individual needs and express your personal feelings less strongly. People focus on eyes because eyes are harder to control consciously than the mouth and the rest of the face so they are more likely to reveal the emotion of what you are thinking. This is not as important to us in the west because we want to express our individual needs and feelings, so we focus on the whole face to communicate very clearly. There is no need to look just at the eyes because there is plenty of other information available.

A mask gets in the way of using the whole face to express yourself and also read other people. In the west, we might feel uncomfortable wearing a mask because we cannot see clearly what other people are feeling and not being able to read others can feel like a threat. However, it doesn’t feel as much of a threat if you are not used to reading the mouth in the first place.

Another example of the differences between the two mindsets is in the meaning of happiness. In the west, this is seen as a linear progression and something that we need to maximise. Happiness is something we need to work towards to make sure that we get enough of it as possible. We expect happiness to increase over time in a cumulative way.

In many Asian countries, there is much more of a holistic understanding or attitude towards happiness where happiness and unhappiness co-exist in a constantly changing balancewhich means there is no need to focus on maximising wellbeing.

In the west, the desire to maximise the drive towards positive emotions and happiness has a strong link with cardiovascular risk factors because the striving for positive emotions promotes healthy behaviours. This kind of relationship and the assumption of maximising positive emotions does not really exist, for example, in Japan.

Doctor-patient interactions

Doctors’ views on health are influenced by their training and this in itself brings certain biases and skews. There are big differences in terms of health perceptions between doctors in different countries, for example, on dietary attitudes towards cereals, dairy or wine. There are also differences in how important practices such as food and exercise are for good health i.e. there are cultural differences between doctors.

Every interaction between doctors and patients is a transaction between two parties with different levels of power (based on social class, ethnicity, gender and cultural dimensions) which influence the consultation. There are differences in how doctors explain the diagnosis and optimal treatment. Searching for the agreement is a kind of negotiation which means that it is influenced by cultural context just like any other kind of negotiation.

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There are also differences in communication styles. A patient’s personality and beliefs about how much ’powerful others’ should be responsible for making decisions is culturally influenced. Even within a country, there will be cross-cultural differences which will influence patient-doctor communication.

Different individuals, social and cultural groups use different language in communicating distress to doctors. If the doctor cannot decode this language which might be verbal or non-verbal, they are in danger of making a wrong diagnosis. Cultures also differ in how patients show and express distress - this can influence how doctors translate symptoms into an illness. These cultural contexts are linked to the wellbeing of internal psychological states. People from other cultural backgrounds might see things differently and report more physical issues. This partly goes back to the western model of distinguishing between mental and physical illness.

Key takeaways

• Culture has a wide-ranging and imperceptible impact on healthcare decision-making.

• Culture is often invisible. It is really difficult to see cultural patterns when we are prone to seeing them in our own context as normal. It is good to take a more questioning approach to your own context.

• Culture plays a big role in medical interactions and influences how people see an illness or treatment, as well as doctor-patient interactions.

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Speaker: Anthony Rowbottom, Co-Founder, BoxeeIn a presentation that was full of personal insight, Anthony Rowbottom explored why finding your Why can help you to gain much more from professional development.

The problem with professional development

Professional development can often be thought of as ad hoc, unplanned, in the moment and not very useful in the longer term. It can also be inconsistent because we feel that we are using it to plug a gap. Although we can be enthusiastic when we attend training sessions and we might take one or two elements of them into our working lives, they do not generally change who we are, what we do and how we do it. This is a missed opportunity as the point of these sessions is to learn and build on what we know and to improve ourselves.

If we look at the journey we go on with our professional lives, we tend to go from one training session to another without a rigorous or directional plan.

• At the start of our careers, there is a steep learning curve and we try and soak in as much information and learning as possible. This tends to involve the harder skills.

• We then get thrown in at the deep end and are expected to struggle along. We try to understand our strengths and weaknesses and after a while, we improve and feel like we know what we are doing. Over time, our level of learning suffers, and we generally tend to do the things that we have always done because we have always done them that way. We tend to focus on the harder skills, rather than improve at the softer end. This creates an inconsistent approach to learning without any pre-planning.

An underlying reason for some of this is that we tend to think of our strengths and weaknesses differently. People believe that their strengths are inherent and that they don’t change over time. We also believe that weaknesses tend to be malleable and that we can address them by going to training sessions. We don’t necessarily go to training sessions in areas we are very good at or need to improve on.

However, studies have shown that if you focus on your strengths, things that you think you are good at and things that others think you are good at, not only do you learn more and learn faster but there are a number of other positive side-effects, such as:

• We are more engaged in whatever we are learning.

• We are less stressed.

• We are happier and more confident.

• We have greater job satisfaction.

• We feel happier in our daily lives at work.

When we try and understand our own strengths, there are five key issues:

• We don’t necessarily see ourselves the way that other people see us. What we see as our strengths might not be the case for others.

• Our perception of our strengths is often things that we find easy.

• Our strengths are often things that we find hard too i.e. things that we have overcome.

• We think too narrowly about what a strength is.

• We often get caught up in social comparison.

Focusing on strengths and finding your own Why

To find your own Why, it is important to look also at What and How.

• What - everybody knows what they do from a professional point of view. This is quite explicit and tangible.

• How - some know how they do it i.e. their USP and what makes them unique from others.

• Why - very few companies, brands or services know why they do it. ‘Why’ is the reason you do what you do. It is a purpose, cause or belief.


Find your own WHY: How understanding yourself can lead to better professional development

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These ways of thinking and processing information arise from two distinct parts of the brain.

• The neo cortex is the newer part of your brain. It sits at the front and is rational and analytical.

• The limbic brain is the older part of the brain. It is not able to process language but gives us hints as to what we are thinking by producing feeling. We then post-rationalise using our neo cortex.

When we think about professional development and market research, we know what we do and how we do it but why we do what we do is often ignored by comparison. Those who really understand why they do what they do learn fastest, as they understand where they want to be and how they get there.

Your journey

We all have moments in life where we take stock and ask why is it we are doing what we are doing.

We can use these energies to direct our enthusiasm into a new reality. This is something that we already do on a day to day basis in our work lives. Most businesses have annual brand plans and strategic planning cycles which tend to be five-year cycles. However, we don’t tend to use this same rigour and planning mentality for our own professional and personal development.

By mapping out your Why i.e. your goal in life, you can then take the Why and plan five-year cycles with it. This can allow you to focus on what you want to do from a learning perspective, such as building confidence and experience. Looking at the Why can help you to break down your life and career into five-year plans to enable you to proactively focus on what you want to do.

Key takeaways - How to find your own Why

• Ask yourself what you are good at and what your strengths are. Understand your own personal Why.

• Align this with how others see you. Find out what your team and company think of you. Focusing on your strengths will get you noticed in a positive way.

• Once you have this information, you can focus on where you are right now and where you ultimately want to be. You can then look for anything that can help support you with this.

• This approach will turbo-charge your learning, increase your job satisfaction and increase your happiness. It will decrease stress and disengagement. It will ultimately make you a better market researcher and make those around you happier.

• Finding your own Why can be quite tricky and utilising it in a practical way can be trickier still.

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