Feb13

Experience-by-Proxy as a Medical Decision Making Tool

Posted by Brad Davidson from OCH Behavioral Insights - NJ, North America

By Brad Davidson from OCH Behavioral Insights - NJ, North America | Published: February 13, 2013

computerNow that patient-centered decision making is becoming a reality, it begs the question: are we, as patients, really prepared to make life-or-death decisions on our own behalf?

The biggest problem I have making many of the decisions I am faced with in everyday life, not just in health, is that I simply don’t know enough about the options I’m choosing between. I am fully capable of ordering a cup of coffee—I’ve had lots of different kinds of coffee, and on any given day can be trusted to order myself a latte or a grande or whatever.

But if you ask me something I really don’t know much about, either experientially or theoretically, I’m going to be at sea, metaphorically speaking. To reuse an example I wrote about recently, when my builder asked me if I would prefer for him to install flexible tubing instead of traditional pipes for a new sink, I really didn’t have any idea, at all. He’s the expert, so I asked him what he would do. And he did what anyone might do in that situation—he told me what was good and bad about each, but made it clear that, really, flexible tubing was the bomb. You’d be an idiot not to go with flexible tubing.

And it turns out, he’s wrong. It works fine, but the water tastes like rubber, so you have to let the tap run for about 30 seconds before you fill up a cup of water. Not a huge deal, but what happened is, he gave me advice based on what would work best for him; it’s a lot easier and faster to install flexible tubing, so why not suggest it to me? I mean, he did give me the options, and he told me the truth about each in terms of cost, durability…but he never really told me what it would be like to actually live with a sink that produced water that had flowed through, or worse, sat in, flexible tubing. It was a decision he had to execute—it was a decision I have to live with. There’s a really, really big difference.

This lack of context when making decisions is one of the key problems facing patients who are now tasked with the emerging paradigm of patient-centered decision making, that is, the job of making their own health care decisions. Patients lack the experiential knowledge of what it might be like to live with option A versus option B. Doctors and other health care providers, who are much more familiar with the choices being faced, really never live with the consequences of these decisions, they merely execute or observe them. Just like a plumber, their choices are based on their own interpretation of what is best for the patient, which is probably in some measure based on what makes most sense for them, given that they have to carry out the technical aspects of the decision. This is why we are moving towards patient-centered decision making in the first place, so that the patient can make decisions based on what he or she believes will be best for him or her, given their values, their situation, etc. But if we give patients the kinds of information that doctors use to make decisions, or the kinds of information my plumber gave me about ratings, durability, costs, etc, we’re only helping patients understand the consequences of their decisions from the point of view of someone who doesn’t have to live with them—we’re still not helping them understand what it will be like to live with the consequences of different decisions.

A lot of very important medical decisions are made only once by any given individual, so whereas I might have another sink put in some day and be able to make a second decision differently based on the experiences of the first decision I made, sink-wise—in the medical context, you pick your option and you live with it. We may be providing patients information about these decisions, but in many ways it’s hard to say that the decisions themselves are “informed.”

What we need, then, is some way to give patients a window into the possible futures that might exist for them, depending on which choice they make, which option they follow. Like the Ghost of Christmas Future, we need to have some way to show patients what their lives might be like with choice A, choice B, or no choice at all.

This is, in part, the theoretical underpinning of one of Ogilvy CommonHealth’s two South by Southwest (SXSW) core conversations taking place in Austin, TX, early in March.

One of the best tools for achieving this is video testimonial by patients who have been faced with similar choices, and who made one. These patients can talk from experience about what it is like to make such a decision, why they made it, and what it’s been like since then. Another patient may have made a different choice, and can talk about the consequences of that choice from their distinct point of view. And suddenly a patient who was choosing from medical options based on things like survival rates and risk-benefit can now make decisions based on the experiences of people like them, facing the same issues they faced; people living with the consequences of their choices, for better or worse. This we call “experience-by-proxy”—borrowed experience, which allows you to gain knowledge of a path followed before you follow it for yourself.

These experiences-by-proxy won’t necessarily help make the decision for you, but they can make your decision more grounded in reality. If you are unsure if you need a hip replacement, and watch several videos, one of which has a patient saying, “It changed my life, I have no idea why I waited so long,” and another of which says, “It was horrible, I should have waited longer, and here’s why…”, you may still have conflicting opinions. You may still want a better quality of life with a new hip, but fear the consequences of an operation that is never guaranteed to go right. You may still be on the fence…but at least now you have a clearer vision of what it would be like to live with the option to go forward with hip replacement, and to put a face and a life to the theoretical risk and benefit you considered earlier.

To learn more, go to http://schedule.sxsw.com/2013/events/event_IAP7391

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Please allow 24 hours for response.

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Nov8

Getting to Know Patient Bloggers

Posted by Ludivine Delattre from OgilvyHealthPR - London, EMEA

By Ludivine Delattre from OgilvyHealthPR - London, EMEA | Published: November 8, 2012

How can we engage with online health activists and patient bloggers? This is a question our pharma clients are asking more and more frequently. But maybe the first question we should all be asking is: Do online health activists and bloggers want to engage with pharma? Increasingly the answer is yes, but there are a couple rules of engagement, as we have learned from discussions with bloggers.

1. It’s OK to listen, but don’t just eavesdrop.

Health activists and bloggers are well aware that pharma companies are listening in social media channels to gain insights into how people view their company and their products. But there is a difference between being listened to and being heard. Bloggers value the response and comments they get from their community, that’s why they do what they do—to be connected. And generally that goes for pharma too—an authentic, personal conversation will usually be greeted positively.

2. They are not journalists, they are people telling stories.

Many bloggers are happy to receive information from pharma companies, but they don’t want to be sold to.  They are not in the blogging business to promote drugs or devices—they got into blogging because they want to tell their personal story because it helps them cope, because it helps them connect with other people. So they might be interested in hearing about a new treatment that can make a difference to themselves or their peers. But they don’t want to be sent a press release; they would rather have content in a format that is appropriate to share with their audience, using the right language, tone of voice and level of detail.

3. Not all engagement takes place online.

Bloggers are social by nature—they are reaching out to networks and communities of people because they want to converse and share. This means that they also like to meet up in person—with pharma as well. The most successful way pharma has been engaging with bloggers and activists is in the real world, via blogger summits. Providing an opportunity for bloggers to get together in person can be transformative, not only for the bloggers who for the first time can get to shake hands with someone they have been conversing with virtually for years, but also for the sponsoring company, which can gain priceless information, insight and goodwill.

At the end of the day, sometimes the most effective engagement is the old fashioned kind: authentic relationship building, where the two parties listen and respond to each other in a spirit of mutual trust.

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Oct2

Radical Creativity and a Little Bit of Dirty Talk

Posted by John Nosta from OCH Specialty Marketing - NJ, North America

By John Nosta from OCH Specialty Marketing - NJ, North America | Published: October 2, 2012

 

If your strategy is to “think outside the box,” you might as well give up.

Because today, there is no box. 

There’s no cardboard container that defines yesterday’s boundaries. Today we live in a world of radical connectivity, where ideas intermingle, evolve and explode in the digital ether of creativity. Today we live within a sea of words, concepts and ideas that create the communication ecosphere. It’s a system that is alive, and in a profound way…wait for it…actually is self-organizing. It’s ideas driving new ideas! And it’s this exchange of thoughts and ideas that provides the catalyst for profound and life-changing events. It’s the Big Bang of Creativity! The slope of creativity and innovation is changing and getting so steep that you’ll need to have the digital tools to hold on tight. Otherwise, you’ll slip off into the abyss of ignorance.

It’s ideas having sex!

Matt Ridley, British journalist, scientist and author, clearly gets it! Throughout history, the engine of human progress and prosperity has been, and still is, the mating of ideas. His passion for thought and the exchange of ideas comes through loud and clear in his TED video.


Technology is advancing our abilities to a point beyond our mere human capacity. We are becoming super-creatives, where ideas fly like sparks, and this confluence of thought will ignite a fire of change. Jason Silva, in his over-the-top perspective, helps bring this magic into view.  His characterization of our new creative world is inspiring and captures the energy of this change. Jason is a filmmaker, futurist and self-proclaimed “epiphany addict” who loves to fool around with ideas!

So, get down and dirty…and connected!

But you might not really want to use conversation in a conventional way. Our conversation can be very smart, very public and very engaged. But it exists between you, me and the world. It’s this “ping-pong” conversation that echoes across the digital space and can spark a revolution of thought. Yesterday’s “blue sky” meeting has evolved into today’s “blue universe“ engagement.

The rules of creativity are changing. Are you connected?

CONTINUE THE CONVERSATION:
Questions? Comments? You can contact the author directly atblog@ochww.com. Please allow 24 hours for response.

You can also follow John on Twitter @JohnNosta.

 

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Sep13

What Happens When a Consumer Becomes a Patient?

Posted by Michele Moss from Ogilvy CommonHealth Consumer Care - NJ, North America

By Michele Moss from Ogilvy CommonHealth Consumer Care - NJ, North America | Published: September 13, 2012

It happens to all of us, sooner or later. Whether it’s a health concern your doctor brings up during a routine office visit. Or you ask your doctor about a medicine you saw advertised on TV, online, in a brochure in the waiting room, or something health-related a friend or family member told you.

At that moment, there is a paradigm shift in the way people think and act. A person’s mindset is different when under the care of a doctor. Language is different when being treated for a specific disease state. Listening is different when a person has to take ownership of his or her own well-being. Processing information is different in a heightened state due to illness.

Now patients become information seekers. About their condition, about medicines that treat their condition, and about over-the-counter products that can help improve their overall health and wellness.

Once informed, patients become information givers, eager to share their newfound knowledge and experience with family, friends, and colleagues. Now conversations begin with: “My doctor told me…”.  And these 4 words give instant credibility to what is being said about a medical condition and the medicines and products used to treat it.

So as the patient continues to “shop around” for health information and treatments, we see the evolution of the cycle, with the patient now becoming a consumer; a consumer of health goods and services. This is reflected in how we define these terms today. For example, Merriam-Webster’s Collegiate Dictionary defines a consumer as one that utilizes economic goods, and a customer as one that purchases a commodity or service; Merriam-Webster’s Medical Dictionary defines a patient as a client for medical services.

Not so long ago, it would have been unthinkable to speak of patients in terms of “buying” medical care. A person was considered “under the care of” a physician; this bond was sacrosanct, and no one would ever consider questioning what the doctor said. In fact, the venerable century-old Dorland’s Medical Dictionary defines a patient as a person who is ill or who is undergoing treatment for disease (they do not even have an entry for consumer or customer).

But as today’s consumers find themselves more and more responsible for their own health and wellness, the slogan from retailer Sy Syms rings true: an educated consumer is our best customer.

So, how did you become an educated consumer of healthcare?

Fill in the blank: “My doctor told me____”.

 

 

 

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Sep6

Who’s Driving Care Coordination?

Posted by Denise Lenci from OCH Payer Marketing - NJ, North America

By Denise Lenci from OCH Payer Marketing - NJ, North America | Published: September 6, 2012

Close coordination among healthcare professionals is widely seen as an avenue to improved patient outcomes and lower costs. Better care coordination is a national healthcare priority; the Affordable Care Act includes incentives to encourage it and healthcare providers are forming new alliances to deliver it.

At the center of these efforts, of course, is the patient. So are patients experiencing better care coordination?

Recently I got a firsthand look at this question when my daughter suffered what appeared to be an allergic reaction. The emergency department doctor was baffled, but ordered a variety of tests, told us to call the next day for results, and handed us a prescription. The next day, we were told it would take at least a week to get the results and that someone from the hospital would contact us. The doctor we visited a few days later told us we would never hear from the hospital, re-ran the tests, gave us a tentative diagnosis, and wrote a different prescription. After about a week when we hadn’t heard anything, we called the doctor’s office and were told the test results were normal.

Yet, my daughter was still experiencing troubling symptoms and the new medication wasn’t helping. So we scheduled an appointment with a specialist. We picked up a copy of the medical records from the first doctor and found that several abnormal test results were circled, but were never explained to us.

The specialist confirmed the diagnosis and prescribed yet another medication. When we got home from the pharmacy we found that we had been given the wrong drug. In fact, it was another patient’s prescription.

My family is not alone. Ask around and you’re likely to hear a similar story. In a Kaiser Family Foundation survey, two-thirds of consumers said that coordination among the different healthcare professionals they see is a problem; for many, it’s a major problem.

You could point a finger at healthcare professionals who are not doing all they should, but when you consider the volume of patients seen, tests ordered, procedures performed, prescriptions written, and insurance claims processed in a typical practice, the challenge is understandable.

In any scenario, patients need to play a more central role in coordinating their own care.

Many of the respondents in the Kaiser Family Foundation survey said they had taken steps to improve the coordination of their care. Here are some of the actions they reported:

  • Checked that a drug they picked up at a pharmacy matched their doctor’s prescription
  • Followed up on test results
  • Brought a list of all their medications to a doctor’s appointment
  • Brought a friend or relative to a doctor’s appointment to help ask questions and understand what the doctor said
  • Told a healthcare professional about any drug allergies—even when they weren’t asked
  • Created their own set of medical records to ensure that their healthcare professionals have all of their medical information

A good start, but these steps still represent an episodic approach to managing one’s health care. The Institute of Medicine notes that patients need to obtain and understand information about their condition and about relevant healthcare services in order to make appropriate health decisions. Seem obvious? Maybe so, but multiple studies have found that patients often do not understand their treatment plan and the role of each healthcare professional involved.

Healthcare professionals benefit from the use of “maps”: diagnostic and treatment algorithms, clinical practice guidelines, and care pathways. It’s true that much of this information is accessible to patients on the Internet—but only with a lot of digging and the ability to decipher medical jargon.

With the national spotlight on care coordination, the time seems right to find new ways to engage patients in driving their own care and providing them with more sophisticated tools to do so. As healthcare marketers, we do a good job of informing patients about specific medications and medical devices. We have the skills and technology to do more.

How about a patient Global Positioning System—or GPS?  Let’s help patients see a full picture of their condition and the options available for managing it. Let’s provide them with resources to navigate the decisions they will face. Each step of the journey should be clear. Each transition between care settings made with confidence.

Healthcare payers, in particular, are well placed to support patients in this way because they have a consistent presence in patients’ care. But, just as doctors, hospitals, skilled nursing facilities and other providers are teaming up to deliver better coordinated care, other participants in the healthcare market can and should team up to put the patient in the driver’s seat.

Chronic conditions, such as diabetes and cardiovascular disease, which entail multiple healthcare professionals and settings of care and, often, the involvement of family caregivers, are a clear priority. At Ogilvy CommonHealth Worldwide we are working with pharmaceutical industry clients in cooperation with payers, healthcare providers, advocacy organizations, and others to equip patients with chronic conditions to better manage their own healthcare journeys and, ultimately, arrive at more satisfactory outcomes.

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Jul24

Why Is It So Hard to Learn From Somebody Else’s Mistake?

Posted by Donna Ambriano from OCH Medical Marketing - NJ, North America

By Donna Ambriano from OCH Medical Marketing - NJ, North America | Published: July 24, 2012

Recently, I was fortunate to have the opportunity to drive to Key West from southern Florida. (I know, I know, it sucks to be me. If you’ve done it before, you know what I’m talking about. If you haven’t, I highly recommend it). It’s an absolutely spectacular drive along Route 1, with crystal blue water as far as the eye can see on either side of a long, straight, wide-open road. Really long. Really straight. And really wide open. With a heavy foot on the accelerator and some decent horsepower, one could really cut some time off this trip. Or at least pass that annoying RV piled high with bicycles, kayaks, and fishing gear, going a grinding 40 mph, and towing a rusting, mustard yellow 1994 Pontiac Aztec.

That was probably the same thought that flashed across the minds of many of my fellow drivers…right before they became names on the roadside memorial signs that dot both sides of the Overseas Highway from Homestead to the Southernmost Point.

I’ve been driving to the Keys at least once a year for 20 years. And every time, there’s a big sign with flashing lights that announces how many fatalities to date have been reported. And every time, it’s in the double digits (13 in 2012 at the time of my trip, in case your inquiring mind wants to know). So why do we never learn, even when the evidence is right in front of our eyes?

I started wondering about this as we meandered along behind the RV under cloudless blue skies, taking in the stunning vistas of mangroves, watching the boats from far away and the pelicans from closer up, and counting the small, white signs that represented the site of gruesome tragedies. At least 39 people in addition to the aforementioned 13 had ignored the history of the unfortunate drivers before them—and that was just between Key Largo and Key West.

Never mind the cause of their crashes (yes, the majority are alcohol-related). How about, “Those who don’t learn from history are doomed to repeat it”? The sad signs were there. Obviously. How could somebody miss them?

Maybe the answer lies in the dual concepts of “proximity” and “causality.” The ability to learn from our own mistakes is globally recognized: we make a mistake, and the result affects us directly as we are very close to it (“proximity”). There is a direct connection between our action (or inaction) and the consequence (“causality”). This is borne out at a neurological level and can be documented via electroencephalography. Within 50 milliseconds of a screw-up, your brain involuntarily sends out an initial reaction called error-related negativity (ERN) involving the anterior cingulated cortex. This part of the brain monitors behavior, anticipation, reward response, and regulates attention, helping you recognize that an error has occurred. (Also known as the “uh oh.”) The second signal, called error positivity (Pe), shows up 100 to 500 milliseconds later. This signal shows that you are aware of and paying attention to your mistake and its results (informally, the “you IDIOT” response). Numerous studies have shown that we learn more effectively when the ERN signal is larger, suggesting a bigger initial response to error, and the Pe signal is more consistent, demonstrating we are paying attention to, and thus trying to learn from, the mistake.1

 Our ability to learn from others is a little more complex. A 2011 Scientific American article shows that people can learn from other people in a competitive situation—but more from their competitors’ failures (what not to do) than their successes. In an experiment, volunteers played a simple game, modeled after foraging for resources in the wild, against a computer. While the computer was making its move (which simply consisted of changing the color of a box), the live player’s mirror neuron system (a system known to respond to the actions of others) was engaged as if the player him/herself was making the same choice. If the computer’s choice failed, the mirror neuron system of the live player immediately shut down the mental simulation—in other words, the live player’s brain learned from the computer’s mistake so he/she would not make the same error.2 Why? Proximity and causality: the live player was directly involved with the computer player, and the decisions the computer player made directly influenced the decisions and actions of the live player. The relationship between the person and the computer came down to learning “what’s in it for me” by seeing what failure looked like, and acting on that knowledge to achieve success.

So back to those unfortunate accident victims: Shouldn’t they have learned from the examples of their fellow fatalities? I would think that living to see another day would be a pretty strong motivator to trigger the “what’s in it for me” learning response, wouldn’t you? Again, this is all about proximity and causality. If you don’t see the accident, or the fates of the victims don’t impact your life directly, your neurons won’t react the same way. You may feel distressed or sad about the people behind the memorial plaques, but you have no direct experience of their failure and therefore no context for how you could learn from their mistakes. On the other hand, if your brain is sending out ERN signals while you’re behind the wheel, you’re probably already involved in something awful…and hopefully, will have the opportunity to experience the Pe response and learn how not to repeat the mistake in the future. Unlike the unlucky 13.

 

 

  1. Lehrer, J. Why do some people learn faster? Wired. 2011. Available at: http://www.wired.com/wiredscience/2011/10/why-do-some-people-learn-faster-2/. Accessed June 19, 2012.
  2. Swaminathan S. Monkey see, monkey don’t: learning from others’ mistakes. Scientific American. 2011. Available at: http://www.scientificamerican.com/article.cfm?id=monkey-see-monkey-dont. Accessed June 19, 2012.

 

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Jul17

HCPs Who Access Data: Just Like the Rest of Us!

Posted by Mary Anderson from Ogilvy CommonHealth Med Ed and SCI Scientific Communications & Information-NJ, North America

By Mary Anderson from Ogilvy CommonHealth Med Ed and SCI Scientific Communications & Information-NJ, North America | Published: July 17, 2012

Guess what! Scientists, clinicians and other healthcare professionals own and use smartphones, iPads and an array of desktop and personal computers. These same people are fundamentally interested in the clinical studies and scientific evidence that result from research studies. They read specialty and  peer-reviewed journals and are asking, “When will I be able to read more via my personal devices?” As lay consumers, they can access everything from instructions on how to build a nuclear bomb to the recipe for Uzbeki-style lamb via their digital devices, yet the journal articles that satisfy their professional needs and passions are not yet uniformly available. Go figure!

SCI Scientific Communications & Information recently utilized a three-wave electronic survey to understand just how eager clinicians, journal authors and industry stakeholders are to receive data in a digital format. The results are in line with society at large. They want more!

Data collected from 50 internal medicine and primary care practitioners showed 86% accessed peer-reviewed literature from 2010 to 2011, and the overall proportion of information accessed with these modalities increased from 52.2% to 64.6%. Mobile tablets showed the highest percentage increases.  Preliminary results from 15 authors who published more than four articles over the last three years show that they decreased their print-only submissions to 15.3%, from 25% of the submissions two years ago.

While computers and laptops remain the primary devices for accessing online peer-reviewed content, HCPs say they will want and expect that journal articles become available for e-readers and smartphone applications. These devices are likely to outpace PCs/laptops based on portability and convenience.  Industry stakeholders anticipate a rise in open access and non-print options. They aim to please as long as regulatory and compliance agents within their organizations get on board and clarify the rules around more novel dissemination approaches, such as podcasts. In the meantime, they support open access publications and utilize QR coding at congresses to disseminate posters and presentations.

Like all other consumers, HCP readers perceive that technology will make their access to information more timely, cost-effective and convenient. They want to see e-mail notifications of new articles, smartphone applications that work for middle-aged sets of eyes and tablet applications.

Summary excerpted:

Hudson C,  Cecere E, Yalamanchili R, Anderson M, Pucci M, Aloia D, Scheckner B. Utilization and attitudes on technological advances in medical publications. Podium presentation, ISMPP, 2012.  

 

 

 

 

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Jul12

Mum, Dad, Reading Glasses, Arthritis and…iPhones?

Posted by Stephanie O'Hagan from OgilvyHealthPR - London, EMEA

By Stephanie O'Hagan from OgilvyHealthPR - London, EMEA | Published: July 12, 2012

“Pass me my reading glasses, will you? I can’t see the screen.”

For those of us working in the healthcare communications industry, words like apps, social media, digital, mhealth and self-management are part of everyday life. But what words make up the everyday life of our parents and grandparents? Well I don’t know about you, but my parents often struggle to even see the screen let alone have the confidence to use online and technologically advanced tools to look after their health. They’ve just about learned how to call me on Skype but setting up a Facebook account to keep up to date with my latest holiday snaps is way beyond their comfort zone. But this isn’t to say they can’t do it.

The ageing population is one of the key challenges and opportunities du jour for the healthcare industry. We can’t deny that the population is getting older, just as we can’t deny that digital and technological advancements are getting bolder. The question is: how do we make this oxymoronic marriage one made in heaven?

“I see next door have bought a nice new car.” For our parents and grandparents, it’s all about keeping up with the Joneses. For us, it’s all about influencing, motivating and supporting the Joneses to help them make positive decisions for their health.

According to a US-based survey, 40% of doctors believe that using mobile health technologies that monitor fitness and eating habits can reduce doctor visits, and 88% support patients monitoring their health at home. Combine these insights with the 10,000+ health apps available on iTunes and the math kind of speaks for itself.  But how do we apply these stats to an ageing Mr. and Mrs. Jones?

The World Health Organization has also been pondering this very topic. By 2050, nearly one in every four people will be over the age of 60. WHO believes that innovative technologies can help maintain the independence and physical health of older people. Mobile devices can now connect HCPs to seniors to family like never before, helping older patients remember to take their medication and stick to diet and fitness plans.  Devices now also have the ability to monitor health patterns and alert doctors when there are signs of trouble.  Older people no longer need to feel isolated in their daily healthcare needs.

In the healthcare communications industry, we need to carefully consider how we can use these technologies to assist potentially reluctant people like our parents—we must ensure that we listen to our audience, giving them what they need rather than what we think they need, finding out what they are comfortable with using, finding out if it is more appropriate to assist the caregiver over the patient, and taking a multi-generational approach. My mum and dad might not know how to use this app, but I do.

So it is up to us then. It is up to us as children and grandchildren to show the older generation they have our support and to pass on positive attitudes about using new technologies for healthy living. It is up to us as healthcare communicators to develop carefully designed and targeted tools, and to highlight the health value of using these, to help the ageing population embrace the technological revolution as much as we do. It is up to us to do this in a way that inspires, motivates and, above all, drives people to the sustainable action of taking control of their health. If we can make Mr. and Mrs. Jones next door embrace this, our parents will embrace it too.

 

 

 

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Jun19

Time To Get Serious About Gaming

Posted by James Robertson from Ogilvy Healthworld - London, EMEA

By James Robertson from Ogilvy Healthworld - London, EMEA | Published: June 19, 2012

It’s game time

We live in a world that has incredible medicines, highly trained medical staff and easy access to masses of medical information. In addition, pharmaceutical companies and other organizations strive relentlessly to increase disease and product awareness. Yet people are still ignorant about their health, and the healthcare industry struggles to drive significant behavior change in those most in need. When you combine this with the fact that Joe Public is bombarded with more than 5,000 ads a day, it is clear that new approaches to healthcare marketing are needed.

Some think that gaming might be the healthcare industry’s knight in shining armor.  Games are no longer made purely for entertainment purposes. We are witnessing the rise of “serious games” — games that are designed to educate and inform.

Gaming provides a powerful and effective way to engage, educate and motivate people. They can:

  • Improve adherence, expedite the acquisition of disease knowledge and increase self-efficacy, as demonstrated by Re-Mission
  • Incentivize glucose monitoring in diabetic kids, as with Bayer’s Didget
  • Raise awareness of little-known medical conditions through award-winning campaigns like Back in Play
  • Increase cerebral performance as witnessed when my parents play brain-training games on their smartphones

These are just a few examples of what can be achieved. If you need further convincing of gaming’s influence in healthcare, just consider the recent launch of the Games for Health journal and the fact that the similarly named Games for Health conference is in its eighth year.

Gamification vs. gaming

All aspects of life are becoming increasingly influenced by gamification—something you might have heard a lot about recently. Gamification is the application of gaming mechanics to routine, everyday activities. Adding rewards and incentives to dull and monotonous tasks, such as HR training and timesheets, makes them more enjoyable and makes people more motivated to undertake them.

Most people are unaware that they already engage in gamification. You know that progress bar on your LinkedIn page? That’s gamification. The levels and rewards you receive from your favorite coffee shop’s reward card? That’s gamification. Your frequent flyer program? You get the idea.

We see these mechanics more and more with the proliferation of health and wellness apps, but if we could truly integrate them into patients’ (and HCPs’) everyday lives, then we could see considerable improvements in health outcomes and really drive behavior change.

Only fools rush in…

Gaming can be powerful, but with great power comes great responsibility. It is our responsibility to think about the why and the how of any games that we develop.  Research is required to understand what you want to achieve, what game style will resonate with your audience, where they operate in the digital landscape, what will be considered a success, and so on.

Importantly, a multidisciplinary team should lead any development. Depending on what the purpose of the game is, that team might include gamers, scientists, marketers, psychologists, doctors and/or patients. With decent insights, thorough thinking and plenty of testing, you could reach the top of the healthcare leaderboard.

So if you think gaming or gamification can bolster your communications efforts, it’s time to get your game face on and have some fun!

 

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Apr26

Do Scare Tactics Work?

Posted by Donna Ambriano from OCH Medical Marketing - NJ, North America

By Donna Ambriano from OCH Medical Marketing - NJ, North America | Published: April 26, 2012

That’s the 54-million-dollar question. The CDC is betting they do, and has launched a series of graphic ads, featuring real smokers, to answer it.  Entitled “Tips from Former Smokers,” the videos show what it’s like to live in the aftermath of health disasters caused by smoking. The series can be viewed here: http://www.cdc.gov/tobacco/campaign/tips/resources/videos/

But do scare tactics really work? There have been reams of studies to fuel the debate, on a wide variety of topics ranging from dental hygiene in the 1950s to the more recent DARE and gruesome pre-prom efforts in high schools nationwide.  The short answer is: it depends.

According to a FastCompany article from 2005 entitled “Change or Die,” the odds of you making a difficult and enduring behavioral change that would literally save your life are 9 to 1. That’s a hard, scientific fact: people would rather die than change their behavior. Want proof? Dr Edward Miller, Johns Hopkins University medical school dean and hospital CEO, studied patients whose heart disease was so severe they underwent bypass surgery. Bypass surgery is traumatic, expensive, and temporary. Half the time, the grafts clog up in just a few years—mostly due to the fact that 90% of coronary-artery bypass patients do not change their lifestyle, despite the fact that they could avoid the pain and need for repeated surgery—never mind arrest the course of their disease before it kills them—simply by switching to a healthier lifestyle.

Part of the reason that traditional death threats don’t work is because people fall back on denial. When a heart attack happens, patients are scared enough to follow doctor’s orders for a few weeks. After that, death becomes too frightening to think about, denial returns, and old lifestyle habits come back.

OK, you say, so that’s heart attacks. That’s a one-time (hopefully) event. Smoking is a chronic behavior. Isn’t that different? Well, sort of. One could argue that it’s even harder to scare someone out of a chronic habit, as magical thinking dictates that if it hasn’t happened so far, it probably won’t. Then again, if you haven’t started smoking yet, would a fear-based message help prevent you from starting altogether?

An article in Prevention First from 2008 seems to say the answer to the last question is an emphatic NO. In assessing numerous studies aimed at preventing alcohol, tobacco, or other drug use in youth, Prevention First concluded that scare tactics are not effective in preventing teens from trying certain behaviors because:

  • The audience doesn’t believe the fear appeal or scare tactic, as they do not match their own personal experience
  • Audiences ignore or minimize the importance of negative, sensational information
  • Messages that emphasize guilt, tension, or anxiety motivate the audience to ignore or minimize the importance of the threat
  • Scare tactics may result in a feeling of powerlessness—“I can’t control that, so why bother trying?”
  • Young audiences feel invincible, and think “that won’t happen to me”
  • Messages may have the opposite effect in risk-taking individual

However, what if you could develop a compelling campaign that utilized scare tactics in a unique way to empower the audience to change? Enter the Truth Campaign. Originally created in 1998 to market antismoking, anti-industry messages to teenagers in Florida, the campaign was taken nationwide in 2000 by the American Legacy Foundation. This campaigned harnessed the $100-million power of Legacy and hard-hitting creativity to address the “truth” behind tobacco. One of its most memorable and effective ads showed a group of teens pulling up to the Philip Morris headquarters in NYC and stacking 1200 body bags on the sidewalk outside. All throughout, someone was yelling into a megaphone that these body bags represented the number of people killed by smoking every day. Other ads focused on diseases caused by smoking, toxic ingredients in cigarettes, and pointed out that cigarette companies profited by selling products that killed people. As a result of these and similar ads, teen smoking decreased in the 2000-2002 timeframe that the campaign ran.

So why was this fear-based campaign successful, when so many others were not? The answer lies in the approach. Unlike campaigns that simply threatened the viewer with horrible consequences, this one turned not smoking into a statement against industry power, manipulation, and authority, appealing to the teen desire to rebel. The use of fear was focused and channeled towards making the audience outraged at the tobacco companies for using them. Body bags were symbolic of death, but not their death. The diseases were caused by tobacco company tricks, and were signs of corporate indifference. The audience was empowered to do something after viewing these ads—specifically, to not smoke.

But what if you were already a smoker? Would fear tactics work on you? An Australian study suggests that they might. In 1997, the Australian minister of health assigned a commission to take on current smokers by reviewing 40 years of psychological research and reports commissioned by various Quit campaigns. The resulting campaign used insights that showed a “personal agenda” approach would work best. Utilizing graphic medical imagery, the ads crafted a connection between the desire to smoke and the inevitable medical consequences of doing so. One ad showed fatty deposits being squeezed by a surgeon’s hand from a human aorta. Another took the viewers along as inhaled smoke traveling into the lungs, where it begins to rot them. Each of these scenes was followed by a typical “smoker’s moment” showing someone lighting up and inhaling, apparently ignorant of the damage being done. By focusing on relatively certain rather than uncommon events, the campaign was able to show in real time that “every cigarette is doing you damage” and to make it relevant to the here and now, rather than the distant future. Now, there was a tangible connection between deciding to smoke and what that decision did to your body. Every time you lit up, you thought about that and maybe decided the damage wasn’t worth it. So how did this campaign do? In testing, it scored the highest among its target audience when compared with approaches that elicited a less visceral reaction, and with antismoking ads created by tobacco companies themselves. An evaluation of Phase I showed that three out of five smokers and ex-smokers said the campaign encouraged them to stay off or quit cigarettes. Also, the yearly quit rate increased from 19% to 24% following the campaign—meaning that the increase in the number of those attempting to quit rose by 20,000 smokers

So will the CDC effort bear fruit? It has many of the traits that made the aforementioned smoking campaigns successful: it shows real-time consequences, uses real people to underscore that indeed, this could happen to you; and isn’t overly threatening or dramatic. Most importantly, like the “trust” campaign and the “every cigarette does damage” campaign, the scare part is focused and relevant to the audience—a conduit to the main message instead of the whole message. The smokers featured are on the young side—diagnosed in their 30s and 40s—ages that aren’t considered “old,” people who are easy to relate to. The tonality is straightforward and real: these people really, really, really wish they had never started smoking. They genuinely seem to want to make sure you don’t. Or that if you do, that you stop before you look like they do. It’s strong stuff, but I’d argue it’s not traditionally fear-based. While showing the awful aftereffects of smoking, there’s an emotional connection there that makes the threat more real, as you can so readily empathize with the narrators. You like them, and you don’t want to be them. And therein lies the real power of these former smokers: by quitting the very thing that damaged them so much, you don’t have to be.

 

 

References:

  1. Centers for Disease Control and Prevention. Smoking and tobacco use. Available at: www.cdc.gov/tobacco. Accessed April 18, 2012.
  2. Deutschman A. Change or Die. Available at www.fastcompany.com. Accessed April 18, 2012.
  3. Prevention First. Ineffectiveness of fear appeals in youth alcohol, tobacco, and other drug (ATOD) prevention. Springfield, IL: Prevention First. 2008.
  4. Apollonia DE, Malone RE. Turning negative into positive: public health mass media campaigns and negative advertising. Health Educ Res. 2009;24(3):483-495.
  5. Hill D, Chapman S, Donovan R. The return of scare tactics. Tab Control. 1998;7:5-8.
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