A study has shown health related Google searches double the week before a patient visits an emergency room and 50% would be willing to share search history with providers. This could lead to predictive and preemptive care, directing patients to the right treatment earlier.
Voice Applications are getting Louder in Healthcare
Technology attempts to put the Black Dog of Depression on a leash
A study has found ‘Brain Training Apps’ could help depression patients. And mood predicting tech may be able to stop depressed moods before they arise. Researchers are talking about bringing clinical grade brain-stimulation for depression into the home. And consumer devices are also in development
An Anti-Viral Shot for the Anti-Vaxxers
After sustained public pressure, major social media platforms, including Facebook, Instagram, You Tube & Pinterest, have taken steps to reduce the visibility of anti-vaccination content. This hazardous spread of ignorance has been linked to low vaccination rates and subsequent disease outbreaks
UK health secretary Matt Hancock was labelled dumb for a knee jerk call to ditch ‘archaic’ pagers. Pagers save lives where mobile phones can’t go, e.g. zero reception spots. This ‘aversion’ to old stuff is just as bad as the ‘craving’ for the shiny new. But focusing on tech grabs headlines rather than boring stuff like er… the patient and their entire journey
I try to get along to as many London Quantified Self Meetups as I can. Most of the presentations are very interesting. The discussion of peoples unique experience in personal experimentation is usually fascinating (If like me you are interested in that sort of thing!)
What is great, especially if you can’t make a meeting, is that all talks are recorded. Ok you miss out on the interaction, questions and networking but it is still a great resource. Thanks to Ken, one of the organisers for making this happen.
The archive of Videos and Presentations can be found here. I would certainly recommend having a look.
And of course in the true spirit of self promotion I have embedded my recent quantified self video and presentation below 🙂 Of course I hope it is interesting, but if not you have plenty of others to choose from! Maybe see you at the next #QS Meet Up 🙂
Wikipedia seems to be attracting even more Pharma interest in recent weeks, particularly as a recent IMS report highlighted how much doctors and patients rely on its content.
It was a pretty immersive week for me last week regarding Wikipedia:
A breakfast meeting on the subject
Meeting up with some devout Wikipedians over Sunday lunch
Finding a little time to make some edits of my own (non pharma related of course)
Personally fielding some professional questions about this fascinating community of knowledge
I saw an excellent presentation from, Paul W , a veteran Wikipedian, with 10 years tenure, over 10,000 edits and nearly 400 articles to his name. He is also a professional PR guy. You could be forgiven for thinking that these 2 personas would not sit comfortably in the same room, let alone in one human shell.
Paul shared some valuable Wikipedia guidance for PR agencies, that demonstrate PR & Wikipedia are not incompatible entities, as long as the right approach is taken.
These guidelines actually make very useful reading for those in Pharma. Page 10 is particularly interesting as it outlines the steps required when editing. There is also a nice summary of Do’s and Don’ts.
These guidelines were created collaboratively on an open Wikipedia page, with input from the community.
Meeting ‘real life’ Wikipedians was an interesting experience. My discussions with them reinforced the need that anyone with a conflict of interest needs to work with the community to make edits. I met an administrator who proudly declared he had deleted over 100,000 pages. While this deletion count seems to be a badge of honour, the motivation behind this, is ensuring Wikipedia, is of a high quality and authored from a neutral point of view. So any ill advised attempts by Pharma to blunder in and start editing drug or disease pages will inevitably backfire.
Some of my Wikipedia recommendations:
Work with the community. Wikipedia is written from a neutral point of view (one of its five pillars ) The premise is that if you work for a Pharma company, then your opinion about that company, one of its drugs or disease areas, will be biased. The solution is to work with the community to develop content, identify suitable editors who have contributed good quality articles on similar subjects, suggest articles for creation, use forms to request an edit or use the talk pages.
Be transparent and declare conflicts of interest If you try to contribute under XPharmaCo it won’t work and rightly so. Corporate or group accounts are not allowed on Wikipedia. It should be, for example, Rebecca, who, on her user page, clearly states she works for XPharmaCo, outlines her conflicts of interest and intent.
Be human You need to speak like a person not a corporation. Any attempts at corporate speak or a heavy handed approach will simply be met with contempt. Wikipedia is not a corporation rather a community of dedicated volunteers.
Be bold Industry regulations are unclear when it comes to Wikipedia. Take a clear ethical and considered standpoint. You will need to have a plan however don’t expect clear regulatory guidance. The UK PMCPA digital guidance spectacularly misses the point, suggesting if a company starts editing Wikipedia it should ensure everything is correct. I am afraid the community and consensual nature of Wikipedia makes this impossible to guarantee.
Have a go If you think Wikipedia is of interest why not try editing it yourself! You may also want to look for volunteers in your organisation to start making edits. Clearly these edits need to be outside of any conflicted area and the above bullet points still apply!
I look forward to hearing your opinions or examples where Pharma is currently or is planning to get involved with the Wikipedia community. And if you have any suggested edits for this blog just let me know…
‘What sort of sandwiches do you call these? Uuurrrgghh they are from Tesco! With all the money Pharma is making can’t you at least get lunch from Waitrose or M&S. And where the hell are the prawns?’
These are some specific memories from a hospital lunch meeting over 10 years ago with a group of doctors from the Elderly Medicine department at a Birmingham hospital, however it was typical of such events.
I was a medical representative at the time, bringing the departmental staff a lunch in exchange for a miniscule amount of time to talk about my drug.
There clearly IS such thing as a free lunch as many of the doctors used to take a sandwich and walk off before the talk, I recall one of them muttering about the the quality of the mayonnaise and how the rep from Pfizer at least puts on a decent lunch (I wondered if she stayed for the Pfizer talk – probably not)
I started the talk, with such a dismal time allocation, that even if my pharmaceutical treatment was for premature ejaculation I would have struggled to reach a conclusion. (Nothing so exciting unfortunately – Gastric reflux)
If it was not bad enough that my words were smashing down on the stony ground of disinterest, one doctor began talking loudly on his mobile phone, I forced myself uncomfortably on, trying to explain to the group with something approaching passion that all Proton Pump Inhibitors (PPIs) are not the same.
The doctor continued to talk on his mobile, then a loud interruption from the chair ‘I will only allow one conversation at a time here’ he boomed.
At last I thought, a return to some decorum. I carried on talking but so did Nokia doctor. The chair interceded again, even more forcefully ‘ I have told you only one conversation at a time!’ and it was then I realized he was talking to me. ‘A doctor is on the phone this could be a life or death situation’
‘Fair enough but can’t he just cart his sandwich laden girth out of the room to check’ were the, thankfully, unspoken words of my l’esprit d’escalier.
Anyway Nokia doctor soon concluded the conversation, his wife now clear what he was having for his tea that evening. I was allowed to continue.
In the dying seconds I waffled something about how they should consider my PPI due to the low interactions with Warfarin in elderly patients. The short discussion resulted with unanimous agreement from the doctors all PPI’s are the same and that they will continue to use the competitor product (Did I mention to them apparently it causes terrible diarrhea? – probably a bit late now…)
As I hurriedly grabbed my case and coat a few of the more helpful Doctors enthusiastically explained where the nearest Waitrose was for next time.
The reason for the anecdote is not to mock doctors or the pharma industry but rather highlight and contrast an historic unhealthy working or rather not-working relationship between the 2 parties.
Fortunately things are different now. The feedback via projects I work on and the forward thinking clinicians I speak to, is that there is an appetite to work with Pharma as equal partners to solve some of the challenges in the NHS. Providing value, increasing efficiencies, improving patient outcomes, reducing hospital bed days through the use of innovative services and technology are just some examples.
The health service is moving on, but is the Pharmaceutical industry?
Will pharma seize this opportunity or will it be just another trip to Waitrose to stock up on the prawn sandwiches?
I feel I must start this blog by plugging a book. And no it is not one I have written.
The 2 reasons for plugging it are:
(1) It is actually a very good book
(2) I have ‘lifted’ a few of the healthcare examples for this blog
The book ‘Big Data – A Revolution That Will Transform How We Live, Work & Think’, isa broad discussion on the opportunities and challenges around big data now and into the future.
Anyway read on, unless you want to see a summary video blog of this post, on a very scenic but windy Budapest hill top!
Taking it from the start, what is Big Data again anyway?
Big Data is defined as ‘data sets so large and complex that they can’t be processed by traditional tools’
A fairly vague and subjective definition.
The advent of Big Data as a term has unsurprising coincided with the voluminous explosion of data in our world.
A nice 19th century example illustrates that Big Data is not necessarily a new concept. Commodore Maury used ship logbooks to identify more efficient routes at sea. It cut journey times by a third. This was data that was previously never shared, meaning that sea crossings relied on the experience, instincts and intuition of the captain.
This historical example highlights a very important aspect of big data. Using the original data for a secondary purpose. There were many regulatory and practical reasons for logging a ships position however improving journey times was not one of them.
Today several factors are coalescing to drive Big Data
Ease of collection: We can attach affordable sensors to practically anything
‘The Data Exhaust’: A huge volume of data is generated as a by product of our daily actions, e.g. internet searches, phone calls, credit card transactions, medical monitoring and so on
Storage: There are now cheaper and more accessible ways of storing large volumes of data
‘Processing Power’: Affordable and accessible tools now exist to combine and interrogate mass data sets
‘Big Data Mindset’: Leading organizations and individuals are becoming increasing skilled in exploiting opportunities inherent in the data
Big Data is even proving that Einstein got it wrong, with one of his famous quotes. (actually many attribute this quote to Einstein but the evidence is not conclusive )
‘Not everything that can be counted counts, and not everything that counts can be counted’
It is true that not everything that we collect will be of use, but there is no way of predicting this at the outset. So there is a strong argument for ‘counting’ absolutely everything. And with the technology available there is very little we cannot count.
Anyway bring it back to healthcare with the examples:
Tracking and predicting epidemics: The Google Flu example is not a new one, however the essential insight that a set of, seemingly unrelated, keywords searched for in a particular locality can predict a flu outbreak is interesting. (in addition to flu related search terms) Google might, for example, tell us ‘Increased searches for chocolate bars correlate with a greater incidence of the flu’ in a specific geography, although we may only speculate on why.
Medication Adherence: All sorts of seemingly irrelevant data points, such as where you live, how long you have lived there, if you own a car etc can be crunched to predict your likelihood of taking your medication as prescribed. It is pure correlation. Buying a car won’t necessarily help you take your medicines at the right time. Again not a new example but an interesting and controversial use of #bigdata
Human health data: 16 different biological data streams were captured from premature babies, that when combined in the right way, using algorithms, were able to detect an infection 24 hours before it became visible. This means earlier more effective treatments.
In all these examples the data tells us What is happening but not Why . Big Data is there to predict but not to provide answers. If drinking orange juice and aspirin was to lead to remission in certain types of cancer patients, the what (i.e. remission) is more important than the why. Of course the why would be of immense interest in further study.
These examples only mark the surface of what is possible in healthcare. We miss a big opportunity as most of the data captured from patients, i.e. ECG data is just discarded. In most cases the systems are not in place to integrate the various streams of data and deliver meaningful insights.
All sorts of questions remain about who owns the data, and current data protection rules break down in this new world. How can you meaningfully opt into the collection and use of data, for a purpose that has not even been envisaged yet.
Big Data is Big News in many fields but surely, despite my bias, the advances in healthcare will be the most exciting.
Recently I presented a workshop on Social Media to a global assortment of patient advocacy groups.
An incredibly enriching experience, I walked away feeling I had learned even more than I imparted.
And that for me was a good thing – I loved hearing the groups share their successes and how they search for opportunities where Social Media can enhance the support they can give to patients.
The most significant thing that struck me was their incredible sense of purpose .
When you consider big companies, the goal is often ‘Just Do Social Media’, the sexy tactic waiting for a strategy.
These guys had an abundance of drive and clear goals, with Social Media a potential vehicle.
They were not interested in a Social Media project for the sake of it – it needed to be aligned with a greater purpose.
The group shared some incredible examples of their work, through committed individuals bound together as a team.
One such example was a change to one countries national policy in terms of reduction on medication copayment . Social Media clearly has the power to support such efforts.
It was interesting to hear some of the things that the group wanted from Social Media.
Enhancing their offline advocacy and public policy initiatives
Establishing more meaningful and enduring connections with patients and other important stakeholders
Planning the use of Social Media, to be able to respond quickly yet in the most appropriate manner
Helping patients to understand as much as possible about their condition and its management
Generally making sure they are using Social Media in the best possible way
It was great to hear this feedback directly from those at the front line rather than the usual insipid market research presentations.
The use of Social Media varied widely amongst the groups, so there is clearly a big opportunity to magnify the impact of their campaigns by using Social Media.
Indeed many were new to Social Media, but others were particularly established, caring for vibrant and burgeoning online communities. These communities offer mutual support and work towards a common purpose.
My biggest personal challenge was minding my language, not so much the expletives, rather speaking at the right pace, to a group of non-native English speakers.
I had to restrain myself from going into a 450 word per minute frenzy on this exciting topic and not peppering my vocabulary with technical and business jargon. The feedback was I managed this, although it required some serious concentration.
So I learned that objective setting for the patient advocacy groups is not a priority, as they are pretty clear on this already.
Areas they may need further support on are:
Understanding the tools available to understand the broader digital landscape in their therapy area
Aligning ‘traditional’ advocacy and public policy initiatives with Digital and Social Media
How to measure success and understanding what Social Media has contributed.
To be fair these are my assumptions not their requests – with the above recommendations I am probably guilty of self-marketing as I would love to be involved in more of these events!
Technology is getting emotional, thankfully not in a stroppy or petulant way.
It is not so much about computers expressing emotions, rather becoming more attuned to our own emotional states.
The Q sensor is one device that can monitor emotions and stress levels. An interesting application is in autism where it has been able to monitor stress levels, that are not discernible from the child’s expressions or body language.
The child can appear to have a very sudden ‘meltdown’ where in reality the sensor shows a gradual build up of stress and frustration, culminating in a sudden emotional crunch point.
Smart cameras that recognise emotions via facial expressions have also been used in autism, in this case predicting other people’s emotions. Autistic children, often unable to discern moods and expressions of others, are given feedback from the device, helping them be more sensitive to other people’s emotions.
These emergent devices have also been used in market research, e.g. assessing the impact of advertising. Rather than gain participant feedback solely via questions and self reported feedback, a much richer and authentic picture can be gathered via biosensors and cameras that track facial expressions and emotional response.
These devices have been proven to work effectively in the research stage, yet are still costly.
It won’t be long before they become mainstream and we are all using these devices.
Consider a specific medical example where a doctor is interacting online with promotional or educational content from a pharma company.
The content should already be tailored to that doctor’s specific needs and situation. The beauty of this technology is that it can add another communication layer, tailoring the content to the doctor’s mood and needs at a specific moment in time.
A doctor who normally loves rich data and detail, but who is busy and tired will automatically be provided a shorter summary. A doctor who becomes distracted could be quickly re engaged with a timely question or request to input some information, or being served up some compelling and entertaining content.
Scary? Intrusive? Well who would have thought we would be where we are now, the privacy we have been prepared to trade for various online benefits.
The possibilities are immense for marketing across all sectors.
And it wont be long before our computers have more emotional intelligence than the average medical sales rep. (Although some may say that day arrived long ago)
Almost immediately I felt a slight sense of frustration and embarrassment.
These feelings were not evoked by the ‘egocentric’ act of ‘Self Googling’ (honest), I mean everyone does that…don’t they?
The frustration was that Google perpetually (ahem yes I checked repeatedly) self corrected, assuming I was actually searching for another Gary Monk, (actually spelt with 2r’s and captain of Premier League football team Swansea City)
This meant I had to click through to the ‘right’ Gary Monk every time.
The acute embarrassment was not created, by finding something I would rather not see about myself online, rather by noticing that once I had clicked through to the ‘real’ Gary Monk, my most recent blog post was August last year.
Well I have been busy etc etc, but still my gut reaction was that I needed to post something, anything. Just write absolutely anything, at least with a revised date it will look more current!
The goal (no footy pun intended) I immediately set myself was for this blog site to be number 1 in Google and of course for Google to no longer assume ‘gary monk’ was a typo in favour of the 2R version.
I have cheekily employed some immediate tactics in this post. Not wanting to help the other Gary Monk (with 2Rs) in the search engine stakes I have refused to write his name correctly anywhere in this blog, referring to him henceforth as 2Rs. I have ‘generously’ used the name Gary Monk throughout this post, even in the blog title and alt tags of the images (in case you didn’t notice) in the hope that this increased ‘keyword density’ might appeal to Google when Gary Monk (1R) is typed into the search field (most likely by Gary Monk himself)
Maybe my blog will not have the gravity to usurp the captain of a mid-table premiership footy team, but it will make this Gary Monk feel like he is doing something positive towards his goal. Also I am not against 2Rs owning his 2R space but would prefer his gets his online hands off the 1R territory.
Now I am not entirely comfortable with peppering Gary Monk throughout this blog post especially resorting to speaking about myself (that’s Gary Monk to be clear) in the 3rd person in order to shoehorn a few more gratuitous Gary Monks in there, but it is a means to an end. (although I am not sure which of the 50 shades of Grey Hat SEO this falls under)
Longer term I have also committed to writing regular blog posts to meet my objectives of being Google’s preferred Gary Monk and getting this site to the top of the rankings.
After some reflection, I realised I have a goal of personal Google domination and at least the semblance of a plan to get there (admittedly it may need some work!) but I have not explored my purpose for doing this?
Is it ego driven? to generate some discussion and debate? provide useful content to the relevant online communities? for fun? to generate leads for my business? to increase my online presence and impact?
Any one of these is ok, if I am clear about it. I should of course establish success metrics where appropriate, for example being able to quantify business leads gained (or possibly increase in head circumference size for the more self-indulgent purposes)
However this quick fire reaction, actually means I am actually guilty of what I often challenge Pharma on, in the course of my work. The knee-jerk “We need to do this now and this is how we will do it” without exploring the purpose and what real success actually looks like.
‘Let us try to optimise our websites for search’ without considering whether any of our target patients or doctors will actually go there.
If we do get them to our website, what will they actually do differently as a result, what call to actions are in place to both drive and measure these behavioural shifts?
The list goes on… ‘we need to ‘do a social media campaign’, create a series of mobile apps, maximise hits on our site…’
These objectives are often formed without understanding how our audience or company will actually benefit as a result.
So then, I need to go back to defining my purpose, or simply wait for 2Rs to retire from professional football.