Social Media Wiki

2010 Dose of Digital Dosie Award Winners

It’s been a long time in the making since we first announced the Dosie Awards back in March. It’s now time to tell you the winners. I just finished announcing the winners at the BDI conference “Social Communications & Healthcare: Case Studies & Roundtables” to a packed house of about 350 (standing room only) people. If you want a copy of the presentation I gave there, you can download it here (PDF file): 2010 Dose of Digital Dosie Awards Winners (1367 downloads).

As a reminder, the Dosie awards were created to find the best examples of social media in pharma and healthcare. The nominees for the awards were drawn from the Pharma and Healthcare Social Media Wiki you’ve seen on this blog. If a site or program was listed on the Wiki, then it was a nominee. This means there were about 550 nominees, so we had to pare this list down to a set of finalists. You voted for the finalists and we revealed the finalists a few weeks ago. You then voted on the finalists to pick the ultimate winners and now we have them. For the Pharma Company of the Year in Social Media award, a company needed to have at least five entries on the Pharma and Healthcare Social Media Wiki to be nominated.

A few stats about the contest:

  • 500+ nominees
  • 700+ #dosie tweets
  • 400+ Facebook shares
  • 3500+ votes over two rounds

For those who have wondered who actually voted in this contest, the results might surprise you. We asked an optional question in the ballots and here is how people identified themselves in the final round voting:

  • >50% “patients”
  • 15% “caregivers”
  • 10% “industry service providers”
  • 5% pharma/healthcare manufacturer employee
  • 5% HCP
  • 4% “consumer advocate”

And, for those who are wondering which pharma companies had the most Finalists, wonder no more:

  • Johnson & Johnson – 6
  • sanofi-aventis – 4
  • Novo Nordisk – 3
  • Pfizer – 3
  • Roche – 2

This contest also yielded some really interesting insights for me. I’ll share some specifics about that later in this post. In fact, the Dosie Awards were a bit of an experiment and demonstration. What I wanted to demonstrate was three things:

  1. The power of social media
  2. Our lack of control of social media
  3. The tremendous opportunities of social media in pharma and healthcare

Based on the participation in voting, the winners, and many of your comments, the demonstration was a success, but more on that later. Let’s get on with the winners. If you don’t like or agree with the winners, don’t blame me…you voted for them. I’ve included a bit of my commentary about the contest and the Finalists and winners later in this post.

2010 Dosie Award Winners

-

There were 10 categories in this year’s awards:

  • Brand-Sponsored Patient Community (Communities created by a pharma or healthcare company for a brand or corporate effort)
  • Patient Community – Non-Brand Controlled (Communities created with no direct affiliation to a pharma or healthcare company)
  • Healthcare Professional Community (Communities exclusive to healthcare professionals)
  • Facebook Page (All pharma and healthcare Facebook pages and apps whether corporate-sponsored or not)
  • YouTube Channel (Pharma and healthcare company YouTube pages or videos including corporate and brand specific efforts)
  • Twitter Feed (Pharma and healthcare companies using Twitter at a corporate or brand level)
  • Company Blog (Pharma and healthcare company created blogs at the corporate or brand level)
  • Patient or Caregiver Blog (Blogs created by patients or caregivers, not owned by a pharma or healthcare company)
  • Industry Observer Blog (Blogs created by industry observers and commentators…like Dose of Digital)
  • Pharma Company of the Year in Social Media

There are three award levels in the Dosie Awards: gold, silver, and bronze. Each category has five Finalists. Just making it as a Finalist is quite an achievement since some categories had as many as 50 nominees. All Finalists can proudly display the Finalist badge on their site to show the world that, according to the voters, you’re among the best in healthcare social media. Here’s the nifty Finalist badge:

The winners will  get to display either the gold, silver, or bronze Dosie Award badge on their site:

Below I’ve listed the finalists for each category followed by the winners at each level (gold, silver, bronze).

Enough already…here are the winners:

Best Brand-Sponsored Patient Community

Accu-Chek Diabetes Link

Children with Diabetes

Crohn’s and Me

Diabetes Handprint

Voices of Diabetes

Winners

Children with Diabetes

Diabetes Handprint

Accu-Chek Diabetes Link

Best Patient Community – Non-Brand Controlled

American Diabetes Association

Crohn’s and Colitis Foundation of America

dLife

Juvenation

TuDiabetes

Winners

dLife

TuDiabetes

Juvenation

Best Healthcare Professional Community

doc2doc

Medscape Physician Connect

Ozmosis

Sermo

SocialMD — this site was voted in as a Finalist, but was not eligible to win since it no longer exists

Winners

Medscape Physician Connect

doc2doc

Sermo

Best Facebook Page (pharma or healthcare company)

Changing Possibilities in Hemophilia

The Coalition to Prevent Deep Vein Thrombosis (DVT)

Gardasil

Johnson & Johnson

sanofi-aventis VOICES

Winners

Johnson & Johnson Corporate

The Coalition to Prevent Deep Vein Thrombosis

Changing Possibilities in Hemophilia

Best YouTube Channel (pharma or healthcare company)

GoInsulin

Johnson & Johnson Health Channel

Mayo Clinic

Pfizer Europe

Pfizer UK

Winners

Go Insulin

Johnson & Johnson Health Channel

Mayo Clinic

Best Twitter Feed (pharma or healthcare company)

AF Stat (@AF-Stat)

Expressions of Kindness (@xpresskindness)

Johnson & Johnson (@jnjcomm)

Race With Insulin (@racewithinsulin)

Roche (@roche_com)

Winners

@racewithinsulin

@jnjcomm

@xpresskindness

Best Company Blog (pharma or healthcare company)

Advancing the Science (Mayo Clinic)

GSK More than Medicine

J&J BTW

Pfizer Think Science Now

Red Cross Chat

Winners

Advancing the Science (Mayo Clinic)

JNJ BTW (Johnson & Johnson)

Red Cross Chat

Best Patient or Caregiver Blog

Beyond Meds

But You Don’t Look Sick

DiabetesMine

Lemonade Life

Six Until Me

Winners

Six Until Me

Diabetes Mine

But You Don’t Look Sick

Best Industry Observer Blog

ePharma Rx

Pharmalot

Pixels and Pills

Roska Digital

Wall Street Journal Health Blog

Winners

ePharma Rx

Wall Street Journal Health Blog

Pixels and Pills

Pharma Company of the Year in Social Media

Allergan

AstraZeneca

Bayer

Boehringer Ingelheim

Eli Lilly

GSK

Johnson & Johnson

Novartis

Novo Nordisk

Pfizer

Roche

sanofi-aventis

Shire

Winners

Roche

Johnson & Johnson

Novartis

Congratulations to all the winners! If you would like to display the badge on your site, you can copy it off this page or contact me and I can get you a higher quality image that you can adjust to whatever size you need.

Commentary

-

I should say at this point that the Finalists and winners didn’t at all surprise me. That doesn’t mean that I agree that they are necessarily the best examples out there, but rather that what happened was exactly what I expected to happen. That is, the only thing I knew for sure was that it would be impossible to predict the winners or Finalists and that literally anyone could win. That’s the thing with social media and is part of my demonstration…you don’t control the conversation, you don’t control the debate, and you don’t control the outcome. If you try to exert control, it just might all collapse around you and make matters even worse. I chose not to try to influence the voting in any way or restrict how many people and who could vote for what. The only rule was that there was one vote per person. Anyone was free to vote for who they wanted, for whatever reasons they wanted.

You might argue that this format means that the awards wouldn’t necessarily find the best examples, but the most popular. That’s not quite true. What this format does is exactly what I outlined in my original post about the awards. When I explained that there wasn’t formal voting criteria, I did add that this: “This year’s Dosie Awards will focus on finding the best uses of social media in pharma and healthcare.” So, you might argue that those sites and programs that used social media the best (i.e., most effectively) were the ones that won. In many cases, this was true. Some winners and Finalists are great programs and they effectively used social media to get people to vote for them. Other programs that I’d say are mediocre won because they were able to use social media to get people to support them. This leads me to the demonstration I was attempting with the Dosie Awards.

Yes, the awards were designed to find the best examples of social media in pharma and healthcare, but there was also a secondary goal…this demonstration. I wanted to demonstrate was three things:

  1. The power of social media
  2. Our lack of control of social media
  3. The tremendous opportunities of social media in pharma and healthcare

My hope was that this demonstration would help us all understand social media a little better and how best to use it (and not use it). So, the Dosie Awards were more than a contest, but also (I hope) a bit of an educational session for all of us. Here are my thoughts on  each of the three things I wanted to demonstrate.

The Power of Social Media

When I opened the awards to public voting, I figured that a few people or groups would be really successful in getting others to vote for them. What I didn’t anticipate was that  they could start a mini-movement within the awards. For those paying attention, you’ll notice that the Brand-Sponsored Patient Community,  Best Patient Community – Non-Brand Controlled, and Best Patient/Caregiver blog categories were dominated by diabetes sites. Of the 15 Finalists in these categories, 11 were diabetes-related (and also the Gold winners in each category). How’d this happen?

Well, some of the diabetes communities who rallied their members to vote for their community also mentioned that people should vote for diabetes sites in other categories. It was a really smart way to bring even more awareness to diabetes via this contest. It just so happens that, in my opinion, many of the diabetes sites that were Finalists are some of the best examples of social media use out there. We could all learn a bit from them, so it’s a good thing they got some additional exposure.

To further show the power of social media, some less well-known, but well-promoted sites also were Finalists and winners. A couple of examples that come to mind are Changing Possibilities in Hemophilia (only 206 “Fans” on Facebook) and @xpresskindness (630 followers now, but only 420 when the contest started). For Changing Possibilities in Hemophilia, they put out messages on their wall asking for people to vote for them. @xpresskindness’ inclusion is a bit more of a mystery, as they did no promotion that I could find, but managed to get support from someone (perhaps the agency that created it?). However it got there, it got there thanks to the power of social media. Without social media, neither of these programs would have been Finalists. They would have been overshadowed by much larger, more well-known programs, but social media sharing gave them a chance to win. Another great example was doc2doc beating out Sermo, which has many times the number of members, or how Roche (2 Finalists) beat out J&J (6 Finalists) for Pharma Company of the Year in Social Media.

One final demonstration of the power of social media is how quickly this contest spread. There were more than 400+ Facebook shares and 700+ tweets that used the #dosie hashtag (and a bunch of others that didn’t). In addition, votes came from all over the world (30 different countries at last count). Without social media, would any of these people have found out about the contest?

Our Lack of Control of Social Media

This goes hand in hand with the power of social media. It’s not always going to work out the way you want it or how you expect it to work out. This contest was a great demonstration of this. I’ll go back to the domination of some categories by diabetes sites as an example to demonstrate my point here as well. I certainly wasn’t planning to have one disease state exert this much control over the awards and, yet, this is exactly what happened. I’m not saying it’s bad, but it’s not what was planned.

One thing that was certainly not planned was SocialMD showing up as a Finalist. It was among 30+ nominees in the Healthcare Professional Communities category. After seeing that it made it in as a Finalist, I decided to check it out a bit more, as I wasn’t very familiar with it. Turns out that SocialMD doesn’t exist anymore and hadn’t for about 4 months. And, yet, it was among the top vote-getters in this category. We very carefully audited all the votes in this category and were not able to detect anything fishy. So, why would a defunct site end up with this many votes? I have no idea and haven’t been able to figure out why (if you know, please let me know). If the voting is open, as it was, there’s not much control that you have over who wins and that’s just what happened. I certainly didn’t want a defunct site to be a Finalist, but it wasn’t up to me. I did decide to take it out of the running for any gold, silver, or bronze awards though, which I think only made sense.

One more example would be Pfizer UK‘s YouTube channel, which was a Finalist. Far from a channel, there’s only one video on the channel (I must admit that it’s good though). Combine this with the fact that Pfizer Europe‘s YouTube channel was also a Finalist. How’d this happen? That’s an easy one…support from Pfizer. It’s tough to say that Pfizer UK’s channel is a good one (especially when you compare it to the winners), but that wasn’t the competition. The most votes won. It was out of my control, just as much as what happens in a lot of social media is out of our control.

The Tremendous Opportunities

When I announced the awards and listed the nominees (all 500+ of them), I got emails, DMs, and calls from about 10 people who all had a similar concern. They each thought that having this many nominees (50+ in some categories) would make it impossible to select a winner. Their main concern was that they weren’t familiar with all of the sites to make a fair comparison and that it would take a long time to go through them all. And, to be sure, these are some of the people that I consider among the most knowledgeable about this space, so for them to say that they weren’t aware of everything tells me that most people are in the same position.

A few people urged me to cut the number of nominees to a more manageable amount, but I let everything on the wiki count as a nominee for a reason. I wanted people to be overwhelmed by the number of examples. That was the point. While some of the sites and programs on the wiki have a long way to go before they are ideal, there is no shortage of them. That is, there are a bunch of examples of pharma and healthcare companies using social media today. They aren’t waiting for guidelines that might never come (or be terribly negative and restrictive), they’re out there now. If your strategy is to wait because it isn’t clear what can be done, I’d call your attention to the Pharma and Healthcare Social Media Wiki where you can see 300+ industry examples of social media programs. 300+ examples of your direct and indirect competitors using social media to reach their customers today. What are you waiting for? 300 more examples?

Of course, there is one warning that comes with all these examples as well. During the course of the awards, I hope that people got to see programs that they didn’t know existed in disease states they didn’t think had much social media activity. I want people to see the list for one more reason beyond letting them know that it’s all right to do social media programs. I want people to see the list for the exact opposite reason too: so they DON’T do social media programs.

I’m not saying to avoid all programs. I’m saying to avoid creating something that already exists. There is no need to have 5 different support communities for a certain disease. Doing this makes each community a little weaker, as it dilutes the wisdom of the group. But, some companies can’t resist and insist on having their own community despite the fact that there’s no need or call for it in the market. That’s a waste of time and money that could be better spent (donating that money to help cure the disease in question is a good start). Instead of creating another community that essentially already exists, how about working together? How about directing your customers to a resource that is already working well and that members are getting real value from today? That might require (gasp!) you working with a competitor. However, nearly every pharma company now has something like “patient health first” as part of their vision or mission. Well, creating another community that’s  drain of resources isn’t putting patients first.

Need an example?

There are 12 multiple sclerosis (MS) specific communities on the wiki. That doesn’t even count the MS communities on sites like Patients Like Me.

12.

Do we really need 12 or would everyone be better off if these people could all go to one place and share their knowledge and insights with everyone else? I think the latter would be a richer experience for everyone. My point? Before you jump in and create something in social media, especially a community, see if one already exists. If one (or 12) exists, then you need to ensure that your community offers something well above and beyond what’s already out there. If  you don’t, you might be wasting your money, which could be used much more effectively somewhere else.

Final Thoughts

It’s been a month and half since announcing the Dosie Awards and it’s been an interesting and exciting time for me. Thank you to everyone who voted, tweeted, or otherwise supported the awards. I hope that you got something out of the process as well. Next year there will be even more categories as we expand beyond social media to other digital technologies and platforms. For now, congratulations to the winners!

Can Your Electric Bill Show Us How to Improve Medication Adherence?

Dose of Digital Mini White Paper

I’ve talked about medication adherence a few times on this blog including some thoughts on how to improve it (most recently: “The Only Way Pharma Can Improve Compliance: Fun“). [Quick disclaimer: I'm using "compliance" and "adherence" a bit interchangeably in this post. I know they're different, but I'm going to spare a big debate. Just go with it. Thanks.] It’s certainly not an easy challenge and one that no one has figured out yet. There are certainly incremental improvements that have been made over the years, but we have yet to discover a “magic bullet.” But perhaps there isn’t one. Instead, maybe there are a number of different “cures” with one working for one person and another working for someone else. If we believe this is the case, then the only way to find these “cures” is to try something. In fact, we’ve got to try a number of different things, see what works, and throw out what doesn’t.

One area where I think a big impact can be made is in game theory. That is, using the concepts and theories of this field of study to help improve adherence. I’m going to cover this concept in more detail in an upcoming post, but the short version goes like this (via Wikipedia): “Game theory is a branch of applied mathematics that is used in the social sciences, most notably in economics, as well as in biology (most notably evolutionary biology and ecology), engineering, political science, international relations, computer science, and philosophy. Game theory attempts to mathematically capture behavior in strategic situations, in which an individual’s success in making choices depends on the choices of others.”

Classic Wikipedia definition, so here’s the English: Don’t worry about anything but the last part of the definition.  As you likely have observed, we humans don’t make perfectly predictable or rational decisions when it comes to health, but game theory could be used to figure out that these decisions might not be so irrational after all. There’s certainly application when it comes to medication adherence where even for life-threatening conditions, adherence rates remain startlingly low.

For those of you who read the last part of the game theory definition carefully, you might be a bit puzzled as to why this applies to adherence. It ends with: “…an individual’s success in making choices depends on the choices of others.” What do the choices of others have to do with your behavior especially when it comes to adherence? Again, more to come in future posts on this topic, but the short explanation is this: the decision as to whether or not to take your medication as prescribed is equally influenced by factors you develop for yourself as factors that others develop. In other words, the reasons you use to justify whether or not to take your medication come in equal parts from your beliefs and perceptions as they do from the people around you. You’re not the only one who determines whether or not you take your medication. Other influencers include spouses, children, doctors, nurses, pharma companies, friends, pharmacists, and many others (and in different orders for different people). Yes, ultimately, you have the final decision, since you’re the one putting the pill in your mouth, but you aren’t the only one with a say in what you do.

The question then is this: which behaviors of others have the biggest positive influence on a person’s adherence?

This is where the real gaming aspect comes into play. As humans, we are genetically programmed to want to be winners. There is no second place in evolution. For that reason, many of our behaviors are geared to ensure our genetic success. This is why find spouses and take care of our children. It’s a primordial drive in all of us. In most cases, we strive for our genetic success over others. This is far more pronounced in the animal kingdom where you can watch males square off (sometimes to the death) for the right to mate. We humans don’t exactly do this, but sometimes we do either literally or figuratively (see any reality TV show for examples).

Since we’re programmed to want to come in first, that means we’re similarly programmed to not want to come in last. This is one of the big motivators in game theory and the explanation behind the problem, Prisoner’s Dilemma.

The question is, can this same fundamental theory apply to medication adherence? I think it can. But first, you should know where this idea came from.

I recently read an article in USA Today, “Do you use more energy than your neighbors?”, that talked about how some electric companies were trying some innovative things to reduce their customers’ use of electricity (interesting…wonder if pharma companies would be interested in helping reduce their customers’ use of their drugs?). There are a few reasons why the companies are interested in doing this, but I won’t get into them here. It also turns out that these companies have tried a number of things, but finally hit on an idea that involved comparing customers’ electricity use to that of their neighbors. This is the basic idea of what it looks like:

(Image from: Treehugger)

Well, imagine that this was your electric bill. What would you think? Would this be enough to get you to make a change? It probably won’t make you run out and buy solar panels for your roof, but I bet it will be in the back of your mind when you leave a room and don’t turn off the lights. This bill would be pretty hard to ignore for most people and most would make some minor changes even if the changes were subconscious. Game theory at work…no one wants to be last. This is especially true when your identity is attached to last place. Of course, here the information is anonymous (i.e., no one knows which specific neighbors are included), but you know where you stand. While you don’t like to be in last, you also don’t want someone else to be in first place. The higher your use of electricity the easier it is for everyone else to exceed the average (mean) performance. After all, you’re the one skewing the average much higher. So, you reduce your usage to both move yourself up in the standings and also to make it harder for others to achieve what they want. This, of course, motivates others to perform even better. In cases like the electric bill where it isn’t a zero-sum game, one person winning doesn’t mean that everyone else loses, there are grades of “winning.”

This innovative idea was presented at a recent TED conference and you can see the presentation below if you want to find out a little more. However, for now, know that this program has reduced electricity use by around 2-3%. As USA Today put it: “While that may sound small, the savings add up. The Sacramento Municipal Utility District, which started sending the reports to 35,000 households in 2008, says the households saved enough energy in a year to power 800 homes for a year.” That’s meaningful. Over time, I’d expect that these numbers only improve as people do more to try to be among the most efficient.

Here’s the TED talk:

Now, let’s apply this same concept to medication adherence. Let’s say that we knew you were on a chronic medication and how often you took this medication. What if you got a report each month that showed how often you took your medication? What if this report not only had your adherence rate (actually compliance rate, I suppose), but also that of others taking the same medication? If you found out that your rates were well below the average, what impact might that have?

Of course, it’s not this simple…here’s why…

First, you need a way to track someone’s adherence. I’ve already told you that people don’t really use trackers, so we’d need a solution for that piece. Among big reasons why people don’t use these trackers is because they’re hard to use and there’s not a real motivation to use one. Plus, they aren’t fun. Now, if you knew you were in a competition against others and the only way to ensure that you got proper “credit” in this competition is to track your actions, would that motivate you to track your actions? The answer is “it depends,” but, to be sure, this is a proven, effective model to get people to track their actions. Look no further than foursquare. Make no mistake, foursquare is a game. Period. The only reason why people get so religious about checking in is to steal mayorships from others and maintain their own (and get badges). Take mayorships away from everyone and I guarantee that foursquare goes away overnight. So, perhaps by adding a little competition to the mix, you can get people to track their medication use. Alternatively, you can use pharmacy refill data as a surrogate for adherence.

Second issue…privacy. All of this, of course, would have to be opt-in…or would it? If all the data is de-identified and pooled, there isn’t a privacy issue. And if people are actively using some tracker, then you can ensure that there’s a proper opt-in. If you can show that people get a benefit from giving up a little privacy, you’ll also be successful.

A few more details we can consider: what if the report that people got wasn’t just the numbers, but also included tips for how to improve your adherence and also medication-specific stats on why taking the medication is important (e.g., reduced mortality rate by X%).

The question then becomes: is seeing your rates compared to others enough of a motivator to get you to change your medication adherence? It’s probably not for most people. While we don’t want to come in last place, we also choose not to be involved in some “contests.” Just having a higher rate probably isn’t enough bragging rights to make it worth the effort. So, let’s up the ante. What if the standings weren’t in compliance rates, but in years left to live instead? On average, we can show for some drugs that there’s an improvement in mortality or other outcomes by taking your medication as prescribed for as long as your doctors deems appropriate. So, instead of showing that you took your medication 45% of the time and the average was 65%, we show that your additional years of life gained from taking the medication was 1.2 and the average was 2.5. That’s a game worth winning.

This wouldn’t be an easy system to implement, but it could be done reasonably simply via smartphone applications. There’d need to be a little data crunching to get to the outcome data, but it could be done for a lot of medications (just look for the pharmacoeconomic data to get started). Stay tuned in future posts for more of my thoughts on how we can use basic game theory to improve all sort of things in healthcare. In the meantime, feel free to give me your thoughts and turn off some lights. You don’t want to be in last place, do you?