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Two decades of digital: the changing habits of pharma and HCPs

When Chris Cooper of EPG Health launched his ‘European Prescriber Guide’ software twenty years ago, he was among a select few taking digital in pharma seriously. Since then he has seen the industry slowly come to embrace every aspect of digital. He tells pharmaphorum how pharma can learn from the past to enter an innovative future.

“I always knew pharma was notoriously slow to adopt change,” Cooper says when asked about the unexpected digital changes he has seen in the industry over his career, “but I never thought 20 years ago that change would take this long in digital!”

Luckily, he says, the industry has now got to a stage where it is starting to think beyond just clicks and impressions and is treating doctors as consumers of valuable and relevant information – and there has been no better time for pharma to harness this to make their content more impactful than ever.

This is a path Cooper has been on for some time, though, and he was somewhat ahead of the curve when, in 2000, he founded the European Prescriber Guide, which aimed to give up-to-date prescribing information to HCPs via a software application.

Now the company, known today as EPG Health, is providing its offering through the website Medthority using cutting edge tech to hyper-personalise content for HCPs and provide information in a variety of formats.

A gap in the market

When Cooper started EPG Health, the digital landscape was very different.

“Market level affiliates would often be far more innovative with the use of digital on a tactical level – however, at a regional level, having conversations about how digital could be used as part of a multichannel strategy was extremely difficult.

“There were some exceptions to the rule – a handful of thought leaders emerged throughout the noughties, and the industry started to pay attention. People like Len Starnes formerly of Schering and Bayer, and Kay Wesley formerly of AstraZeneca.

“Those and others like them were catalysts for change in their businesses, and the sector. I didn’t always agree with everything they and others said (and made no secret of it), but did agree with the direction of travel, and continue to have huge respect for their contribution to our sector, and digital in particular.”

Unfortunately, Cooper says, thought leaders like these tended to be exceptions to the rule at that time, and meaningful conversations about what digital could do rarely happened at a strategic level, but instead remained “a pitch” at brand/tactical level.

“Consequently, projects would often have a ‘one off’ feel about them, rather than forming part of a wider strategy,” he says.

Since then, Cooper says, the industry has shifted its focus away from digital promotional activity and towards educational digital programmes.

“While some pharma companies are still quite internally siloed in their approach, we have seen, over the past few years, more clients with internal joined-up thinking around digital projects. We have seen a move from pure marketing-driven initiatives to multi-stakeholder involvement – including medical, marketing, and digital teams.

“We’re also starting to see longer term commitment to projects, with regular content updates, evolving goals, and a focus on activities that help build and sustain HCP engagement over time.”

As pharma’s comfort with digital has increased, so too has HCPs’ – but rather than making it easier to reach them in higher numbers, Cooper says this has led to more difficulties due to the vast range and volume of competing sources available to them.

“They are now using multiple devices and channels at home and at work,” he says. “They are always ‘connected’ but have become more selective, choosing where, when and how to access content. This means we have had to become much more creative, flexible and adaptable to their needs.”

Because of this, pharma needs to start creating content that specifically works for digital platforms, rather than just putting existing, channel-agnostic content online.

“HCPs consume highlights when they lack time, and therefore need quick access to key messages, short videos, intuitive instruction and interactive content – but they still require long-form scientific content for when they want to deep dive into the detail.

“We need to provide options to cater for the personal needs and preferences of individuals.”

From software to website

Like most companies, EPG Health has had to adapt to changing times to keep ahead of what HCPs want to see from pharma’s digital engagement – and its origins lie in Cooper spotting a gap in the market when digital was still in its infancy.

Doctors at that time were only able to access prescribing information through disparate forms of media, such as annual books or manuals, Excel spreadsheets circulated by email, and a handful of websites.

“Information was typically out of date by the time it was published and would often be published only once a year. This is all before the actual content and the variance in its nature and substance across the various media was even considered.”

Cooper says pharma at that time could best be described as “experimental” in the digital space – there was a lot of interest (and some investment), but few if any constants or strategies to encompass that.

“The rate with which new treatments or revisions to existing treatments came far outpaced the cadence of updates to the existing sources of information on prescription medicines.

“I felt an opportunity might exist to provide pure digital publishing solutions that could link pharma clients with doctors and other healthcare professionals in near real time.”

Cooper’s solution was to create a software application (delivered on a CD-ROM) that would allow users to browse available treatments for various conditions and diseases, and for those same users to be exposed to a form of interactive self-directed learning – sponsored by pharma companies – called ‘Knowledge Centres’.

“The software could periodically connect with a central server to pass back a log file detailing which product the user had viewed and what their search behaviour had been.”

The software was called ‘The European Prescriber Guide’, which became the ‘EPG’ in ‘EPG Health’ and launched in early 2002. With the rapid growth of internet access, the company was able to go online in 2003, simultaneously going from a predominantly European audience to a global one.

Since then, EPG has continued to evolve its offering based on advances in digital tech, and while Cooper’s goal to ease the discovery of medical information for HCPs has remained the same the way the company delivers this has changed significantly (see image below).

Now, 17 years later, the company’s current website, Medthority, is still adapting content based on HCPs’ use habits, but is starting to do so through the use of machine learning and advanced AI analytics – and like many in the industry, Cooper believes AI is likely to play an increasingly important part in the digital channel.

“It allows us to show doctors content that will interest them, is not repetitive and is logical based on their prior behaviours, or the behaviours of similar users,” he says. “It’s similar to how Amazon will show you items you or others like you might be interested in.”

Using AI like this, he says, drives very significant change in the way, depth and frequency with which HCPs interact with digital content, and will ultimately help pharma companies adopt a more personalised approach to digital engagement.

“If we can break down the central premise (i.e. the benefits of and argument for) a treatment into its constituent parts – a series of key messages – we can use the technology to expose doctors to as many of those arguments as possible, and also put them front and centre of the user experience.”

In general, Cooper adds that pharma should focus more on both the true power and potential of the technology (and how to plan and use it), as well as accelerated and deeper multichannel integration of digital channel capability across all communications, involving reps, MSLs, scientific meetings, third party platforms, social and email channels to effectively get their message heard – thoughts that have been backed up by EPG Health’s own research (outlined in a whitepaper Accomplish Meaningful Engagement Online).

Digital renaissance

Cooper says that his business has been fortunate to both survive and thrive through years of ups and downs in the industry’s relationship with digital.

“These times could roughly be subdivided into a near decade long period where many of our own customers were not quite getting what it was we did (but knowing it was important enough to buy it); then a renaissance where digital became part of the lexicon; to a third age of industry revolution where we – with thanks to our customers – have been able to invest in and harness the kind of technology I once only dreamt of.”

He adds: “We could not have done that without pharma, or the many who have believed in what we do and the driving vision along the way.

“There has been a cultural change in the role digital plays, and the sense that – finally – the significance of digital overpowers the ‘new car smell’ of the tech that has come and gone, and will continue to come and go.”

He says that the industry needs to work much harder now than it did ten, or even five years ago to achieve digital engagement excellence.

“It is much more complicated and resource heavy than it was. While our technology played a large part in defining our business for two decades, we came to realise that our business and its transformation was about so much more than just the technology.

“In fact, our digital transformation was evolving so fast that our technology could not keep pace, and we had to accept that we could no longer develop and maintain it in-house. To stay ahead, we decided to outsource and use PaaS with AI, machine learning and data handling that would allow us to grow and meet future digital demands and behaviour of HCPs.”

This has allowed EPG Health to focus on other important components of transformation that don’t relate specifically to the technology.

“This includes introducing the right personnel, structure and processes to help us work effectively with evolving technology and our multi-stakeholder customer teams, including optimising content for digital consumption, multichannel integration, virtual events, etc.”

On the up and up

Cooper says that he still sees the industry facing many challenges in its digital engagement (see the top 10 challenges) – and one area in particular where more work still needs to be done is bringing understanding and true digital expertise into pharma and unifying that expertise into multidisciplinary customer teams at a tactical level.

“Having knowledge of the technologies, the capability of the technology, and the nuanced nature of digital work would hugely benefit customer teams, how they invest, and what return on investment they secure.

“Often, it feels that this competency is left to chance at strategic level by the customer organisation, with the corporate organisation gambling that the protagonists in their tactical teams have that knowledge, or that vendors like us will fill the gaps.”

Cooper says that although many customer team leaders are adept and knowledgeable in terms of what digital does in broad strokes, even today he sees a continuing focus on numbers of impressions and not enough focus on quality of engagement metrics, such as behaviour change and how many strategic targets were reached with the key educational messages.

“If a digital project is not thought through, planned and executed properly – in all regards from the key educational messages, the way those are presented for consumption, and how that consumption is measured etc. – then we are left with an overly-simplistic measure of ROI.

“In fairness, that is where we ourselves were perhaps 10 years ago, but today it is simply not good enough, and dramatically underestimates the potential that can be unleashed by leveraging the right expertise, domain knowledge (from the customer and our own teams), and the technology –  all combined and working in concert.

“The capability to understand engagement and behavior change is here now, and we need to get past basics such as volume of X user reached and look at how people engage, react and what they do next.”

He adds that it is key for companies to know their strengths and weaknesses.

“The ambition and will is there for pharma, but digital transformation involves a rapid and unified company-wide journey. That’s really difficult, and often there are too many obstacles to overcome, projects take too long, cost too much and will eventually be abandoned without external support.

“This might be solved by outsourcing, as we found.”

Nevertheless, Cooper remains optimistic about the future of digital in pharma.

“The industry is far better aligned with digital now than it has been at any point in my career. Most – if not all – of our customers are digitally native. That was not the case 20 or even ten years ago, and it makes a huge difference.

“Talking to customers today who expect (and are used to consuming) best-in-class digital in their everyday life  – and so recognise ‘good’ for themselves – has been one of the key drivers behind the change we have seen, in particular in the last five years. Digital now sits front and centre for many customer teams.”

About the interviewee

Chris Cooper

Chris Cooper
Chris Cooper is the founder and chief executive of EPG Health. He has 30 years’ experience in digital, 20 of which are in the health sector. In that time, he has grown a digital business and led the evolution of its medical website for healthcare professionals, including the technology, content, commercial offering and people. He has been a consultant to pharma, workshop leader and advisory board members on digital marketing. He is currently looking for investment to grow the business further.

About EPG Health and Medthority

EPG Health Logo
EPG Health is the publisher of Medthority, an independent medical website for healthcare professionals (HCPs). Supporting modern digital behaviour and preferences, Medthority provides a trusted learning environment with convenient access to content that drives better treatment decisions and patient outcomes. With an actionable reach of over a million HCPs globally, EPG Health provides pharmaceutical companies with an integrated toolset to reach and engage target audiences with Key Educational Messages (KEMs) while measuring the outcomes.

For more information visit www.epghealth.com

About the author


George Underwood is a senior member of the pharmaphorum editorial team, having previously worked at PharmaTimes and prior to this at Pharmafocus. He is a trained journalist, with a degree from Bournemouth University and current specialisms that include R&D, digital and M&A.

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