Is ROI the Holy Grail of Medical Education?

Webinar Transcript

Lee Altenburg: Hello, everybody. Welcome to my webinar on medical education measurement. My name is Lee Altenburg, and I am the Vice President of Analytics for Avant Healthcare and I have been living and breathing in the world of pharmaceutical analytics for almost 20 years now, which is hard to imagine. I've been on the client side at Eli Lilly and at Pfizer, and also on the vendor side at DS Associates, and now at Avant Healthcare. So, measurement is near and dear to my heart.

So, today, for the next, oh, 15 or 20 minutes, I'm hoping to share some ideas with you around ROI and, specifically, whether ROI actually is the Holy Grail when we think about medical education measurement.

So, hopefully, we can have a dialogue at the end. I'd love to hear from you and hear about your experiences. So let me share some ideas, and then we'll open it up to the broader group.

Just as a quick housekeeping, if you have any issues hearing me, seeing the slides, feel free to send a note via chat. You'll see a chat feature, and I've got a whole team working here to answer any of your technical issues.

Okay. Medical education is a huge value add to healthcare professionals. We see it through the research. They value this peer-to-peer interaction. I think the challenge we have as a pharmaceutical industry, is how do we actually quantify that value and how do we understand the portion of that value that's really coming from medical education when we think about the multitude of channels that a healthcare professional is exposed to?

So we kind of think about ROI as the Holy Grail. So when we think about "Let's move the needle," what's successful? Is ROI really our metric that's most critical? Or are we actually overlooking some other critical metrics?

First we're gonna do a little bit of a history lesson. So, I think traditionally, most of the criteria we use when we think about whether or not a medical education initiative is successful or not is around, "Hey, how many people actually attended? How many people came to our dinner program? Who were they? Were they healthcare professionals? Were they nursing staff? Were they office staff? Who are those folks?"

So as kind of vulgar as it sounds, we talk about butts in seats. I think for many years we've talked about how many people are filling our programs, and we also think about, "Are those folks the brand targets?" We know our brand teams spend huge amounts of time, resources, valuable dollars on developing brand strategies and really coming up with core segmentation of our customers. And as we think about it, how many of those customers that attend our medical education initiatives are actual targets?

So I think brand teams today spend a lot of time thinking about, "What's the percentage of targets that are attending?" I definitely believe that that's a core part, but what might be overlooked is what are those core beliefs of our customers, both before an initiative, during a medical initiative, and right after? Is our medical content actually moving the needle on informing our healthcare professionals about those core therapeutic area and disease state objectives?

Then, ultimately, are those core beliefs translating to behavior change? So are our core customers actually showing a change in behavior, whether that be measured by sales impact, prescription changes, a couple months after?

So, as we think about ROI, I think most people probably think of ROI as sales change or sales impact. Most brand teams do a good job of measuring ROI of this channel. Now, it definitely happens, probably during the brand strategy planning process each year. I think, on an annual basis, brands do a great job at really evaluating that behavior change. But is that behavior change also taking into account whether those core beliefs and perceptions were also changed?

So, as I think about ROI, I think ROI is an excellent measurement tool. But, is it inconsistently both defined upfront and applied? I see some of those inconsistencies not just from pharmaceutical company to pharmaceutical company, but also brands and products within the same company. It's really this single dimensional metric, and I would argue ROI is actually not a great decision-making tool. I think it overlooks some key components and concepts that a really well-rounded measurement approach should include.

So, what does good look like? We hear that term quite often. So, when I think about measurement, I think, "It has got to reflect this new multi-channel model that we are living and breathing in in the world of pharmaceuticals." We have new multi-channel strategies that look at a customer across the multitude of channels that we're interacting with them on, and does our measurement really assess those strategies?

Are we really understanding the core brand strategy and associated market objectives for that strategy? How do we evaluate whether we're moving the needle on those core objectives? Are we gauging customer experience and the associated financial impact?

As I said before, brand teams only have a certain number of resources. So, the dollars are not limitless. As we think about the measurement plan, how do we help those brand teams prioritize their spend, determine that ongoing investment, and really understand if we have one more dollar to spend, which channel will we get the biggest bang for our buck?

So I do think we need a really well-rounded approach that takes a multitude of components of measurement and helps provide insights from that integrated measurement plan.

So now I'd love to hear from you. Hopefully, we'll get some interesting insights. Which of these components ... and, again, this probably isn't the exhaustive list, but which of these components, when we're defining good measurement, do you think is most important? So if you could look at the list above and choose two—hopefully, it's easy to click on the top two—I'd love to get your thoughts. We'll take just a second.

Results are coming in. I know this is hard. I'm asking you to pick your favorite children here. As I think about these, it's hard for me to prioritize and gauge.

Okay. We will go ahead and broadcast the results, so you can see what the top ones are.

We'll go ahead and end the poll. Perfect.

Okay. So, it sounds like the top results were really helping to prioritize that spend and evaluating the return on some of the marketing objectives.

So, I kind of led the witness here. I actually think they're all important, so I can't choose one of my favorite children. I actually think, to have a truly well-rounded measurement plan, we've gotta do all these things. And look, this list probably isn't exhaustive, but I think, in this complex pharmaceutical analytics world that we're living in, we've got to get better and probably move the needle and push things farther than we're really used to pushing.

So what do I think is missing? So as I've kind of been on both sides of the coin, both at the client side and on the vendor side, I really think we do a great job at measuring overall activity and seeing who was engaging with us from a medical education perspective. And I also think we do a good job of measuring behavior impact.

What I think sometimes we skip over is really that belief change—so laddering up those core customer beliefs to the behaviors that we're trying to change.

So how do we really measure those core beliefs? Again, align them to each core behavior change and build it into a plan that not just includes medical education, but also the other channels. I think that's really where we have an exciting opportunity to move the needle and get a little bit more sophisticated in our measurement.

So, at Avant Healthcare, we've developed a medical education measurement framework. So, as we think about, "How do we assess the overall effectiveness of our investments and the associated tactical recommendations," we've got four key components you'll see here on the left side. The top, which is really the base level metric, and then we get deeper as we go down the list at the bottom.

The top is about overall exposure. So, for example, how many customers are we actually exposing to our medical education content? In the example you'll see on the right is that we've invited 100 healthcare professionals to a dinner program.

Now, we know not all 100 of those healthcare professionals are going to choose to engage with us and actually attend the program. So maybe we have 58 that actually attend. That would be the interaction phase of this measurement framework.

Then the next phase is all about experience. So of those physicians that chose to attend the program, did we move the needle in the core perception and belief metric? Did they have a reported and improved perception change based on the content that they heard?

Again, I think this is the phase that we see sometimes folks skipping over. We do a great job at monitoring, on an ongoing basis, the exposure and interaction, and then we move directly to impact. I think we have an opportunity to really focus on the experience piece as well.

So, impact is what we traditionally think of as ROI. This is really about behavior change. What actually changed? And a lot of times, we measure that by sales impact. There's a multitude of different metrics, but it's really about core behavior change.

And again, I think most brand teams, we do this, whether it be definitely on that kind of annual process during brand planning. But we also do it, I think, at core intervals after key promotional interventions.

So, I'd love to get your thoughts. We're gonna have another question come up. I wanted to get your thoughts around HCP interaction with pharma. So I'm gonna read a statement, and then I'd love your thoughts.

Some healthcare professionals receive one contact from pharma per hour every day. Do you think this is too high, too low, or about right?

So results were already coming in, which is great, before I even said it. As you're voting here, I think we all know that doctors can be inundated by pharmaceutical companies and the multitude of ways that we engage with them and contact them.

So, I'll broadcast the results here. It looks like we had about 53% say that that was too high. Only 15% said too low, and 30% was about right.

Well, you're right. It was about right. So, what we see from some research from ZS Associates is that some HCPs receive one contact every single hour per day from pharma. So let that sink in a little. Doctors are people, too.

As we think about that, how do we leverage channel preference data that is now readily available from a variety of vendors to really help deliver the right message at the right time via the right channel to the right sequence? I really think it behooves us to think about how we're engaging and what types of content we're engaging our physicians on.

So one example here, if you look at the graph here on the right, is data from ZS Associates' AffinityMonitor database. What this shows is overall engagement rate from healthcare professionals on the X axis. On the Y axis, it's type of content that pharmaceutical industries are serving up to those prescribers.

I'd like you to focus here on this dot, key opinion leader and peer opinion and insight. It has one of the highest engagement rates of all types of content. What does that mean? Doctors want to hear from their peers. They value the interaction and the knowledge and the content they get from peer opinion leaders.

So, not only do we need to really leverage and unlock this channel preference data, but let's use it to help develop that multi-channel strategy. What I think is most important is the measurement plan associated to it. So, then we can truly understand and analyze the engagement across these channels and figure out where we might need to adjust things. How do we leverage this data to develop that plan? The data is so rich now, it really behooves us to use it in the best manner.

So, another example I'd love to walk you through is really around the buyer journey. So I know within the world of pharmaceuticals, we talk a lot about physicians and how do we get them from kind of the baseline awareness of our brand to the overall retaining them as a core customer?

So, in this example, I'll show you the baseline starting step for the buyer journey is awareness, with the objective of really creating that interest for the healthcare professional in peer-to-peer discussion and education with medical content.

Some examples of channels we could invite them, whether it's through reps, through direct mail, through emails, or even utilizing a platform like Medscape or Doximity, to a medical education initiative.

I think as we develop the buyer journey, it's also critical to have a core integrated measurement approach that measures each phase of this journey. So in this example, for the awareness phase, are we measuring impressions, click-through, open rate to really see, are we moving physicians from the awareness phase to the interest phase?

The interest phase, the objective here is how do we enroll interested HCPs into programs, whether that be live, virtual, on-demand, and then measure, are they enrolling? Are they opting in? Are they clicking through? Again, I think that measurement component, at each phase of this journey, is really critical.

The next phase is evaluation. So here, we're trying to have educated and engaged physicians really partnering with us through active ... That's the key word, active peer-to-peer discussion. The measurement here is are they attending? Are they engaging with us? What's the feedback we're hearing?

Then the final stage of the buyer journey is really about retention. The objective here is a commitment to building, managing, and strengthening those HCP relationships as they move on through the medical education journey.

I think the measurement component here is are they interacting? Are they opening? What are they saying to us on the surveys? Are we taking that data and really applying it and using it?

So, I think this overall buyer journey, as our brand teams work through and develop this for each of the brands, we need to be really understanding, from a measurement standpoint, how are we measuring, and how are we applying those measurement learnings to help influence and evolve that overall buyer journey?

Now, we know a single interaction and a single kind of micro-action doesn't necessarily change belief, as we think about the buyer journey. So in this example, we have an example of a current belief from a healthcare professional that “agitation is just another component of Alzheimer's disease that is sufficiently addressed when I prescribe medication to treat my patients with Alzheimer's disease.”

So, in this example, the HCP might have read a journal article or viewed a patient case example, listened to a podcast, even attended a disease state event. All of those micro-actions work together to change a belief.

So, in this example, the future belief is "I can address and recognize agitation as a unique syndrome associated with Alzheimer's that requires a separate diagnosis and treatment plan."

So, again, I think the critical piece here is a single engagement alone doesn't necessarily impact and change core beliefs. But the series of channel engagements really will.

So, as we're thinking about this multi-channel strategy, I would just urge us to also have the associated measurement plan across those channels so that we're helping to inform the broader strategy.

So, hopefully you've learned a little bit. I've kind of been maybe a little bit provocative in some of my thoughts. I don't believe that ROI in and of itself is the Holy Grail. I think we've gotta expand our thinking about measurement. We live in this multi-channel world. How do we understand those customer channel preferences, measure that customer experience, and then integrate it across channels to have an integrated measurement approach?

So, again, I don't believe that ROI in and of itself is really a sufficient measure of success. It's got to be integrated to that broader measurement plan.