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Medical Education of the Future

Mark Iskowitz, Editor-in-Chief at MM&M, sits down with our thought leaders, Lee Altenberg, Bradley Banker, Rob Spalding, and Trina Stonner to discuss the emerging trends shaping the future of medical education.

Webinar Transcript

Marc Iskowitz: Hi. This is Marc Iskowitz, Editor-in-Chief at MM&M. I want to welcome you all to today's webcast, “Emerging Trends Shaping the Future of Medical Education.” I'll introduce our speakers in a moment, but first, a brief intro. As anyone who follows trends in HCP promotion knows, peer-to-peer marketing is a thing of the past. Doctors don't learn in the same way they did during the heyday of paid speaking, when external experts would regurgitate a bunch of clinical or scientific data on a slide deck to a room full of doctors dining on an expensive meal.

It's not that marketers are turning away from scientific and medical content, just the opposite, but budgets are shifting away from HCP promotional activities and more into medical affairs and into a variety of newer methods to enhance educational experiences with HCPs. A quartet of experts from Avant Healthcare is here today to explain how pharma can incorporate these trends to better meet HCP preferences for data driven and experiential engagements. I'll now introduce them.

Lee Altenburg is VP Analytics for Avant Healthcare. She provides strategic vision, expertise, and leadership in the development of customer-focused, data-driven solutions for Avant Healthcare customers. She has vast experience in both US and global projects that utilize analytics to drive impact for healthcare organization's sales and marketing effort.

We're also gonna be joined by Bradley Banker. He's an Executive Consultant of Digital Strategy and Engagement for Avant Healthcare. Brad is a transformative thought leader with 22 years of experience expanding the innovation offering of multiple communication agencies, servicing Fortune 500 companies and healthcare brands. Bradley's extensive history includes leveraging new formats in immersive platforms. This has resulted in numerous award-winning, first in class solutions that have activated audience of both the consumer and HCP varieties across multiple disease states.

Rob Spalding, our third guest, is Chief Strategy and Marketing Officer for Avant. He has more than 20 years of experience in the healthcare industry, 15 of which he spent in large pharma companies across several brands in global and US markets. He joined Avant in 2013, and today he leads the strategy across the agency to ensure Avant is delivering relevant, integrated medical education solutions for clients in a measurable way.

Last, but not least, we have Trina Stonner. Trina's an industry veteran on both the client and clinical sides. She serves both in her role as President. Prior to joining Avant in 2010, she spent 15 years with a major Midwest pharma company. Trina actually began her career as an advanced practice nurse, and she earned her Masters of Science degree from St. Louis University.

In a minute, I'm gonna hand it over to Rob, but I just want to let everyone know that our quartet of speakers is gonna talk for about 45 minutes, and then there'll be time for Q&A, so feel free to send in your questions, and we'll take them. Okay. Rob, handing it over to you.

Rob Spalding: Thanks, Marc, and welcome, and thank you for joining us for a discussion on emerging trends and that are shaping our future in medical education. Before we kind of get into the trends, we wanted to give you just a quick kind of introduction to Avant Healthcare, because we know some of you may not have heard about us before. Avant is a privately held, medical education agency that has been focused 100% on pharma and biotech industry for the last 24 years. We specialize in creating medical stories with content that we create with you that is rooted in the healthcare professional's beliefs and behaviors that you're trying to change.

We take those medical stories and then share them with healthcare professionals through a multi-channel approach to provide a consistent experience to each one of the healthcare professionals. We also partner with our clients to help them to identify key opinion leaders and digital opinion leaders, to help them maintain an active engagement plan that aligns to their objectives. Avant also has two sister agencies. One is called AVAIL, that focuses on speaker bureau services and meeting planning. The other we have is a firewalled off agency that focuses on CME, called Forefront Collaborative.

That's a little background about our company. Marc introduced you to our team that's gonna be presenting to you today. So, let me kind of share with you how we've been ... the topics, the trends that we're gonna be going through today. The first one is about immersive and immediate medical education. That's gonna be focused on the delivery of content. Then we'll talk about credible content that emphasizes science. From there, we'll jump to the rapidly evolving role of medical affairs. Then we know that there's been a lot of discussion about patients becoming more and more educated, but today we're gonna talk more about the integrating the e-patients. Finally, we'll talk about measurement within medical education and how that is changing and evolving.

Before we jump into the trends, we wanted to share, just briefly, our methodology of how we got to where we are today. We started with nine focused areas that we wanted to explore, based upon some feedback from our clients and just the general shifting industry trends. We put a small team together to individually research each one of these topics and get more in depth with them through both primary and secondary research. They prepared individual packets of information to a team of, internally at Avant, of 20 experts in their own field to work, to ideate on both trends and on some solutions to those trends.

We then took the results of that brainstorm session to our Avant Healthcare Advisory Board, which is a cross-specialty advisory board that we have just within Avant that we go to for to bounce off ideas from them from time to time to understand what their point of view is on the trends and solutions that we kind of came up with. Then we also share those trends with some of our clients to get their perspectives and insights. Now, we're at the sharing phase of where we want to share this content more broadly, and the first part of that is this webinar, where we're starting to talk through our trends. Let's jump into our first trend right now. I'm gonna have Bradley take that over and jump into that first trend.

Bradley Banker: All right. Thanks, Rob. Our first trend is focusing on immersive and immediate medical education. So, our analysis revealed that the time is coming that effective medical education of the future will require brands to offer deeply immersive, immediate, and experiential content. This is due in no small part to the flurry of recent technological advancements that are literally transforming how customers are engaging with brands now. These extraordinary new formats, devices, and enhancements to the digital screens that HCPs are utilizing every day are suddenly now more immersive and immediate, and it's redefining how information is experienced.

So, the manner in which brands can communicate medical information now includes virtual reality. For those that don't know, that's an entirely simulated, artificial environment. Then augmented and mixed reality, which is the merging of the real and the virtual worlds, where physical and digital imagery can coexist. We have 360 degree video now, which is as it sounds, meaning video recordings where of you in every direction is recorded at the same time. Voice assisted, which obviously references all the new voice assisted connected devices that are out there. Then, finally, proximity engagement, where contextual information can now be pushed to a user at a specific location, down to even a few meters.

We're really experiencing a seismic industry paradigm shift here. This revolution is very similar to the smart phone and tablet explosion that we had at the earlier part of this decade. We have new devices bombarding the market every day from the biggest names in tech. Even though we are only in the early stages of this movement, we already have a lot of great tools in the market. So, in the VR/AR/MR category, we have things like Oculus, and HoloLens, and Samsung Gear, and Google Cardboard, and PlayStation VR, and 360 degree video is more prevalent than ever. We have cameras from GoPro, and YI, and Samsung, and Ricoh. Those are all flooding the consumer space and now working into the healthcare realm. We have voice-assisted technology, which is quickly emerging. So, these are tools like Amazon Echo, and Google Assistant, and Siri. These are all helping us to change how we control our worlds.

From a market standpoint, a market that's currently at just north of 17 billion today is projected to surpass 215 billion by 2021, so it's really beyond massive when you consider it in that lens of compound growth. I think this statement from Mark Zuckerberg kind of really summarizes the potential impact that we're referencing here. He says, "The big picture is that every 10 to 15 years there's a major new computing paradigm, whether that's DOS, then Windows, then web browsers, mobile phones, and apps. Each one gets to be more natural to interact with, more natural gestures for controlling, more immersive."

It strikes me as very likely that the next one is going to be around virtual and augmented reality. So, most importantly, as we kind of move into the field of healthcare, this growing trend is far more momentous than just technology for technology's sake. These new solutions are really poised to directly impact patient care and enrich our medical understanding. When you think about it, one could argue that reality is mostly just a series of electrical signals interpreted by the brain, and the more believably we can transport someone, the more memorable the education and that emotional connection will be from the experience.

So, these hyper real platforms are going to allow us to create heightened peer and patient interaction and provide deeper immersion into scientific content. This is especially so for MOA and pathway animations. It'll also allow us to depict a more meaningful simulation of the patient’s plight, so it's gonna allow us to bring more amazing replication of their experiences to us. We are already seeing this technology improving patient outcomes. There's a trailblazing team out of Cedars-Sinai that is already using VR for therapeutic intervention. They're using it to address pain needs and other chronic issues.

It's leading Dr. Brennan Spiegel, who's their director of the program, to already state and proclaim that VR is starting to change the way we deliver healthcare at the hospital. So, pretty powerful statement there, right? What they're doing is they're virtually transporting patients out of what they call the bio-social jail cell that is the traditional hospital bed. They're virtually taking them to fantastical, new destinations, like Icelandic glaciers and summits, or Hawaiian beaches, or a Cirque du Soleil performance, or even to the living room at home with their loved ones, capture in frame and replicating that in home experience.

So, this technology is already demonstrating true clinical benefit. Their results are showing that VR can reduce pain scores within 10 minutes of use, and it's being utilized there as a drug-free adjuvant to opioids. When you think about that, you have to consider it not only in the terms of patient outcomes, but potentially to health economics, right? There's some really powerful, innovative thinking going on in this realm.

So, when we consider these powerful platforms specifically for medical education, we think the opportunities present themselves in a number of ways worth exploring. Some of the concepts our team is ideating on include first mixed-reality program experiences, where the room can include interstitials, and holograms, or virtual peers, using tools like HaloLens or Vuzix goggles. This is all about taking it beyond the tablet, so to speak, or content specifically designed for voice assisted delivery with some acknowledgement that it's a unique format providing an entirely different user experience. Just a data point to consider here: we know that 23% of all HCPs are already using these tools, and that number's growing, and it's going to continue so.

Maybe the consideration of creating reality round tables, where a consortium of experts can be filmed in a 360 degree setting for more of an enduring VR experience, leveraging proximity engagement using Beacon technology. Great opportunity here to deliver support materials to the point of care or activating booth traffic at a Congress event. And then finally, just more AR for interactive print. You know, it can be used for workbooks, and detailing, and invites, and to bring those static images to life for that more immersive, visual communication of what we're talking about here. Now, I'm gonna transfer back to Rob, and he's gonna talk about our next trend, credible content for emphasis on science.

Rob Spalding: Thanks, Bradley. Not only do we need this immersive education. We also need to think about how the content itself ... We know that HCPs want pharma to deliver education that's rooted in science, right? The question is more how can we get healthcare professionals the type of deep science that they desire to the right channels? Let's look at some data first of what healthcare professionals are self-reporting. From our colleagues over at DRG, based upon a research they did with almost 2800 physicians, 24% of them view pharma websites as influential in clinical decision making, as measured by a top two box score on a scale of one to five. Compare that to the sales rep at 29%, which is a lot of times our comparator that we use, right? Then compare that to 71% of third-party HCP-focused websites.

You also look at, regardless of the survey, whether it's DRG or whether it's another source, HCPs rate typically the highest source of information as their colleagues in helping them to make clinical decisions. For the DRG survey, specifically in this survey, it was at 80%. So, with this significant gap in differences, we wanted to explore why HCP websites and colleagues continued to gain more trust. So we partnered with, engaged our Avant Advisory Board that I mentioned earlier in the conversation for their kind of insights and their thoughts on this. What we know, based upon gaining their insights, as well as just our kind of knowledge of working in the industry, is that HCPs are looking to their colleagues for efficacy and safety that are more real world and go beyond just what the package insert is saying.

They're also looking to their colleagues for treatment algorithms and diagnosis of specific patient populations, especially those with comorbidities. The HCPs are also going to third-party websites for a more holistic view, beyond just clinical trials that are used on the label, and they want more peer reviewed content to ensure the validity of that data. They're seeking out this data, because some HCPs do realize that there are guidelines that limit pharma to representing a more real patient in their practice, those with more complex comorbidities, et cetera. They also want someone they can trust to share their experiences with, as a colleague, that understands their practice or their health system and the specific types of patients that they feel that they have.

So, while seeking out these types of trustworthy sources will not likely change in the future, we do believe that it will begin to evolve. For instance, today a majority of the discussions with colleagues are live, or in person, over the phone, and we believe that this change, with the changes in sophistications of EHRs, introducing communication tools into their platform, that HCPs will more widely begin to leverage these alternative communications.

Additionally, social media platforms are continuing to grow in adoption of their interest with healthcare professionals, both closed platforms, like Doximity and Sermo, and then open platforms, like Twitter and YouTube. As this happens, we know that digital opinion leaders will continue to gain their level of influence and their sphere of influence and become an important type of colleague, similar, but also very different than a traditional key opinion leader that healthcare professionals will want to go to for sources of information and for content.

How do we apply this to medical education? Well, we believe that digital opinion leaders are important to consider in developing relationships. They need their own engagement plans with different objectives from traditional key opinion leaders, because they are very different in what they're looking for, and there's a very small overlap between those two. We also want to find a way to bring colleagues or peers together without a speaker, a traditional speaker. HCPs want to hear from their colleagues, and they want to hear from a key opinion leader or speaker. They are very different types of discussions, right? They have different goals for the healthcare professional themselves.

Then another thought is in how do we leverage medical affairs to share the content that healthcare professionals actually want to receive, with broader sets of data, and to have that increased relevance that they're searching for? To explore this idea and this trend a little bit further on medical affairs, I'm gonna let Trina kind of talk some more to this.

Trina Stonner: Great. Thank you so much, Rob. As Rob has mentioned, one of our key trends is this role of medical affairs and the increasing prominence of it, as well as spend, in many large knit and small-sized pharma. Many of you who are sitting in those organizations might be seeing that. I would like to share just a little bit of some of those external factors that with are seeing that is supporting this. Recently, in an advisory board, we were sharing a patient-centering program, and it was based out of a commercial side of the business at a large pharma company.

This is a quote from one of the advisors and what pharma considers patient-centric in their commercial programs, "It just seems like pandering to me." I think this really continues to support this increased skepticism that many of our clients and all really types of HCPs are having in regards to pharma. Recently, I listened to a TED Talk. It was based from October 16, 2016, by Rachel Botsman, if anyone is interested. She's really discussing this new wave of stopping distrust of institutions and what's going on in this phenomenon. I really think pharma is trying to overcome and at least try to minimize some of that skepticism, which tends to be influencing this role of medical affairs.

Medical affairs organizations, as I said, have continued to grow in prominence. It's really due to significant changes in that clinical healthcare landscape. We all know that the sales rep is having increased access issues. Recently, in a 2015 survey by Bain, which is depicted on the right hand side of the slide, and then again just recent data supporting this in 2017, the role of the sales rep as providing that credibility and information has continued to decrease. With the last survey it continues to now be the fifth resource for the sales rep that thtat HCP continues to use for information. But there's definitely other issues and changes that are affecting this. This increased regulatory scrutiny of off-label discussions. I'm sure that we all, when we have our advisory boards and we are building content, HCPs want more real information about patients, and who do they want to talk to?

We definitely have to think through this credibility gap between commercial and what the scientific information that is needed by our HCPs. In addition, there's heightened complexity of healthcare delivery systems. Based on what the sales rep needs to do in providing those answers, as well as medical affairs, it's really based on the type of stakeholder audiences. They have increased. Lastly, this explosion of complex information and big data and being able to sort through it.

But what are some of the changes that are occurring just in the medical affairs environment? We know that there's been a deepening role of the MSLs as HCP strategic allies. I recently saw data that showed a 300% increase in the medical liaison positions and roles within pharma. There's been this increased pressure to provide indirect value, as we've discussed, to a more group of key stakeholders outside of the HCP. A shift, a focus on disease state management and patient outcomes versus just the branded information. The expanding role of health outcomes and research and the need for medical affairs to be able to be deep in understanding of real world evidence.

As Bradley has already shared, this growing demand of visualization tools, they need to be learning different. But although medical does not provide the same type of education that commercial teams provide, there is still this desire and the need to increase the amount of visualization tools. Some additional data that we have seen and we continue to see that in many of clients is the very limited role of digital budgets for medical affairs. But I would just challenge, why should it be different than the commercial side? Lastly, that increasing need for critical insights for a real time basis. I think gone are the approaches to medical affairs and MSLs to just sharing slides, but also during those meetings, in those very valuable HCP insights, is how do you gather that? There does need to be a competency in doing that.

So, can medical affairs be a key strategic partner? We believe so, and we're continuing to see that with many of the clients that we work with, as well as in the marketplace. They're able to do that by two: by expanded partnerships and what they are able to develop, as well as that diverse role. We know that there does need to be a liaison between our internal and external experts at our institutions, as well as in pharma. The ability to engage with behavioral research. This is really an explosion of behavior economics, and I will discuss that a little bit on the next slide. This need too for interaction with third-party specialists and those outcome specialists and medical liaison specialists really being brought in to many of those payer discussions.

Then secondly, this diverse role that medical affairs can play. All of this can be with the field medical, as well as with the corporate medical teams, but the need to, for both of those roles, to have better business acumen and understanding, the ability to define clinical outcomes and understand that science, and as I mentioned earlier, the ability to really glean insights in a real-time fashion. As I mentioned, there's also the need to understanding the psychology of clinical decisions. I think many of our sales representatives are educated on understanding this, as well as marketing that we are seeing, but the importance of medical affairs also.

A recent paper, a prospective paper in The New England Journal of Medicine just this year in February, and it's Dr. Jerry Avorn, really talked about the biases that are currently understood that HCPs are having, that typically we think they're rational decision-makers, but really they're prone to this irrational decision-making. So, it's so important for those medical affairs teams to understand the role of behavior economics, just like our sales and marketing team colleagues do.

So what can we do? We know that it's important to have that unified medical story. You can see I don't have a brand story listed on here, but this importance of unified medical story. But it really shouldn't be in silo of building your unified medical story, realizing there are many influential dynamics that should be included. We know about the clinical development plan, market access, definitely on that commercial organization of understanding that market assessment and the launch plan, but looking for those medical affairs teams. And as you are building the unified medical story, my challenge, and as you look internally, what is your strategic medical communication plan, scientific platform? Do you have a scientific lexicon? As well as your approach to strategic and scientific engagements.

So where are we continuing to go with medical education and medical affairs? We are really building to that future state, being proactive, being value-based, and the importance of competency and real-world evidence and being able to speak to it, clinical patient outcomes, value-based partnerships, and lastly, I would say insight generation. So, I'm gonna turn it over to Bradley again to talk about that e-patient.

Bradley Banker: Thanks, Trina. So, as we forward to the next slide here, I just want to talk a little bit about the e-patient, right? Our research has uncovered that the trend, that the old way of paternalistic, one-way, doctor-driven care is changing, as the patients themselves are changing. We know that the e-patient now is more informed about their condition, actively using wearable technology, and viewing care as a continuous series of events, as opposed to episodic. This is all summarized by the fact that today's patient is evolving. They are heavily researched before they even step into their physician's office. Many are now capturing their health data and actively managing their conditions.

The first use of the term e-patient was coined by Dr. Tom Ferguson. He defined them as individuals who are equipped, enabled, empowered, and engaged in their healthcare. He was really prescient, because that patient activity has rapidly expanded beyond the early days of simple internet skimming to the broad channel use that they're using today that includes consulting blogs, and forums, and social networks, and smart phone apps, and all these emerging resources. Today, we have over a million patients registered in online super communities, like smart patients and inspire. We have patient voices assisting the editors of the British Medical Journal, offering POV from that patient perspective.

While these empowered patients are clearly more educated coming into the office, there's still great opportunity for HCPs to drive education and health literacy to the patient. As I mentioned, this empowered patient is also more likely to be utilizing wearables. The FitBits and iWatches of today, well, they're just the beginning. Future devices are gonna become smaller, and smarter, and integrated into our textiles, our shirts, our socks, our patches, and potentially even implantables. From a market standpoint there are already 500 million wearable devices in use, and analysts area predicting that nearly 250 million devices will ship by the year 2021 and surpass 50 billion as a global market.

All of this is kind of in keeping with the fact that more people are tracking their information. 60% of Americans are already tracking their weight, diet, and exercise in some form or another. This trend is going to continue all the way to active drug delivery, we believe. So, most importantly, when we consider these wearables, you know, they're really presenting an opportunity for pharma to empower patients and provide real time data to physicians. They're already improving drug R&D, and assisting with clinical trials, and elevating patient engagement, and improving adherence of course, and ultimately providing information to better inform outcomes data.

So, you combine this with a focus on patient activation, right? Which is a major component of health policy and reform. We know that efforts like the ACA are beginning to emphasize shared decision-making, and wellness, and self-management, and just this general shift to more of a patient-centric system of care. A number of healthcare systems are embracing tools like the patient activation measure, or PAM for short. Just for clarity, activation here means having the knowledge, skill, and confidence to manage one's healthcare. This survey tool consists of 13 statements, such as, "I know what my medications do," or, "I am confident I can tell my doctor my concerns, even when he or she doesn't ask." Then it quantifies against four levels of activation, from more passive state to more progressive stance.

The long and short of it is showing that studies that patient activation is associated with better health outcomes, healthier behaviors, and lower costs, meaning that the more activated patient is more likely to exhibit more positive health behaviors and utilize things like preventative care. There's also a growing correlation that when patient activation measures change, health outcomes tend to change in that same direction. So the challenge and frankly the opportunity, as we see it, will be in providing solutions that help HCPs navigate the myriad of platforms and massive data streams that are coming to them, while also providing next generation education tools to improve that HCP-to-patient dialogue.

Our agency is already delivering on campaigns that aim to assist that activated patient through solutions like HCP coaching videos for direct-to-patient education. The goal here is to assist the activated patient when navigating discussions on challenging health topics, like painful sex or frequent urination. We also believe there's opportunity for wearable clinical context education, meaning programming that's specifically tailored to inform HCPs on how to interpret the data from all of these multiple wearable platforms and then maybe elevating the importance of discussion on what is happening between those patient consults. We also see an opportunity to bring forth education that helps HCPs incorporate solutions like PAM into their patient engagement strategies. Experts from the American Medical Group Association are already recommending deploying PAM during patient onboarding. And then potentially there's an opportunity for MedEd agencies to provide additional intel on HCP point of view to proactive brands that will need to acknowledge the evolution of the patient journey, as the shared decision touchpoints are gonna naturally influence how those look in the future. Now, I'm gonna pass it onto Lee to talk more about the important of measurement.

Lee Altenburg: Great. Thank you, Bradley. So, I'm excited to talk about measurement and really the explosion we have seen in terms of data and analytics in recent years, specifically as it relates to medical education. We know medical education creates real value for healthcare professionals. The challenge for pharma is that it's a lot more difficult to quantify the portion of that value that's directly attributable to medical education. So, we know that there's really a pretty broad opportunity today for better measurement plans, so we can actually assess the pull through of how those specific medical education campaigns have actually impacted the underlying customer's both perceptions and beliefs and then ultimately whether or not we move the needle in terms of behavior change.

So, we have a fundamental understanding that customer beliefs and perceptions drive customer behavior and ultimately brand loyalty. So, we think it's critically important to measure those customer beliefs and perceptions, and let's not just focus on sales impact and really ROI.

In today's world, we think pharma hasn't necessarily consistently applied those core measurement principles that really uncover whether medical education ... Did we reach the intended customer? Did we move the needle on changing those core customer beliefs? And ultimately, did we impact customer behavior?

Before we talk about the future, we'll do a little bit of a history lesson that traditionally pharma has measured success and really utilized some criteria, such as how many folks have actually attended some of these core medical education initiatives, and who are the folks that attended? So when we talk about what good looks like, a lot of those success metrics were really based around butts in seats. As crass as it sounds, it's were they the right butts in the seats? We know brand teams spend quite bit of resources, time, and effort in terms of determining who those brand targets are and what is that brand strategy, and so success was really determined of, hey, what percentage of our targets were actually in attendance?

We know in more recent years, we've evolved the measurement criteria to really look at those core customer beliefs, both immediately kind of before and during the medical initiative, right after, and then we look to see did that customer behavior change a few months after the initiative? Most pharma companies really evaluate that customer behavior based on TRx, prescription change, or sales impact. Now, we know there still is a significant need for improved measurement plans to really assess whether or not we're impacting those perceptions, beliefs, and ultimately behavior.

So, measuring medical education impact I think is just as critical as assessing some of the lagging metrics, such as TRx, or sales impact, or total prescriptions. We really need to understand those core beliefs about a brand or a disease state, because we know those core beliefs, those often can be leading indicators. If we can impact those core belief statements, then we know the behavior change will also follow in educational engagement. So, as we're developing those core belief objectives, we need to also establish the measurements framework, so that we can measure whether or not those core educational engagements had the intended impact, both before an engagement, immediately after, and at subsequent time periods after that.

So as we think about ROI, I think traditionally ROI has been kid of the Holy Grail in terms of measurement really across a multitude of channels, not just medical education. I think the challenge with that, does it miss some other equally critical components of measurement? So, ROI is a great measurement tool. I think the challenge is that it's often inconsistently both defined and applied, both within the same company and definitely across pharmaceutical companies. It's also this single dimensional metric. What it's not is a great decision-making tool. So, as we think about the future, what should good look like in terms of measurement?

As Bradley, and Trina, and Rob have spoken about, we are in this new multi-channel model. We know we are engaging with customers across a wide range of new and emerging channels, and our measurement approach really should reflect that new multi-channel model, so that it can help prioritize spend, and as we're developing these strategies that we've been talking about in the last half hour or so, our measurement approach should both assess the impact of those strategies and help us determine the ongoing investment. As we're developing marketing objectives for some of these new and emerging trends within medical education, we need to have the associated measurement approach that goes along with that, so we can gauge our customer experience and associated financial impact and help provide some insights from, again, those integrated metric plans. I think the true value of measurement comes not just from looking at a single channel within medical education, but really integrating across the broader customer channel strategy.

So, as we think about a measurement framework and how do we assess the overall effectiveness of investments and tactical recommendations, we've got a framework here that goes from pretty baseline and traditional metrics, such as exposure, all the way down to customer impact. So, we'll start with exposure. That's really an activity metrics. So, we know we tried to expose our customers and, again, those core brand-targeted customers, to our educational content. In this example you'll see at the bottom, we've invited 100 HCPs to a traditional dinner program. Now, we know not all of those HCPs are gonna choose to actually engage or interact with us, so the next level of measurement is interaction. In this example, 58 healthcare professionals actually attended our medical education event. Now, this is the piece that often gets skipped, the experience perspective. So, are we actually seeing improved perception and belief change specifically as a result of our medical education initiative? We often move straight from the activity metrics around exposure and interaction directly to impact, which is really where we look at sales impact and TRx change. We're skipping that experience perception, where I think to really get a well-rounded measurement approach, we should be looking at all four of these pieces of the broader measurement framework.

So, how do we move on from here and actually improve our impact assessment of medical education? Again, I've talked a lot about these core brand beliefs. But I think we need to understand what are the beliefs that medical education can impact, and as we develop new and emerging channels that we are interacting with our customers through, how much can our medical education impact those core beliefs, and how long will it take? We know there's often leading indicators that help us determine whether or not we're actually impacting those brand beliefs, so we need to ask ourselves, what are those core leading indicators that we need to be observing to attract those indicators?

The great news about measurement today is that there's been an explosion of tools, big data, platforms that can enable this measurement. So, finding those right tools, whether it be the appropriate data visualization platform, whether it be new data that we previously didn't have access to, but finding those right tools and figuring out what are the right time intervals to measure. So, today we can use real time survey capture. We can use text messages, Bitly. Again, there's an explosion of tools and platforms that can enable us to really evaluate whether we're moving the needle through an education engagement. Again, using that broader framework that not just looks at kind of the activity metrics in terms of exposure and interaction, but gets deeper and looks at customer experience and impact change.

And we've got interactive dashboards. We've got Tableau, Power BI, that really can analyze data in real time and give us insights around data from a measurements perspective, that can help us figure out what our strategy should be moving forward. So, how do we bring all this together? I think we need to expand our thinking around measurement. Let's not think about measurement of medical education in a silo. We really need to be looking across the channels and integrate our measurement approaches and measuring that customer experience. I think developing these integrated, multi-channel measurement plans truly can help us assess whether or not we're pulling through our medical education and actually impacting our healthcare professionals' perceptions, beliefs, and behaviors.

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