Effective Targeting

In America, more money is now spent on online advertising than on radio or print. The heavy hitters here are auto manufacturers and big packaged goods companies. Their dollars are gravitating in that direction because expensive research is showing them it’s money well spent. Many other businesses can read the signs, and are redirecting their advertising budgets accordingly.

Significantly, online budgets are being further delineated between ads delivered to those using computers versus searching on mobile devices. Use of mobile devices, of course, is skyrocketing.

Health care companies have ventured into online advertising quite slowly, making up only one percent of all online ads. Pharmaceutical companies in particular have to wrestle with presenting required side-effect disclaimers on small screens.

To my mind, however, the greatest challenge to mobile health advertisers is accurate targeting.

I don’t want an ad for an AED served to me on my iPhone when I’m searching for an emergency room to bring a loved one.

One trend that helps better define delivery targets is the growing disparity in age between users of home-based computers and those who are coming to rely on Smartphones and tablets for searches. Folks above 50 years old or so have settled in with their desktops, while younger people are going mobile. Young people research health-related issues such as STDs and pregnancy; older (computer-using) Americans want to know more about heart attacks and IBS. Further, studies show that 18-40 year olds are far more likely to download and use apps that aid in monitoring diet and exercise than are older people.

Every company will have to address the targeting issue, and it’s not going to be easy to make the fine delineations that can make the difference between making a sale and wasting money. For example, I’m working currently with the orthodontic device company OrthoAccel and their product AcceleDent (which accelerates tooth movement so braces can come off faster). OrthoAccel may have an opportunity to effectively advertise their products to potential patients by targeting adults, teens and parents of teens who are searching for local orthodontists. But the company shouldn’t advertise to those searching for information on dental implants – an entirely different category of patients.

Of course, any discussion of targeting advertising through analysis of web browsing behavior and online profiles brings up vexing privacy issues – a subject for another blog.

AdAge recently published a fascinating and potentially very valuable graphic. As part of their American Consumer Project, AdAge commissioned GfKMRI to combine their data on 25,000 American households through the Patchwork Nation segmenting system, which breaks down areas of the country (in this case, counties) in to 12 different kinds of community. This categorization, which includes factors such as economics, culture and politics, goes far beyond overly simplistic terms such as “blue and red” in an attempt to bring more detail and nuance to demographic information.

In this case, the result was a map of the United States that shows the prevalence of major illnesses by county. I’ve reproduced a static version of the map below. For an interactive version that reveals data by county, click here.

Prevalence Map Major Illnesses by County

I, for one, was surprised at the irregularity of illness distribution. What’s with the apparent prevalence of cancer in Northern Iowa/Southern Minnesota? I didn’t know Mormons in Utah suffered so much from ulcers. And speaking of irregularity, look at the pattern of those suffering from Irritable Bowel Syndrome that follows a swath from Virginia through the Deep South.

The information in the map has been further augmented by a partnership with Modern Healthcare that examines how different generations want to receive health care marketing messages and the increasing relevancy of cross-generational caregivers. A summary is included in white paper available here.

This data should prove extremely useful for medical device and medical technology companies (i.e. digital health/mHealth) in their efforts to more effectively target their efforts in prevention and disease treatment.

Digital health saturation point?

Each time I’m tempted to prognosticate, I recall the observation often attributed to Yogi Berra:  “It’s tough to make predictions, especially about the future.” Alas, I’ve chosen to be in a field – mobile healthcare technology – that seemingly compels speculation. How else to anticipate market trends and prepare accordingly? We all do the best we can.

Exacerbating the difficulty of accurate prediction is the astonishing speed at which the industry is growing. According to MobiHealthNews’ 2011 apps reports, over 13,000 consumer health apps for the iOS platform (used by the iPhone and iPad) will be available by this summer, along with 6,000 professional medical apps. About the only thing one can say with certainty about medical apps is, like ants at a picnic, more will be coming.

In the very near future, using mobile health applications will be nearly as common as playing Words With Friends is today

Of course, every app developer is making predictions as well, leavened with great hope that theirs is the “breakout” app that will be embraced by the public. But such an outcome assumes the public will first embrace the concept of using mobile health applications at all. And that’s where I’m going to go out on a (admittedly very sturdy) limb and say, “Yes. In the very near future, using mobile health applications will be nearly as common as playing Words With Friends.” But I will not be so foolhardy as to predict which applications will achieve lasting popularity.

In fact, I’m more interested in speculating – not on the popularity of mobile health applications – but rather where such use will reach its saturation point. At what stage will physicians and the patients for whom they provide care come to a common agreement as to threshold where the use of the app is insufficient at advancing care, and the patient will be compelled to visit the doctor in person.

This threshold is anything but well defined. You might, for example, feel that tests that require bodily fluids would necessitate an office visit. But it’s reported that a team of South Korean scientists has developed technology that reliably diagnoses some diseases from analysis of a drop of blood or saliva on the touchscreen of a smartphone.

Instantly accessible online health information and personal monitoring (and even diagnosis) is having a profound and permanent affect on the patient/doctor relationship. My take is that both parties will arrive at consensus on a case-by-case basis. Mobile health apps will become a vital part of an equation where patients and caregivers will determine if use of an app is as good as (or even better) than an office visit.

My colleague Joe Hage of Medical Marcom announced recently that the LinkedIn Medical Devices Group, of which I’ve long been a member, now holds the distinction of being the largest medical group in The Land of LinkedIn, with nearly 100,000 members.

Big can be good. For example, having so many members increased the accuracy of a recent poll I conducted through the LinkedIn Poll application, by ensuring a statistically relevant sample size. A big membership means I enjoy a wealth of late-breaking news, questions and comments from individuals who share my concerns and interests.

But big can be an impediment as well. In a short article on medcitynews, we learn that Joe recently had the experience of attempting to connect with group members in San Diego (I assume for possible face-to-face chats), and found to his chagrin that the group members in that one city numbered over 1,900. It was then that the practicality of creating subgroups presented itself.

…you can easily connect with like-minded business people who live in your area

Consequently, LinkedIn’s Medical Devices Group now offers four options that can be mixed and matched to customize a subgroup just to your liking. You can select by Function (such as Design & Development or R&D), by Specialty (e.g.: Cardiovascular; Dental; entrepreneurs and more), by Interest and by Location (which currently lists twenty-one cities).

This is a terrific option. With it, you can easily connect with like-minded business people who live in your area. Everyone knows how important it is to get “outside your silo” and compare notes with your counterparts at other companies. These interactions can be anything from organized group meetings online or at a conference center (hashing out hot topics such as medical device taxes, and the changing role of hospitals and, of course, job opportunities), to a one-on-one over coffee.

Of course, you can also avail yourself of this valuable resource in your travels. If your plans include visiting any of the twenty-one cities listed on the subgroup, you can quickly, easily (and inexpensively!) find and reach out to colleagues and create opportunities to learn more and expand your network.

Certainly one of the fields most affected by the Internet’s information free-for-all is healthcare. For good and ill, nearly everyone now uses the Internet to check on symptoms, treatments and research. Witness the spectacular popularity of such web sites as WebMD. To most caregivers, this flood of easily accessible information has been a mixed blessing, what with issues such as self-diagnosis and patients second-guessing physicians.

Healthcare vendors also need to confront the consequences of democratic freedom of information access. Recently, there was a lot of press about Hugo Campos, (see his blog here) a patient-activist who was demanding that Medtronic release to him the raw data captured by the company’s implantable cardiac defibrillator, which had been implanted in Mr. Campos in 2007.

Any medical device company should have in place – right now – a carefully considered strategy

Any medical device company should have a strategy

After some fits and starts, Medtronic complied with Mr. Campos’ request. But before doing so, Medtronic wrestled with the issue, particularly how it might affect their relationship with doctors – their direct customers. As Mr. Campos himself put it, “CRDM companies rely on their relationship with doctors to sell their products. Going directly to patients can offset this balance and be seen as having a potentially deleterious effect on their business. They are very careful to not upset the relationship doctors have with their patients.”

Mr. Campos appears to know the impact requests such as his may have on the industry. “I am asking for a significant shift in the way medical device companies do business,” he says.
Those of us in healthcare can justifiably fret about the potential consequences of providing what is often highly technical data to those without the training to correctly interpret that data. But the fact is, the genie is out of the bottle. Any medical device company should have in place – right now – a carefully considered strategy for how to respond when faced with a scenario comparable to the one faced by Medtronics. Not doing so means you run the risk of alienating your customers and suffering a public relations fiasco.