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ISSUE 20 Winter 2013

ISSUE 20 WINTER 2013 INSIDE THIS ISSUE A Letter from Bob Chandler


What Climate Change Means for Global Health


PR Measurement: Where We’ve Been and Where We’re Going Korea’s Drug Pricing Policy Under Pressure

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The Art — and Now the Science — of Communications that Work


Inside Digital Health


Are You Really Listening or Just Waiting to Speak?



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Since 2007 Chandler Chicco Companies has been part of inVentiv Health. inVentiv Health offers best-in-class Clinical, Commercial and Consulting services to global companies seeking to accelerate performance. With 13,000 employees in 40 countries, inVentiv Health rapidly transforms promising ideas into commercial reality.


JEANINE O’KANE Managing Director, Biosector 2 New York Author,,“What Climate Change Means for Global Health” Credentials Jeanine has more than 20 years of business leadership experience in the development and execution of global public relations programs. She has worked on a variety of products across numerous therapeutic areas, including arthritis, asthma, cardiovascular disease, diabetes, oncology, vaccines and women’s health. Why Climate Change? “Macro trends that impact health like the growth of megacities, populations change and the impact of climate change are trends I have been following for some time. Stuck in my apartment during Hurricane Sandy, the climate change issue really came to the forefront for me. It is critical for us and our clients to learn more about climate change as we rethink health in this shifting environment.” Contact

MARIANNE EISENMANN Head of Chandler Chicco Companies’ Research & Measurement Division Author, “PR Measurement: Where We’ve Been and Where We’re Going” Credentials Marianne is dedicated to promoting research as a fundamental tool for building PR strategy and programming. Marianne serves on the Measurement Commission of the Institute for Public Relations. She is also on the IPRA/United Nations DPI Advisory Group, and a member of the Marketing/ Public Relations Committee for the Hudson Guild in New York’s Chelsea neighborhood. Why The Outlook for Measurement? “As one of the industry ‘measurati’ I am confident in predicting continued efforts to establish standards in both traditional and social media measurement, more focus on measuring outcomes and integration with other elements of the marketing mix.” Contact meisenmann@

SYDNEY RUBIN Head of Chandler Chicco Companies’ Multiplatform Content Group Author,, “The Art — and Now the Science — of Communications that Work” Credentials Sydney spent 15 years as a reporter, editor and producer for newspapers, magazines, a wire service, TV and digital media. Her journalism career included a decade working as a newspaper reporter, domestic and foreign correspondent for The Associated Press, as well as a freelance writer for magazines such as Sports Illustrated, Elle, Popular Science, Atomic Home and others. Favorite Subject Covered as a Writer? “Public Health in Africa AND The Velvet Revolution in the Czech Republic”

NICK BARTLETT Head of Digital and Social Media for Chandler Chicco Companies Europe and inVentiv Health Communications/ Europe Author, “Are You Really Listening or Just Waiting to Speak?” Credentials If it ends up on a screen then Nick’s got an opinion on it! Eighteen years in healthcare, 14 in digital. Driven by a passion for what’s possible rather than what’s not, Nick has served on various committees across the industry, is a member of the Chartered Institute of Digital Marketing, and loves rugby, cricket and coffee. Biggest Pet Peeve about Social Media? “Everyone’s willing to talk about it, but not many of these people actually do it and even less are willing to push the boundaries!”

Contact srubin@

Contact nick.bartlett@

Seol-A Kim Director of Public Affairs at Macoll Communications Consulting Author, “Korea’s Drug Pricing Policy Under Pressure” Credentials Seol-A Kim specializes in healthcare public affairs including market access and advocacy group communications. She advises a wide range of healthcare clients on the best way to present cases to ensure maximum chance of success. Seol-A served the Ministry of Health and Welfare for a decade during which she was dispatched around Asia to develop new markets for Korea. Korea’s Best-Kept Secret? “The spectacular Leeum Samsung Museum of Art, which houses fantastic works of both traditional Korean art and international contemporary art, including works by Damien Hirst, Andy Warhol and Donald Judd.” Contact

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WHAT IS PRimeCut? PRimeCut is a Chandler Chicco Companies publication designed to share our perspectives on trends affecting the industry, our thoughts on best practices and new developments at CCC. We’ve called the publication PRimeCut because we think it represents cutting-edge PR theory and application, and also one of the neighborhoods where we work and live: New York City’s dynamic Meatpacking District. We hope you enjoy it.


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A letter from Bob Chandler

Some years are simply a bit more trying than others. Twenty-twelve tested our constitutions with a number of challenges in the form of natural disasters, economic slowdowns and manmade tragedies. But such years also show the strength of communities, families and businesses. I’m proud to say that regardless of the challenges of the past year we continued to do spectacular work for some of the world’s best clients. The feature article in this issue of PRimeCut discusses one of the greatest challenges facing all of us, climate change — cited as “the biggest global health threat of the 21st century” — and its impact on the health industry. Jeanine O’Kane, Managing Director of Biosector 2 New York, explores the consequences of a warming planet in local communities and why research, cooperation and education should be top priorities for our sector.

In this issue, we also talk digital with Ritesh Patel and Tom Marotta, and hear from Nick Bartlett on the dynamic role of social listening. Sydney Rubin, head of the multiplatform content group, looks at how art and science now both play a role in more effective communications, and Marianne Eisenmann, who leads our research division, recaps the year in measurement. We round out the issue with an international perspective from our Korean affiliate, Macoll Communications, discussing that country’s drug pricing policy and the introduction of a potential risksharing model. The unpredictability of the past 12 months refined our ability to adjust quickly to changing market dynamics, which puts us in a position of strength for the year ahead. It also makes us a more valuable partner to our existing clients and those we’ll be adding to our roster in the coming months. As we start this New Year, we look forward with hope to a productive and successful 2013.

Best, Bob Chandler


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CLim Me

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change ans for Global Health By Jeanine O’Kane

In 2009, a report by The Lancet and University College, London, UK, asserted that climate change could be the biggest global health threat of the 21st century. While such a sweeping statement can be hard to put into perspective, a quick glance at the news on any given day shows the repercussions on the health profession. Whether treating injuries and conducting blood drives after Superstorm Sandy, tracking the spread of an animal-borne disease or warning of the risks of a severe allergy season, medical providers, epidemiologists, healthcare communicators and other professionals face increasing demands and challenges. Being an effective communicator in this environment requires an understanding of the issues, the role your product or service can play and how your priorities must evolve to serve stakeholder needs.


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Whether you agree with the causes or not, climate change communities by real people.

Climate Change 101 Climate change is basically a long-term shift in the weather that can show up, for example, as changes in average temperatures and precipitation from one decade to the next. One reason for climate change is nature itself, proven by geologic records that show large-scale variations occurring periodically for the last several hundred thousand years. The other reason (the one charged with controversy) is the increase in greenhouse gases caused by humans burning fossil fuels — oil, coal and natural gas — that add heat-trapping carbon dioxide (CO2) to the atmosphere. The current CO2 level is the highest it’s been in 2.1 million years, which some experts say is likely the reason for higher average temperatures, also known as global warming.

The Impact on Human Health Whether you agree with the causes or not, the reality is that climate change is upon us. And while it is a global phenomenon, its consequences are felt in local communities by real people. The United States Environmental Protection Agency (EPA) has identified four major climate change concerns and their potential impact on everyday life: Reduced Air Quality Scientists say warmer temperatures will increase the frequency of days with unhealthy levels of groundlevel ozone that can damage lung tissue, reduce lung function, increase respiratory symptoms and aggravate asthma. It is particularly harmful to children, older adults, outdoor workers and those with asthma and chronic lung diseases. Climate change can also increase fine particles in the atmosphere that, when inhaled, can aggravate cardiovascular and respiratory diseases. Finally, the spring pollen season is occurring earlier in the United States due to climate change, which is obviously bad news for allergy sufferers. Climate-Sensitive Diseases Warmer climates may enhance the spread of diseases transmitted through food, water and animals, such as deer, birds, mice and insects. Examples are salmonella

and other food poisoning bacteria that grow rapidly in warm environments, water-borne diseases caused by flooding and stormwater runoff, and diseases such as West Nile virus and Lyme disease carried by insects. Extreme Weather Events As evidenced by the recent and dramatic consequences of Superstorm Sandy, extreme weather events can wreak havoc on millions of lives in a matter of hours. The frequency and intensity of extreme precipitation events are projected to increase in some locations, as is the severity of tropical storms. These events can threaten human health in a number of ways, such as reducing the availability of fresh food and water; interrupting communication, utility and healthcare services; contributing to carbon monoxide poisoning from portable electric generators used during and after storms; and contributing to depression and posttraumatic stress disorder in storm victims.

What’s Being Done There is little doubt that climate change will significantly impact human health worldwide, especially in developing countries with weak healthcare infrastructures. The good news is that work is underway to address the issues. The World Health Organization (WHO), for example, adopted a work plan back in 2009 to support its member states in protecting human health from the effects of climate change. Among their priorities are to raise awareness of climate risks, develop partnerships to increase knowledge and best practices, improve understanding of the linkages between health and climate and strengthen health systems. Closer to home, the Centers for Disease Control and Prevention (CDC) established its Climate and Health Program in 2009 to identify populations vulnerable to climate change, prevent and adapt to current and anticipated health impacts, and assure systems are in place to detect and respond to current and emerging health threats. It is working to translate climate change science for states, local health departments and communities; create decision support tools to build capacity to prepare for climate change; and serve as a

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is upon us and its consequences are felt in local

credible leader in planning for the public health consequences. These types of organizations and initiatives, while extremely broad in scope, provide roadmaps for individual companies, institutions and agencies to follow in advocating for their own populations in the face of climate change. The healthcare industry as a whole can focus its efforts and priorities in three key areas: • Research. A better understanding of the complicated links between human and natural systems is needed to develop prevention strategies and health incident responses. More research is also needed on the complex interplay between risk, location and environmental conditions, i.e., just how climate change affects people locally. This will guide the development of tools to help communities respond to their particular situations. • Cooperation. Collaboration between agencies, providers, nonprofit groups and other healthcare stakeholders is essential. Such partnerships can help identify and allocate resources to people who are most vulnerable to the harmful effects of climate change. • Education. Knowledge is one of the most powerful weapons in battling health problems in any environment. Helping people understand and prepare for climate change health risks is crucial, especially when many ignore, doubt or feel helpless against the phenomenon. Communication and early warnings to highly vulnerable populations, including children and the elderly, are especially important. Clearly, the healthcare industry is a major force in reducing the human health ramifications of climate change. By understanding the science, preparing for the challenges already being experienced around the world and working proactively to mitigate risks, the sector can be a major contributor to climate change solutions. n

Climate Change and Healthcare Communications As climate change comes to the forefront of the healthcare conversation, pharmaceutical companies have an opportunity to reinforce their positions as expert authorities and reliable information sources. Here are guidelines for approaching the topic credibly and responsibly: • A 2008 article in the American Journal of Public Health noted that communication among healthcare agencies, businesses and other stakeholders is essential to evaluating the industry’s response to climate change issues. The development of new and better drugs should be informed by input from healthcare professionals and ongoing assessments of the most vulnerable populations. • Pharmaceutical companies must stay abreast of current and pending regulations on emissions and other global warming mitigation actions, and be vocal and accountable stakeholders. • Every company must be transparent about its contribution to climate change, both to preserve business and fulfill an ethical pledge. Public relations initiatives are essential to communicating environmentally responsible initiatives and commitments.



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PR Measurement

Where We’ve Been and Where We’re Going By Marianne Eisenmann

Throughout the past 12 months I was closely tuned in to the developments in PR measurement — attending the leading conferences; participating in the IPR Measurement Commission and the International Association for Measurement and Evaluation of Communications [AMEC] meetings; contributing to the discussion on PR measurement standards; and developing solutions for clients. This is a time of real change for PR measurement. We continue to be challenged by the need for accountability, all the way up to the C-suite. We are seeking solutions to evaluate social media, calculate return on investment and quantify intangibles like relationships. At the same time, industry groups and measurement specialists are collaborating and working harder than ever to create standards for PR measurement and align on an industry-wide point-of-view on approaches and methodology. Here’s a look at where the industry has been over the past 12 months and where we’re headed now.

PR Industry Standards Emerge Standards for PR measurement are long overdue and have become a leading topic among the “measurati.” Organizations face a pressing need to compare the results of multiple PR campaigns across brands, business units and geographies. In the absence of an industry-wide methodology for data collection and analysis, in-house communication teams and their PR agencies are using inconsistent definitions and calculations for results reporting. This frustrates management and puts budgets and resources at risk. To gain or keep their seat at the table, senior communication leaders want transparent, replicable metrics – similar to those presented by their counterparts in marketing or finance – to demonstrate their results. Therefore, practioners are asking for guidelines to ensure that all their PR efforts are being measured using the same methodology. In some cases, communications teams have already established their own guidelines and pushed them out to their agency partners. The first step in addressing the need for standards was the Barcelona Principles. Established in 2010 at the 2nd European Summit on Measurement and endorsed by PR industry organizations, the principles provided the first important contributions to PR measurement standards, specifically stating that (1) advertising value equivalency (AVE) does not equal the value of PR, (2) measuring outcomes is preferred to measuring outputs and (3) the effect of PR efforts on business results should be measured when possible. The Barcelona Principles were followed in 2011 with standards on how to conduct the underlying research for measuring public relations performance in a paper called “Standardization in Public Relations Measurement and Evaluation.”

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The progress toward standards gained momentum in February 2012 with the founding of the Coalition for Public Relations Research Standards, which is committed to creating a broad platform of standards and best practices for public relations research, measurement and evaluation. The initial partners include the Council of Public Relations Firms (CPRF), the Global Alliance for Public Relations and Communication Management, the Institute for Public Relations (IPR), the International Association for Measurement and Evaluation of Communication (AMEC) and the Public Relations Society of America (PRSA).

common lexicon. Feedback is welcome via the comments section, and the glossary will be updated monthly. An updated Valid Metrics Framework for social media was also shared.

The coalition took a first significant step in June when it unveiled proposed interim standards for PR research and measurement for traditional media analysis, social media measurement and ethics in PR measurement. In line with International Standards Organization (ISO) processes, the coalition is seeking industry input on the proposed interim standards, followed by review by a panel of research customers and rigorous validation. It is a long road to become an officially sanctioned standard, but this is a solid first step. It is also a collaborative process, with industry thought leaders working together to draft standards, and a call for broad industry input a critical part of the process.

Though the strides in standards dominated the PR measurement conversations over the past 12 months, there were many other recurring topics. Here are five themes that you are likely to encounter in your daily measurement work.

Standards for Traditional Media Measurement The “Proposed Interim Standards for Metrics in Traditional Media Analysis” address some of the core elements of traditional media metrics, such as calculating impressions, what counts as a media


All the standards processes will be market-driven, and practitioners’ comments are encouraged. The goal is to create a common language and unified metrics from which we can all benefit. Look for more on standards in the coming months.

Top of Mind Topics

Impressions vs. Influence in Social Media Arguably the most discussed topic in measurement after standards is how to do it for social media. There are many commercial tools available to assist in this effort, and their pros and cons have been widely discussed. There is no one answer and, like traditional media, measurement needs to be tailored for specific programs. One common theme emerging is that we don’t always need to measure the whole universe of conversations, but rather focus on what is being generated by relevant influencers in the space. Of course, determining influence is another challenge, which includes consideration of who do they know, who listens to them and what

A good objective should facilitate the measurement of business impacts and outcomes, not just outputs, as distinct from a series of tactics. “hit,” assessing sentiment and quality – basic measures on which practitioners have consistently failed to achieve consensus. As the comments from industry professionals to date suggest, these are important first steps focused on outputs only, and we need to go further to address the outcomes linking PR to business results. But while there is still ground to cover, this effort is what we have to date and brings us closer toward establishing a common language, transparency and consistency. The next phase for developing traditional media standards is already underway.

Standards for Social Media Measurement The effort to establish social media measurement standards began in 2011 with the creation of the #SMMStandards Coalition, a cross-industry collaboration that unveiled its roadmap and first interim standard in June 2012 at the AMEC European Summit. These include a “content sourcing and methodology” table that helps clients know “what’s inside” the measurement for full transparency and easy comparison (like a food nutrition label). Later this year we expect further proposed standards from the coalition on reach and impressions, engagement and influence. Also introduced at the summit was a glossary of social media terms called Plain Speaking, a central repository for definitions and terms in social media measurement to promote consistency and a

their affiliations are. This is a more strategic approach to tracking and measuring the impacts of conversations in social media and planning appropriate proactive initiatives.

Measurable, Business-Oriented Objectives are Paramount The importance of establishing measurable objectives is already clear. A good objective should facilitate the measurement of business impacts and outcomes, not just outputs, as distinct from a series of tactics. Measures of outputs should go beyond media impressions and article count to include message pull-through or other quality measures, such as visuals, accuracy and tone. Or even better, move closer to measuring outcomes, such as, Do people who engage with your messages take action? Do they go to your website for more information? Do they download a toolkit or take a quiz? Are they sharing your materials? Do donations increase over the course of a media blitz? Objectives should also be specific, so “increase awareness” is not as good as “increase awareness among working moms with school-aged children.” A business objective with regard to PR may not necessarily directly relate to sales, but it will answer the general question, “Was this effort worth it?” in a way that business minds can understand.

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It also will make the case that the total value of PR is greater than ROI by showcasing the impact on reputation, stakeholder relationships, public opinion and other intangible gains.

Whether measuring outputs or outcomes, it is important to set the measurement tools in place right from the start. So, if you are measuring consumer engagement with digital tools, be sure you are set up to track the number of apps downloaded, contest entries received, quizzes taken or whatever the objective may be. If you will use survey research to track change in awareness or perception, be sure you have a benchmark as a starting point, and a plan and budget in place for post-activity research to demonstrate the change.

New Thinking on Return on Investment Closely related to measuring business objectives is return on investment (ROI). There is no silver bullet here and don’t expect one anytime soon. But there is some continuing dialog on ROI prompted by a Council of PR Firms working group and the Miami Debate at the International Public Relations Research Conference (IPRRC), among others. The recommendations focus on adhering to the strict financial definition of ROI – money in, money out – because anything else will discredit the profession in the eyes of the boardroom and executive suite. However, to account for the intangible and long-term benefits of PR that can’t be easily calculated in financial terms, we need to capture the “Total Value of PR.” This approach will allow practitioners to express the impact of their programs on things like sales, sales leads and cost savings in well-accepted financial terms when possible. It also will make the case that the total value of PR is greater than ROI by showcasing the impact on reputation, stakeholder relationships, public opinion and other intangible gains.

Progress in Measuring Intangibles, Like Relationships To better illustrate the intangible value of PR efforts, such as those for a public affairs or issues management effort, PR measurement experts are employing increasingly specialized measurement approaches. One example is the Measuring Engagement and TRacking Influencer Communications [METRIC] Model, which measures evolving relationships with stakeholders by defining the

desired actions, assigning them a weighted value and tracking the activity of a defined stakeholder group over time. [Full disclosure: the model was developed by me and my team at Chandler Chicco Companies and is currently implemented for several of our clients.] Unlike many other custom measurement tools, there is a case study in the public domain, so practitioners can access and apply it to their own scenarios.

Measurement Is Not an End in and of Itself At a minimum, we all need to be measuring outputs (quantitative results), if not outcomes (how the quantitative results correlate with measurable impacts). But metrics are not the end of the road for evaluation. Measurement is a powerful tool that can guide program refinement and development over time, create best practices and reveal key learnings for future programming. Practitioners should not let reports sit idle or become doorstops. They must elevate the importance of such reports by outlining actionable insights for the next phase, and highlighting strengths, weaknesses, opportunities and threats. For example, did some reporters respond particularly enthusiastically to your messages? Did a whole category of stakeholders seem disinterested in engaging? Did you generate attention from influential bloggers or create a buzz on a social media channel? Why? The answers to these kinds of questions will help strengthen communications programs. Take the time to think of measurement not as an end point, but as part of a continuous feedback loop.

What’s Next? With continued focus by businesses on accountability, measurement is likely to stay in the forefront for public relations practitioners for years to come. The topics mentioned above will continue to lead the conversation, and we look forward to keeping you updated on new measurement tools and approaches. We can certainly expect to see much more on standards in the near future, which will serve the industry well in aligning on measurement for all. n

This piece was originally published in the International Public Relations Association’s Frontline magazine, September 2012.

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orea’s Drug Pricing Policy Under Pressure By SA Kim


ast year brought a huge shift in South Korea’s drug pricing policy away from the positive listing system it adopted in 2006. In April 2012, the government implemented a mandatory price reduction policy to slash the price of drugs in an attempt to reduce healthcare expenditure. The government is also exploring the introduction of a risk-sharing model to improve patients’ access to new drugs and help to create financial stability within the National Health Insurance (NHI) program. With these changes, the need to closely analyze the rapidly changing policy environment has never been greater. To help shape and inform the evolving policy environment, it is important that the industry actively engage major stakeholders through effective communication and partners to find effective win-win solutions. Over the last few decades, Korea has developed a unique healthcare system and, through the NHI program, Koreans can gain access to the majority of healthcare services at an affordable price. Within this system, the sole ”payer,” or funding decision-maker, is the National Health Insurance Corporation (NHIC), which works closely with the Health Insurance Review & Assessment Service (HIRA) to evaluate whether to provide reimbursement for treatment. In 2011, the total healthcare expenditure escalated to approximately 46 trillion Korean won (USD 40 billion), with drug expenditure accounting for 35.5% of this. Additionally, disbursement from the NHI for insurance payouts has risen to 36 trillion won, partially explained by growth of the aging population coupled with increased prevalence of chronic diseases. In an attempt to manage these rising costs, the government is implementing strict policies to stabilize spend and plan for the impact of healthcare trends. The national drug price-cut policy is a key strategy to drive stabilization of NHI finance, with the aim of reducing drug costs by an average of 14%. Government drug price cuts and reduced price policies create complex challenges for global pharmaceutical companies as they try to adhere to their global price strategies. This conflict can often result in a negative impact on patient access to new drugs due to delays in their listing for reimbursement. In recent years, South

Korea has become a reference price market, with neighboring countries referring to drug prices in South Korea to establish their own prices. The mandatory drug price cut in South Korea therefore has implications across multiple markets, deepening the conflict over drug prices between global pharmaceutical companies and the South Korean government. With the growing demand on health systems to provide more innovative treatments to help their population, while struggling to reduce expenditure, there is an opportunity for the government and industry to work collaboratively to find more creative approaches to drug price negotiations and to enable more people to have access to the right drugs. As these processes evolve, the NHIC continues to explore new ways to balance reduced costs and patient access. In April 2012, new research into the feasibility of risk-sharing schemes was conducted. The financial rebate (refund) system is also about to start its national implementation phase following a three-year pilot program. Global pharmaceutical companies, which have been facing uncertainty of reimbursement due to price challenges, are paying attention to which system will be adopted for the listing of new drugs. The drug pricing system – and exploration of risk-sharing schemes – in South Korea is rapidly changing and is expected to continue to evolve for the next few years as the government and the industry find a balance. Throughout the process of adopting a novel drug pricing system from the initiation to the implementation stage, it will be necessary for the government and industry to work closely to find a mutually beneficial solution. In global terms, South Korea will be a relatively late adopter of a risk-sharing model, and so has the benefit of learning from other countries and case studies. As such, the risk-sharing scheme developed for South Korea is expected to be an improved model. As the government works to develop improved models, it is necessary that the industry work hard to become a policy partner through clear and transparent communication. Together, they can share learnings and global experiences to help create the win-win outcome. n

SA Kim is director of public affairs at Macoll Communications Consulting, Korea’s only integrated communication service provider that specializes in crisis and conflict management, public affairs and public relations. SA Kim can be reached at

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The Art – and Now the Science – of Communications that Work By Sydney Rubin


lients often come to us for our expertise in communicating science, and our ability to take complex research data and translate it into a narrative that persuades and is easy to understand. But these days, we’re also turning to the science of communications for guidance on how to craft content that reaches and affects target audiences in an era of incessant information flow. A burgeoning amount of research provides valuable insights into how people receive, process and act on information. Much of this research is being done in the field of cognitive neuroscience, where technology such as functional magnetic resonance imaging is giving us our first fascinating glimpse into the mysterious place between our ears. For the first time, we can see what people are likely to do rather than simply listen to what they believe they’ll do. Data being gathered by behavioral psychologists and even anthropologists provide pointers in how to better sell a product, encourage medication compliance, raise disease awareness or motivate behavior change. Keeping up with all the research each month is almost a full-time job.

information each day, the equivalent of a short novel. To read every word of information that was sent to you in 2011 would have taken you the first three months of 2012. (And that’s if you weren’t watching TV. The number of hours Americans spent in front of TV screens doubled between 2005 and 2009.)

Our attention spans are shortening and technology is changing the actual physical makeup of our brains in ways we don’t yet fully understand.

For professional communicators, the research into the science of communications couldn’t come at a better time as we seek ways to better compete to capture attention.

Our attention spans are shortening and technology is changing the actual physical makeup of our brains in ways we don’t yet fully understand. Lloyd’s, the world’s oldest insurance syndicate, was interested in finding out why they’d seen a significant increase in the number of people leaving dangerous appliances plugged in, which led them to a study of attention spans. Lloyd’s research team found the average attention span over 10 years had fallen from 12 minutes to just five.

All of us are caught in a dizzying swirl of emails, Tweets, Facebook posts, videos, apps, texts, advertising and more. Most Americans are exposed to 63,000 words of new

What does this mean to a PR or marketing professional shooting a video for YouTube, producing a podcast or crafting materials to teach someone about a disease? It

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The most tailored messages persuaded nearly 40% to stop smoking, compared to 26% of those receiving less tailored messages. means that if you want to “go long,� then content must be strategically structured with the limited attention span in mind. It must be based on an understanding of how to capture and hold attention, and part of the answer to hanging on to an audience is tailoring. Researchers at the University of North Carolina School of Public Health asked whether dietary behavior could be improved by more carefully tailored messages. They interviewed about 600 adults, asking how many fruits and vegetables they ate, their ages, ethnicity, gender, readiness to change diet and confidence in their ability to change. Randomly dividing the group, they sent some people tailored messages and others a more general, untailored communication. Content was delivered one time in a packet sent by U.S. mail. Four months later, participants were asked whether they’d received a packet. Nearly 73% of those receiving the tailored messages remembered receiving the envelope compared to 33% of the group receiving non-tailored messages. (A small group did not receive packets.) Those receiving tailored messages also were more likely to recall the content.

A few years later, University of Michigan researchers looked at whether the degree of tailoring mattered in helping smokers stop smoking. Messages were tailored based on demographics, social environment, motives, barriers and coping strategies. The messages were tailored in various ways and embedded in small stories of smokers who successfully quit. The most tailored messages persuaded nearly 40% to stop smoking, compared to 26% of those receiving less tailored messages. Eye-tracking technology was used to measure the way readers absorbed the stories themselves and the way they reacted to the illustrations used with the words. The bottom line is this: effective communications in this new level of noise needs a new multidisciplinary approach embedded in our best understanding of the mysterious human brain. At different times, we need the skills of PR specialists, professional journalists, business and medical writers, digital strategists and content creators who understand how to work across all platforms. Communications has always been about the art of the narrative. Now, more than ever, we need to understand the science of content creation as well. n

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Inside Digital Health | Q&A with Tom Marotta and Ritesh Patel In June 2012, inVentiv Health acquired Kazaam Interactive. We immediately combined Chandler Chicco Companies’ existing digital strategy services with the technology expertise of Kazaam Interactive to deliver innovative digital solutions to clients. We sat down to talk with two of the leaders of Chandler Chicco Digital, Ritesh Patel and Tom Marotta, about the current landscape in digital health and their hopes and predictions for the coming years.

If you could describe the ideal digital health landscape in three words, what would those words be? TM: My three words: relevant, passive, educational. It’s my opinion that there are simply too many apps/ campaigns today that are all desperately vying for the attention of consumers, making it very, very noisy and preventing consumers from first learning key aspects of their condition or therapy. I would love to see experiences in digital healthcare that are more relevant through opt-in personalization; passive, offering apps that use sensors, recommendations or intelligence to do most of the work for you; and educational, providing important, useful information to consumers so we get back to assisting patients and caregivers with decision-making, rather than just trying to capture short-term attention with a shortlived campaign. RP: Engaging, shareable and relevant. We need to really engage people in their own words within their own environment in the way they want to be engaged, be that video, social or just plain brochure-ware about a brand.

When did you first hear the words “digital health”? Is it today what you imagined it would be like when you first heard those words? TM: Admittedly, I used to think we’d see the greatest advances in devices and the ability to manage/monitor health using advanced technology and online platforms. While this is definitely the case, I never imagined the power of social media and how FAST information can be deployed, consumed and shared by the public. People crave to find that one bit of information they need to feel more comfortable, make a key decision, share with their loved one, etc. I believe it’s the social networks/platforms that will continue to bring tremendous innovation and solutions for how we deal with disease management and our overall health and wellness.

How do you think digital and social technologies will evolve over the next five years? What will we be doing in 2018 that we’re not doing now? RP: Healthcare is struggling in two areas: electronic records and community. There is a provision in the Affordable Care Act that requires everyone to have a digital healthcare record by 2016. Patients will finally have a health record that they will be in charge of and that they can take to any doctor they wish. Today there are more than 300 electronic health-record vendors. We anticipate there will be a consolidation among these vendors and the big players, like IBM, GE and Microsoft, will start capturing the market. It will be exciting to see that, but also challenging because we’ll have to figure out how to work with these big players. The other big trend is around community. We will see an explosion soon. Right now, there are communities around some of the major disease states, such as cancer and diabetes, where patients are getting together. As the industry’s electronic health records become digital and therefore more unique, people will begin collaborating around the lesser-known diseases, forming communities and connections to receive support and looking for opportunities to get payors to give better deals. So the wave of the digital record is going to lead to more communities of like-minded — or like-disease — patients.

Describe your dream health app? TM: Something that can provide “motivation” in a way that’s natural. We know that public goal-setting and tracking increases compliance, so something for medication adherence, weight loss or just basic fitness that taps into this phenomenon would be very interesting to me. An app that feels like a REAL person — or group of people — that motivates you to change your behavior to achieve better health would be very cool.

PRimeCut Winter 2013 15

People crave to find that one bit of information they need to feel more comfortable, make a key decision, share with their loved one. What excites you most about digital/social in health? IMG_1752.jpg TM: With the mass adoption of social media platforms like Facebook, there are opportunities for some incredibly powerful data mining, “online” studies, etc., that could never happen in real world. While privacy and other important factors need to be addressed, the aggregation and analysis of this massive amount of user data — health behaviors, medication efficacy, etc. — can make for some very valuable research. RP: Everybody has a passion. Mine is digital. Those who’ve worked with me know that everything I do, I always think of a digital way to do it. With respect to the healthcare industry, I believe there is a ripe opportunity for us due to a huge amount of inefficiency in the market. A combination of connected technology as well as the healthcare reform act is opening up a whole new set of opportunities for things like crowdsourcing, digital health data and social media to add value in new ways to generate revenue, connect with the customer or contain costs for the healthcare industry. It’s very exciting.

Why is digital such a natural fit for a company like Chandler Chicco? TM: At CCC, I absolutely love how digital isn’t just an “add on” to a set of marketing tactics. Rather, folks within the organization understand that a brand’s core marketing strategy is to be supported with a well-thought out, integrated set of online and offline tactics. Understanding which channels to use and why is an often-sold capability of other firms, but I’ve seen firsthand how the talent within CCC truly lives and breathes that approach with every brand they support. Very few other agencies can go as deep and wide across the spectrum of digital strategy, capabilities, innovation and execution. We have strength in all of those capacities.

RP: I completely agree with Tom: What sets our digital group apart from competitors is the integration of strategy. A lot of our competitors will do the strategy and then hand it off to another source or service. Because of our broad perspective, we’ve been able to accomplish a lot of “firsts” in healthcare social and digital media, like the first pharma-branded Twitter page. There are a lot of challenges specific to healthcare and social media, but we have been able to figure it out. We are unique because we’ve been able to understand, execute and deliver this for clients. n

Ritesh Patel is Global Head of Digital and Innovation for inVentiv Health Communications and Chandler Chicco Companies. He leads digital and social media initiatives that leverage leading-edge digital thinking and seamless technical implementation to enhance inVentiv’s approach to healthcare communications. Ritesh can be reached at Tom Marotta was President and CEO of Kazaam Interactive and now leads the Chandler Chicco digital offering out of Newtown, PA. He works with teams and clients to provide strategic guidance on how to best connect brands with their customers by employing multi-channel marketing techniques and innovative digital campaigns. Tom can be reached at tmarotta@

Are you really listening or just waiting to speak? By Nick Bartlett

A modern social-listening programme can identify people’s motivations and information needs. Human behaviour has changed. People now not only have an expectation of free and open speech but, via the internet, they have the tools to practice and express that freedom. Language, borders and knowledge no longer prohibit opinions being aired and vast communities come together to be heard, none more powerful than in healthcare. Some companies’ reactions to this new social world? Build higher walls, talk a lot, decide nothing, block out the sound, cover our ears and pretend to listen.

The listening dynamic To create and effect change, someone has to listen. Listening leads to understanding, understanding builds relationships, relationships create communities, communities unite for a common goal and stuff gets done. Stop listening and this falls apart. Let’s put this into perspective. What are the outcomes of modern social listening? How do we realise this dynamic in every communication, every day? It’s not so difficult and, if you think about it, it’s just human nature. 1. W  here do we start? Simply pay attention. It is the simplest piece of the puzzle and yet the hardest for our industry to comprehend. Digital marketing allows us to understand the psychology of our audience like never before. Active listening allows us to find out about people’s motivations, what information needs drive them, what inspires them, whom they talk to, how they talk and whom they respect. There’s no need for engagement here, there’s no need to talk – just to listen, think and listen again. 2. W  hat then? Now it’s time to stand up for something that they believe in. A belief is an individual or community’s version of reality (think politics). You’ve listened so you know what your community members believe. Now give them a reason to want to listen to you so they can make the choice to believe in you. 3. How? Show them you understand, make their lives better. This isn’t via an app or another lazy website, this is truly engaging and building a relationship based on mutual understanding. You can only understand if you listen.

© Chandler Chicco Companies

4. H  ow do we do that? There are three options: a) Give them a service they truly need b) Improve their experience with you or your products c) Find a cause that’s worth affecting 5. M  ost importantly do something remarkable. When did we get so complacent? Why have we stopped aiming high and extinguished aspirations and whole technologies with the easy excuse of regulation? Social media (among other technologies) has the power to bring communities together like never before. As the world becomes increasingly connected, we as marketers must strive to use whatever technology helps us to listen harder. 6. T  ell the story! The most important part of your listening: learn the language of your customers. If they think in pictures, paint; if they talk passionately, speak with feeling; if sounds resonate with them, orchestrate something brilliant. Don’t just tell your story, make them believe. 7. Lead and engage. At last, you have tumbled through the listening strategy and are at the tactical delivery stage of blogs, networks, iPads and personalisation. But these are just tools to help you deliver your story. These are all things that help demonstrate that you have listened. The result – inspiration. The outcome – longterm, profitable relationships with your customers. Next time you brief for a project or hear a proposal, ask yourself whether the solution in front of you is what you want, or whether it’s the result of having listened to your customers. Have you been listening or just pretending? n

PRimeCut Issue 20: What Climate Change Means for Global Health  

The latest issue of PRimeCut kicks off 2013 with a look at the current health landscape and factors that will impact the future. The public...

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