Pharma 2-0 (former blog)

EndoGoddess, the mobile app

Jennifer Dyer, MDDr. Jennifer Dyer is no ordinary physician, she is an mHealth pioneer and social media expert known to her legion of Twitter followers as EndoGoddess. Last year I interviewed Dr. Dyer for my white paper on The Social Physician. At the time she was practicing pediatric endocrinology at Nationwide Children’s Hospital in Columbus, OH. During our discussion, she mentioned a pilot texting reminder program she had launched for her teen patients. She was delighted that there was an improvement in medication adherence and reduction in A1C levels over a three-month period. She was eager to implement the program with a wider audience. Fast forward several months. The “aha” moment that she could actually bring her diabetes app to life came during last March’s South by Southwest (SXSW) conference in Austin. After appearing on a health panel, she was surrounded by investors and companies interested in discussing how to commercialize or license the tool. Until then she had not been convinced that there was a market for the mobile app, but the reception at SXSW opened her eyes to the possibilities. Concurrently she had observed that some of the initial gains her patients made began to disappear. The researcher in her hypothesized that the teens needed more than reminders to succeed.

Filled with enthusiasm from SXSW and recognizing there was more work to do, Dr. Dyer decided to leave full-time practice to devote all her energy to building out EndoGoddess, the diabetes app. As she pointed out, “This is a really big opportunity to make a difference in healthcare. Everyone has a phone, and it is great way to streamline medical care.” Another motivator was her belief that doctors must be part of the process. “So many patient tools are developed in isolation, with no physician input. Unless the tools work for both patients and doctors, they are doomed to fail,” she told me.

Dr. Dyer teamed up with Duet Health, an Ohio-based mobile health developer, to complete development of the app. She integrated BJ Fogg’s behavior change model into the design to address the regression she saw among her initial testers. According to the model: Three elements must converge at the same moment for a behavior to occur: Motivation, Ability, and Trigger. When a behavior does not occur, at least one of those three elements is missing. Dr. Dyer realized that her initial app had a trigger (the reminders) but lacked the other two elements.

EndoGoddess appDr. Dyer and the team at Duet Health worked diligently to refine EndoGoddess, the mobile app, and launched it publicly on September 21st in the iTunes store. It sells for $.99. The app contains all three elements cited by BJ Fogg for the targeted behavior of checking blood glucose levels 4 times per day. • Motivation comes from iTunes rewards on a weekly basis so that the user can download a song • Education comes from the multimedia content within the app related to diabetes • Triggers come from the app's daily inspiring messages taken from the diabetes online community as well as medication reminders or alarms that each user designates

EndoGoddess the app may be live but it is still very much a work in progress, according to Dr. Dyer. She is already updating it with new features and is eager for user feedback.

There are many ways to keep tabs on Dr. Dyer and her progress with EndoGoddess, her blog and Twitter being two excellent sources. She will also be speaking at Mayo Clinic’s Annual Health Care Social Media Summit in October, BlogWorld in November and the mHealth Summit in Washington, DC in December.

You can also reach her through plain old email at

My Top 10 Social Media & Technology Resources in Health

I gave a presentation recently to a group of social media newbies. I thought it would be good to leave them with a list of resources for future reference. It was a great opportunity to think about the sources I turn to when wanting to keep up-to-date on technology's impact on health and the delivery of healthcare. There are many more excellent online outlets, but these are ones I think are top-of-the-line.

  1. iHealthBeat - This daily newsletter is a publication of the California HealthCare Foundation, although it is really written and edited by The Advisory Board.  It covers all things related to the intersection of technology and health. I love it, and find so many useful articles, summaries and stats. Subscribe!
  2. Pew Internet & American Life Project - Susannah Fox is the resident expert on Health at Pew. Her analysis and insights are always first-rate. I read everything she publishes and always turn to Pew for recent data related to social/digital/mobile and health. Follow Susannah on Twitter, too.
  3. Dose of Digital Pharma & Healthcare Social Media Wiki - Jonathan Richman, Director of Social Media at Bridge Worldwide, provides the healthcare industry with one of the most useful resources available in the social health sphere. He has organized the go-to list of patient and professional communities (sponsored and independent); pharma and healthcare pages on Twitter, YouTube and Facebook; blogs from patients, caregivers, industry and observers. And more! Check it out and bookmark it.
  4. CDC’s Health Communicator's Social Media Toolkit - For those who think that government can't get it done, think again. I remember seeing Ann Aikin of CDC at a social media event and was so impressed by how well they had integrated social, digital and mobile media into their communications strategies. Now they have documented their hard work and lessons learned in this amazing piece of work. It is a how-to guide on using RSS, podcasts, blogs, video, Twitter, social networking sites, widgets, mobile, ecards, online games...and more. And it's available to all at no charge.
  5. FDASM -Fabio Gratton, Chief Innovation Officer of Ignite Health, put up this site in late 2009 to help the industry keep up-to-date on the FDA's Social Media Hearings (Nov 12-13, 2009). He has assembled all of the materials (documents, videos, presentations, interviews, resources) related to the hearings and continues to update it as new information emerges. It's also a great place to see how crowded the agency space is in health and pharma. Peruse all the logos on the right-hand side of the page.
  6. Social Media University Global - Lee Aase is a name you should know if you're interested in social, health and doing it right. Lee has attained rock star status within social media circles as the Director of Mayo Clinic Center for Social Media.  But that's just his day job. By night he is the Chancellor of Social Media University Global (SMUG), a site he created to help others navigate the new social order. It is a rich resource that provides practical, hands-on training in social media with "101" (intro) courses on topics like social networking, blogs, tagging and wikis. He also covers Twitter, Facebook, Flickr and YouTube.  Lee has also written his own 35 Social Media Theses. Watch out Martin Luther!
  7. MediGuard - This is my go-to site to find out how patients really feel about the drugs they are taking. The quantitative data about satisfaction, usage and side effects is a good barometer and the verbatims provide excellent context. Anyone can register to use the site.
  8. Fierce Mobile Healthcare - Everyone is talking mobile health. I find this site's newsletter to be a great way to keep tabs on what's going on. Fierce Mobile Healthcare  is part of the Fierce empire  (Fierce Biotech, Fierce Healthcare) and provides a solid round-up of news in the space.
  9. iMedicalApps -  This is a physician-led site where practicing doctors provide commentary and reviews of mobile medical technology and applications.  For people interested in understanding what is really valuable to a physician (vs. what agencies tell you is valuable), then the site is a must.
  10. e-Patients - A window into the thinking of "equipped, enabled, empowered and engaged" patients. It turned me on to the Society for Participatory Medicine, and I like to read the perspectives of the many contributors.

Happy New Year - let's make 2011 a great one.

Mayo Clinic Center for Social Media

Much happening as it relates to social health and medicine (not socialized, just social). Mayo Clinic recently announced the formation of  its own Center for Social Media. The mission is to speed adoption of social tools that lead to better health behaviors and outcomes, both internally within the Mayo system and externally across the country and globe.  No hospital system or institution has done more to harness the possibilities of social than Mayo. They post a range of high quality video content on YouTube (a must-see is the video of the elderly couple playing the piano in the Mayo atrium, which went viral and now boasts over 7 million views); they have nearly 66 K followers on Twitter; their Facebook page has 23 K fans.  Plus they have a News blog, a podcast blog and a Sharing blog where patients, relatives and employees can write about their experiences. And let's not forget their amazing - and free - repository of medical, disease and treatment information for consumers: So Mayo has quite a bit of experience to share. Services they plan to offer through the Center for Social Media include social media training for healthcare employees, consulting and coaching for healthcare organizations, conferences and events, and resources like guidelines and toolkits.

Much of the credit for Mayo's success in this sphere goes to the unstoppable Lee Aase, who is the Manager of Syndication and Social Media for Mayo Clinic and is among the new Center's leaders. By day Lee runs the Mayo social operations and by night he is the august Chancellor of Social Media University Global (SMUG), a free online higher education institution that provides practical, hands-on training in social media for lifelong learners. I had the pleasure of appearing on a panel with Lee last November at Northwestern during Kellogg's annual Healthcare Conference. I had heard of Lee and knew of his rock star status within social media circles but had no idea what a nice person he'd turn out to be. Warm, approachable, engaged. And how could you not like someone who starts a social media talk with Martin Luther and the theses? BTW, Lee has 35 of his own.

One of my favorite physician bloggers, Bryan Vartabedian (@Doctor_V) of 33 Charts, wrote a good blog post about what Mayo's move represents. I particularly liked his point that "health care social media isn't owned by marketing." Right on. Its utility goes so far beyond marketing and advertising and public relations. It is about education, research, care delivery, improved outcomes.

Finally kudos to the upper echelons at Mayo for supporting social media. Others take note.

The Connected Physician

There is so much going on in the world of physician communication via digital, mobile, social. It is amazing how much some doctors are sharing online. When I first started out in the healthcare biz, physicians would never open up like this. I have observed this trend on blogs and Twitter. So I was not surprised to learn from a recent Manhattan Research study that physicians are (finally) more apt to connect with patients online. According to their Physicians in 2012: The Outlook on Health Information Technology study, 39% of physicians currently email, secure message, or instant message their patients, which represents a 14% increase since 2006. Within that group, dermatologists, medical oncologists, neurologists, endocrinologists, and infectious disease specialists are the most active. The top activities include:

  • Answering clinical questions
  • Discussing symptoms and/or treatment options
  • Determining whether an office visit is necessary

Physician acceptance is a big part of moving physician-patient online communication forward. The statistic above means that over 60% of physicians are not partaking of the Internet to talk to patients. Liability issues, privacy and doubts about benefits to practice efficiency are among the reasons cited.

The C-Tweet: Where are all the healthcare CEO's?

This article was co-written by Bunny Ellerin of Pharma 2.0 and Eileen O'Brien, digital pharma diva. twitterTweeting is fast becoming a must-do vs. a what-are-you-doing for business generally and CEO's in particular. Just last week Twitter published Twitter 101, a guide to help businesses leverage the service. Last month, BusinessWeek ran an article about business leaders who use Twitter and profiled 50 CEO’s from a range of industries. There was definitely an over-representation of tech CEO’s, but BW also talked to those from advertising/pr, construction, research, media, retail. But none in healthcare.

Where are all the healthcare CEO's on Twitter? We found a couple like @paulflevy (Paul Levy of Beth Israel Deaconess Medical Center) and @livestrongCEO (Doug Ullman of Lance Armstrong Foundation) but not many others.

If you’re a CEO or high-level executive, why use Twitter at all? Well, at the core, you are the company’s chief evangelist and represent the brand best. As Michael Hyatt, the CEO of a publishing company, pointed out in the BW article, “Twitter enables me to humanize Thomas Nelson and thus better connect me with our key constituents—our employees, authors, and customers.” Others cited reasons like:

  • Building relationships with customers/clients/vendors
  • Generating real-time feedback from those people
  • Disseminating information quickly to internal and external constituents
  • Meeting potential employees and getting a sense of what current employees really think
  • Acquiring new product/service ideas

We encourage more in the healthcare C-suite to tweet. We follow several CEO’s on Twitter, and have compiled a list of Dos and Don'ts for C-level types to follow when using this amazing technology.

1. Content. To engage people, you must post a combination of business-related information and personal anecdotes. On the business side, this is really why people are following you, so let followers know about company news, important events, interesting company tidbits/facts. You can also post links to interesting articles or retweet good posts. It's ok to highlight press releases, but don't make them your main contribution. Followers will unfollow you quickly if that's the only thing you post. Twitter is about interacting and sharing, not just reprocessing canned messages. Plus, you should pepper your posts with a bit of the personal from time to time. It will draw people in.

Good content examples:

Richard Rosenblatt, CEO of Demand Media, has a great Twitter style. Here are a few of his @demandrichard posts: sharing info on the business, inviting people to connect, letting people get to know more about the person.

  • "Demand Media Daily Fact: Demand Studios has paid out more than US$14MM to its creator community as of June 2009."
  • "Looking forward to the Fortune conference in LA. May attend thursday. Please reply if you are attending."
  • "Made it to mtns after the conference; worth it...3 glasses of wine down and kids all over you tube and watching our videos on wakeboarding."

2. Interaction. Twitter is not just a vehicle to push information out about your company. It's about engaging in the dialogue. The most successful CEOs on Twitter make an effort to interact with followers. Search topics on Twitter and answer questions or provide advice. If you are overwhelmed by questions or comments from followers, be sure to say so and let them know that you aren’t ignoring them.

3. Tone. Authoritative but not smug. And definitely throw in some humble now and again. The regular folks will relate and admire you all the more.

4. Authenticity. It’s got to be genuine and in your voice. The ideal is for you to write your own posts from wherever you happen to be. But let’s get real. Not everyone who should be tweeting has the desire or even has the manual dexterity to do it. So you may need a little help getting started. Pick someone who knows you well or can get up to speed quickly. Be sure to listen first (follow others) and get a sense of the community before you jump in.

5. Don't Tweet to Tweet. Personal details are good (see Content) but not that interested in what you ate for breakfast (unless it was with Obama) or that you'll be on the phone all day.

6. Commitment. Be prepared to be in this for the long haul. The only thing worse than an out of date CEO blog is an abandoned CEO Twitter account. No fewer than 3 tweets a day or people won’t take you seriously. Once you have been tweeting for a few weeks and feel comfortable, add your Twitter name to your email signature and business card.

7. Follower etiquette. Follow others who interest you. It is imbalanced if you have 2200 followers and follow only 100. You can’t engage in a dialogue if it’s all one-sided. Plus, part of the value of Twitter is hearing what others have to say. Also encourage people to follow those you like to follow.

8. Have an opinion. There aren’t too many public company CEO’s on Twitter because their CFO’s and compliance people worry it might affect the stock price. But if you’re a private company CEO, then have an opinion. Don’t like parts of the health care bill, say something. This is your opportunity.

9. Twitter is a Permanent Record. It goes without saying that once someone has Tweeted it’s public record.

10. Twitter vs. Facebook. No contest. Twitter is a business tool. Facebook, while it is trying hard to position itself as a business tool, is a personal update tool. Haven’t used either? Don’t waste time on Facebook, go straight to Twitter.

Are you ready to go? Set up an account at and follow us at @BunnyEllerin and @EileenOBrien.

If you have no clue how to get started, but know you should be on Twitter, contact us for help.