Technology progresses quicker than you can open your advent calendar. Chris Finch analyses what the launch of Microsoft Surface RT will mean for its rivals – and for pharma.

Microsoft announced its intention to go head-to-head with Apple and Google in the battle for tablet computing supremacy with the launch of its Surface RT in October. This is an important step for Microsoft given its recent failure to penetrate the smartphone market with its Windows Phone 7. However, it could also have an impact on pharmaceutical sales and marketing professionals where iPads have seen rapid adoption in recent years.

Apple of my eye
The use of Apple’s iPad by pharmaceutical sales representatives has more than doubled since 2011 and now accounts for 65% of market share, according to a study published by Manhattan Research in August 2012. Interestingly, nearly a third (29%) of doctors in the survey said they were more likely to consider prescribing a drug when a pharmaceutical rep used an iPad during a face-to-face meeting.

Whilst the Manhattan Research data are from the US, in my experience the UK pharmaceutical market is following closely behind. In the last twelve months, we have received a huge increase in requests from our UK healthcare clients for iPad solutions – be that sales materials for representatives or internal business tools. Other suppliers to the industry are experiencing a similar increase in demand. Nick Merryfield, Managing Director of NHIS, commented: “In the last twelve months we have responded to requests from our clients to make our solutions available on an iPad, either by building new apps specifically for the device or by ensuring the compatibility of existing products.”

With this in mind, if you haven’t already been given an iPad by your company then the chances are they are considering doing so soon.

Biting the Apple
Having used the Surface RT for the last month, and the iPad since its launch, and as a supplier of solutions for both platforms, the following is my objective view of both devices as a tool for the pharmaceutical professional.

Apple’s products often generate huge – almost tribal – loyalty amongst their users and the success of the iPhone and iPad indicate that they have got many things right. However, Apple clearly targets consumers; so does the iPad still have the edge in the commercial world?

Not everyone is entirely positive about the proliferation of iPads. Many IT departments are resistant to their adoption because of the difficulty in maintaining multiple platforms and the ’locked down’ nature of Apple’s iPad operating system (iOS). Deploying applications is complicated and iPads do not support the core software used by corporates such as Outlook, Excel, Word and PowerPoint – meaning they are an additional piece of hardware (and expense), rather than a replacement for the laptop.

The Holy Grail of ‘closed loop marketing’ is often talked about within the pharmaceutical industry. But many companies are still some way short of achieving this. If anything, the addition of the iPad has slowed progress even further because of the difficulty of integrating it with other legacy software, leaving some marketers feeling frustrated.

Not all representatives are delighted with the iPad either. In the clamour to get content onto the latest ‘sexy’ device some companies have simply digitised existing materials and put them onto the iPad as a PDF or static application. When speaking recently to a pharmaceutical representative they commented: “Having an iPad is great, but if all it does is show the same content as a paper detail aid with no interactivity, then it’s just another piece of equipment adding weight to my bag.”

Underneath the Surface
The Surface RT has many similarities to the iPad – touch screen, Wi-Fi, apps etc. – but there are some clear differences.

From a hardware perspective, the Surface RT has a magnetic cover that turns into a keyboard. When combined with the built-in kick, this stand makes typing with the Surface a viable alternative to a laptop. The screen of the Surface is a different shape to the iPad and, whilst the widescreen 16:9 aspect ratio looks a bit odd in portrait mode, it is great for displaying video and other content in landscape. The Surface has built-in connectivity that the iPad doesn’t, including full-size USB, micro SD and HD video-out ports. However, from a design perspective, although the Surface looks slick, the simplicity and high quality finish of the iPad takes some beating.

The Surface RT has been launched alongside Windows 8, Microsoft’s latest operating system. The new ’Metro’ interface with its brightly coloured ’live’ tiles is clearly designed with touch screens in mind. However, with Windows 8, users have the same experience whether on a laptop, tablet or smartphone. This lowers the training costs for companies and makes it easier for users. 

Lastly, and perhaps most importantly, the Surface RT runs the traditional Microsoft Office software – Excel, Word and PowerPoint. Although you can’t install other existing Windows applications, this should be a possibility with the Surface Pro, which is launching in 2013. This makes the Surface a viable alternative to a laptop/netbook, making it possible to have a single device – something not currently possible with an iPad. 

Who wins?
There are still many factors in Apple’s favour. The vast number of apps available through the App Store means that the iPad has a head start on the Surface that Microsoft is unlikely to ever catch up.

The retina display of the new iPad has three times the pixels of the Surface’s display, making viewing images and video more pleasurable on the Apple device.  The iPad’s camera beats the Surface’s camera hands down – although I would question how many people actually use their tablet to take pictures or video.

Importantly, there is no 3G option for the Surface RT, so if you want access to your emails whilst out and about, then you need to use tethering on your mobile device or find a Wi-Fi connection.

The future
For most people the iPad would be the device of choice if they were buying it for personal use. As an entertainment tool the iPad is superior with a huge selection of games, video and audio content available, as well as the overwhelming array of apps on the market. But, like it or not, the primary purpose of the iPad provided to you by your company is not to provide your entertainment – it is a business tool with the objective of making you more efficient and effective. This is why the Microsoft Surface may have a big future within the pharmaceutical sector.

As companies refresh their hardware, IT departments are sure to be challenging their sales and marketing colleagues with questions like: “Why have two devices when you can have one?”, “Why support two platforms when you can support one?”, “Why confuse people with multiple operating systems when you can have one consistent experience across every device they use?” In the long term the Surface probably makes life easier for IT departments and makes more financial sense for companies.

However, the Surface may also provide an opportunity for companies to create truly integrated applications that make life easier for the sales people that use them and add more value to the healthcare professionals with whom they interact. Closed loop marketing is a concept often discussed but seldom implemented; perhaps the Microsoft Surface is the vehicle that will finally make it a reality.

Chris is Commercial Director of Software Development Company at The Technology Studio.

Fearless pharma blogger Maxine Vaccine prepares for her new job with a trip to Matalan, the Body Shop and the online NHS.

Yes, it’s true. After the Bank Holiday I’m starting a new job. Those lovely people at Pharmajobs helped me look for the right role, employer and region, put me in touch with specialist agencies and companies that matched my aspirations and talents. And then my line manager at Munchkin Pharma said “Would you like a new role?”

She explained about key account management. No more sales pitch blues, no more marketing message Mondays, no more NLP courses, no more free samples. A new life of consultative selling – providing solutions – being an expert on who you’re selling to rather than what you’re selling. In short, a proper grown-up job. Finally, she asked me: “Do you have any questions?”

I said: “Will I need a new outfit?”

My manager gave me her famous tight smile. “Ah yes, that’s something else we need to discuss. That attitude of yours.”

But seriously, what is changing in my professional life is the shift from a ‘lone wolf’ approach – hitting the road with one goal in mind, only talking when there’s a product to be sold, regarding my colleagues as deadly rivals, living just to put ticks beside names on my list – to a sense of being embedded in a dynamic professional network of stakeholders across various sectors. Every day brings new people and new ideas.

I’m not just a lonely sales functionary, I’m one of many points of contact between a changing company and its changing customer base, and my role is to communicate and learn, to work out how Munchkin Pharma can meet customer needs across a local healthcare landscape that is changing so fast it feels like the NHS has become a computer game. I feel more connected to my own colleagues as well as to the people with whom I’m building commercial relationships.

Instead of the false personalisation of sales – the fake smile, the fluttered eyelashes, the lowered voice – there’s the real personal engagement of understanding what your customer wants to achieve, the customer understanding what you want to achieve, and the common ground on which you both take a step forward. That only happens when you think hard instead of just talking hard.

Farewell to the black book, hello to the iPad. And what’s commanding my attention for much of the working day is the increasingly widespread and diverse character of the NHS online. It’s not just who is commissioning and prescribing, it’s how, for whom, on what basis and according to which budget. If the NHS had a Facebook profile its relationship status would be ‘It’s complicated.’

This weekend, I’m getting my hair reshaped and my wardrobe restocked. I’m partying in my usual restrained style. Another day for rest and recuperation, and I’ll be ready for the working week. And then the real fun will start.

How do you view CRM: as a chore, as a way of saving effort, or as a valuable window on your customers’ world? Leading CRM vendors tell Pf where the pharmaceutical industry sometimes gets it wrong – and how a combination of new business thinking and new technology can turn customer data into powerful insight.

Customer Relationship Management (CRM) is more than an electronic system for data handling. It’s a well-established business strategy for collecting and utilising the most relevant information about the market. As such, it is a function of the whole company that lends itself well to an integrated commercial strategy. A glance at the industry’s news shows that customer and sales data affect every aspect of a pharmaceutical company. Moreover, how a company uses those data to develop its products and communicate their value to customers can have a significant impact on customer relationships.

But is CRM in danger of going stale? Has it become something that only sales people use, and even then not whole-heartedly? Is a perceived lack of progress with CRM due to problems with the technology, the people using it, or companies’ approach to it?

The answer, according to the specialist CRM suppliers Pf spoke with, is all three. But as they also told us, these drivers of fail need to change. A new ‘golden age’ of CRM is on the way.

Dead-end data
According to David Round, General Manager at Cegedim UK, the most common problem of CRM use in the pharma industry is poor awareness of its potential: “If you have a particular group of users who don’t feel the system works for them, and therefore don’t put in the richness of information that they could, that has a bigger impact on the CRM project as a whole.” Unless the company is using CRM to its best advantage, field sales professionals may lack confidence in it as a tool. 

In addition, Round argues, not every CRM system is fit for purpose: “Where technology can be a hindrance is where the way that it works is relatively fixed or determined in some dark room somewhere, and it doesn’t match the day to day process of the people who are using it. The technology, if it’s not designed correctly with the end users in mind, can actually contribute to a lack of return or a reduced return on investment for the CRM solution.”

Adam Nicholson, Commercial Director at Conigi, identifies four sources of CRM blues: CRM only seen as a sales team tool, thinking limited by previous CRM experiences, fear of the system’s complexity and (conversely) fear/perception that it cannot deal with new commercial realities. All of these, he says, are consequences of narrow thinking: “The reality is that if you pick the right vendor and the right solution, you have enough headroom for development to build what you need now and as your business changes.”
Not seeing the wood for the trees, the insights for the data, is another source of CRM frustration. Dan Goldsmith, General Manager at Veeva Europe, argues that the most successful pharma companies are able to derive “rich and insightful information” from CRM by moving “beyond the operational or transactional information” to a deeper analysis of customer behaviours – with the CRM supplier “not just supporting their business processes but helping them innovate the way they engage and architect the customer experience”. 

Nick Plank, Director, C&C Group, says that CRM systems, like pharma’s operational model, have evolved to meet the needs of a changing NHS in the past decade – and will evolve further as technology continues to advance. “Ten years ago, the environment was very much focused on the rep and in particular on the traditional one-to-one face-to-face style of territory organised sales forces. Fast forward to the present and CRM looks very different, with KAM structured teams engaging with customers on an account basis as opposed to a geographical brick structure, plus a variety of new stakeholders in CRM from medical development advisors to medical science liaison. A fully-integrated CRM accessible to multiple stakeholders is now essential if business functions throughout the enterprise are to have holistic visibility of the account and contribute data from their specific areas such as information gathered during digital engagement.”

Keep taking the tablets
All relevant stakeholders are agreed on the revolutionary importance of the iPad and similar tablet computers for CRM in the context of field sales. These devices take CRM out of the office and onto the road more effectively than ever before. They also have the power to support closed-loop marketing and related strategies, giving CRM a more dynamic role in the customer relationship and in the pharma company.

David Round comments: “I think that CRM is about to enter a pretty golden age, because the birth of the tablet computer and the iPad in particular means that the rep can use the system much more effectively on the go. Reps are more inclined to enter information just after the call than wait until they get home, and what the iPad does is give them the ability to record this information with much more richness and much quicker after the interaction. Obviously, mobile access to the internet is still limited in many medical locations, and for this reason, the CRM must be able to provide most of its functionality in an office mode. As many reps would point out – what’s the point of having a mobile CRM that only really works online?”

In addition, the iPad gives the field-based sales rep rapid access to market information at a time when the UK drug market is going through dramatic change. The ability to keep track of the changing customer base and to structure new relationships with new types of customer is essential, and new technology is vital for this. As Adam Nicholson observes: “Gone are the days when you had a linear customer relationship in place and a linear CRM system to manage that. With the changes in the NHS, you’re going to have to have dynamic processes in place and a dynamic solution to manage it as you move forward.”

The iPad is arguably the first technology to make mobile CRM an effective reality. Dan Goldsmith argues that “it really hasn’t been until the introduction of the iPad that we’ve seen both widespread adoption and significant results delivered to pharma”. There are three reasons for that, he says: the mainstream adoption of mobile technology, the industry’s new appetite for “advances in digital and interactive presentations with customers”, and the reliability and simplicity of the iPad itself – “the ideal device at the ideal time”.    

A recent IMS report highlighted the growing importance of embedded business intelligence within the fully-integrated CRM. “This is where hosted European sales data warehouses are particularly useful, because they reduce costs by providing a single integration for analytical CRM across Europe,” says Nick Plank. “A managed hosted European approach to analytical CRM means employees across Europe can access market intelligence online when and where they need it without installing software. It also aligns well with the current move from on-premise systems to Cloud CRM because analytical data can be passed directly to the operational vendor using site-to-site integration – giving reps access to information immediately, wherever they are, via their mobile CRM tools or mobile business intelligence apps.”

Building dynamic relationships
What makes for an effective CRM system? The answer depends on how the sales professional and the company use the system. CRM is not about customer data: it’s about customer relationships.
David Round emphasises the need for “human-centred design”: it’s essential for the CRM user to be able to see the data in context and react appropriately. He uses the analogy of a sat nav system: it’s a superb tool to get you through unknown territory, but you also have to keep your eyes on the road. So the best systems support customer relationships instead of providing an electronic surrogate for them.

Round also warns against being too well-informed. If a rep greets a new customer they have never met before with the words Hi, I’m Jo. How are your children Sally and Billy? the relationship will get off to a bad start. What the rep really needs is the relevant background information to understand the customer’s role and make proactive suggestions from the start.

As Adam Nicholson observes, the CRM system has to deliver insights at both the quick overview and the deeper insight level: “We are rich with data within the industry; the old challenge has always been how you turn that data into information. Successful solutions should allow an individual to look at their data at a top level when they need it, but give them the ability to drill down into the customer data or the sales data to gain more in-depth analysis when needed.” 

The best CRM solutions are able to serve the needs of the most ambitious sales professionals and companies. Dan Goldsmith comments that cutting-edge CRM systems are enabling “interactive presentations, delivering better segmentation and targeting down to a more individual level, as well as collecting more psychographic or behavioural information”. The ultimate (and realisable) goal is a “behavioural profile” of each customer that feeds back into the sales message and interaction.

The bigger picture
The closed-loop marketing model implied by this approach cannot begin and end with sales. Adam Nicholson speaks for all forward-thinking CRM vendors when he says: “If you really want to make CRM work, it’s about engaging all the functions, be that marketing, medical, regulatory or finance, because if you implement the theory of CRM it actually impacts and improves business processes across all the functions.”

If you started reading this article with the mental image of a lonely sales rep (that’s you, that is) wrestling with interminable on-screen figures on a laptop in a hotel room, or on a tiny mobile phone screen in a rail station café, maybe it’s time for you and your company to consider upgrading your hardware, software and probably footwear. New CRM systems are able to support an integrated strategy of commercial interaction at every level of your company, and mobile devices exist to make the most sophisticated CRM systems easily applicable wherever you are.

With the right CRM system, the right mobile platform and the right attitude, you can: research each customer’s needs and behaviours; gain up-to-date information on the rapidly changing customer base; be fully primed with the right clinical information and tailored marketing messages; read and record key information without eyestrain or signal problems; and fit the technology to your individual needs and your company’s business goals. It’s up to you.

UK pharma companies are not doing enough to help medical sales professionals succeed in the modern environment, new qualitative research has shown.

The study, designed to understand the real world challenges of field-based executives, indicates that the working practices of UK pharma sales executives have changed dramatically in the past three years.

The combination of a maturing KAM model, the emergence of joint working and an increasing reliance on iPad technology, is driving a radical shift in the NHS/pharma relationship – and is forcing medical representatives to develop new skills to thrive in the new environment.

But many sales professionals claim that they have been given inadequate support to help them prosper in an evolving marketplace, and that some employers remain reliant upon traditional training methodologies to see them through, despite rhetoric to the contrary.

The findings are the result of the first phase of an ongoing research exercise by Pharmaceutical Field, and follow a series of one-to-one interviews and roundtable discussions with existing sales professionals in the first two months of 2012. “Early indications, from what will be a sustained research programme throughout 2012, are that, across the board, the role of the medical sales professional has evolved considerably,” says Chris Ross, Editor of Pharmaceutical Field. “In 2008, when we conducted a similar exercise, whilst the term Key Account Management was beginning to gain traction, the concept of joint working with the NHS barely merited a mention. But it would seem that both aspects are now playing a central role in the day-to-day work of the medical representative. The problem is, too many argue that the training they are given to manage relationships with their local health economies – and indeed the metrics upon which they are judged – mirrors that of the traditional drugs rep. And when it comes to joint working, the majority of respondents are describing confusion on both sides of the NHS/pharma equation. The industry clearly has work to do in this regard.”

The 2010 launch of the iPad, along with the subsequent introduction of similar mobile devices, has revolutionised customer communications for many industries – and it would appear that pharma is also beginning to enjoy the benefits of digital technologies, albeit slowly. It is estimated that around 25% of UK medical sales professionals are now using iPad or equivalent to detail their products to customers – and this is very much in line with Pf’s research. A fifth of those canvassed have been issued with mobile devices and are using them with customers. Feedback suggests that HCPs find multimedia presentations more engaging and memorable. One regional account manager, from a medium-sized UK pharma company, said: “Gaining time with customers remains one of our biggest challenges, and it’s not unusual to be given just a few minutes in a corridor or a hospital canteen. Making the most of that time is imperative. We’re finding that detailing our products via the iPad has a much greater impact than printed leave-pieces, and the customer experience is significantly improved.”

Despite this, representatives from some of the smaller pharmaceutical companies that have taken part in the study still appear to be using traditional detail aids – and believe that it will take some time before the use of tablet devices in the field reaches a critical mass.

The Pf study also indicated an increasing number of medical sales professionals are choosing to work on contract, rather than on headcount at mainstream pharmaceutical companies – with job security cited as one of the key factors.

At a time when both the Government and the NHS are calling for value for money, how can pharma introduce and promote innovation and value propositions? Tony Swift discusses ways and means of promoting eye-catching solutions through the key account approach.

In my two previous articles, Making it work and It’s all in the execution, I discussed the transition to Key Account Management (KAM) structures that many pharmaceutical companies are currently addressing. They focused on the difficulties of execution and considered various related issues such as:

• The move towards decentralisation
• The role of leadership
• The importance of support from the people in power
• The need to change the culture, beliefs and behaviours of individuals within the business
• The requirement for supporting the new strategy with a process including short-term objectives, incentives and controls that drives the whole execution initiative.

My final article on this topic covers the issue of building innovation and value propositions into a company. This topic is, of course, fundamental to any pharmaceutical company. For example, the rationale for many pharma companies is to build a drug portfolio that differentiates itself from the competition – either through a cost advantage or by improving patient outcomes. This article concentrates on building innovation and value propositions into the KAM process and is based on the premise that to justify moving to Key Account Management, account managers have to be armed with value propositions that are attractive to the customer.

KAM and Jobs
Over Christmas I was lucky enough to receive the recent biography of the late Steve Jobs, the former CEO of Apple. It was a fascinating read and highlighted the pros and cons of working for the guy mainly responsible for building one of the most successful companies in the world. The key message that came out of the book for me was the total focus Jobs had on delivering the very best products for the company’s customers. Apple was able to do this repeatedly with products we are all familiar with, such as the iPhone, iPad and iPod. Jobs also managed to achieve success in the world of animated cinema through his company Pixar, which produced films such as Toy Story, A Bug’s Life and Finding Nemo, before being sold to Disney. Disney bought Pixar primarily because, for the first time in its existence, a company was out performing it in its core area of animated film production.

So why was Jobs continually able to innovate more successfully than his competitors and what lessons can pharma learn from his approach when moving towards a KAM structure? I will address this later, but would note that Jobs’ success had little, if anything, to do with market research and asking the customer what they needed – as Jobs stated, customers don’t know what they want until we’ve shown them.

The demand from pharma
It is clear that pharma’s primary customer, the NHS, is now a series of complex and multi-layered accounts with an increasing number of stakeholders and influencers. Prescribers, payers, patients and policy makers are looking increasingly for pharma companies to offer true value added solutions rather than just products. Key Account Management represents a real opportunity for pharma to develop an effective value proposition and nurture closer and more effective relationships with key customers.

I attended a conference recently and a member of the audience asked a leading member of the NHS how pharmaceutical companies could more actively engage with the health service. The response was: “Don’t just bring pills and gadgets in the future, bring us value added solutions that drive the QIPP agenda with a documented and robust cost/benefit analysis.”                                       

This is an increasingly typical response. Sir Ian Carruthers, Head of the Government Innovation Review Team for the NHS, stated: “The pharma industry needs to think more in terms of working in partnership with the NHS rather than just sending in the sales force…the NHS needs your disruptive contribution to help reform, but too few companies are coming forward.”      

The Government and NHS leaders are crying out for more innovative input, although potential trust problems between the NHS and pharma can impede the implementation of some value added solutions. In any event, there is no doubt that demand for more input from pharma is growing and, given the Government and NHS agenda, it appears this can only continue.

Can pharma deliver?
Our experience at Apodi shows that companies currently differ significantly in their ability to deliver innovation and value added solutions through their Key Account Managers. However, a number of companies are extremely well set up to drive this agenda with specific divisions established to identify new ways of working in partnership with the NHS. Some have managed to integrate the operations of these ‘centres of excellence’ with other parts of the company – particularly brand management, sales and KAM management, and marketing.  In other words, innovation and execution are inextricably linked.
Other companies are not so well positioned or structured to deliver such value added solutions. In this situation, the validity of establishing a KAM structure needs to be addressed. I was recently party to a discussion between a senior executive of a pharma company and a service supplier that went along the following lines:

Service supplier: “Do your KAMs have real value propositions/solutions to take to the customer?”
Senior executive: “No.”
Service supplier: “Why not?”
Senior executive: “There is no real process to identify propositions and any that are identified are blocked because of budgetary constraints, restructuring issues and so on.”
Service supplier: “So why invest in KAMs?”
Senior Executive: (Silence).

Success ultimately depends on the KAM delivering real value to the customer. If that is not possible, companies need to critically analyse whether they should invest in Key Account Management rather than, or as well as, a ‘share of voice’ solution.

An innovative culture
For those companies still at the starting blocks in terms of building and delivering innovative value added solutions to its customer(s), the key question is what steps are needed to drive these processes into the company?

a) Establish a ‘Centre of Excellence’
Firstly, it is clear that it takes investment to truly understand customer issues and develop a deep knowledge of the marketplace to identify how experiences and value can be improved. Such insight is a powerful foundation for strategic, product and service innovations that create value for all parties.
In the early stages, we believe a company needs to establish a function to identify value added solutions. This should be centrally driven and staffed full time by people with the appropriate skills. Whatever these centres of value added excellence are called, their role is to generate propositions that can be shared with other parts of the company to assess whether the propositions should become part of the ‘tool kit’ of Key Account Managers.

b) Develop links with other parts of the organisation
As mentioned earlier, it is critical to link innovation and execution. This may be best done by the company encouraging – even demanding – that the Centre of Excellence coordinates its activities with other parts of the organisation, particularly those involved in executing the value added solutions.
How well a company coordinates these activities and actually makes things happen depends on a number of factors. For example, we have seen companies identifying value added solutions and introduce them to the Key Account Management structure, but then nothing happens. In this situation, the company needs to implement a rigorous process of establishing short-term objectives, incentives and controls to ensure that behaviours change.

c) Focus
Steve Jobs stated that his real passion was to build a company where people were motivated to make great products and that everything else was secondary. The focus he was able to engender in his company was extraordinary. Leaders need to assess whether they are instilling a culture that supports innovation and building value added solutions for their customers.

The impact of value
With the NHS now being a complex, multi-layered organisation with an increasing number of stakeholders and influencers, most value added solutions will differ depending on the company’s particular circumstances, product portfolios, services and so on. They will, however, be focused in one or more of the following areas:

a) Prescribers: solutions may address best patient outcomes, other clinical benefits and cost effectiveness of treatment

b) Policy makers: solutions may address care pathways, disease management targets and integrated care clinics

c) Patients: solutions may address adherence, access, provision of information, support groups and integrated care clinics

d) Payers: solutions that address funding issues, monitoring usage issues, etc.

Back to Steve Jobs     
Ultimately, Apple was so successful in building the most innovative products in its industry because the company, through Steve Jobs, ensured that innovation and value added solutions became part of the DNA of the company.

If a company is establishing a Key Account Management structure, we at Apodi believe that pharma companies need to follow these same principles. After all, what is more important when establishing a KAM structure than making sure account managers are in a position to deliver real value to their customers?  

Tony Swift is the Managing Director of Apodi. He may be reached on tony.swift@apodi.co.uk.

As 2011 draws to a close, it's clear that the world of the medical sales professional continues to change. In an environment increasingly dependent upon proving value, it's pleasing to discover that on a global scale, the work of the drug representative is valued by more than 90% of physicians. Undoubtedly however, the number of representatives in the market place has fallen dramatically in the past few years. In the UK, commentators estimate the collective field force now totals somewhere between 6,500 and 7,000 - a significant reduction from the heyday of some 12,000-plus less than a decade ago.

A key article in this month's Pharmaceutical Field moves beyond the rhetoric of a changing field force and, in an all-too-rare moment of clarity, presents some actual real world data that shows how both contact rates and face-to-face calls with GPs have incrementally fallen in the last ten years. 93% of global physicians may well value the information exchanges they enjoy with industry representatives, but in the UK, access to GPs continues to be a major challenge. In a changing NHS, starved of resource, this will only continue. The fall in contact rates may, of course, simply be due to the industry's wider transition towards a KAM approach – and the fact that newer customers and influencers may be even harder to access than the traditional GP.

One further area of change for sales professionals is the incremental move from traditional detailing methodologies, to more digital means of presenting information using mobile technologies. Between 2006 and 2009, only 16% of new marketing initiatives in Pharma was being developed for mobile devices. By 2010 this global figure is now around the 50% mark – and many of these developments are being placed in the hands of sales representatives via iPad and other mobile devices. Developers and, more importantly, customers claim such presentation is more engaging and memorable – but crucially, the delivery of information to GPs via mobile technology still requires human interaction to bring it truly to life. Digital detailing is there to support the work of the 'rep', not replace it.

So there is much to look forward to as medical sales moves into a new year. The landscape is changing and the challenges don't get any easier – but the value of human-to-human interaction in the exchange of key medical information remains as strong as ever.

Despite huge investments into CRM systems some pharma companies still struggle to get all of their staff to embrace and fully interact with them. Pf’s Iain Bate explores why, and what the future holds for technology in the industry.

There’s no doubt that technological developments have changed the way we live and work from year to year – maybe even from month to month in the 21st Century. But has the world of healthcare been travelling in the slow lane of the intergalactic highway?

The potential that technology offers to pharma, and the general world of healthcare, is enormous. But is the pharmaceutical industry, and its staff in particular, using it to maximise the returns of billion-dollar investments?

It would seem that technology is the ‘buzz word’ on the lips of a few of healthcare’s major players at present. The DH recently invited people to nominate their favourite health-related mobile phone ‘app’ – be it for keeping fit, to locate a hospital or chemist, or helping to manage an illness. Creative minds were also asked to design their own health app with a panel of DH judges deciding on their favourite from the most popular entries.

Health Secretary Andrew Lansley says it’s the Government’s intention to give people better access to information using modern technology and the exercise is a “unique opportunity for the NHS and those who develop apps to not only showcase their work, but to bring to life new ideas and realise true innovation in healthcare”.

As part of the DH’s technology revolution, patients may also soon be offered online consultations with their GPs using programmes such as Skype. Clearly the Government is embracing the convenience technology offers to patients, but are other sectors in healthcare as interested? It would seem there is still some way to go.

 

In two minds

Pf ’s 2010/11 annual Company Perception, Motivation and Satisfaction Survey suggests that not all respondents are completely convinced by the power of technology in the workplace. Although the Survey – which relates to 2010 and the early part of this year – found that nearly 90% of respondents have access to a CRM system, only 43% find time to use it in the field and more than a fifth of people fail to accurately record post-call reports with important clients.

Questions have to be asked as to why, despite multimillion pound investment and training by pharma companies, there remains a percentage of staff that still ignore the power and potential of the technology at their finger tips.

Results from the Survey reveal there’s no difference in uptake by key account managers, primary and secondary care representatives, those in primary care roles only, firstline sales managers and secondline sales managers and the use of CRM technology between differing age groups – although surprisingly 10% of respondents in these positions with less than two years of experience said they did not have a CRM system, compared to just 5% more experienced colleagues.

The launch of the iPad in March 2010 promised to revolutionise the way sales representatives, and those in similar roles, use CRM systems in the field. However, nearly three-quarters (70%) of respondents from the Survey are still presently sent out with laptops containing their customer-relationship systems.

When quizzed on what they’d change about the hardware which houses their system, the majority of respondents said that their CRM was too awkward to carry, with poor running systems an issue and that batteries ran out too quickly. Apple claims its second-generation iPad now enjoys ten hours of use away from a plug socket in the field.

Yet the switch to the latest convenient tablet devices may not necessarily be about high levels of investment, it may be down to maximising value for money as Paul Shawah, Vice President, Multi Channel Strategy, Veeva Systems explains. “I would say the life cycle of devices within the industry is generally about three years, sometimes a little bit longer,” he said. “When a company invests in new technology they typically depreciate that over that period, so they don’t want to replace it in the field for that time to maximise their investment.

“However, with the introduction of game changing technology like the iPad, this has changed. We see a number of our pharmaceutical customers are justifying the business case to move to the iPad even before their tablets are fully depreciated. This speaks to the business benefit that pharma expects to achieve from the iPad and the related applications only available on that device.”

A convenient shield

Despite technology eliminating mundane process in the workplace and offering the potential to assist employees and improve their efficiency at work, it has historically been used as a shield to mask poor performance and abused as a means to waste company time – a recent online survey by AOL found that nearly half of Americans (44.7%) rank surfing the web as their primary activity during the two hours they ‘waste’ each day at work.

But it would seem that a high number of respondents do value the opportunities CRM offers. Almost two-thirds (64%) said they always enter correctly the amount of customer sales they make into their CRM. But 21% admitted they fail to always report face-to-face meetings with clients. More surprisingly, over a fifth of participants said they do not always record the number of products they had sold to clients.

The lack of honest accuracy is surprising considering the amount of time spent using CRM systems each day. A third said they spend between one and two hours a day on their system with a fifth spending three hours or more on their CRM. During their time using the management system, more than half (55%) said that call reporting was the most useful feature.

Although respondents were less impressed with the KAM abilities of their software with only 19% believing it to be the most useful facility. When questioned about what they would change given the chance, 45% said they wanted an improved database, over a quarter (28%) called for their system to be overall more useful, and 18% said they would prefer their CRM to be easier to use.

 

The next level

But what of the future of CRM systems? Will they be easier to use and have improved customer databases? David Round, General Manager, UK, Cegedim Relationship Management, says the regular interaction we now have with technology means we’ve all come to expect the latest developments.

“End users are significantly more ‘technology-savvy’ than their counterparts of even five years ago,” he explained. “If anything, the challenge for companies is to ensure that they provide their end users with the types of technology that they use as consumers. It’s also important to focus on the usability of your software to ensure maximum use. Technology companies – and pharma – must work together to develop a better understanding of the interaction, to ensure it meets users’ needs in the field.”

One main reason that users have become more ‘savvy’ is down to the use and interaction with social media. Whether at home or at work, websites such as Twitter, Facebook, LinkedIn and most recently Google+ have driven an increased use of various forms of technology – especially on devices such as smartphones or tablet devices which reps are calling for in the field.

Pharma companies, both in the US and UK, have flirted with the idea of fully embracing the power social media harnesses, but at present are restricted by the PMCPA’s Code of Practice and by the FDA – who has again delayed the publication of its guidance.

The FDA says it is “difficult to provide a timeframe... due to the extensive work and review process, or ‘Good Guidance Practices’, which ensures that FDA’s stakeholders are provided well vetted guidances articulating FDA’s current thinking on a topic”.

Although the FDA may be unsure on how to direct healthcare companies, David Round believes the introduction, both professionally and personally, of social media has had an impact on staff and their expectations.

“For the modern professional person, much of their everyday life is conducted online – for example on shopping, utilities, insurance or booking a holiday – and many users then want the same level of capability from the tools they use in their job,” he added.

Dan Goldsmith, General Manager, Veeva Europe, agrees there has been a significant shift in the way we operate and interact due to our experiences online through tagged posts or hash-tagged searches. But although the 800 million users on Facebook – more than half which ‘log-on’ every day – and 175 million people on Twitter have no problem saying hello to friends, pharma finds it more difficult reaching out to people.

“Social media create a new avenue for healthcare dialogue and will only continue to pervade our lives,” said Dan. “Consequently, I believe that pharma faces two challenges. The first is to decide how to participate in the online dialogue with stakeholders and then to create those interactions through the channels we’re all familiar with, such as Facebook and Twitter.

“The second is to figure out how to leverage the model of social dialogue internally to support stronger collaboration and more focused communication among employees. Already, we see some companies taking advantage of the latest social business tools to connect employees with one another and to access and share information in real time.”

Clearly CRM solution providers understand the potential modern technology and social media platforms offer to companies. Whether pharma and its workforce get fully up to speed on the intergalactic highway sooner or later remains to be seen.

The FDA has approved Calgary Scientific’s medical imaging device, ResolutionMD Mobile, as a mobile diagnostic app for use in the US.

The new technology gives physicians remote access to patient images and reports stored within any healthcare facility, enabling clinical diagnosis of the patient from any location.

Dr James A. Brink, Professor and Chair of the Department of Diagnostic Radiology at Yale University School of Medicine, said: “The ability to view diagnostic quality images on mobile devices promises to speed healthcare delivery, particularly for urgent conditions or after hours.”

The mobile app promises complete security and advanced capabilities through minimal bandwidth, even on 3/4G wireless. The technology also ensures that patient image data cannot be lost or stolen, and no highly sensitive or confidential patient data is ever retained on the device.

Dr Byron Osing, CEO and Chair of Calgary Scientific, said: “Lost or stolen patient data is a critical issue in the medical IT sector, with regular announcements of significant HIPAA compliance fines being levied and legal settlements in the tens of millions of dollars.”

“The FDA clearance of the ResolutionMD solution is a key strategic step forward for the Medical IT sector in enabling a high performance and secure ‘mHealth’ paradigm, as well as ensuring that vast regions of the world that are currently dependent upon wireless connectivity can now leapfrog directly into the realm of advanced medical solutions," added Dr Osing. 

Non-diagnostic versions of the app are already licensed under OEM agreements with global leaders in medical imaging and information technology.

The software has also been approved by Health Canada, has acquired the CE Mark for distribution in the EU, and is available on Apple iPhone and iPad devices. 

Calgary Scientific is a provider of accessible, advanced visualisation solutions in medical imaging and web, mobility and collaboration enablement technologies, used to help industries achieve secure access with their existing technology.

Healthcare is in the top three sectors for business use of the iPad, according to data from US company Good Technology.

The company believes health services are embracing the iPad because “its unique design makes it easier to perform time-sensitive, mission-critical tasks”.

Its conclusions are based on an analysis of the company’s customer base, whose iPad deployments range from one to more than 1,000 iPads.

John Herrema, Senior Vice President of Corporate Strategy at Good Technology, said: “We took a close look at our customers who have deployed iPad devices so far. We found that the financial services sector dominated, accounting for 36% of Good's iPad activations to date. The technology sector came in second at 11%, followed closely by healthcare at 10 percent.”

One example of this uptake is Kaweah Delta Health Care District in California, which is using the iPad in areas like pharmacy, emergency, dietary, home health, hospice, clinical engineering/bioMed and for private practice physicians and nursing supervisors.

“One reason the iPad is being adopted in the industry is because hospitals' current mobile devices have become a ‘barrier’ due to their size, weight and battery life,” said Nick Volosin, ISS director of technical services at Kaweah Delta Health Care District.

In addition, the emergency department estimates that it could trade a COW (computer on wheels), which costs $7,500, for three iPads, costing $1,500.

Kaweah Delta Health Care District is also looking into having the iPad work with a barcode scanner for a portable device for MAK (Medication Administration Check), added Volosin, which helps prevent medication errors.

Experts predict that the tablet computer could be a ‘game changer’ for Electronic Health Records (EHR) adoption, due to EHR applications that are specifically designed for the iPad.

By Di Spencer, Pf Web Editor

In a recent poll, you (users of Pf’s website) voted in favour of the use of the iPad by the pharmaceutical sales force. A pretty solid majority of 44% agreed that pharma sales people should have the use of iPads in the field. A more reserved 31% felt that the use of iPads ‘might be appropriate in some cases’, while a further 20% felt there is no need to replace current CRM systems. Demonstrating your commitment to equality, just 5% you held the view that only professionals in certain roles should have the use of iPads.

The iPad – in case you’ve been living in a cave for the last few months – is the latest attempt by iPod and iPhone creators Apple to convince us that their range of electronic products beginning with i are vital to our existence in the modern world. Essentially, it is a tablet computer designed as a platform for audio and visual media and web content – fulfilling similar functions to the iPhone, albeit on a larger scale, but is much bigger and therefore awkward to carry around.

OK, so you may have detected a hint of cynicism in my tone, but I’m reliably informed that many people consider the iPad the greatest thing since sliced bread (it was, apparently, the most successful launch of a computer product ever) , and some of these people work for pharma companies. The industry has been quick to jump on the bandwagon and, judging by the results of our poll, sales executives are strongly in favour of this kind of revolution.

Its appeal lies in its low weight, long battery life, ease of use, relatively low cost and the fact that it can be used for presenting product information in an attractive and interactive format. Companies are even looking into following up basic presentations with ‘apps’ that doctors can download to their own iPads or pass on to patients.

Whether or not the iPad is going to lead to a revolution in pharma sales remains to be seen. But what do you think? Do you agree with our poll results? Will the iPad provide genuine value to the ‘rep in the field’, or is it just a case of everyone wanting the latest flashy gadget?

For more on the pros and cons of using the iPad in pharma field sales, see Andrew Tolve’s comprehensive discussion of the issue.

Contact the author: diana.spencer@healthpublishing.co.uk