Award: Healthcare Engagement Strategy 2012 Open Dialogue Award

Winner: AstraZeneca #rxsave Twitter chat

We thought that using Twitter would help us reach a broader audience of community advocates than through our traditional channels”, says Jen McGovern, AstraZeneca’s Director of Patient Assistance Programs, about a one-hour-long live conversation that AstraZeneca hosted last year in the highly public social media environment of Twitter.

Over the past few years, Twitter, the global social media phenomenon where people exchange public messages, or ‘tweets’, restricted to 140 characters each, has been the subject of much debate as a possible platform for stakeholder engagement by regulated organizations. In the case of pharmaceutical companies, while many have a presence on Twitter, few have proactively invited live conversation in the way that AstraZeneca did in their ‘#rxsave’ Twitter chat about patient prescription programs.

A Twitter ‘chat’ is simply a collection of tweets, grouped by a common set of characters preceded by a ‘#’ hash to form a ‘hashtag’ such as ‘#rxsave’. By grouping these messages together, individual Twitter users can listen to and participate in a ‘conversation’ with each other. When AstraZeneca hosted the #rxsave chat in February 2011, they effectively invited anybody who was interested to join in, and provided some context: the chat was about AstraZeneca’s prescriptions savings programs in the US.

Reaching patients

McGovern says that the Twitter chat was an experiment to find out how useful Twitter might be in reaching patients across the US who are eligible for AstraZeneca’s Program. “We wanted to explore Twitter as another channel to engage with community advocates working with patients who are eligible for our programs”, she says. “From offering patient assistance for more than 30 years, we know that for every patient enrolled in our program, there are many more who are eligible but going without their AZ medicines because they haven’t applied. Eligible patients live in communities in every state, making it a challenge to reach them efficiently and effectively.

AstraZeneca also saw the chat as an opportunity to hear from patients. “We wanted feedback on how to operate our prescription assistance programs more effectively and efficiently to serve patients”, says McGovern, adding that the company hoped Twitter would help them “…to get more people talking about prescription assistance programs, and to listen to what people had to say about ways that we could reach more eligible patients.

The chat generated hundreds of tweets from a range of stakeholders with diverse viewpoints. Patients, patient advocacy groups, healthcare professionals, and industry observers joined in the conversation and many more listened in quietly or read the transcript afterwards. Most participants welcomed AstraZeneca’s attempt to engage in an open environment, and as in any public forum, a wide range of views were expressed. The one detractor among over 200 people who used the hashtag failed to put a damper on the constructive conversation.

The response was overwhelmingly positive and participants provided great recommendations and ideas. There was healthy dialogue between @AstraZenecaUS [AstraZeneca’s US Twitter presence] and patient advocate groups, and information sharing among all participants”, says McGovern.

Breaking new ground in a regulated environment

The challenge of real time open conversation for pharmaceutical companies, and one reason why few have attempted it, is summed up in a tweet from AstraZeneca shortly after the start of the chat: “Re Qs about subject matter, we are unable to discuss meds or disease in 140 characters in realtime given current regulations”. In a sensitive regulatory environment, where pharmaceutical companies are limited in what they can discuss directly with patients, the concept of deliberately engaging in two-way Twitter conversation, asking questions to stimulate a public response, broke new ground.

In the absence of FDA guidance at the time, we chose a topic where we could have a robust and worthwhile conversation with participants that didn’t get into specific medications or disease states”, says McGovern, who ‘moderated’ the Twitter conversation and led AstraZeneca’s part in it. “As a pharmaceutical company, when we talk about our medications, we also have to talk about their risks and benefits, which is difficult to do in 140 characters.

The concept of moderating a social media conversation is somewhat limited with Twitter, since the only voice in the conversation that anybody may control is their own. Unlike other social media channels, it is not possible to delete or block any other participant from the conversation, and this is one of the factors that makes Twitter such a risky environment for the unprepared. There is also the challenge of identifying which messages to respond to and doing so in a timely, relevant and regulatory compliant way. “We did experience a high volume of tweets that flowed pretty continuously during the course of the hour.  From an operational standpoint, we found what worked well was to have someone focus on translating the content we wanted to share into the 140-character limit. That freed up one person to read through the tweets and be as responsive to as many as possible without also having to type up the responses”, says McGovern.

McGovern says that the chat was successful in confirming to AstraZeneca its direction regarding working with patient advocates, but that she also hopes the sharing of ideas between participants benefited the people who joined in. “We would like to think those who participated in the chat appreciated seeing the opinions and ideas of others who have an interest in this topic.  The AZ team benefitted from receiving this input.  While many of the ideas and comments put forth were ones that we had considered in the past, or were ones that were outside the scope of our program capabilities or resources, the discussion confirmed some of our thinking about challenges and opportunities for working with advocates as an important channel of information to patients.

Social media policy

McGovern says that Twitter simply provided a new channel to engage stakeholders who AstraZeneca was already speaking with. “We’ve been engaging with advocates for many years talking about strategies for reaching eligible patients.  Using Twitter was really just a way to expand this ongoing conversation”.

When I asked her what recommendations she would give to others in regulated healthcare organizations who want to engage stakeholders in a real-time social media environment like Twitter, she said that it starts with having a well-communicated social media policy:

  1. Have a formal social media policy that aligns your company’s policies and values with the guidance from regulatory agencies such as the FDA.
  2. Be clear with all internal and external stakeholders about your social media policy and the ground rules for the social media event.  Let people know what to expect and how to engage.
  3. Make sure you are doing this for the right reasons – this needs to be part of a thoughtful communications strategy supporting a specific organizational objective. 

For going where others in your environment had not been before in the pursuit of dialogue with patients, we award AstraZeneca the Healthcare Engagement Strategy 2012 Open Dialogue Award.