Background

In 2011, the organizers of e-Patient Connections Conference approached Creation Healthcare’s Founder, Daniel Ghinn, after the company’s analysis into recent social media crises in the healthcare arena. They asked if Daniel would prepare a workshop to equip communicators and business leaders in healthcare organizations to be better prepared to identify and respond to a social media crisis, and to facilitate this workshop at e-Patient Connections in Philadelphia. What follows is a summary of the workshop’s content.


Defining Social Media

“Social Media” is a widely-used term, and is just as widely interpreted. When discussing social media, some may think of popular web-based communities they are members of; others might consider applications that keep them in touch with friends or colleagues via their mobile devices. For the purpose of this discussion about social media crises, let’s define “social media” as follows:

Social media includes any online media outlet, application or tool that allows people to collaborate and share information. Access may be via any Internet-connected platform including a desktop computer, tablet or other mobile device.

Many social media sites encourage people to publish information about themselves as a ‘profile’, and allow users to share that information online with others. Social media encompasses a wide range of categories, including but not limited to the following:

Social Networking tools such as Facebook, Badoo, QQ, or LinkedIn; Social Bookmarking tools like Delicious or StumbleUpon; Social News sites including Digg and Reddit; Community Forums such as CafePharma; Social Wikis, like Wikipedia and Intellipedia; Blogs, with tools including Blogspot and WordPress; Microblogging tools, of which the most popular is currently Twitter; and other Sharing sites such as Quora or Answers.com

What’s the Tone?

The way people talk about social media can be an indicator of their feelings towards it. When we consider the kinds of words used to describe social media amongst individuals in any organization we often find a mix of fear and excitement, with each person experiencing more or less of one or other emotion at any time.

Is Social Media Changing the World?

It might seem a bit far-fetched to think that social media could be changing the world, but let’s take a closer look. What is the role of social media in the events that shape history? Does social media change the way in which social events occur, or the speed at which events develop?

Consider this quote from the Los Angeles Times, August 28, 2011, in an article describing recent events in Egypt and Libya:

“…young Egyptians armed with Twitter accounts instead of assault rifles emerged as rebel darlings.”

Or this quote from the UK’s news publisher The Guardian on August 16, 2011, in an article describing how police in London accessed BlackBerry messages as a source of intelligence during the recent riots in UK cities:

“Police revealed they had considered switching off social messaging sites including BBM [BlackBerry Messenger] and Twitter.”

Reports such as these are only likely to heighten the sense of both opportunity and danger associated with social media. For healthcare organizations it is certainly no longer possible to ignore the fact that the engagement landscape has changed forever.

From spark to inferno

Here’s another quote that seems especially relevant to the current social media environment, written well before you or I knew of Facebook or Twitter:

“A tiny spark can set a great forest on fire.” (James 3:5)

In the context of your own organization it can be helpful in crisis planning to consider what a ‘forest fire’ would look like. What is the worst case social media scenario you can imagine? Now, working back from that, what series of events would lead to such a crisis?

Be Prepared

If you can spot the potential ‘forest fire’ when it is just a spark, you can much more easily deal with it, as long as you have good procedures in place. Being prepared starts with listening. There are many ways you can do this – pharmaceutical company Boehringer Ingelheim has developed a comprehensive custom tool to track social media activity around their brands. Others manually monitor social media activity or employ others to do this.

The Price of a Social Media Crisis?

On March 30, 2011, KV Pharmaceutical ranked number one in the Wall Street Journal’s ‘NYSE Biggest Percentage Decliners’ list with a share price that dropped over 20% in one day and, at the time of writing this article almost six months later, has failed to recover.

What went so badly wrong for KV Pharmaceutical? Let’s work backwards…

Earlier the same day, March 30, 2011, the FDA clarified its position with regard to KV Pharmaceutical’s product Makena and stated that it does not intend to take action against pharmacies that compound their own version of the synthetic progesterone product to prevent premature births.

This was important because just three weeks earlier, the FDA had granted orphan drug status to Makena, meaning that only KV Pharmaceutical would be able to sell it for the next seven years. However, when KV Pharmaceutical announced a significant increase in its pricing for the product, angry patients united on a Facebook page entitled “Shame on you, KV Pharmaceutical and CEO Greg Divis”.

The Facebook page rapidly gained hundreds of followers, who were actively engaged in discussions about the product, brand, and the price point. In just three weeks, the page’s 1,400 fans had reached a far wider community and were sharing stories, photos and strategies to engage policymakers.

I asked Christine O’Connell, the Facebook page’s founder, about the role of Facebook in the campaign to rally support. She told me that it provided the best platform to reach many people quickly and share ideas:

“I started this page quite simply because I was outraged. I knew if other people knew about this unconscionable price increase, they’d be outraged too. Facebook gave me the best platform to reach a lot of people in a short time.

My hope was that we’d stir up enough public anger to somehow force KV Pharm to right this wrong. I wasn’t sure how the page could achieve that, but I believed that if we put our heads together, we’d figure something out.

And that’s exactly what happened. Not only did affected moms and dads get involved, but doctors, news reporters and medical organizations joined the conversation. We shared information and ideas on everything from boycotts to contacting our Congressional representatives.

I really think this was the power of social media to inform, educate and rally people at its best! I’m so pleased that common sense has prevailed.”

Social Media vs Traditional Media

Whilst traditional communications processes might have been adequate for most public relations challenges in the conventional world of the established media, this example illustrates how social media has completely changed the rules of engagement. Digital consumers are not playing by the same rules that might have been good enough for crisis management plans based on traditional media.

The reach and speed of a platform like Facebook completely change the environment in which corporate and brand communicators operate. Here are just a few ways in which social media is different from traditional media:

  • The ‘journalists’ of social media do not call your press line to ask you for a quote before they publish
  • Social media publishers ‘go to press’ at any time of day or night
  • Compelling stories have the potential to achieve huge reach very quickly – before you have even woken up
  • In social media, everybody has a voice, instantly.

Digital Governance

Thinking back to the ‘forest fire’ example, it may be helpful to consider the approach taken by fire rangers who look out from towers to spot signs of danger early. In a sense, good digital governance is like good fire rangers. Good digital governance means being in control of your organization’s digital engagement and having clear systems and processes in place to manage this. This is covered in more detail in Robert Hanvik’s article on digital governance.

Some organizations, such as the US Air Force, have developed a clear ‘decision tree’ system to facilitate a rapid and consistent response to digital engagement. Within healthcare, others have learned from this too. In Canada, Pfizer has implemented a similar system that informs an escalation processed based on clear indicators.

Developing a Crisis Plan

With an active listening strategy, and sound digital governance in place, you will be well equipped to develop a social media crisis plan. Your plan should include identification of roles and responsibilities, bases for consistent decisions about engagement, and most importantly it should be well tested.

You can test your social media crisis plan by carrying out a ‘war room’ exercise modeling various social media scenarios. Include anybody who may have a role to play in responding and identify their responsibilities. Such an exercise should help you identify any weaknesses or possible gaps in your systems.

Learning Through Engagement

In the world of healthcare, Johnson & Johnson has had its fair share of social media engagement and, it might be suggested, crises. Amongst the most memorable was the ‘Motrin Mums’ incident in 2008, where an advertising campaign failed to hit the mark with mothers who reacted angrily on Twitter, creating a social media outcry over one weekend that led to wider mainstream media reporting.

The legacy of this social media crisis lives on; social media assets created at its peak are still online including a Youtube video that has had over 111,000 views to date.

Johnson & Johnson was quick to respond, however, using the same channels of engagement as the online community, apologizing via its blog, JNJBTW.com.

In fact, Johnson & Johnson was already, and has continued to be, proactive about its social media presence. Running a Youtube channel since mid-2008, where a high level of engagement takes place, and lessons are learned, the company later established a Twitter presence in 2009.

When I spoke with Rob Halper, Johnson & Johnson’s Director of Video, whilst judging the Healthcare Engagement Strategy Awards in 2010, in which the company won Best Engagement Through Video, he was happy to share advice from his own experience engaging via the J&J Health Channel on Youtube, which posts videos open to comments and has to date served up more than 4.5 million video views. Here are five lessons he shared:

  • Keep the content fresh
  • Monitor comments every day, on a regular basis
  • Be open and honest. If you make a mistake, or offend somebody, take responsibility for it.
  • Don’t try to sneak in a commercial message without being transparent about it.
  • Remember it’s a living organism – it’s not something that’s static. You have to get your hands dirty. And it’s fun!

Has this proactive engagement approach paid off for Johnson & Johnson? I’d say it has! Consistently ranked amongst the top corporate brands in the world, the company was the top pharmaceutical brand and the second corporate brand amongst all sectors in the 2011 Harris Interactive Poll, beaten only by Google.

Engage

So, you are listening to conversations in social media; you have sound digital governance in place; and you have a well-tested crisis plan. Now you can confidently engage via social media, making the most of every opportunity, responding appropriately and safely to all your online stakeholders and reaping the benefits of a successful social media strategy.


To speak with Creation Healthcare about putting in place a safe and effective framework for digital engagement, contact us now.