Transitioning from local to global engagement

By Paul Grant

Engagement’ was a hot topic at the ePharma Summit, then again a few days later in New York where I presented the [intlink id=”hes2010-winners” type=”post”]award winning engagement strategies from the HES Awards[/intlink] at the Hilton Times Square.

Some of the thought-provoking questions which arose in discussions about engagement:

  • Where does ‘engagement strategy’ sit within an organisation?
  • Should each country have one, or each brand?
  • Who should be involved in defining it?
  • Is it an output of the marketing department, communications, IT, PR, brand teams, legal, policy, or perhaps a new division that we need to form?

The answer is potentially much more difficult, and yet fantastically rewarding for those companies that dare to embrace the future. Here it is;

“Healthcare engagement strategy sits above all functional departments of an organisation.”

Engagement Strategy affects the entire business

Think of it in this way. At the most fundamental level, an engagement strategy defines the idealized relationship between the company and the people who distribute or buy the company’s products and services. It will be a defining characteristic of the parent brand.

It is true that global change has introduced a paradigm shift for communications teams to consider, thanks to the advent and uptake of social media. The concept of engagement in a digital world absolutely requires ‘two-way’ connections, by default. Thus a challenge.

Regulated industries with established organisational structure and procedures are simply not yet in a position to move quickly enough – for the moment. Notwithstanding this, we know that we can help individual brands and departments to do their best in pushing the envelope within the constraints of the organisation, or country legal framework.

For the most significant result, there is only one way that an organisation can change en mass. From the top. Such a statement creates another more complex problem: Where is the top? Is it the global headquarters, a brand leadership team, or perhaps an individual territory or divisional head?

‘The top’, in my opinion, is the person or persons who have ultimate responsibility for the face of the brand and the relationship with the customer – globally.

The Internet nation

By now we should all know that the Internet has no rigid or territorial boundaries, according to established legal or geographic definitions. A semblance of difference exists in the use of top-level domain names such as .co.uk, .it, .eu, or .com, although these hardly define or limit the area of reach and operation.

This may be a hard pill to swallow, but it is the unavoidable truth.

The Internet is actually a single globe-wide ‘nation’ of information providers and information seekers. There is no governing body, no single law enforcement, and no passport to become a citizen of this nation. All that is required by an individual or group is a data connection and a computing device.

In our experience, the boundaries of this nation are lingual, not legal. Creation Healthcare research across many languages and countries has shown us that online health consumers do not look for information based on where they live. They seek answers based on their own personal health symptoms, using the language vocabulary that they have available to them.

Successful community platforms such as patientslikeme.com and tudiabetes.org are testament to the perceived value that patients experience when they are able to find another person, anywhere in the world, that has the same healthcare needs as their own.

For those who have only one language and are non-English speaking, there is a tremendous disadvantage for in terms of their possibilities for obtaining health information. Many of the best sources of health information online are still predominantly in English. We refer to this social injustice as the ‘Health Divide’, a phenomena affected by other larger issues such as culture, digital inclusion, literacy, economics, age, and more. You can read more about this in Daniel Ghinn’s article “Language barriers create a new digital health divide“.


Global Engagement Strategy

An engagement strategy will truly work with continuity and consistency when it has global definition. At Creation Healthcare we talk about “Global strategy, local knowledge”, because we know that rolling out a global strategy requires knowledge of the local legal and cultural context.

My quiet prediction is the first pharmaceutical company that gets this right will be the world leader in product sales within five years.

Seriously defining a global engagement strategy requires overcoming a few challenges. These needn’t be overwhelming. As with any corporate transformation it may take a lot of planning and hard work, but may be the determining factor which gives the winning competitive edge.

Internal considerations

Knowledge on how to do it

One of the most common obstacles to defining and implementing a global strategy is the lack of knowledge in the first place on how to even approach the subject.

Few companies have a global engagement strategy in place, even outside of pharmaceutical and medical device manufacturers. They may have a strategy for global logistics, sales and research pipelines, core functions necessary for a global business, a global employment policy, a global outsourcing policy, yet what we are talking about is quite different.

In principle, the guiding question for defining global engagement strategy is, “how will our brands interact with people and be perceived by people all over the world?”. Note, this is not about any particular channel (social media included), it is a guiding principle.

Independent global strategic consultancies such as Creation Healthcare aim to understand the nuances of culture and language and how to navigate the differing legal frameworks, so that executive teams can workshop these issues in a fully informed way.

Designated budget

Budget for a lot of pharmaceutical initiatives are usually assigned by a brand team and may only be sufficient for one territory based on the cost-centre. There is little reason for such a team to think on a global scale, unless the corporate culture is modified to include motivational incentives. Alternately, the control of budget can be changed so that the purse strings are released only when a suitable global engagement strategy is in place.


An international company may have very little time available for new initiatives, culture change, or training relating to new concepts.

Yet the most dynamic companies of this age are committed to company wide training every week. Employees of Google spend 4 hours each week on individual and group training, simply to keep up with the changes in their own product suite. How much more so do companies need to up-skill and become aware of the enabling technologies and platforms which could be simplifying and contributing to their own global engagement strategy?

A misinterpretation of ‘global’

For some organisations, any job title with ‘global’ in it means that the person is part of the “others”. That is, they are not in the principal territory for the company, but are in the ‘rest of the world’ division. In this situation there is an internal cultural change required, which can sometimes even necessitate organisational structure change too.


If your company is based in the United States, or France or Asia, it is easy to be predominantly focused on that landscape in that territory. Often this territory garners the most sales. We call this ‘centricity’ i.e US-centric, Franco-centric etc.

Creation Healthcare has found that unless a company headquarters is actively interested in learning about the differences and inputs of other territories, any effectiveness of engagement strategy will be limited to the ‘home’ country.


Again a product of centricity, the corporate company headquarters will usually have the principal internal or external legal advisors. If these legal advisors are predominantly corporate lawyers based in (and experts in) the home country or are not strong in international law, there will not be a comprehensive understanding of the needs and legal constraints in other territories.

Lack of supporting infrastructure

Given that many companies have a heritage lasting decades and even centuries, it is no surprise that the corporate structure is less than nimble and is based on many years of doing business in the same way.

Infrastructure which can cause resistance to global engagement strategy includes; reporting structures, financial and accounting centres, communications teams, marketing teams, IT systems and so on.

I remember how a European company hired a new CEO from the US. When he started his first day he attempted to contact his family back in North America using Skype and Facebook. His computer network settings would not allow it, so he called up the IT Manager, who nervously explained that their corporate policy did not allow it – so that the company network was protected from danger and for the purpose of employee productivity. The forward thinking CEO instantly insisted that the ban be lifted and that he be given immediate access to these globally accepted industry tools.

It is an interesting story which makes a valid point. Perhaps no other individual would be able to bring about such a change so quickly. It is for this same reason that the only real hope of successfully defining a global strategy is when it is led from the top.

The acquisition and merger of pharmaceutical companies affords a unique opportunity to consider structural change which may lean towards globally-focussed leadership and global implementation.

Not thinking that a campaign can be global from the outset

If at the outset, a campaign is targeted at one territory, then it is no surprise that it may not ‘roll out’ particularly well on an international stage. Very few teams actually start with an expectation that a campaign or a strategy will be global, however this simple paradigm shift can make a massive difference to the operation and reach of marketing budgets.

One globally focused pharmaceutical company is ensuring that there are KPIs and bonuses for teams that think globally.

Ask yourself, “how readily useful in other territories is the work that you are producing for your own brand?”

Technology considerations

Geographic implementation challenges

If a campaign relies heavily on one platform which is state-of-the-art, there will automatically be many regions of both the developed and underdeveloped world that simply cannot take advantage of these assets.

Different preferences by language area

Creation Healthcare studies have shown that different language types have favored platforms for interaction. For example, it is very generally true that German speaking Europeans are more likely to engage using Twitter than Spanish speaking Europeans. Also in some therapeutic areas Spanish speakers use blogs and wikis as a source of healthcare information, whereas French speakers spend more time on forums. In many areas of digital engagement, the United States is approximately 12-17 months ahead of Europe in adoption trends.

Silos of information

A problem which exists in many corporations, not only within the pharmaceutical industry, is that there are usually a number of locations where information is held. Poor knowledge management and information systems are still holding back efficiencies. Such disparate silos of information mean that the possibility of discovering trends is very difficult, and the guarantee of consistent global communication unlikely.

This cascades down to inevitably create a disconnect between the various steps taken by a patient or healthcare professional as they experience the brand.

At the most basic level, media itself is not global

Aside from internal and technological constraints, it is an unfortunate fact that the media and communications industry are themselves not truly global in their reach or ability to roll-out global initiatives. A person buying a media package, or a license for one territory, may be confounded by obstacles when trying to reach into a different territory.

Health Divide

As mentioned previously; ageism, language, financial circumstance and many other factors mean that the provision and acquisition of healthcare services do not occur on an even playing field.

In conclusion

I’ll admit that this reads like a list of reasons why global engagement strategy isn’t possible. Perhaps this is a bridge too far for some. I am also aware that this is only an introductory list of items and that there are many other individual and unique considerations for every organisation.

In spite of this, we humans love a challenge. Many of the greatest and most significant legacies to the human race started with a problem or a grand vision of the future.

For those that are willing to embrace the changing globe, and the changing expectation of the people of the Internet nation – the world is yours.

If you would like to discuss these matters in a more confidential setting, please [intlink id=”contact” type=”page”]contact us[/intlink].

If you have some thoughts which you would be happy to make public on this matter, tweet it out with the hashtag #globalengagement.

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Meet the Author

Paul Grant