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Ben Plomion, Chief Growth Officer

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Though COVID-19 and its swift and pervasive impact on daily life have cast our present in a shadow of uncertainty, one thing remains clear: We’re in this together.  Overcoming the challenge to our immediate and enduring well-being is taking a combined effort––not just from hospitals, doctors, pharmaceutical companies, medical equipment manufacturers, politicians, and all the other essential enterprises and workers facing the pandemic head-on, but from every American.  Now more than ever, everyone has a part to play. 

For most, the part is small: to protect themselves from contracting and spreading COVID-19 by simply staying home. Businesses, too, must play a part. But, for many, knowing what part to play can be its own challenge. GumGum, a technology and media company specializing in machine learning solutions that extract value from text, images and videos, had the good fortune to recognize its own part early on––and how, in playing that part, it could help other companies play theirs. 

One of GumGum’s core businesses is its contextual ad exchange––a solution specialized for safely and effectively engaging digital audiences. The company immediately recognized that its platform gave it a unique ability to quickly and widely communicate messaging that could help slow the virus’ spread. The company also knew that it could help brands contribute to that effort through GumGum Smile, a unique initiative for making a measurable positive impact on society that it was developing with the Ad Council.

When GumGum is running a GumGum Smile campaign, it donates a portion of every direct advertising dollar spent by brand clients toward creating and distributing messaging that inspires engagement and action around public issues. And no public issue is more important than slowing the spread of COVID-19. 

GumGum launched the first digital coronavirus messaging efforts, in support of a White House- and CDC-backed Ad Council PSA campaign, when in late March it began running pro bono In-Screen ads across its publisher network featuring the hashtag #AloneTogether to communicate the importance of social distancing. 

Many media companies felt the urgency to get the Ad Council’s messaging out, but GumGum was able to initiate its campaign just days after the Ad Council announced that it planned to launch national PSAs in response to the coronavirus pandemic, because GumGum’s ad creative and operations teams are uniquely agile and the company’s pre-existing flexible work-from-home policy meant that it was prepared, infrastructurally, to execute the campaign with all team members working remotely.

The campaign’s performance has been exceptional, delivering 91.5% viewability and a click-through-rate of .41%, more than four times the industry average for digital display advertising. 

GumGum has been utilizing its computer vision and natural language processing powered contextual targeting technologies to reach audiences in both the 65-and-older demographic, to whom COVID-19 poses the greatest risk, and the 18-25 demographic, whose constituents are most likely to flout social distancing protocols.

“Our targeting tactics and strategy have been working extremely well,” explained Ben Plomion, GumGum’s Chief Growth Officer, who helped facilitate the #AloneTogether GumGum Smile initiative. “The campaign is generating tremendous interest in the social distancing message and driving traffic to the CDC’s COVID-19 information site.” 

GumGum has now launched a second campaign utilizing its new In-Video overlay unit, which features a dynamic animation and a new, more direct #StayHome message. With the support of its brand clients, the company plans to continue running GumGum Smile campaigns to facilitate COVID-related PSAs until the threat posed by the virus shows signs of abating. 

“I believe there is no more important message than the one we’re delivering right now, but I want to be clear: GumGum is not doing it alone,” said Plomion. “We’re bringing unique technological capabilities and our platform, but it also takes the patronage of our partners to make it happen. Like with so much right now, we’re getting it done together.”

When the world changed due to COVID-19, we adapted. With a firm digital backbone in place, as a whole we migrated to a true digital-first mindset. The coronavirus pandemic has essentially taught us how to conduct our lives online through working, educating, monitoring our health, socializing, banking, shopping, and more. We have seen the advent of totally virtual scenarios for conferences, meetings, and social events, including holiday gatherings, birthday parties, reunions, and happy hours. Social media has seen an increase in new customers, engagement with existing customers and total screen time. People have changed their behaviors as a whole to get through this pandemic together.

As our thoughts turn to what life will be after this pandemic—the question we’re really asking is: what can we expect? How much behavior change will continue due to residual issues of the pandemic, and will the digital-first mindset continue? Have consumers and professionals come to value certain efficiencies enough to continue to embrace them? What behaviors will be forever changed?

The Healthcare Vertical

For health care, it has been an enormous effort to adjust and reframe, notwithstanding the taxation and overall burden this pandemic has placed on the system here in the United States and worldwide. While dealing with the influx of COVID-19 patients and social distancing measures, medical offices quickly translated their practices to telehealth opportunities to be able to continue to serve the population. The US Department of Health and Human Services eased and/or suspended certain regulations related to telemedicine, which was not a targeted mandate until the year 2021. The rules that were relaxed include the ability to use consumer-oriented video chat services and prescription services. Many health plans also waived copays for telehealth visits.

Telemedicine, still in its infancy, has been afforded an opportunity to shine, and has seen trajectory growth during this period. Telemedicine is predicted to be a behavior that withstands the test of COVID-19 time and leaps ahead into the future. Companies are now making available new insurance plans for small businesses that are centered on telemedicine and virtual primary care. These employers are counting on telemedicine to provide primary care as a way to lower healthcare costs while boosting the overall access to care. When one considers that this type of health care provides an opportunity for broader access to expertise and specialists to underserved areas, while offering convenience and flexibility in timing, lower costs, and ease of use, the prediction certainly makes sense.

Telehealth Adoption

Healthcare professionals are utilizing and benefiting from the available technologies while patients have taken to their phones, tablets, and computers to login for appointments when the doctor is in. On March 1 of this year, 40% of US practices had telemedicine systems. By April 1 that number jumped to 80%! Ninety-five (95%) percent of hospitals in the United States now offer a telemedicine option and 95% of employer-based medical plans offer it as well.

This kind of impact and increase does not happen without consequence however, and much like the way electronic health records systems have strived to develop, telemedicine is still in its infancy as a platform and will need to evolve and adapt to drive more efficiencies and better customer experiences.

Physicians have come to realize the technology as a value-add for their practices and patients. And patients have come to appreciate that they can address certain medical issues from the comfort of their own homes, which has been key during the coronavirus pandemic—a development that will no doubt continue once the current health crisis abates.

At this juncture, telehealth’s growth shows no signs of slowing down and widespread adoption appears imminent. Even when we emerge from this world of social distancing, telehealth is positioned to become mainstream. Look for the future to include more integrations with apps and wearables as an added benefit.

The impending death of the third-party cookie has understandably received a lot of attention from marketers, media agencies and measurement companies – particularly in the pharma industry.

Cookies – those little pieces of information left by websites and saved on browsers, allowing marketers to track online behavior and browsing history – have formed the backbone of many of the digital media tactics pharma marketers have relied on in recent years. Moreover, they provided the industry with countless insights that made our jobs more efficient, helped us to better understand our audiences and got us closer to the truth behind the numbers.

Just five or so years ago, cookies provided us with fantastic new measurement tools that both opened our eyes to new realities and confirmed old assumptions about digital media. Cookies-based measurement helped marketers realize that organic traffic, especially from social channels like Facebook and Twitter, was most impactful. Cookies showed us that endemic advertising drove action and that programmatic advertising could be overwhelmingly efficient.

Not everything about cookies has been perfect from a measurement perspective; in some cases, for example, cookies-based measurement has facilitated an environment that favors efficiency over context. However, as new privacy controls and regulations continue to crumble away third-party cookies, so does some of the progress, solutions and the insights they’ve yielded. As a result, pharma marketers, media agencies and measurement companies are searching for cookie-less tactics to ensure they can still reach their target audiences.

There has already been some headway, with some companies reaching back to old solutions, namely relying on email addresses to identify and connect users through active opt-ins. While this is a logical first step – go with what you know – we learned from experience that opt-in only measurement makes it difficult to discern traffic that is truly representative of actual audiences. This runs the risks of compounding problems we are already experiencing in terms of representation in measurement.

Therefore, it is important for pharma marketers to keep in mind that a few numbers from a results report may not tell the whole story about target audiences and their online – or offline – behaviors. As such, it is necessary for the industry as a whole, including measurement companies, to find ways to measure – possibly through re-weighted analysis and first-party data integrations – that are clearly representative of audience behaviors and needs.

The Death of Social Traffic Measurement, Or the Canary in the Cookies Coal Mine

Safari, which represents a majority of mobile browser usage, hasn’t allowed use of third-party cookies since September 2018. And Google, which represents two-thirds of desktop browser usage via Chrome, has been gradually modifying its cookies policy and plans to eliminate them entirely by 2022. As calls for increased privacy continue to get louder and more public – logically and understandably – even more tech companies will follow suit.

But the dissolution of cookies is not new, as publishers who count on social traffic know very well. Following the Cambridge Analytica scandal, Facebook updated its privacy policy in 2018 and prevented publishers from collecting personal information, including cookies and device IDs, from users browsing in-app. As a result, it became increasingly difficult for publishers who received traffic to their content from Facebook to recognize and identify those visitors, and near-impossible for measurement companies to connect those advertising impressions to identifiers that enable marketers to track downstream impact. For pharma marketers, it meant social-driven traffic to their advertising campaigns was under-represented (or ignored) in impact analyses, potentially affecting willingness to invest in similar campaigns in the future.

Social channels can be useful for driving organic traffic, where a person sees content, identifies with it, and chooses to visit the site. Additionally, social platforms like Facebook have algorithms that help identify people who have interest in certain types of content and then serve them with more, relevant articles. Taken together, early analytic measurement showed the value of social in driving audiences and action.

However, once Facebook eliminated use of third-party cookies to collect personal information, the positive impact of social traffic on ad campaigns began to dissipate, with search – the main driver for measurable traffic – becoming the proxy for performance. As a result, social measurement is essentially living in a “cookie-less” world today. Social publishers are being measured mainly by the value of the search traffic they receive, which is not representative of the business model clients purchase.

In the end, clients lose the ability to optimize media funds accurately, leaving them in a pickle as measurement is only as good as the sample it can collect. Without cookies, current media measurement methods can potentially overlook the context and behaviors of people who find content via social vs. search or other methods.

Fortunately, measurement companies recognize these issues with social measurement and are actively working on solutions. These companies see the trends in social measurement as a canary in the coal mine, an indicator of the issues to come when cookies officially disappear completely, not just for social publishers.

Going Back to the Future, Or Email Opt-Ins Are Our Density… Umm, Destiny

Not too long ago, before the industry realized how to harness cookies in a more analytical way, registered users who provided an email address were a key tool to measure ROI for pharma marketers. At that time, email addresses were the only way to link to patients’ health records in a way that was HIPAA-compliant.

As the reign of cookies comes to an end, I have read and heard a lot about turning back to measurement methods that rely on a website’s opted-in members who provide emails. Because registered users agree to privacy terms, this measurement allows for privacy-compliant methods to collect and connect personal information. So it makes sense that email identification is a leading candidate for the future of pharma digital measurement.

Up until about five years ago, when digital measurement based on cookies became widespread, it was well-known that measurement based on registered users was lacking. The limitations were simple: registered users are often not representative of a site’s traffic.

What's frustrating to the pharma marketer is that, with increasing barriers to third-party cookies, the measurement data available from 2015 to 2017 was more representative than it is today. And today’s data is going to be better than what's coming next. As measurement enhancements and methodologies evolve to safeguard privacy of personal information, it appears we are (unfortunately) regressing in our ability to measure a fully representative audience.

The Takeaway

It is likely that whatever pharma measurement tool the industry lands on, whether that be email opt-ins or new tech integrations, will have some consequences that could – at least temporarily – set back our understanding of how online advertising impacts offline health behaviors. Measurement has extraordinary value, but the best way forward is to recognize that big data solutions require critical understanding of how data collection and methodology impact results.

Mark Zuckerberg said, “Think about what people are doing on Facebook today… they’re building an image and identity for themselves, which in a sense is their brand. They’re connecting with the audience that they want to connect to.” This is the exact strategy that pharma marketers should follow to ensure success with digital and social media. By combining psychology with technology, targeted content can be delivered to patients who are seeking certain health care information in a space where they have a propensity to search at a time when they are trying to make an informed decision. Psychological theories provide a framework for understanding and predicting a myriad of human behaviors and thoughts. Two theories in particular that are most relevant in pharma marketing with digital and social media are the information gap theory and the social proof theory.

The information gap theory of curiosity is relevant in pharma marketing when patients believe that there is empty space between what they know and what they would like to know. Patients crave compelling content. They may be intrigued to know the complete efficacy of a medication prior to introducing a new drug regimen into their personal health care treatment plan. In digital pharma, an effective technique in creating curiosity is developing a headline that captures the attention of readers who will click on it. The 4U formula with headlines that are unique, ultra-specific, useful or relay a sense of urgency drives traffic, shares and search results. “On average, five times as many people read the headline as read the body copy,” according to David Ogilvy whose 1963 book Confession of an Advertising Man is required reading for advertising classes.

Headlines need to be specific enough to attract and persuade readers without being too specific so that readers believe it is unnecessary to click through the data. Information that is forthcoming may be alluded to in a headline, but all of the answers are not provided at the outset. Patients are coaxed into delving deeper. They enthusiastically access the Twitter blog post or Facebook ad by clicking and searching in a definite spot for the information they need.

Another effective technique in generating curiosity is leveraging emotional triggers. It is critical to understand the specific words and behaviors that can be used with patients to drive transformation, cause a reaction and create change. Studies report that emotional responses to a basic online ad have over 200% greater influence on buying power than the actual content. Social media messages that extend beyond the features of medicine and connect with personal feelings and experiences is stronger than a message based solely on science, brand characteristics or facts. It persuades patients to take a moment to consider another point of view and engage in a personal way that has meaning to them. It becomes knowledge that is exchanged in both directions and not a sales pitch aimed purely at the patient.

The social proof theory contributes substantially to the success of digital and social media marketing in pharma when patients who sway other patients adopt beliefs or mimic the actions of individuals that they admire or trust, such as celebrities. Patients have an intense desire to gather information from their influencers, including other patients. For example, patient-generated content, such as online testimonials or reviews, are invaluable in showing other patients that a medical device or prescription medication is dependable. Research indicates that more than 80% of patients click on an online ad with content created by other patients with testimonials.

During the coronavirus pandemic, a surge of patients are directing their attention to online influencers for advice and recommendations instead of seeking medical help at a hospital due to their fear of becoming infected by the disease while at a healthcare facility. With celebrity influencers, some communications about medications and medical devices rely on FDA guidance. Recently, Kim Kardashian West overcame slight adversity with a pharma campaign for Diclegis, a pregnancy morning sickness medication, that stirred up an FDA warning two years ago. Complying with regulatory guidelines while maintaining both transparency and authenticity, helps celebrity influencers prevail over possible negative effects of a flawed marketing campaign.

Another technique in social influencing is adding social plug ins and sharing buttons that show the number of shares a particular sliver of content produced indicating positive experiences that other patients will mimic. Patients who are influenced by the actions of other patients are more likely to send along posts that have been shared by other patients. More traffic is directed to the site when content is shared broadly on social or digital media. The interplay is significantly higher which translates into greater sales and higher revenues. In online patient community chat rooms, such as PatientsLikeMe or AskaPatient, connected patients, who are inspired by the opinions and astuteness of others, take the next step and churn out their experiences by further chatting. Half of the patients who use the internet to self-diagnose with online chat features reserve an appointment with a doctor and then ask the doctor for the brands noted in the chat rooms.

In summary, by integrating into technology not only the information gap theory of curiosity, with headlines and emotional triggers, but also the social proof theory, with social influencers, social plug ins, and sharing buttons, pharma companies experience increased search engine traffic, better brand identity and improved leads. The key is for pharma marketers to provide online paths that help patients and influencers exchange data offering different alternatives to inform decision making. Influencers help build brand trust with almost half of the patients depending on their recommendations from social media. Nearly three quarters of patients who have had positive experiences with a brand are likely to suggest the same brand to their friends and family on Facebook, Twitter, and various patient chat rooms. Pharma companies are realizing that there is not one suitable approach with online marketing; rather incorporating the element of psychology into their online marketing platforms adds to their bottom line success.

Resources

Coleman, D. (2013). Rules engagement: 7 tips for successful pharma content marketing. eyeforpharma.

Cornejo, C. (2017). Social media influencers in healthcare and pharma: What’s their role? WEGO health.

Englestrom, C. (2020). Social media marketing for pharma industry. InsightsSuccess.

Jones, S. (2017). 5 Psychological theories to help you understand your prospects. MPH creative.

Mohsin, M. (2020). 10 social media statistics you need to know in 2020. Oberlo. 

Shewan, D. (2017). 6 ways to use the curiosity gap in your marketing campaigns. WordStream.

Williams, B. (2018). The power of emotion in pharma advertising – stronger than ever in 2018. Bastion brands.

In mid-May, the Commonweath Fund, Harvard University, and Phreesia collaborated to publish findings of COVID-19 impacts on outpatient visits and telehealth; this provides an update to an earlier April publication. From mid-February to mid-May, data from more than 50,000 providers from Phreesia's client base and more than 12 million visits was analyzed.

According to the latest findings, “As in-person visits dropped, telehealth visits increased rapidly before plateauing. The rebound in visits is due to more in-person visits rather than more telemedicine visits.” The research found the rebound in visits to be true across all specialties studied (see chart below). Providers reported consistent data “in the initial decline and resulting rebound in visits” regardless of organization's size.

Age, however, does appear to factor in to the rebound levels. Older adults are showing higher levels for rebounding in doctor visits versus school-age children when comparing April to May data. For example, those aged 65-74 showed a 61% decline in visits for the week starting April 5th but only a 30% decline in visits for the week starting May 10th. Children aged 6-17 recorded a 71% drop in visits the week starting April 5th and a 53% decrease in visits the week starting May 10th.

The Commonwealth Fund “promote[s] a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society’s most vulnerable, including low-income people, the uninsured, and people of color. The Fund carries out this mandate by supporting independent research on health care issues and making grants to improve health care practice and policy. An international program in health policy is designed to stimulate innovative policies and practices in the United States and other industrialized countries,” states their website.

One of the group's researchers, David Linetsky, Phreesia's SVP Life Sciences, also joined DTC Perspectives for our virtual DTC National: May event discussing the Point of Care space. Click here to hear more insights: https://www.dtcperspectives.com/virtual-dtcn/view-past-webinars/

PatientPoint and the Everyday Health Group have created an exclusive partnership to provide consumer and professional content in POC spaces across the country. The partnership “aims to create a more interactive, engaging and immersive point-of-care content experience – replacing fear and anxiety with community, curiosity and confidence,” stated the news announcement.

The release continued, explaining that “EverydayHealth.com consumer health and wellness content to be featured on PatientPoint digital waiting room screens and interactive exam room screens will include engaging, fun and ‘snackable' healthcare news, interactive quizzes/polls/assessments, infographics and tips. Breaking medical news from MedPage Today will be featured on digital PatientPoint screens in the physician back office.”

Mike Collette, Founder and CEO of PatientPoint, along with Dan Stone, President of the Everyday Health Group, proudly expressed their commitment to serve patient populations and healthcare professionals by leveraging technology and engaging, informative content. Both companies continue being among those leading our industry, as providers of health information and news, including during the COVID-19 pandemic.

CheckedUp announced yesterday the launch of their new advanced telemedicine platform for specialty care. CheckedUp Virtual Visits was created by physicians to ensure that its development meets the needs and engages patients and physicians at the point of care, especially as this space and our world become increasingly digital-centric.

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“From early on, our leadership team viewed the COVID-19 crisis as an unprecedented challenge requiring an innovative response,” said Mark Goethals, Vice President of Marketing, CheckedUp [via the news release]. “Our efforts are focused on a new, post-COVID healthcare delivery landscape, delivering the service and functionality of a virtual examination room to patients and enabling providers to deliver superior virtual patient care. CheckedUp Virtual Visits allows physicians to meet their patients when and where they are, while providing innovative tools for providers and patients during their digital consultation. We are also happy to extend that accessibility to our partners in the life sciences, so that they can be a part of tomorrow’s healthcare conversations.”

Dan Schwartz, the company's Senior Vice President, Sponsorship Sales added, “Current telemedicine systems, while serving an important role today, offer very little by way of additional in-office technologies, making exceptional care possible. We expect to change that.” Evolving beyond the traditional telehealth system, the new released noted that their HIPAA-compliant innovation “simplifies scheduling and operations, allows patients to see the dedicated specialist they know and trust, and brings the same easy to use technologies physicians use in the physical exam room, into the virtual realm.” Notes and information from each consult made by the physicians will be tracked to help further streamline the administrative side of such virtual treatment.

It was announced yesterday that Matt McNally, CEO of Outcome Health, has been named to the Board of Directors of the Ad Council. McNally joins “a prestigious group of senior marketing and media executives who provide expertise, insights and financial support to ensure the Ad Council’s social good communication campaigns are effective and impactful,” stated the non-profit organization's news release.

“For Outcome Health this relationship with the Ad Council as an opportunity for new partnerships in areas like content creation, access to new expert content and distribution through our Point of Care network and other new channels,” explains Matt McNally, CEO, Outcome Health. “I have always admired what the Ad Council has done during times of health crisis, from Polio to HIV/AIDS and most recently COVID-19. Our company is looking forward to collaborating with the Ad Council board and its members to advance social change, particularly during this time of unprecedented public health crisis and economic uncertainty.”

According to an industry press announcement, “Outcome Health is the only healthcare platform working with the Ad Council to launch and distribute ‘Out There for Us,' a campaign that thanks all essential workers for their dedication, resilience and courage amidst the COVID-19 pandemic. By distributing the campaign at Point of Care, Outcome Health is giving doctors, nurses, healthcare professionals, allied healthcare workers, pharmacy and support staff on the frontlines a better chance to see these special acknowledgements.” The Ad Council announced the “Out There for Us” campaign this past Monday (April 27th). As an extension of their current and on-going COVID-19 efforts, this campaign will feature “Good Job”, a new song from fifteen-time Grammy winner and musician Alicia Keys. In addition to the POC distribution via Outcome Health, the campaign will also utilize social media, video assets, and digital OOH ads. These will be “strategically placed on route to hospitals, highway road signs and outside grocery stores in cities facing heavy surges of the virus. … a take over within New York City’s Times Square and one of the largest OOH billboards in America, located at the junction of I-10 and 100 in Los Angeles.” The media has been donated from the Ad Council's partners and the creative agency, R/GA developed the work pro bono.

This is the latest work from Outcome Health. The point of care company has been partnering with “nonprofit organizations, health advocacy groups, industry content creators, and its own original content created with information from the CDC and federal and state Departments of Health” to provide accurate and timely information to patients and healthcare professionals. Some of their work has also focused on vulnerable or at-risk populations, including children or domestic abuse sufferers.

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Point of care has always been a critical stage for reaching consumers and patients in their healthcare journey – and now, that has amplified since the emergence of COVID-19. As Mark Boidman, Head of Media & Tech Services at PJ Solomon told Karen Newmark, Executive Director of the Point of Care Communication Council (PoC3) in a recent interview, “there is no better place than the POC setting because it’s an authoritative setting, it’s a trustworthy setting, and it’s a setting where consumers are going to look for information and trust it and listen to it.”

When addressing media buys and inventory at large, Boidman acknowledged that some advertisers have paused, postponed, or cancelled their inventory purchases. But he expressed “the hope is that this is a short-term pause and that things will come back quickly once we come around to the other side of this virus.” He also predicts, when patients resume more normal doctor visits, that point of care will see an increase in traffic as people “realize that health is everything.”

PoC3 issued a message earlier this month to its members and our community at large, recommending four key “important considerations” to DTC marketers: “1. Know that this public health crisis is temporary. … 2. Look at the specifics for your brand and business to guide you in decision making. … 3. ROI and efficiency matter. … 4. Consider appropriate strategic evolutions or shifts within your POC plan.” The association group reminds us that each situation is “unique and will change over time through the course of the pandemic.” Being nimble and accommodating will help best serve patients, healthcare providers, and our industry.

POC3 will also be releasing a COVID-19 study as it relates to the point of care space in the coming weeks. This survey of executives from top POC marketing companies will reveal how such businesses are adapting in a post-COVID-19 world as well as what they are doing to support the healthcare and pharma community during this crisis.