Understanding the human brain to maximise adult learning

People gain knowledge in a variety of ways, but key in any educational platform is that the training is a memorable and rich experience. This is even more applicable for medical education where the content is sometimes intellectually heavy, and dare I say, often not delivered in the most appealing manner. At Mash, when tasked to provide training programmes, we strive to ensure delivery is interactive, entertaining and pitched appropriately to delegates’ everyday lives.

In a recent programme we’ve developed, the training was designed so delegates could discuss, think and report back to each other on the challenges uncovered during tuition, while minimising ‘chalk and talk’ lecturing. Delegates were also asked to step outside their own world and understand the challenges facing healthcare professionals and other members of their team. With the programme now running globally it’s clear from feedback that the different elements of this type of training fuel learning and, more importantly, motivation. The ethos behind the methods used in our training programmes is based on current thinking. At Mash, we believe in science, and that science is fundamental to what we do. A basic understanding of the functionality of the human brain in information retention is critical when we design and deliver any of our training courses, whether that is internally to clients or externally to healthcare professionals.

Some leading neurologists believe stimulation of different areas of the brain during the learning process improves the transfer of knowledge into long-term memory. However, the brain is made up of different areas with different and complex functions. All regions of the brain have different stimuli, so this is where broad-spectrum learning techniques are required to maximise retention of information in what is normally a short period of time.

Take the brain stem for example – responsible for basic vital life functions. If in a training environment, the brain stem is not satisfied and the student is scared, at the wrong temperature or hungry, the brain stem will distract from the normal higher-level learning processes. The retention of information communicated will decrease and the delegates won’t get the most out of the training. It’s of key significance to look at the bigger picture of the environment in which we will be communicating with our trainees.

Colin Rose’s method, outlined in his book ‘Accelerated Learning for the 21^st Century’, focuses on information absorption and we firmly believe this is critical to running a successful programme. Neuro-linguistic programming (NLP) is the process by which, as humans, we absorb information around us. There are only a finite number of ways that information can enter our brain – the five senses, sight, smell, hearing, touch and taste. Essentially, a delegate will remember 95% of what they teach to someone else, 80% of what is experienced personally by them, 70% of what is discussed with others and up to 30% of what they see, read and hear.

In a corporate environment it is not always appropriate to use all of the NLP pathways. However, by maximising the number of senses stimulated, the amount of information passed into the memory will increase. If, simultaneously, you adopt a teaching method that utilises both linguistic and creative regions of the brain to be stimulated concurrently, then training efficacy is particularly enhanced.

Brain-friendly learning techniques are becoming increasingly common and gaining a larger following among educators. It has become clear that in modern society, traditional teaching methods have less of a role to play as science unlocks more information in the psychology of learning. A change of focus in the teaching methods from traditional styles, as well as a basic understanding of how the brain works, could unlock the potential in you and your delegates. 

Daniel Baldwin

Facilitating Better Patient Communication

In my last blog I made the case that poor patient adherence often results from inadequate communication between healthcare professionals and their patients.  So, how can the healthcare industry help support healthcare professionals (HCPs) in ensuring their patients achieve the optimum benefits from products?

Since communication and relationship building are at the core of everything that Mash does, here are some of our top suggestions to maximise the face-to-face time that patients have with their HCP.

Talk the talk – No two people express themselves, or their symptoms, in exactly the same way. This is complicated further by the divergence in communication styles between men and women, and by age and culture. To facilitate discussion, industry can help establish a common language between the HCP and the patient, utilising discussion aids, for example, so the HCP can better appreciate a patient’s symptoms. Patients can then be reassured that they have been a) heard and b) provided with individualised instructions on how best to manage their condition.

A picture speaks a thousand words – Help speed up diagnoses by providing tools that allow patients to express themselves in a way the doctor can access easily. Simple pictorial representations could dramatically improve identification of symptoms from both a HCP and patient perspective. They may also provide a starting point for discussion and, consequently, help to identify how much the patient understands about their condition – enabling more targeted advice from the HCP.

Be clear, be concise – Recognising what is possible within the confines of a consultation is essential to good patient-HCP communication. Overloading HCPs with recommendations on what to communicate to their patients within a 10-minute consultation may put pressure on the doctor and could overwhelm the patient. Instead, industry can help HCPs communicate by identifying the relevant key points of the condition and treatment advice. This allows both patient and HCP to be confident that the essential details have been covered effectively - and, more importantly, been understood - when the consultation is over.

Knowledge is power – The Department of Health states on its website: “more informed patients are more empowered people”. Industry can help supplement the key points discussed above by providing well written, patient-appropriate literature that also signposts to trusted and verified sources, such as patient support groups, which the HCP can provide to help counter patients’ follow-up questions post-consultation. This not only frees up HCP time during a consultation for more effective discussion, but also caters to those patients that learn visually rather than aurally, or who need additional time to process the HCP’s information; in short, those for whom a 10-minute discussion may not be constructive. HCPs can then be confident that, while they have not been able to discuss every aspect of an illness in detail with their patient, they have provided a credible starting point to help patients become more empowered to  self-educate and self-manage.

Self-management and self-education are becoming increasingly important considerations as rising populations and recession put ever more pressure on global healthcare provisions. So, in addition to clear and concise communications, it is also timely to provide patients with the tools to help themselves. This, in particular, provides the pharmaceutical industry with the opportunity to offer sound, evidence-based information in an accessible format that can genuinely help facilitate and improve HCP interactions while encouraging patient empowerment.


Catriona Raleigh

It’s that time of year again…

With the falling leaves and morning chill in the air, it certainly feels like summer is over.  For all you pharmaceutical marketers, whether you are agency-based or in-house, your environment is however hotting up.  With offices full to the brim with job bags and emails about everything from stand plans to speaker briefs, to the colour of fruit smoothies, it can only mean one thing; it’s conference season!

Conferences are indisputably an integral part of many healthcare professionals’ year, offering an arena for discussion and continued education, as well as interaction with their peers...and industry.  In principle, with your key target audience under one roof, it seems like a highly relevant environment to maximise your engagement with HCPs.  The big question is whether this maximisation requires spending hundreds of thousands of pounds on a top of the range stand and expensive, interactive digital experiences, or whether there are more cost-effective ways of achieving the same thing? With everything for us at Mash beginning with a why, it seems pertinent to ask: why this specific conference? What do you want to achieve? Are you really reaching the HCPs who will be prescribing or recommending your products? And are you reaching enough of them to make it worth the expense?

A fresh look at why you are attending a conference is vital, especially if you are attending “because we do it every year” or “our competitors are always there”.  Not attending a conference does not necessarily do a brand a disservice, especially for products that are market leaders in their field. If you are confident that there are alternative means of communicating to your target audience, or reaching more of the change-activators within your target group, then there’s no need to be intimidated that your competitor is attending and you are not.

Once you make the decision to attend, the next point to consider is how to maximise your investment. What are you hoping to achieve and what will your return look like? For example, if you have a £30,000 outlay on a UK conference attended by 1,000 HCPs, you would hope that 500 of those attendees will visit your stand: a cost of £60 per HCP.  Not too bad, I hear you say, but if you drilled down into the number of truly change-activating conversations held with those stand visitors, then realistically, this could be as low as  25. Working out at a spend of £1,200 per positive HCP connection, it begs the question, is this a reasonable return on investment?

But then you could argue that this calculation is missing a trick as conferences aren’t just about engaging HCPs on your stand.  Conferences often act as catalysts for change and what is happening off-stand, in the symposia, in the poster presentations and on your competitors’ stands, is just as important as what takes place on-stand for your brand. It could also be argued that face-to-face interactions with your target audience enables you to build a deeper understanding of their issues, needs and preferences, which is invaluable in helping you shape your future communications.

So, the right conference can be a good investment and allows you to explore the medical landscape of your brand and not only see where your brand fits but also where to set your sights for the coming year.  Medical marketers should never lose sight, however, of the many other ways to build successful and fruitful relationships between HCPs and the brand - educational programmes and tools, joint working initiatives, CPD modules and PR campaigns - can all offer excellent returns on investment and are viable alternatives to attending a conference just because you think you should.

Does commercially-sponsored CME in the US have a pulse?

Controversy and questions over what’s ethically acceptable persist in an industry where the traditional model of continuing education for HCPs was largely directed by commercial sponsorship from big pharma. There’s no question that the call for transparency and non-biased CME has had a significant impact on what the 2011 model looks like. But, if a recent move by Pfizer is anything to go by commercially-sponsored CME may have just been down, not out.

Back in 2008, at the height of criticism for big pharma-sponsored CME, Pfizer announced they were eliminating all direct funding for CME programs provided by medical education and communication companies. But now in 2011, it seems they’ve found ways to support the CME that shows them in their best light. The National Comprehensive Cancer Network (NCCN) has recently received a $2 million educational grant from Pfizer to support the first CME program measuring the impact on patient outcomes and clinician performance through data collected in the NCCN Oncology Outcomes Database for Breast Cancer. Now, who could lever criticism at such a move? Driving forward physician performance is undoubtedly a goal of CME and a $2M investment is no small chunk of change for furthering progress in this area.

Sponsoring delegate attendance at congresses (see Astra Zeneca’s recent announcement that they’re ceasing to do this), or running overtly promotional events is never going to be en vogue again, particularly with the Sunshine Act coming into effect next year. But we welcome pharma educational grants to improve patient care with open arms. It’s a win-win – transparent, supportive and relevant role for big pharma in CME and it helps us to improve patient care, which is, of course, our ultimate goal.

Gemma Bloomfield

http://www.mashhealth.com/gem-b.html

Why Patient Understanding Directly Impacts Adherence

In a world where immediate access to information is ubiquitous, it might seem strange that low patient understanding is still a front running influencing factor in patient adherence – but there is evidence to show this might be the case.  In fact, a lack of understanding, or a misunderstanding, of a disease and its treatment, combined with a lack of patient confidence in their ability to self-manage, can be compounding factors in low patient adherence. 

At Mash we are all about the “Why?” So, why, when information is theoretically so easily accessible, is patient understanding so low? 

This problem is often attributed to the fact that many physicians (the leading influencers in adherence according to a recent Capgemini report) are restricted in the amount of time they have available to diagnose patients, let alone educate them on the benefits of self-management and compliance.

But, taking the UK as an example, between 1992 and 2007, primary care physicians actually increased the amount of time they could spend with patients, with the average doctor-patient consultation in England now lasting around 11 minutes.  But is increasing the amount of time spent with patients what is needed to increase patient adherence? We feel that in a system where up to 40% of orally treated cancer patients are non-compliant, the problem must be deeper than a simple matter of consultation length.

A recent US study showed that physicians tend to overestimate the amount of information they provide a patient, and underestimate the amount of information a patient would like, during a consultation. In reality, the average doctor only spends 49 seconds discussing a new medication with a patient – a fact which is unlikely to change as a result of minimal increases in face-to-face time. With those statistics in mind it is perhaps less surprising that the recent Capgemini report suggested that up to 50% of patients leave a consultation unsure of their physician's instructions.

To really address the understanding=adherence problem, the attitudes of the healthcare industry towards medication education within the confines of a consultation need to be addressed.  Practitioners require the means to understand their patients’ educational needs and the tools with which to address the knowledge gap. Patients, for their part, may need to adjust their expectations regarding what they need to know from their doctor, and what they are able to educate themselves on – and will consequently need adequate support to self-educate and self-manage.

Therefore, the problem of adherence is not a question of time, but a matter of communication and how that time is used to effectively communicate with a patient to satisfy the evolving requirements of a consultation: to provide not just a diagnosis but also the education needed to enhance patient adherence. But that is a topic for another blog...

Catriona Raleigh

Account Executive

Publishing Evolved

I recently attended a day seminar by the leading evangelists from Adobe -  the market leaders in creating software for graphic and multimedia designers.  Any creative agency will have someone in their ranks who uses Adobe’s Indesign, Photoshop and Illustrator on a daily basis.

These programmes, and the way designers use them  (primarily for creating printed and web based materials), hasn’t changed much in the past 20 years. That is until recently, with the mass introduction of more powerful smartphones, web applications and tablet devices (like the ipad) -  and a little thing called E-pub.

E-pub is essentially, a digital version of a printed piece, formatted specifically for the user’s tablet or smartphone. The user downloads the item and then can read it at their leisure.

With this new way of producing and accessing media, comes a new way of thinking, so our approach to how we can deliver key information gets a much- welcomed additional platform to work on.

At Mash, we often create families of printed materials, such as detail aids, leavepieces and posters. With the introduction of E-pub, we can now offer something new to our clients to fit inside and further enhance these suites of materials.

As the design studio manager for Mash, the thing that has really excited me with E-pub is how we can make content much richer and more engaging, while still delivering the same key messages and data as a printed item.

With printed materials, it is sometimes hard to make the reader interact or fully absorb the data or messaging you are trying to convey.  With E-pub, by doing something as simple as animating a graph, embedding a KOL video or using a 360 degree image that the user can manipulate, you can not only give your information a whole new dimension, but the messages will resonate with greater impact.

For the younger generation, e-pub and the web is the standard way they now access information.  Newspapers and printed magazines are looking to be a thing of the past.  If someone wants to know about the latest dietary supplement, they don’t go to the pharmacy first, they go straight to Google. At Mash, we can offer our clients materials that enable their target audience to easily access their information, and that can only be a good thing. If we can embed the key messages a little deeper at the same time, then even better!

We aren’t anywhere near the point where for example, a digital detail aid will replace a printed detail aid or the personal interaction of a sales rep, but we are at the point where tablets and smartphones are becoming so common that we can expect an e-publication as standard when launching or rebranding a new product.  At Mash, we welcome that with open arms as it gives our creative thinkers a whole new toolbox through which to deliver compelling information within the healthcare market.

In conclusion, E-pub offers an exciting list of possibilities for medical marketing and the way that healthcare practitioners consume information.  It’s in the early stages, but there is no doubt that it’s going to take off in a big way over the next 24 months.  It really does enhance a message, rather then just deliver it in a prettier way. With 3D models, layered images of anatomy with zoom functionality for more detail, videos and sounds, publications within publications….the list of possibilities is endless. I, for one, am very excited!

For more information on how Mash Health can help your company deliver medical marketing e-publications, feel free to call us for a friendly chat on 02089775358.

Craig Hodgkiss

Design Studio Manager

Mash Health’s inaugural round table event

On the evening of the day when thousands of our public servants were striking in response to the Government’s proposed changes to public sector pensions, some of the UK’s leading healthcare experts were discussing some equally controversial issues at Mash Health’s inaugural round table event.

Held at the Royal Society of Medicine, attendees spanning both the private and public sector discussed topics, such as how the current  £20 billion healthcare shortfall can be managed; how  truly to integrate patients into outcomes evaluation and how the Government will determine  the value of a drug, while also endeavouring to create fairness within the provisioning system. With a wide-ranging agenda and an illuminating series of talks from our expert panel, delegates left feeling enlightened and inspired.

Posing the critical question “Who is actually in charge in healthcare?,” Simon Gentry, Managing Director, Campbell Gentry, outlined the complexity of the multiple levels of stakeholders in  UK healthcare at the moment. In broad terms, the big influencers are: ministers, MPs, the media and patient groups. For healthcare to move forward, Simon advised, there is a need to not only engage with these stakeholders but to change current healthcare thinking: focus on solutions and not problems and move from the emphasis on stability to one of positive change.

Dr David Colin Thomé, former National Clinical Director for Primary Care, took up the baton by outlining a vision for NHS commissioning where it truly acts as the “people’s organisation” – ensuring quality of provision and a completely new relationship with providers of care.

Omar Ali, Formulary Development Pharmacist Surrey & Sussex NHS Trust & ERG Panel Member - Cost Impact Modelling for NICE followed with a fascinating and provocative presentation on value-based prescribing. He demystified a complex and nuanced concept and described how NICE will become, in effect, Which? magazine for drugs. In this new world, NICE, rather than saying yes or no to each drug, will have to say yes to all drugs, but stipulate the value of each drug (based on data and Quality Adjusted Life Years) and the price point at which a “yes” for Government funding becomes a “no”.

The consequence of this move will not mean a lowering of drug prices however, it will simply determine the value price the Government is prepared to pay. This price will not be immutable – it will change as and when new data emerge. “There will never be agreement between the NHS and the pharmaceutical industry on the value of a drug because each calculates it differently,” Omar asserted.

Renata Drinkwater, Chief Executive, Expert Patients Programme Community Interest Company (EPPCIC) concluded the series of presentations by outlining EPPCIC’s vision for a truly patient-centred NHS, where patient feedback is rigorously quantified and used to contribute to outcomes evaluation and not just seen as a “tick-box exercise”. One of the key challenges going forward will be convincing commissioners of the value of self-management programmes.

Lively debate and discussions followed, primarily focusing on the struggle of meeting cost-saving targets and the pressing challenges of patient engagement and compliance. It’s clear that the fluctuating nature of the NHS raises some interesting challenges for healthcare professionals and authorities as well as pharmaceutical manufacturing. What is also clear is that it’s time to embrace these changes and recognise the opportunities to change the NHS to be a truly patient-focused organisation.

Our full report on the event will be available from early August, so look out for updates on our website.

Louisa Bassant

Simple and effective patient information is key to the success of any therapy

As we move into an era where, by 2034, 23 per cent of the population is projected to be aged 65 and over compared to 18 per cent aged under 16,¹ more and more people will be living with musculoskeletal diseases, such as osteoarthritis (OA).   

Developments in treatment for both OA and Rheumatoid Arthritis (RA) were showcased at the end of May at the Annual European Congress of Rheumatology organised by EULAR (European League Against Rheumatism).

The exhibition and packed scientific programme clearly demonstrated significant advances in the treatment of musculoskeletal diseases. We have come a long way in the last 100 years.  Take RA for example; 100 years ago patients would be facing the prospect of electric convulsion treatment, whereas today there is a variety of options available, with the most advanced being the cutting edge anti-TNF therapy that is changing the lives of RA sufferers.  Increasing advances are also being made in the management of OA, thanks to the ever-evolving use of hyaluronic acid to replace lost synovial fluid in OA-affected joints.

So, as our population ages, can we confidently say that patients and medical professionals now regard common conditions like OA as ones that are being effectively treated and managed with innovative therapies?  The answer is not as straightforward as you may think, despite musculoskeletal problems estimated to cost European healthcare systems around 200 billion Euros per year.  Effective treatment is only half of the story – as a paper published in this month’s Annals of the Rheumatic Diseases demonstrates.²  It sets out recent efforts to translate the international recommendations for treating RA into patient-friendly language. ²

This is a great step forwards and absolutely necessary if physicians are to achieve the best possible outcomes from any prescribed therapy, not just in relation to rheumatology.  The therapy being prescribed may be the most advanced available, but if the patient is not fully engaged and does not entirely understand the potential benefits that can be achieved by adhering to treatment, then the likelihood of failure is greatly increased.  Here at Mash we have seen time and time again the negative impact of overly technical and complicated patient information compared with the positive impact of clear, simple, well illustrated patient literature that can aid treatment adherence. 

Congratulations to the international Steering Group of rheumatologists and patients who have drawn up this set of patient friendly recommendations. 

1. Office for National Statistics National Population Projections

2. de Wit MPT, Smolen JS, Gossec L, et al. Treating rheumatoid arthritis to target: the patient version of the international recommendations. Annals of the Rheumatic Diseases. June 2011; 70(6): 891-95.

Victoria Harvey, Mash Health.

Three messages and close simply doesn’t cut it any more

The number of pharmaceutical sales reps in the U.S. has declined by 25% in the past five years and a similar trend can be seen across the world. This means sales force effectiveness is a hot topic – how can today’s reps add true value to physicians and their patients?

In May, Team Mash headed to New Brunswick, NJ to attend the Annual US Sales Force Effectiveness (SFE) Conference to find out what leaders in the industry think. 

While it is fair to say that physicians still value sales reps, the traditional sales model of delivering ‘three messages and close’ simply doesn’t work anymore. In order to succeed in today’s selling environment, sales (and marketing) teams must have the capability to develop true, long-lasting partnerships with their customers. So, how does pharma do that?

What came across loud and clear at the conference was that the answer lies in something Mash is hugely passionate about – customer insights! 

It may sound obvious, but pharma needs to back up and re-examine their target audience(s) to really understand what happens in their world. What do they care about? What are their concerns? How can we help them achieve their value proposition? 

A number of models and success stories were presented – ranging from solutions selling to insight selling, but they all had customer-centricity in common.

There’s a quote from Zappo’s Tony Hseih that almost nails it – he says: “Customer service is the new marketing”. It’s pretty close, but I actually think it goes beyond that. What we should be advocating is: “Customer service is the new sales and marketing”. One can’t exist without the other to help them along the way.

Many other exciting subjects were discussed at the SFE conference, ranging from the use of Ipads (do they add value or do busy doctors avoid reps with an Ipad? ) to closed loop marketing. If you would like to see a copy of the Mash Executive Summary of the best bits, please contact gemma@mashhealth.com for more info.

Gemma Mayman