Few would argue that today digital technology represents a critical part of marketing in any business sector.  Though all health care stakeholders are usually late to the technology table, market and customer pressure are rapidly accelerating this adoption. It needs to be emphasized that technologies are not solutions. They must be incorporated into human workflow processes.

To do so in health care, culture must change, specifically with regards to patient participation, shared decision making, and the acceptance of mobile health tools. Digital has been cited as a marketing strategy for pharma. However, a true strategy must embrace the introspective examination of key issues. Who is the customer? What is the role of digital in overall corporate strategy? How do we shift from the traditional marketing and sales infrastructure, strategy, and metrics to one in which digital technologies are incorporated into all corporate silos?

I submit that digital must be an integral part of the foundation of pharma from R & D and clinical trials to marketing and sales. Relegating digital to a separate division implies that it is competing for global corporate resources and that it is an end to itself. I will discuss what is necessary to a true digital strategy.

1. Business partners. Pharma companies are not IT companies. In a recent survey of pharma marketers by COUCH, 92% were unsatisfied with their company’s digital implementation. The majority of responders found the biggest challenges were in the areas of expertise, innovation, and creativity. Marketing in the digital world involves many moving parts. In my view there is not a clear path to the customer. Given the resources devoted to DTC marketing programs and topics at industry conferences, it is evident that pharma now views the patient as the primary customer.

While education to physicians and other providers continues, we see regulatory and logistical barriers restraining those traditional channels. In addition, physicians are being restricted by payers with regards to prescribing, but patients are the consumer, determining if they might be willing to pay more for a given costlier drug.

Whoever the marketing target is however, the digital path is not as direct as traditional marketing. Digital is a pull (by the customer), not a push (by pharma). The customer needs to be engaged at the point of care where it is most relevant. Mobile health tech requires new business models.

For example, from an operations standpoint, there are excellent mobile tools like Prolifiq which can transform the way a life sciences company does business both from an operations and marketing/sales perspectives. Digital strategies should include partnering with companies which address complimentary aspects of a given disease. For instance, companies marketing anticoagulants for atrial fibrillation should partner with medical device companies identifying these patients with remote cardiac monitoring. It is not hard to introduce a digital marketing tool, but there is a significant difference between introduction and adoption.

2. Apps. I have previously discussed why pharma needs mobile apps. The release of the FDA guidance of mobile medical apps was long-awaited by pharma. There are individuals and companies specializing in aspects of mobile health which will make apps appealing and therefore enduring. Partnering opportunities with user experience and behavioral experts who understand how content can be delivered in ways that optimize aesthetics, patient behavior, and clinical workflow is mandatory. Apps delivered via mobile devices at the bedside could help patients understand their diagnoses and medications better prior to discharge. Tools targeted at caregivers who are more connected via smartphones must be an essential piece of the strategy.

With a rapidly increasingly aging population with baby boomers hitting the Medicare threshold, this will become less of an issue. Much has been written about the increasingly blurred lines between consumer and medical apps. Apple’s HealthKit is attempting to merge the two. Pharma would do well to partner with companies like this to deliver their apps in a context of patient management, not specific disease management. This is critical to app adoption because patients with chronic disease need digital platforms which address all their comobidities, not just one aspect of their health. A one stop shopping for apps is much more appealing than a device filled with icons. This is another (and probably the strongest) argument for business partnering as mentioned above.

3. Digital physician KOLs, work with professional societies to develop apps.  My favorite definition of patient engagement is that of the Center for Advancing Health which is “the actions that individuals must take to obtain the greatest benefit from the health care services available to them.” The greatest benefit of derived care comes from being as well-informed as possible and participating in shared decision-making with the provider. A patient cannot by definition be engaged without an engaged partner.

I believe that a DTC marketing approach to apps will not succeed. The root causes of chronic diseases are well-known and rooted in lifestyle behavior. Physicians are uniquely qualified and situated to assist patients in changing behavior.  To leave them out of the loop would be a fundamental flaw in marketing. Physicians will be the digital crossroads of patient-facing apps, provider-facing pharma apps, the EHR, the patient portal, the payer, and the pharmacy. Digital content prescribed by providers will accomplish multiple goals. It will assure the provider that the content is reliable and (hopefully) adherent to privacy and security standards. The provider will know that only filtered actionable data will be transmitted (with other data accessible).

Therefore, the idea of partnering with physicians via digital key opinion leaders, the development and clinical trialing of efficacy of apps in association with professional medical societies should be cornerstones of a pharma digital strategy. Working within these traditional pipeline models, digital can be adopted as quickly as possible.

4. Social media. This is where the action is in digital. Successful apps of all categories have social as a core component of the app. The most successful apps have a social network as a core component. Social is a prime motivator to return to the app, in addition to meeting peers to share the most difficult aspect of being a patient: navigating the health care system. This need for social is the basis for the success of online patient support groups. These groups are potential sources of data which can be extrapolated and grouped according to disease states.

5. Sharing data for population studies. Big data is useless unless good analytics are associated with it, bringing it to life by creating a story and making the data actionable. The combination of point of care content, mobile and analytics will be what truly changes health care in digital.

There are obviously regulatory issues involved in all of the aforementioned imperatives. However, guidelines are in place for all of them and I do not see impediments for successful implementation of them. This list is not meant to be exhaustive but to serve as initial discussion points in broadening the vision of what is perceived today as pharma’s existing digital strategy.

David Lee Scher is a cardiac electrophysiologist and a consultant, DLS Healthcare Consulting, LLC. He blogs at his self-titled site, David Lee Scher, MD.