Digital Commuting Rule of 2-1-1

Every morning I ride the NYC subway from my home to the CementBloc office in Manhattan.   Needing things to do, I have taken to conducting an informal poll of everyone in the subway car.  the poll is observational, and I am categorizing people based on how digital they are on their morning commute:

A)  Digital: Using some sort of electronic device:  smartphone, tablet, even an MP3 player with headphones

B) Analogue:  Reading a newspaper or a book, or a magazine.

C) Totally disconnected:  taking a nap, speaking with a neighbor, or thinking idly.

The typical results of my poll:  Roughly,   (A) is 50%, (B) is 25%, (C) is 25%

By the way, if you are like me, with the newspaper (Wall St Journal) and the smartphone (iPhone) checking email and music concurrently, ou get assigned to the Digital

In other words, the ratio is 2-1-1.  Of course, this depends on the audience and the time of year.  I find that around 7:30 am or 8:00 am the 2-1-1 holds due to students and business commuters that need to stay connected.  In summertime or midday if I run late, a different demographic takes over and you can get more like a 1-1-1 or a 1-1-2.

What does this mean for advertisers who are seeking CRM acquisition prospects?  You may have a captive audience if you can get mobile.  

Going organic: customers, markets, and analytics

It is fascinating to think about the depth of data and connections that one can find when focusing on a particular topic. Take "organic" or "all natural" My colleague Elizabeth Elfenbein and I wrote a Mediapost article with stats on organic trends in the USA. What seemed amorphous is actually quite organzed and is named: Lifestyle of Health and Sustainability. The trend is of continual growth.

We also brought up the perennial nature of organic online behavior, which tends to be of higher quality than promotion responses.   This is because organic visitors to web sites usually have already gathered some other information and are motivated to learn more.

We were also brought into the community of the National Marketing Institute, who has done significant research in this area. They contacted us directly with their expertise. Lesson learned: explore a research project in depth, and reach out to the experts.

Rise in use of QR Print to Online Codes

hSince I last blogged about these 2-D print  "action codes,"  especially QR codes, in February, boy has there been a dramatic increase in their usage.  Take a look at the exponential increase in 2-D action codes in magazines:  over 500 in the month of September, as Mediapost quoted a study by NellyMoser.

QR codes have the highest market share of these at 60%.
The codes are mostly in consumer magazines, and mostly in advertisements.  Healthcare specifically is not cited.

 Thanks to the comment (below)  by reader Ardash K, we can also see there has been a dramatic rise in Google searchers for QR codes.

This shows the mainstream exposure to certain core demographics, and that is a trend that consumer healthcare marketers should realize is at least worth a test.

Turning the Waiting Room into an Education Center

The medical practice waiting room can be a point of either acquisition or conversion for CRM, depending on how educated the patient is about the therapeutic category, and whether that patient is aware of the treatment options.

Come read this week’s MediaPost Marketing:Health Blog to get a perspective on how waiting rooms can be leveraged for better education, and facilitating the patient-doctor dialogue.

There are discussions of how to better educate patients before they see the physician, and techniques for measuring the effectiveness of waiting room programs.

Consumer Youtube channels -- various industries

I've been reviewing YouTube channels of various companies and industries that need to reach consumers. I'm looking for inspirations particularly outside of traditional pharmaceuticals, to industries where consumers need information on how to use products, before making a purchase decision: consider automobiles, cosmetics, and consumer electronics.

The spectrum of channels seems to range from advertising outposts to true peer to peer experiences. At the one end, Honda channels are predominantly commercials, and a few public service corporate videos. Apple's channel is in between in that it delivers instructional videos, but they are delivered in the official corporate messaging and video quality: see this iPad2 video on Apple channel.

Two companies for me have channels exemplifying more of the peer to peer, instructional nature taht consumers in the acquisition stage of CRM really need: http://www.blogger.com/img/blank.gifthey must understand how to use the product. See for example The Mercedes channel, with sample start ups. Video quality less slick but authentic, nad I learn something about the dashboards, engine noise, etc. Then there is Destination Beauty by L'Oreal Paris. Sure, cosmetics firms make plenty of slick commercials with movie stars. But rather than show those, this YouTube portal is a series of tutorial videos by consumer-friendly "artists" that present peer to peer instructions on hos to use the products for face, or hair.

The more authentic, and the more helpful, the YouTube videos, the more influential on CRM conversion they will be.

Social Media recruitment for clinical trials

In rare diseases, one often finds active social media communities of patients and caregivers hungry for information. These communities exist for sharing disease state information, offering support, and occasionally advice on treatment.

Another tremendous application can be recruitment for clinical trials. This is the story of a a recent Mayo Clinic study within cardiology. A team of cardiologists led by Sharonne Hayes, M.D., has contacted survivors of spontaneous coronary artery dissection, also known as SCAD, a poorly understood heart condition that affects just a few thousand Americans every year.

The patient community is within a patient network called WomenHeart

The finding was that for this pilot clinical trial study, the number of patients needed was exceeded within a week; the overflow patients are eligible for a second round, expanded trial.

This is a great example of Acquisition for clinical trials, where social media can be a viable alternative, or complement, to paid media or other event recruitment.

Web analytics trends: more focused, less bouncing

A recently published study, reported on the KissMetrics Blhttp://www.blogger.com/img/blank.gifog, is The 2011 Web Analytics Review. The source of the data is traffic trends from hundreds of thousands of websites across the globe, which have participated in Google’s ongoing study of web browsing behavior.

The study shows year over year differences of a three month time period: Nov. 1 2010 to Feb. 1 2011, versus the same time period a year before. The findings generally show:

* lower bounce rates (leaving from the first page) at 47% on average now
* shorter time on website, at 4:50 average now,
* and fewer pages viewed, down to 4.5 on average.

These figures make good benchmarks for judging engagement of one's own website, although realize that results will differ by country, category, and media mix.

Yet, the trends above hold true worldwide, and also in the USA. There are results for other countries in the report as well.

What might explain these trends, over such a large sample? It can well be the benefit of targeted advertising, combined with improvement of website navigation to be more goal oriented. With this combination, a website has more qualified leads, people with interest and intent, who come to visit. Those interested visits are quickly led to a goal page, or to the information they need.

There are also results broken out by source of website traffic. The most efficient source of all? Cost Per Click paid search, with the lowest bounce rate, the shortest time on websites, yet the highest page totals consumed. This is consistent with the interest of a search initiated customer.

List purchasing and direct mail

One of the ways healthcare companies perform acquisition is via direct mail. It can be a targeted approach to acquire lists and then send patients information. Of course, direct mail can be expensive depending on the piece, and you might expect to get a 1% to 2% response rate on actions like website registrations or calls. Definitely this is an acquisition channel where you can create a basic pro-forma spreadsheet model to gauge potential ROI.

I would recommend Email as an more cost effective alternative for consumer acquisition. These also can be list purchased.

Where do the sources of the lists come from? They are opted in at various sources by the consumers who note that they have a particular condition. The sources of a pharmaceutical direct mail piece to patients is illuminating; see this blog entry and article.

I recommend a test and learn approach when it comes to pharma lists for direct mail or email. Rent a random fraction of the list and see the response rate. Or better yet, use a quantitiy you can afford. Also, consult an agency you trust to find the right list suppliers.

Facebook silent no more for pharma

Until now pharmaceutical companies could launch a branded Facebook page, post news and offers, yet disable comments by viewers to avoid monitoring for adverse event postings. Typical for corporate pharma facebook sites, product pages are harder to find.

However, Facebook has notified pharmaceutical companies that by August 15th they must allow dialogue on these walls. The reason was to enforce and preserve the social spirit of Facebook.

What choices do pharmaceutical companies have after this deadline? There seem to be three options:

(1) Keep their wall pages post free, rendering them like a static website and discouraging return visits and engagement. Per this example.

(2) Continual monitoring and vigilence of content for adverse events using a specialized app or wrapper around the facebook page, and reserving the right to screen for event tracking.

(3) Stay on the sidelines, hard to imagine viable in the long term, given the millions in target demographic consumers that regularly browse Facebook daily.

I would predict an increase in option (2) by this time next year.

Search Engine Optimization -- feeling the impact

Often I am asked by clients I consult with how to improve their search engine optimization. This is a great question, since data shows that:

* Organic searchers are expressing intent and are highly engaged after landing on the website

* More search clickers find the organic listings than the paid listings

* Google is roughly 90% of search engine traffic and is of particular interest.

* It does not require any additional paid media spend

Put it all together, and organic search is a terrific ongoing strategy to enable acquisition for CRM programs.

There are best practices for SEO, and they apply whatever the size of your website.

Consider this Blog you are reading now. As a small time, twice a week technical blogger, I need to get my blog website traffic from where ever I can. Sure I have a few long standing referrals, like Gower Publishing and The CementBloc. Those contribute some traffic. Lately my order of magnitude of visits has doubled, knock on wood. I see this on my Google Analytics reports. The reason is organic search, one of the most high quality sources of traffic you can have.

How did the organic search to this Blog here grow so much, especially on Google? That is a lesson for all website developers in Search Engine Optimization.

Just try running the Google search of "IMS acquires SDI."
Good grief with all the news wires out there, how did this mid-frequency blog of Healthcare Relationship Marketing get to be a top 5 result (and top 5 gets over 70% of the visits) on such a major news story of an industry? This was not planned, I can assure you, but every day, traffic comes here from organic Google keyword searches on that topic.

* Become search-able. Include textual content on highly searched areas: such as tablets, digital trends, health industry and social media, often. Avoid Flash embedding of key text areas.

* Use relevant meta tags. I think my titles and labels really help here.

* Try to become "authoritative" and have valid factual sources on particular areas.

* Multichannel promotion of the website. -- as I update my website, I Tweet, Email, Linked in, and Facebook others so they can have a path to come back here.

* Get your website pointed to by highly respected and trafficked sources. For this blog, things really took off once I got pointed to from highly Followed Tweeters like Relationship Marketing update by Bruce Brown and Salesforce Daily from Paul M and technical blogger J. Polonetsky. Getting pointed to by industry websites by Kyp and adPharm were tremendous helps in not only referral traffic but in establishing credibility for organic search. a big help

Want to dive into SEO traffic for your organization? Feel welcome to contact me at The Bloc.

Also, there is a website from SEOmoz that can give a tutorial and a blog community called SEOMoz where diehard practitioners of search engine optimization best practices for years have been congregating and sharing best practices.

Facebook: cost effective, quality CRM leads

Lots of news recently about advertising on Facebook. Online Media Daily cited E-Marketer data that projects Facebook advertising revenues doubling in 2011.

Yet, on the other hand, an Adweek article last week that Facebook click through rate performance is "abysmal" at about 0.05 percent. Furthermore, the article notes that "The worst performing ad category on Facebook, per Webtrends, was healthcare, which generated 0.011 percent click-through rates and an average cost-per-click of $1.27." That Facebook CTR seems too low for what we've seen, but do not let that deter you either way.

Here is a missing piece of the puzzle: We at The CementBloc have seen that in several major consumer female health categories, that the Facebook click-through leads on pharmaceutical websites are fairly engaged and qualified, far exceeding the goal oriented activity of banner ads on behavioral media networks. However, the Facebook leads are less engaged and goal oriented than either paid or organic search.

What do these numbers mean when put together: A compelling short term Facebook campaign in a high volume consumer health category may let you place 100 million impressions; with ever more demographics on Facebook continually, gaining your large impressions is becoming quite easy. Then your campaign (if having a slightly higher CTR than cited for health) would get 20,000 website visitors for about $26,000. If 10 percent of those attain goals, you have 2,000 highly qualified leads (e.g. registrants or screener takers) at about $13 per qualified lead.

This makes Facebook still more efficient than paid search, and indeed worthwhile considering as a small to mid-scale part of your direct-response consumer marketing mix.

2-D "QR" bar codes

There has been an acceleration of awareness and usage of QR (Quick Response) 2 dimensional bar codes over the past year. A current article in the trade publication CRM Magazine has a QR code overview. This technology is described as an innovative gamble that marketers are taking; it is a low budget allocation, and small but growing awareness by consumers, and readability by smartphone apps. There is even a running blog about 2-D bar codes with very active community postings, including about which mobile phone bar code readers are effective.

A good overview of QR codes and their history is in Wikipedia; they started in auto manufacturing for tracking parts and shipments. Now, an active growth area in QR code usage is in commercial sales and marketing applications.

For an array of pharmaceutical and healthcare advertisements using QR codes, see this link in AdPharm.

At The Bloc we have healthcare clients investigating QR codes for RM related purposes. The primary reason is consumer acquisition, driving from printed offline pieces to a registration website or a promotional offer. The QR codes may in principle be on:

* print ads

* packaging

* patient brochures

* outdoor advertising

All of these are typically a challenge to measure accurately, particularly in a direct response way. As consumer usage of QR codes grows, they may serve as a replacement for vanity URLs which are not always remembered.

Hard data on response rates for QR codes is not standardized yet, but that may be forthcoming within a year or two. In the meantime, this appears a worthwhile experimental healthcare CRM acquisition tactic.

Automated speech processing: commercial state of the art

I have always been fascinated by progress in the area of automated speech processing, since my days as a Master's student at the University of Cambridge in Computer Speech and Language Processing and I spent time with Professor Steve Young at the Cambridge University Machine Intelligence Laboratory.

Thus it was with great interest and pleasure that I read this review of the state of the art of commercial speech processing systems within Scientific American earlier this month. Like many high tech fields, there have been mergers and convergence in the suppliers, to the leader Nuance Communications. Extensive pre-training is no longer required. General listening is now possible in structured sub-languages and categories. Plus, the commercial applications have become widespread, especially related to phone interfaces.

Why is this relevant for healthcare relationship marketing. Possible applications include:

* Acquisition and registration into programs via mobile smartphones, for either patients or professionals.

* Automated dictation transcription processing of the highly structured clinical reports that physicians issue after seeing patients.

* speech to text social network inputs as a convenience, or for the visually impaired.

* processing call center transcripts for marketing intelligence.

* insert your brainstorm here.

Tracking privacy in online advertising

The climate is really shifting in online advertising the past few months. There is heightened awareness from the press on what behavioral information that digital advertisers are collecting. The government is responding:
the Federal Trade Commission has recommended universal “do not track” mechanism that would allow consumers to opt-out of the monitoring systems that follow users’ movements from site to site. For a gooda nalysis on the FTC ruling, see the Privacy Law blog article.

In addition, the leading web browser company, Microsoft, has announced that
the new Internet Explorer browser (IE9) –due out next year will include a “tracking protection” feature that allows users to limit third party data requests.

Meanwhile, online advertisers are trying to insure they are able to deliver effective ads, educating the public on the benefits. See the Wall St Journal blog on their planned campaign.

What are the consequences of increased privacy tools available to consumers? A Forbes magazine blogger notes that this will require marketers to be more intelligent and persuasive with messaging, and not merely rely on consumer background data stored in cookies.

I would say there is another consequence to online advertising and media placement: the premium will be contextual ad placement on relevant content areas, as opposed to websites merely statistically correlated with the advertiser's website.

One final thought ... how many consumers will take advantage of these new privacy features? There has been a mix the past few years.
The "do not call" consumer list gained a fairly high response once it came out. Email span opt out rates can get as high as 10 percent or more on a campaign, showing positive momentum. On the professional side, at first Physician "AMA opt out" of Rx tracking, on the other hand, was fiarly low at the start.

Uptake on privacy tool adoption will depend on publicity, ease of adoption, and the consumer mindset.

Groupons and Healthcare

Are you a Groupon member yet? The group-based, local market volume discount website has been in business for two years and has grown like wildfire. The latest news is how Google has been attempting to purchase them, and as of now Groupon has resisted

Very intriguing to think of how far Groupon can penetrate healthcare. So far Groupon offers have primarily been with cash-based, wellness types of services. These include vision care, spas, dermatology, laser hair removal, and healthclubs. In principle, pharmacies could be active here, for consumer goods and maybe some over the counter items. Indeed, drugstore.com has leveraged Groupon for offers, as shown in this Mom blog.

If you are in a cash-based consumer wellness area, then Groupon seems like a fertile ground for local market retail partnership and testing of offers. It may also be a great venue for acquisition into consumer RM programs.

However, crossing the line to Rx-based medicine seems like purely speculation at this point.

Could Groupons be valuable to new physician group practices that are trying to grow a patient base? A specialty practice physician blogger is considering Groupon as a marketing tool. One hospitalist physician blogger has considered the insurance implications.

Groupon requires login and registration, and so collects data on certain purchase preferences, including health and wellness if those are bid on by the individual joining a group discount. Therefore HIPAA is likely a limitation that prevents placement of more prescription or clinically-based offers.

I look forward to reading studies about the impact of Groupon generally, or on health in particular. Readers are invited to post their thoughts or experiences.

Display banner click rates - falling, but relevant?

A recent article in eMarketer cites a Mediamind study on banner response rates shows a decreasing average annual banner click through rate over the past three years: from .12 percent in 2007 to .09 percent in 2010.

For those not used to reading small banner CTR numbers, what does this figure mean: if you put a banner campaign out in the consumer world, then for each million impressions - per million - then 900 people would click through to your website. Note that if you are running and acquisition campaign and have a great website rate of 10% signups, then your million exposures get you 90 acquired leads.

Thus banners for consumer RM acquisition are, on the surface, not as effective a source as they used to be. True? Is it still a wise choice? That depends on the cost you pay, measured as cost per "lead". You might think of a lead as a website visitor, but really you should get as close to "purchase" as possible.

The study claims that viewers of banners are more likely to purchase than the average person.
However, keep in mind that since banners target by demographics, geographics, and past website viewing behavior, this targeting effect is expected. Also, people rarely view banners in isolation, but as part of a combined media campaign.


To download this report and see the details, click here

The more I experience banner campaigns in pharma CRM, the more I feel that banners are best thought of as brand awareness advertising to reach people near the top of the funnel. Like magazines and billboards, but usually cheaper. Success for banner campaigns is about placement to target audience, and cost efficiencies.

Cost per acquisition buys do exist. However, in healthcare and pharma, the question remains as to whether they can acquire enough.

Blogging on the plane -- abrupt Tysabri landing by AdChoices

OK, while using wireless at 35,000 (first time, thanks Delta), I surfed my personal Yahoo Email and noticed a banner ad at right for Tysabri, a multiple sclerosis medication. Out of place for me given my personal situation. Not sure how I was behaviorally targeted. Learn more about such targeting from Adchoices, click here.


Definitely this was a CRM consumer acquisition media buy. However,
the banner ad brought be abruptly to this landing page. This was a bumpy user experience, I never really learned much about what the drug was, or what the condition was. Just brought me right to the registration form without further explanation.

Lesson learned here? Think about the user experience, and test it in research.

Analyzing iKyp professional data

I always love analyzing and visualizing innovative data streams, and this past week got to look at the output of an IKyp webkey deployment within a pharmaceutical professional setting.


This webkey is an acquisition device for relationship marketing programs, consumer or profesional. It is a USB drive attached to a packet of educational literature, describing the drug, medical device, or professional services. When the drive is inserted into a computer, it calls up a website, that can be a landing page for a CRM or PRM program. In a professional setting, often sales representatives are delivering them to group practices, encouraging the healthcare professionals to sign up for a value added PRM program.

Interestingly, ikyp webkeys all have unique serial numbers, and they can also be programmed to carry a categorical or cohort code, like a sales territory or a metro area. Furthermore, each insertion is date stamped and recorded as a unique transaction in the analytical datamart.

What this means is alot of great analytic potential:

* One can do basic subtotals of how many devices used per day, or per week, and even subtotals by sales territory.

* One can use these for funnel analyses, from manufacturing, to distribution, to usage, to website landing page visits, to registrations.

* Also, the data enables path analysis that can reveal insights. Like how devices are passed around to different professionals, different computers, and used repeatedly over time.

In summary, this mutli-coded physical acquisition device can help a pharmaceutical company understand the effectiveness of its PRM program in ways not seen before.

Social communities: authenticity brings response

Social network communities can serve multiple purposes within CRM: awareness, publicizing a cause, acquisition into a database, or spreading advocacy. However, if you are building a social community, you will get more effect if the social community is authentic.

Very authentic is the new community for metastatic breast cancer from Abraxis,
Share the Little Things. Developed by The CementBloc, this digital community with consumer generated content is groundbreaking. A Facebook presence serves as an alternate portal and awareness vehicle Heartfelt posts by patients, caregivers, family members, and friends show courage and fortitude in the face of this devastating condition. This is a movement, picked up by bloggers struggling with breast cancer.

At the opposite end of the spectrum is a similar looking advertisement,
Get Free Advil. Although appearing as a community at first glance, the advertisement is acknowledged to be models, all in the same stilted pose, pushing samples. Basic product advertising is fine, don't get me wrong, but in Web 3.0, people are seeking communities, and misleading may backfire.

The long tail of online media

How well do you understand online advertising, and where your media company is placing your banner ads and search box results?

Try an exercise... go to Google and type in a small business in your neighborhood.
Perhaps's "Joe's flower shop." You might get a search engine result like this where the results are about florists, and where the text box ads are also about florists and related items. So far so good. Now click on one of the local results, adn you might get a a directory listing link like this.

Notice the banner ads on your local flower shop? Not about flowers -- maybe the ads or for cars, sneakers, mobile phones, even pharmaceutical conditions or particular drugs. Why is this? You weren't looking for these things in your search.

This is a combination of several effects. One is that if you are logged in, and you have cookies enabled, there is demographic and behavioral information that can be leveraged for online media placement. (In fact, try the same exercise while not logged in to any email or social media systems). The other major effect is the media industry's design, a tactic called "the long tail." Note that Ford motors, Nike, or that pharma company did not particularly wish to target Joe's florist and other small businesses for media placement. But their media company may have paid an ad network to find people in a certain demographic: age, gender, spending levels.

Now, how likely is it that a person trying to order flowers from a local shop, will suddenly become interested in buying a car, or go to their doctor about a new pharmaceutical drug? The effect is more likely to be very subtle branding, but not much direct response.

So, if you are placing online media for a direct response consumer RM ad, be proactive and intelligent about where your media company is placing your banners. What percentage of your spend is on this "long tail" that is probably not going to get a very high response rate, due to lack of relevance to the search. If you are paying by the impression (CPM), it may be costly, if you are paying by acquisition (CPA), then perhaps the low hanging fruit can accumulate.