From Ads to Apps

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The changing expectations of healthcare stakeholders are colliding with an explosion of new technologies and greater connectivity, and pharma brands are at the very early stages of experimenting with mobile apps for healthcare professionals and patients as another way to extend their value beyond the molecule. But apps are more than just another form of advertising.
Moving from ads to mobile apps sets in motion many fundamental changes in the traditional advertising model, not the least of which is the kind of people and the types of skills that are required in this new world. Meg Walsh, former healthcare ad agency executive and now EVP, strategy and business development, Augme Mobile, says, “Consumers still react to brand messaging and understand it is part of the fabric of the internet, but they will only interact if there is some benefit or fulfillment of their immediate needs.”
In other words, they want the communication, whether it's an ad or something else, to connect to a service center where they can get what they want, when they want it.
Just launching discrete ads for the sole purpose of brand awareness, disconnected from a broader service platform, doesn't cut it anymore. Unlike the old days, both patients and healthcare professionals are asking for the value up front before trading their time and attention to endure a brief sponsorship message from a brand. “Sponsored services” are becoming more welcome than traditional ads, which may be one reason why DTC spending in 2009 increased a mere 2% from 2008, according to Nielsen Company, and why clinicians are increasingly using apps on their smartphones to educate themselves and help treat their patients.

Seeking new stimuli
Last fall, I was fortunate to get out of my office to listen to some very interesting speakers at several events that have, in many ways, confirmed that I am not the only one who suspects that this shift is important. With the exception of CNN founder Ted Turner, many of the most memorable presenters shared a vision of the future that is a sharp departure from the past. By the way, Turner shared this gem with the audience at the mHealth Summit in Washington, DC: “Early to bed, early to rise, work like hell and advertise.” Then again, he's always been a contrarian.
At another fall event, this one in Boston, Maurice Lévy, chairman and chief executive of the French advertising giant Publicis Groupe, was followed immediately on stage by actor-turned-social-media-guru Ashton Kutcher. They are, of course, two people with very different backgrounds and experiences, but they shared the view that the traditional advertising model is breaking down.
With over 40 years of accumulated wisdom at Publicis, Lévy was very precise when he repeated his new mantra: “Advertising is a service.” His efforts to digitize his massive agency network in the past five years have been well publicized, and in the healthcare space have included acquisitions of Digitas and Razorfish. Lévy's premise was that advertising today must provide access to a deeper brand experience, including services that provide real value to customers. He provided examples of how this fundamental change is happening globally, and how low-cost product and service innovations in the developing world are becoming more rapidly adopted by developing countries, what is sometimes called “reverse innovation.”

Social networks and the ‘app internet'
Kutcher, with considerably less than 40 years of experience in advertising, currently promotes Nikon cameras and leads a social media consultancy. He spoke with utter confidence that platforms like Facebook and Twitter should be “used for what they were built for, which is not advertising.” Instead of ads, his agency, Katalyst Media, “creates thought-provoking and compelling content for multiple platforms,” and has even helped brands like Mountain Dew engage its audience as co-creators in new product development. Maybe content is king again, and smart content distribution is the new killer app.
Even the name “social media” gives us a sense that like other media, eyeballs can be bought, reach and frequency managed, and awareness predicted. But just as radio ads don't work on TV, and TV ads don't work on the web, internet display ads don't seem to work very well in online social environments. The “media” in social media are people and their connections, which are fickle, unpredictable and difficult to scale like gross rating points.
At the same event, Forrester Research CEO George Colony proclaimed: “Technology is changing your customer, and your customer will change your business.” He then traced the evolution of computing from PCs to the cloud, and suggested that the next era of the web is the “app internet.” According to Colony: “In this model, powerful local devices (PCs, smartphones, tablets) run applications that simultaneously and seamlessly take advantage of resources in the web/cloud. If you want to see this model in action, check out iPhone and Android applications.”
Perhaps Colony's most memorable quote, however, was that “IT and marketing must interbreed,” suggesting that the two disciplines have become so intertwined in the past few decades that it's nearly impossible today to market products and services without technology. To put a finer point on it, technology is not just enabling the marketing function, it's transforming it. Ads generally benefit from the application of technology—for example, Photoshop and Final Cut have made ad production more flexible and efficient—but apps require technology for their very existence.

Publishers embrace services
Traditionally, publishers were in the business of attracting eyeballs to their quality editorial, and then serving ads to those eyeballs. Today, online health publishers are adapting to a new world of apps and services, while staying true to its original mission of providing compelling content that informs, educates and motivates patients and health care professionals.
 While augmenting content with a wide array of services, some online publishers are also thinking differently about scale, looking to tie online experiences more closely with real-world, local interactions. Marjorie Martin, VP at AOL Health, says that: “Many health publishers today use content as a strong foundation for offering health services that bridge the gap from the symptom checker to the doctor's doorstep. AOL is planning to offer applications that provide patients a way to virtually meet a provider prior to the first appointment. Once the appointment is made—another online service—a patient will be able to sample local health services near the provider's office.”

Toward lasting behavior change
At the Connected Health conference in Boston in October, talk of technology was pervasive, including electronic medical records, remote sensors and bionic limbs. However, the underlying theme of the meeting was behavior change for better health outcomes. Of course, the end game for our industry is more positive health outcomes for patients, not just better ad recall.
In shifting from ads to apps, we must also raise the bar for accountability and expectations for real behavior change from our communications and service offerings. In other words, treat non-adherence as a behavior modification challenge instead of a marketing communications one.
My favorite presenter at Connected Health was B.J. Fogg, who runs the Persuasive Technology Lab at Stanford University. There, he focuses on technology for creating health habits, automating behavior change and persuading people via mobile phones. Fogg developed a grid of 15 behavior types, and corresponding psychology strategies and persuasive techniques needed to address each. According to his website, “the methods for persuading people to buy a book online are different than getting people to quit smoking forever.” Learn more about Fogg's work on systematic behavior modification at

The role of brands
Finally, if ads are in many ways giving way to apps, where do brands fit in? According to Mike Hudnall, chief service officer, evoke interaction, “The role of the brand has evolved. I think traditional advertising is still important, but we've added new dimensions of service and value to the brand, which is where the real opportunities are. The goal is to offer these services in conjunction with the ads, instead of relying on just the ads themselves.”
My scary vision of a future with all apps and no ads may not come true. However, I have enough evidence to believe that ads are becoming just another way to access an integrated customer service system, and that they must be designed for that purpose.

Joe Shields is director of worldwide innovation at Pfizer

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