Monday, July 30, 2012

Engaging “Opinion Leaders” that may be “Practice Influencers”

I've shared many examples of how N-of-8 can shift opinion to practice.

Another case was when I moderated a group of leading cardiologists to discuss eplerenone, the first agent designed to selectively block aldosterone for the treatment of high blood pressure.

The eight participants in this group included the chair of a major medical society, the client’s chief medical director, and six of world’s top hypertension specialists.  We were to discuss how aldosterone blockade reduces mortality and morbidity among patients with severe heart failure.  Simply put, eplerenone is used to treat high blood pressure by blocking aldosterone, which in turn lowers the amount of sodium and water the body retains. Lowering high blood pressure helps prevent strokes, heart attacks and kidney problems. Eplerenone is also used to treat congestive heart failure following a heart attack.

To say I felt intimidated would be an understatement.  As their facilitator, however, my job was not to go toe-to-toe on the science.  Instead, I was to help determine how emerging science could apply to practice.

The conversation turned to the difference between diastolic and systolic blood pressure.  And after several minutes, I asked the most innocent and naive question:  

“When you say systolic BP, 
what would that mean to 
the average family physician?”

Well, the question was apparently so elementary that my client almost had a cardiovascular event right there.  But then, one doctor responded, “You know, that’s a very provocative question and one that has created some controversy.”  This led to a lively, engaging, and fruitful debate – with more implications for practice than we expected.

Approximately 50 million, or one in four, adult Americans, have high blood pressure. Of those, 73 percent are not adequately controlled, and are at increased risk of heart attack, stroke, kidney failure, damage to the eyes, heart failure and atherosclerosis. Control of hypertension has remained inadequate despite the availability of several key classes of compounds.

"Hypertension is a complex disease with many factors contributing to the problem," said the advisors during our N-of-8.  "For patients and their health care providers who face unique challenges in achieving and maintaining control of their high blood pressure, eplerenone could represent an important new treatment option that goes beyond standard therapies in targeting the aldosterone pathway."

Preclinical and clinical studies had suggested that eplerenone works with relative selectivity to block aldosterone receptors, a key component within the RAAS (renin angiotensin aldosterone system).  This fact, the advisors said, plays a significant role in the body's regulation of the cardiovascular system.

In the discussion, they concluded that data showed the addition of eplerenone to optimize medical therapy could reduce morbidity and mortality among patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure.

This all ultimately contributed to the company’s marketing strategy.  FDA initially approved eplerenone for the treatment of hypertension, but the brand team decided to wait another year for a second indication – the treatment of congestive heart failure (CHF) secondary to an acute myocardial infarction – a first for any drug in the class. 

Eplerenone was launched, and marketed by Pfizer, under the brand name Inspra.

Friday, July 27, 2012

16 observations from a road trip

I really enjoy a good roadtrip.  And when my mind wanders, I often wonder....

  1. Remember the days before travel plazas and oases – we stopped on side of road (and we LIKED it)
  2. I still get excited at the innovation of iPass and convenience of being accepted in multiple states
  3. Those highway distance signs . . . what are they measuring to? City limits or city center?
  4. I noticed there is specific placement of reflector lights on trucks.  Are there federal laws on light design?
  5. What are the sales in May at year-round Christmas shops in the middle of Indiana?
  6. Hats off (but hard hats on) to the highway maintenance workers picking up blown out tires.
  7. How do blowout tire treads get to the SIDE of the road? Wouldn’t they still be in the MIDDLE?
  8. I’ve been playing with that rear-view mirror slanted lever? How does that work anyway?
  9. My favorite road trip snack is Pop Tarts.  Are the “how to open” package instructions necessary?
  10. How many grooves in the standard 'slow down' grooves they carve into the concrete?
  11. all highway signs are the same design, font, colors, etc. Who makes them? Where are graphic standards?
  12. Those blue signs at exits for food, lodging, fuel. How much to sponsor? Would they take other ads besides services?
  13. What's the hardest food to eat in the car? One hand vs two hands? Spaghetti, gyro, crab legs?
  14. We’ve almost eradicated knuckleheads that refuse to change lanes to let cars merge.  But some remain.
  15. Which is better for driving in central Ohio – night when you can see nothing? Or day when there’s nothing to see?
  16. Why did I complain about $4.19/gal for gas then pay equiv of $6.25/gal for bottled water?

Thursday, July 26, 2012

Storytelling: Is it the secret weapon of the 2012 presidential race?

Here's a topical view on storytelling from Arianna Huffington.

If we can all take a break from the breathless back-and-forth about Bain-gate for a moment -- and if you can't, maybe later you can retroactively take a break -- there was a more meaningful exchange that came out of President Obama's interview with Charlie Rose that aired on CBS last Sunday and Monday morning.

The president used many of his oft-repeated lines, saying that "this campaign is still about hope... it's still about change," and that he "underestimated the degree to which in this town politics trumps problem-solving." But it got really interesting when the conversation turned to what the president considers the biggest mistake of his first term. It was, he said, "thinking that this job was just about getting the policy right."

So what else is needed? 

"The nature of this office," he said, "is also to tell a story to the American people that gives them a sense of unity and purpose and optimism, especially during tough times."

That's a spot-on description of one of the key elements missing from the last three-and-a-half years: storytelling. 

But while Obama has accurately diagnosed the ailment, he hasn't delivered on his own prescription. Where is the narrative that will give us that sense of unity and purpose and optimism? His campaign has given us all a crash course on the ills of Bain Capital and the sorts of business practices that shouldn't be happening, but he hasn't given us an alternative narrative of the kind of capitalism that should define the nation as we emerge from the financial crisis -- if, in fact, we ever do.

But of course, neither has the Romney campaign. Indeed, its ineptitude on the subject was underlined when it responded to the Rose interview by saying, "Being president is not about telling stories. Being president is about leading."

So Obama hasn't delivered, but Romney remains clueless about the fact that the office he's running for isn't CEO of the country. It's much bigger than that. And telling stories, casting a narrative, is an essential element in communicating ideas and values, and an integral part of leading -- especially leading from the Oval Office.

"Stories are the creative conversion of life itself to a more powerful, clearer, more meaningful experience," says screenwriting guru Robert McKee. They are "the currency of human contact." Or, as film producer Peter Guber, author of Tell to Win: Connect, Persuade, and Triumph with the Hidden Power of Story, puts it: "Telling purposeful stories is certainly the most efficient means of persuasion in everyday life, the most effective way of translating ideas into action."

And translating ideas into action is, of course, the essence of the president's job. So that's exactly what campaign season should be about -- each candidate telling us the story of where he thinks we are as a country and, more importantly, where he wants to take us. The best way -- the only way -- to do that is with narrative. "The stories our leaders tell us matter," wrote Drew Westen, "probably almost as much as the stories our parents tell us as children, because they orient us to what is, what could be, and what should be; to the worldviews they hold and to the values they hold sacred."

Stories and narrative, as the currency of human contact, are how we all communicate with each other. 
We don't sit down with our friends and loved ones and throw out statistics and PowerPoint slides. We swap stories. In fact, we can't help it. "Stories, it turns out, are not optional," writes Peter Guber. "They are essential. Our need for them reflects the very nature of perceptual experience, and storytelling is embedded in the brain itself." Recent neuroscience research bears him out and shows we are hardwired to use narrative to make sense of the world. Neuroscientist Michael S. Gazzaniga, who studies the functions of the two hemispheres of the brain, has uncovered how the left side, which he calls "the interpreter," takes the jumble of data and sensory information we encounter and spins it into a narrative. "Gazzaniga suspects that narrative coherence helps us to navigate the world -- to know where we're coming from and where we're headed," writes Big Think's Jason Gots. "It tells us where to place our trust and why."

So if the part of our brain that is telling us where to place our trust is all about narrative, doesn't it make sense that any candidate asking us for that trust should appeal to our need for what Romney dismissively calls "telling stories"? This is especially true in times of crisis and transition. Over the last decade our country has been through extraordinary crises, not least the failure of practically every institution in which Americans had placed their trust. How did that happen? How did we get to this point? It couldn't have just been a few bad apples. If we don't know why it happened, how can we fix it? And if a candidate doesn't have a compelling narrative for what happened, how can we trust him to get us out of it?

"Instead of indicting the people whose recklessness wrecked the economy, [President Obama] put them in charge of it," writes Westen. "He never explained that decision to the public -- a failure in storytelling as extraordinary as the failure in judgment behind it."

Unlike Romney, at least Obama sees the need for that narrative. The fundamental tension between Wall Street and Main Street is still unresolved and still not framed in a narrative that gives people the confidence that it will be resolved any time soon. And making the entire campaign about Bain Capital isn't going to do it.

"Every presidential election is a renewal," says biographer and historian David McCullough. "Like spring, it brings up all the juices. The people are so tired of contrivance and fabrication and hokum. They really want to be stirred in their spirit. That's when we are at our best."

Copyright © 2012, Inc.

Wednesday, July 25, 2012

N-of-8 proven across the country and around the world

For years, I’ve traveled across the country and around the world giving talks, facilitating groups, running sales conferences, and moderating focus groups.   

And I’ve observed something quite powerful:   

You could have two teams, sitting side by side, in the exact same room, working on the same problem.  One team would instinctively apply these principles and rocket to successful solutions.  While the other team would realize very little.

That’s why it became obvious to me that I needed to diligently document these tools and consistently share them with my colleagues and my clients.  

So, I designed N-of-8.

Even though I might suggest that you “don’t believe a word I say” and want you to test these concepts out in your own environment, I will ask you to trust the process. 

If you want to move to a higher level of innovation, you have to be willing to let go of some old ways of thinking and adopt some new ones.  The results will ultimately speak for themselves.

Tuesday, July 24, 2012

7 reasons patients choose Mayo Clinic: a case in ePatient branding

The power of word-of-mouth marketing is getting stronger than ever.

Watch this video explaining the top reasons patients choose Mayo Clinic.

And you'll appreciate it even more when you hear that the total cost of Mayo Clinic e-marketing was $0.  It's been about three years since Mayo created its "social media pyramid (ie, right number of servings per day).

Consider the impact for the brand then and how it's getting results now -- and for the future.

Monday, July 23, 2012

6 steps of ForwardFast model: listen to feature on Sky Radio

It was 4 years ago this week that I was interviewed by the Sky Radio Network for an in-flight audio  segment for broadcast on US Airways.

Dennis Michael of Sky Radio showcased ForwardFast, my first book (and one of the first books of its kind), which presents the principles of brand innovation for health, science, and technology products.

If you’re driven to accelerate the adoption of new medical treatments, then this book will show you how to move with urgency to learn fast. track fast, think fast, respond fast, and create fast, then ForwardFast will help you become more creatively prepared and focused to reach the scientists, medical researchers, physicians, nurses, clinics, and the millions of patients who use your brands.

Other topics covered include:
• putting brand innovation to work with the 6 steps of the ForwardFast model;
• defining both a quality offering and a quality experience; and
• understanding what positive brand associations you can create

You can listen to the full interview here:

Tuesday, July 17, 2012

2 key insights from the patent-approval overhaul

Starting last fall and stretching through mid-2013, the U.S. has been overhauling the patent-approval process for the first time since 1952.

The biggest change:

Our first-to-invent system, which favors creators, will become a first-to-file system, which favors whoever files first.

Uncle Sam says the reform will speed innovation. Experts checked the numbers in a recent article in FAST COMPANY.  There were two particular insights relevant to brand innovators:
  1. GOOD FOR INNOVATION—Shorter average patent wait time. 34 months and going down. Startups that qualify for the new fast-track option get their patents reviewed in as little as 12 months, which makes it easier to bring their products to market.
  2. BAD FOR INNOVATION—Fewer patents issued to noncorporate inventors. 31,923 in 2010 and going down. When Canada switched to a first-to-file system in 1989, the race to file intensified--and individual inventors were put at a disadvantage (compared to big firms with lots of resources). A similar scenario could play out in the U.S.
You can read the full analysis at