Doughnut burger served at the 2010 Olmstead County Fair in Minnesota, via Jonathunder on Wikimedia Commons. At the Indiana State Fair in 2010, a vendor of similar burgers was quoted as having come up with the concept after seeing Paula Deen "do it on TV."

Friday, while on Facebook, one of my friends posted this little item from the iPad newspaper, The Daily.

Paula “put a burger and bacon and a fried egg between two donuts” Deen rumored to have type 2 diabetes? It would have been more shocking if she didn’t. The cuisine featured at her restaurant in Savannah, The Lady and Sons, as well as her show on The Food Network, has staggeringly high amounts of fat, sugar, and salt. Come on, when my own mom, the queen of baked goods and goddess of buttercream, disdains Paula Deen’s dessert recipes as being too sweet, something is definitely wrong here.

So, I went on Twitter with this smartass Tweet:

ChristianeTrue Jan 13, 11:14am via HootSuite
Paul Deen: 1.Promote fatty, sugary cuisine to TV audience. 2.Promote Novartis diabetes Rx to same audience. 3.Profit! ow.ly/8stdN

A bunch of us (including Matthew Herper of Forbes, Brian Reid of WCG, and Sally Church of Icarus Consultants) started a frenzy of speculation about which Novartis drug it could be – and we quickly concluded that it couldn’t be Novartis, as their main diabetes drug is not approved in the United States. Novartis actually sent a correction to The Huffington Post, confirming that they were NOT working with Ms. Deen.

Eventually, we started to speculate that it could be Novo Nordisk. I sent an e-mail query to Novo Nordisk’s corporate communications people on Friday, but never heard back from them. Come on, folks, I am not that hard to find.

Now, today, Paula Deen has announced she has type 2 diabetes and she is working with Novo Nordisk, in a campaign called “Diabetes in a new light.” The Novo Nordisk Website copy is punctuated with Ms. Deen’s folksy patter – “ya’ll” and “ya” in abundance – and features lighter versions of her famous artery-clogging recipes. And there are tie-ins to her brands – the version of the Lady and Sons lasagna recipe features “Paula Deen’s House Seasoning” and “Paula Deen’s Seasoned Salt.”

The recipe itself is rather a horror – besides parmesan, nonfat ricotta, and reduced fat mozzarella, it includes low-fat cottage cheese, reduced fat sharp cheddar cheese, Gruyere cheese, and reduced fat cream cheese. Oh, and bell peppers. And no garlic. If I offered this to my Italian relatives, they’d be insulted.

Back in August, celebrity chef Anthony Bourdain took Ms. Deen to task over her cuisine, calling her the “most dangerous person to America.” But he says he is taking no pleasure from the news. But this quote is classic: “When your signature dish is a hamburger in between a doughnut, and you’ve been cheerfully selling this stuff knowing all along that you’ve got Type 2 Diabetes … It’s in bad taste if nothing else.”

And seriously, Novo Nordisk? Seriously? I know you have a great program going with race car driver Charlie Kimball, who has type 1 diabetes. And that you’ve extended that sponsorship program for another year, which is also really great news. Type 1 diabetes can be a devastating diagnosis, and for children and young teens, Charlie Kimball is a great example of success.

But Ms. Deen’s blatant disingenousness about her condition (that she may have been diagnosed as long ago as 2008) and that her own cuisine may have contributed to her condition, plus her recipes shilling her own spice mixtures…seriously? She is not the example I’d want to be holding up as a marketer.

The look on my face right now is the same as Jonah Hill’s as he’s offered a bite of her cheeseburger meatloaf. “I’m not eating that,” he declares.

Good for you, Jonah. I’m not eating that – or buying Ms. Deen’s transformation into an oracle of healthy eating, either.

So when they both visit the pharmacy to pick up their prescriptions, they should not be receiving the same, generic package of educational material about managing their condition and adhering to their medicine, leaders at Catalina Health believe. Rather, they believe their new Health Consumer Journey approach will help drive medication adherence and create healthier outcomes for patients, who will better understand their “individual health journey” as a result.

With one of the world’s largest privacy-protected, propriety pharmacy databases, Catalina Health is developing customized patient education materials based on certain factors about health consumers – their ages and gender, whether they are new to a medication, and whether they have been managing other conditions, for example.

“Our message is delivered at the point of sale at a pharmacy counter,” explains Renee Selman, president, Catalina Health. The company uses a patent-protected methodology that de-identifies a consumer; the company will know age, gender, and other factors through the NDC but will not have access to a patient’s name or address.

In addition, the company has studied patient attitudes and emotions related to thirteen disease states. This helps the company design varying messages to consumers: the company can reach a “healthy optimist” who will attack his or her disease as well the “unconcerned invincible,” who might not care much about managing the condition at all.

“From a data perspective, we understand a lot about the diseases, and we understand the NDC, so we know what kind of medications they’re on,” Ms. Selman says. “To just take it further, and to put more investment into understanding segments and attitude so that you can do a better job for the person on the end of that communication – to me, it’s consumer centric marketing 101 in a lot of ways.”

The company has applied data about the patient attitudes and emotions to the new Health Consumer Journey. For example, a “Novice” might receive a different type of message than someone Catalina defines as a “Moderate Experienced” patient (to see more patient categories and read their descriptions, visit catalinamarketing.com/health/patient-journey.

“If somebody’s a novice, they potentially have a lot more information needs about the condition itself, and they’re just getting used to the fact that they have the condition, and so they might need a lot more general information,” such as information about how they are to take the medicine and the adverse events associated with the product, Ms. Selman explains. “If somebody has been living with the condition for five years, they maybe have less concerns about adverse events because they’ve been taking it for a while,” she says. “But to keep them compliant, you maybe need to take it to the next level,” which could include providing more information about the condition or reminding the patient about the benefits he or she is receiving by taking the drug.

“It would just be a little bit more involved of a message,” Ms. Selman adds.

The new, deeper insight provides segmentation information in which the company has invested over the last few years, Ms. Selman says. “We’re tying in not only the data, but also the emotions and attitudinal segmentation possibilities to make these messages even tighter,” Ms. Selman says.

Consumer centricity comes naturally to Ms. Selman, who has worked in brand marketing, device marketing, and several consumer-driven projects over the course of her career. “It seems natural, but you have to truly be holistic about who’s on the other end of the communication, and you need to decide that you’re going to run your business to help them – and to help them on their journey, and not be hyper-focused on what big-brand pharma wants or what somebody else wants,” Ms. Selman says. “Think about the person on the end of the communication and do the best you can for them because that will drive a better outcome; that will drive better information.”

Non-adherence to prescribed medications can cost approximately $290 billion annually in total direct and indirect healthcare costs, Catalina leaders note. The personalized patient education that Catalina delivers to consumers at the pharmacy point-of-care provides a solution to improve adherence and increase brand profitability, they say.

Ms. Selman says that helping patients control their diabetes, hypertension, and other chronic illnesses can reduce the chances they will land in the hospital, which carries implications for the overall healthcare system.

“Obviously, we’re pretty excited about this model, and we just feel that we’re able to incite behavior change because of this better educational messaging, and we feel this will bring significant value to the manufacturing partners, big pharma that we’ve worked with for years, retail partners, and other partners that might be in the healthcare chain,” Ms. Selman says.

Last fall, Pfizer began running ads for Lipitor that prominently touted the notion that exercise and a healthy diet may not make enough of a difference for two out of three people who must lower their cholesterol. To make its point, the drug maker began its ad this way: ‘Are You Kidding Yourself?’

AstraZeneca, however, is trying a different approach by embracing food. Given that this is Natural Nutrition Month, the drug maker has struck a deal with the Food University, the culinary site, to offer recipes and tips for healthy cooking and eating. The arrangement includes a series of videos featuring a couple of well-known chefs – Sara Moulton and Curtis Aikens – who will offer demos.

One goal, of course, is to improve diets that would lower cholesterol, but AstraZeneca also benefits, because the more people who like to eat – and visit the Food University site – will now be exposed to its Crestor cholesterol pill.

How so? The videos, which can be accessed at both Crestor.com and myfoodu.com, clearly state the segments are sponsored by Crestor. This not so subtly plants the idea that, no matter what one consumes, the AstraZeneca pill may later make everything all right. What is more subtle, though, is the notion that Crestor may start popping up in more online searches for such things as low-fat recipes. And that can yield a healthy diet of a different sort for the drugmaker.

photo thanks to indydina on flickr

Gaming is a big part of American life. Last year, 50% of households gamed often. Most chose that gaming time over some other media or entertainment. Those immersive, entertaining, often all-encompassing games change people’s expectations for what experiences could and should be like. The same mechanics that keep gamers glued to screens of all sizes can be translated to compelling tools for prevention, treatment management and more holistic care.

Think about it – most of the ways we interact with healthcare are uninspiring. As Ben Sawyer, founder of Games for Health, says the interface of healthcare is broken. We’re not engaging people. We give them 7 minutes in the exam room; confront them with complicated, paper-based adherence tools, and set a lot of requirements, but give few rewards. If we take a look at who’s gaming, we see great potential:

• 68% of American households play video games
• 40% of gamers are women (in fact, a greater number of adult women play than boys under the age of 17)
• 26% of Americans over the age of 50 play video games
• 42% of heads of households play games on a wireless device

*ESA 2009-2010

So how could translating that interface to medicine promote healthier choices and outcomes?

Games lead to healthier behavior and outcomes. To quote Debra Lieberman of the Institute for Social, Behavioral, and Economic Research (ISBER), “the beauty of a game is that it gives you a goal.” People work longer and harder if you give them a goal.

Games make people “better patients.” According to study done in the Journal of Pediatrics, patients who use games for health are more engaged in their treatment, show improvement in adherence (16% in this example), and are more knowledgeable about their care plan.

Gaming may be the key to getting us to commit to wellness. Humana has now dedicated part of its innovation department to gaming. Major consumer packaged goods companies are building their offers with wellness gaming. Johnson and Johnson, Unilever, Kraft, Apple, Nike and Disney are developing new products related to health gaming.

*TechWatch, Games for Health: The Latest Tool in The Medical Care Arsenal, 2009

Early adopters are already using gaming mechanics for the ultimate healthy win: sustained behavioral change.

For brands who want to incorporate gaming into their healthcare strategy, marketers must start by asking “what do you want to accomplish?” Healthy brands can use gaming in four basic ways:

1.     Streamline care. Replace reminding and monitoring with involvement and self-tracking

2.     Educate through experience. Use entertainment and experience to create learning people can actually participate in.

3.     Fit into real life. Make tools fun and entertaining so that using them is a want to do, not a have to do.

4.     Reward right behavior. Use positive reinforcement and immediate rewards to sustain behavior change.

Turning that approach into real strategy requires thinking about three connected components: Creating an entertaining experience that people will want to spend time with; Giving them a goal to reach or code to crack that will challenge them; and Setting a reward strategy to incent the kind of behavior we want to see.

For brands who have dabbled in gaming we thought we’d share some common mistakes and how to make them right:

Instead of building the game on your website, make it free standing and mobile.

Instead of asking players to create a new login, let them use an existing login (like Facebook).

Instead of putting a “game face” on an existing experience tool, create an experience that starts from the game.

Our team at iQ regularly creates models, prototypes and storyboards that show how innovative applications of technology can solve persistent healthcare challenges. Some experiments inspire projects, others becoming lasting platforms. We call it Innovation Theater. We always start with a problem and ask “what if.” Here’s an example:

The Problem: Patient adherence

• 28% of patients never fill the first prescription
• 50% discontinue in the first six months
• It’s not as easy as adding recommendations or reminders

The situation is even more challenging in some disease states: for example, up to 72% of asthma patients report that they take their controller medications less than prescribed. Taking that medicine can reduce hospital and emergency visits by 80%. It’s a huge impact on both patients and practitioners.

The “What If”: What if we created a go-anywhere adherence program that helps to make taking medication entertaining and rewarding?

The Result: Avatar Alerts – the mobile companion that rewards you for quick responses. A go-anywhere adherence program that helps to make taking medication entertaining and rewarding.

Avatar Alerts works by inputting or importing a patient’s prescription data. Their mobile device then can alert them through a series of notifications such as phone, text, email and more. If they do not respond to these, they also can choose to alert their support network, such as friends and family. And if they still don’t respond? The patient can choose to notify their social network and deepen their mobile experience online.

Users can log in to track their performance, and use points earned for quick responses to level up and customize their avatar with earned upgrades. The more upgrades the patient earns, the faster their avatar becomes. In addition to customizing the avatar, the patient also can remind – or be reminded by a support network of other patients like them. Within this community, they can compare their progress and even compete against others. When their adherence is on the right track the patient and their avatar finish strong.

So start talking about gaming for your brand. For a discussion guide to help get you started or to see more experiments from iQ, visit: www.whatsyourdigitaliq.com

Leigh Householder is a digital strategist and Ben Harben is associate creative director at GSW Worldwide.

According to analysts with Manhattan Research, 39% of physicians communicate with patients through e-mail, instant messaging, or secure messaging services – with secure messaging services like RelayHealth and Medem showing growth in the past year. These analysts have also found a considerable consumer interest in connecting with doctors online, and physician acceptance is a major key to pushing this type of communication forward.

“One of the most significant influences on the relationship between doctors and patients is simply time,” says Jeff Kozloff, CEO, Verilogue, a market research company that uncovers, analyzes, and delivers insights derived from naturally occurring dialogue between patients and physicians. Verilogue digitally records real-time conversations between patients and physicians, while maintaining patient and physician confidentiality.

“What we’re seeing is more and more references in the physician-patient dialogue to some outside sources and the use of e-mail, the use of clinic-specific Internet sites, and references also to branded and unbranded Websites as well,” Mr. Kozloff told Med Ad News.

Because physicians have limited time to effectively communicate and verify patient understanding of health and treatment information, they are looking for additional resources to help alleviate that burden and to provide patient education.

“We’re seeing a growing number of doctors developing their own Websites or having clinic-specific Websites for the networks they’re associated with that they’re pointing patients to,” Mr. Kozloff says. “What’s interesting about these sites is they’re referencing them as a means of keeping patients informed about certain topics related to their health as well as what’s going on in their local community. In larger group practices, we’re hearing that more and more.”

According to Mr. Kozloff, some of the more sophisticated sites will also tie in with health records, and some are developing social networking components as well. “They are starting to move into the forum and discussion and sharing mode,” he says. “They will be pretty powerful resources.”

In the May issue of Med Ad News, I intend to take a look at what impact these guidelines are having on pharmaceutical marketers and their agencies and how healthcare advertising agencies can work with clients to help meet these guidelines.

One company that is helping marketers meet this need to more effectively educate patients is Chicago-based ContextMedia Inc. ContextMedia develops waiting room TV networks that help healthcare professionals educate their patients minutes before they make decisions about their clinical treatment.

With the new PhRMA guidelines in place, ContextMedia reports seeing a greater demand from clients who would also like to reach a targeted audience at a time and place where they’re already thinking about their clinical treatment and healthcare solutions.

Each of ContextMedia’s point-of-care networks is condition-specific and tailor-built for lifestyle diseases such as diabetes and provides programming on nutrition, exercise, and disease management. In 2008, three of the top 20 global pharmaceutical companies advertised on the company’s first network, the Diabetes Health Network. ContextMedia has more than 600 TVs nationwide with about one in seven endocrinologists as a Diabetes Health Network member, reaching 700,000 viewers each month for an average of 27 minutes.

I asked the folks at ContextMedia to tell me about the scope of the opportunities for pharmaceutical marketers when it comes to waiting-room TV. Other than purchasing advertising spots on the network, I wondered if there would be other opportunities. Could they get involved in the actual programming, for example?

The answer to the latter question is an emphatic “No.” Pharmaceutical companies cannot get involved in the actual programming because all of ContextMedia’s editorial content is independently-produced and medically-reviewed. Advertisers cannot choose or influence this content. However, ContextMedia does say they can work with individual sponsors on their patient education efforts and partner with them to help move these initiatives forward.

“The ultimate value in pharmaceutical marketers sponsoring DHN comes from our ability to directly reach their target audience at the right place, when they are in their trusted physician’s office, and the right time, moments before they make critical decisions about their health treatment and lifestyle changes,” ContextMedia says. “Our research showed that 51% of patients said they had already spoken to, or plan on speaking with their healthcare professional about something they saw on DHN TV – including diet and medication. Advertising on our networks leads to direct action minutes after they see the commercials. We offer the option of category exclusivity to sponsors, whereby they can be the only brand advertised on DHN TV for a given category of treatment.”

Additionally, marketers will not only have the opportunity to play their commercial message on DHN TV, but they can also distribute literature such as brochures, magazines, and handouts that the patients can take with them to read more. ContextMedia also offers a sampling program, which some sponsors have taken advantage of, that provides samples to member offices to be distributed to their patients.

ContextMedia provides active management of each of its member offices, with a team of account managers dedicated to building relationships with them and servicing their needs. The company collects monthly patient traffic numbers and confirmations from each office, and remote software allows the company to keep track of DHN TV compliance and see when the system was on, off, or down.

IMS Health conducted a promotion analysis evaluating the effectiveness of advertising on the Diabetes Health Network for an injectable insulin sponsor of the network. The study measured changes in prescription volume among physicians that had the DHN in their waiting-area compared with a control group of similar physicians without the service. The eight-month study found a statistically significant increase of 5.3% in total volume of prescriptions and a 5.15:1 ROI on the sponsor’s DHN program.

IMS also found physician penetration increased by 3.3% in the total prescription test group while it decreased by 2% in the matching control group.