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In this eBook, Brandon Hall Group explains not only the importance of compliance training but also how to develop a strategy that effectively develops your workforce, mitigates risk, meets regulatory requirements and drives business outcomes.


Bridge the Divide – And Inspire Your Customers

Collaborate internally, harness commercial channels and create customer partnerships based on educational principles


Customers want to be inspired. They want to learn. They want to feel like you’re delivering individualised value to their profession.

How do we, in pharma, meet this demand? Clearly, it’s time to break down the silos. Sales, marketing, product and medical affairs teams should be in partnership rather than in parallel, but how do we build a collaboration model internally that provides a real experience externally?

Should we even be separating our departments in the traditional fashion? Sales rely on marketing, MSLs need softer skills, digital needs integrated and solution-oriented thinking. Everyone needs to inspire and to compliment professional education programs.

Watch this free on-demand webinar to hear from our expert panel. They revealed how they approach cross-departmental initiatives, innovation and education to transform customer relationships.





Heather Moses
Head of Medical Affairs


Dirk Abeel
Global Medical Sales Director
Reckitt Benckiser


Michael Connolly
Director of Enterprise Sales, EMEA


Kumaran Krishnan
Director, Europe Medical Affairs
Teva Pharmaceuticals


Webinar Transcript

Paul:  As you can see we have a pretty well-qualified group and I’d love your questions to start rolling in already if that’s possible. What I’m going to do first however is handover to Michael. So, Michael I’m just going to hand you the microphone and we’re going to see a few slides from you if that’s all right.

Michael:  Okay, great. You’ll help bring up my slides for me Paul, right?

Paul: Yep, just doing that now.

Michael: Welcome everybody. I think we have participants over here in Europe on this side of the Atlantic, so good afternoon, good morning to those of you who are on the other side of the Atlantic. We do have a very full session today, so I’m not going to talk at all really about Qstream, because we’ve got a great panel of industry experts, people who I like to say they walk in the moccasins of the Indian. What I mean by that is they have experience the challenge that you all are experiencing and they’re going to share with you today how they are dealing with them and their companies.

Paul did mention eyeforpharma in Barcelona. For those of you who were there it’s a great event. Dirk and Heather gave a very, very interesting session there that was very well attended on some of the challenges by bridging gaps, breaking down the silos that I’m sure all of you are familiar with. So, I know from that session in Barcelona that today will be a very lively session and you have lots of questions. So, Paul, if you could just go to the other slide I’m just going to take to two slides very quickly.

The purpose of this one is just to share with you the Qstream experience of the last couple of years and how we see pharma evolving. Ten years ago when we first got involved with pharmaceutical companies on the learning and development side and behavior change we dealt primarily with the sales reps. It was all about helping the sales reps do a better job, focus on the products, stay within compliance and that’s where we started off, and it was the sales reps on the HCP primarily, the sales reps sole to the HCP on a fairly transactional model. But what we are seeing now is that as the industry has evolved, as Paul said, last year our series was around the sales rep of the future, the year before that it was around the patient-centric model. They are all now coming together in that you’re breaking down some of the barriers and embracing it all is this whole concept of multichannel marketing. We’re in a digital age, it’s all about digital.

Now, how does digital affect the sales rep, how does it affect the HCP? But most importantly here we’ve got the patient in the center. We are, all of us in this industry today, very patient focused that’s what we should all be doing and therefore we should be breaking down the internal barriers that helps us get on the same page as the patient and give value-added solutions to the patient via the HCP. So, that really is really where we are today and I’ve just got one more slide to show you before I go to the panel.

What we have here is here are some of the challenges that we are faced with today. So, we’ve got the patient, we’ve got the HCP and commercial. We’re all very familiar with the patient goes to Dr. Google right away to see what their problem is, then goes to the HCP whose time core trying to build up trust with the patient and the HCP is expected to have all the answers that the patient has picked up on Dr. Google. So, the HCP in turn is going to look to the pharma sales rep or the MSL, whoever it is. So, there is a more of a burden today on the commercial model to be more value added in the kind of conversations they have with the HCP so that the HCPs then are empowered to deal with the patient. That’s how we see the challenges today and that’s what we’re going to talk about with our panel. So, I’ll hand it back over to you Paul.

Paul:  Thank you very much, Michael, and I appreciate you just setting the theme for us there. What I’d like to do just before we invite everybody else to the conversation is to get you, the audience, awake and interacting with us. So, if you look at your screen right now you will see that it’s changed. It’s changing into a poll question: “What do you believe is the greatest barrier towards understanding customer mindset in your organization?” and I’ve given you five options, you can only choose one, I’m afraid. I’m not very nice like that, and of course if you are speaking from a non-pharma company then please do try and consider your pharma clients or pharma friends when you answer this. So, choose one of the following: Is it bound to pour across company coordination between different departments and now we’ll the siloing that comes with that? Is it down to a lack of curiosity culture or desire to gather insights so that people don’t feel that’s critical in their everyday business? Is it down to reps and MSLs not engaging or listening? In other words they have a product through a messaging focused, it’s very much a push culture still. Is it because of data and data siloing and the poor analysis or communication of that data or finally is it down to incentives and KPI’s targets not pushing our workforce in a direction towards better customer understanding and learning.

So, I can see that about half of you have voted so far. I’m going to hold that open another three seconds and then we will see the results. So, three, two, one. Okay, let’s have a look. Thank you everybody for your votes.

I would say we have a very good audience source. So, this is a pretty big debates that we’re getting a representation from and actually it’s relatively even, I would say, on these results, wouldn’t you? It’s roughly a quarter, well between a quarter and 13% for everything. I guess that probably just means there’re a lot of barriers. Anyway, I’m going to unleash all of our speakers right now and invite them into talk about these results and also based on what Michael said at the beginning what they personally believe that’s particularly critical to making this happen within their organization.

So, Heather, since your top left do you want to kick us off?

Heather: Sure, Paul, thank you. I’d like to speak from working in the U.K. business right now where we have amazing MSLs but we’re challenging them with looking at different skill sets. I think there’s almost, what would have been considered in the past, sales skill set about the curiosity culture result that you’ve shown here that we need to inspire MSL to use more as well and to really be clear. They’re not sales tactics, they’re not promotional tactics but the conversational tactics where you’re not just talking about data of that one specific question but your being curious. You’re asking why and tell me more about that problem so that we can get the right insight, the deeper level insights from our customers to be able to feed that back to the business and solve bigger problems than just that single data request, for example.

I think the curiosity culture is really important to get the right kind of insights and that’s both from sales and from MSLs that are a value to a cross functional team in the office. I’d like to really give a shout out to that and the new challenges of training that we’re doing for MSLs now and to make sure that they can embrace that and really say, “No, it’s not a sales technique but it’s a way that everyone can view about our business.

Paul: And changing culture, Heather, word to say on that?

Heather: Absolutely. I think in terms of culture it goes right from our structure but actually mainly to mindset, so we have to shake off of the, maybe, protective behaviors in the past or where we put up silos internally to now really going to solve really customer problems we have to work together. I think a lot of that has to do with mindset and shaking of four habits of the past or what was an easy way to do our business of the past and to be more innovative, we’ll have to work together more in the future and that requires a big culture change, and we talked about being agile. It’s not just trying to work faster or smarter but taking away our own barriers as we put off with SOPs and things that people have depended on to make their jobs straightforward in the past where now it’s a much more blended approach where we have to just strip away all of the silos to move forward and solve the customer problem.

Paul: Thank you. I should say that all of the comments on today’s webinar don’t reflect the beliefs necessarily of the companies that everybody represents, so people are talking here as individuals as opposed to representing their companies. Anyway, who else wants to do comments on.

Helena: Helena here. If I might continue on with the blended approach Heather just mentioned and before we went live on this webinar we were also discussing that one of the overarching reasons while this might happen is also that we might not have the same goal at a company when it comes to what do we want to achieve for those customers, those segments, etc. One of the reasons might be if we start to look, do we all have the same understanding what the goals are then of course KPIs and incentives differ because of what we are supposed to deliver, but start with that one. I don’t know if anyone of the others would like to repeat what we were discussing before.

Dirk: I agree. It’s Dirk here. If you look even at the five books as Paul said they are quite evenly spread out but I agree what just has been said. First of all the goal has to be the same. how we get here that’s another kind of exercise that’s a cross-functional approach anyhow. Also, I would like to reiterate one, two and three – the lack of curiosity and then the role of the reps and the MSLs, because for me they are going together. I believe that as an organization we should first start getting to the right insights and not always through to our parties but using our own medical sales teams, being its decisively as us being at the sales reps to really through structured unbiased survey to get to understand what is it our customers are expecting from us? What are the challenges they are facing and have to overcome when they’re dealing with their patients? Automatically, that will force us to have a better cross-company coordination will help us in having the right data models behind and also to skew or interns given KPIs in the right direction.

Already there, if you look at it from that angle I think the organization will have to charge but the first point that has to happen from the C-suite down to the sales reps is really to re-embrace again why are we there. It’s to give service, it’s to service the patients and the customers.

Helena: An important part of it is also as we have been talking about earlier is the communication as such. I think that many companies abroad they’re good at communicating top down but sometimes when we reverse that the bottom up communication is stopping or being blocked on certain levels, might be on the sales rep or sales medical level. So, I think that that is also something that might prohibit real cross-functional work instead of causing those silos.

Heather: I think there’s another element of what we’re incentivizing people and what insights we’re collecting from that because if we’re setting goals from top down for people to communicate X messages, X number of times that’s what our people will do. If you’re setting goal from the C-suite to have an excellent customer experience or change the net promoter score for the company or adding patient number impact that will inspire a different set of behaviors than they’d had in the past as well and will inspire the right kind of insight collection because there’s a reason why you’re collecting that information. You can make something off it. You can make a decision based on the insights to reach that bigger goal of customer experience or patient numbers or patient impact.

I think the way we’re incentivizing people will drive the hater and that’s one of the first things we can change to make collaborative goals that really meet real value instead of these really lower level goals that will just drive simple activity based behaviors.

Helena: Yeah, and not necessarily adding the impact on the customer and patient level.

Paul: Do Kumaran and Michael want to come in on this on or shall I move to the next question? Silence, so I hope they’re still here. We’re getting some good audience questions so please do keep those rolling in and I will come to those in just a second.

For the time being I’m going to throw another question you’re way if that’s all right. So, have a look at your screen there’s a brand new question. How well do you currently believe you know and understand your customers? I really want to try and take a litmus test of where everybody actually is today on this front and how well they believe they’re actually doing. So, again five perhaps quite simple questions to answer here. Again, you can only choose one. Do you believe that it’s extremely well? You really understand the what and the why of behaviors, you feel that you get a 360-degree view of you and your customers currently. Do you say well but with an emphasis on the dates of side of things with a tractable events, quantifiable events or perhaps the opposite well with an emphasis on attitudes and perceptions, perhaps the quality to the side of things. Then, the fourth option is only at the individual rep and MSL level. In other words it’s captured but it’s not communicated very well and then finally do you believe that your knowledge even at that level is very poor generally from where it needs to be. Let’s hold that open. Once again, I’ve got the alert half of the audience who has voted already, so I’ll hold it open for three more seconds, so three, two, one. Thank you very much everyone let’s have a look at the results.

This one is a little bit more of a normal distribution shall we say. We got 8% on extremely well but up to nearly a third on the next three with that and then only 4% of people saying, “not at all.” This is obviously not new. We’ve been trying to understand our customers we’ve been trying to segment this. Certainly, the 16 years that I’ve been in this industry we’ve certainly been trying very hard and we’re not there yet. What’s the reason for that? What’s the reason why we can’t make any progress there from what we need to do? Let me invite the panel once again to comment. Whoever one to get first.

Kumaran: Yeah, guys looks like I have been muted, so basically I’m back on line now. I’m going to take this question and try to give my perspective of how well do we currently believe what we know and understand our customers. I’m really not surprised by the recent data shown. Again, perceptions, attitudes, etc. are extremely, extremely important. I often say that it is not what the title in the business card that you carry, it’s all about your behavior. A person from a commercial organization could go into a customer as office and can be absolutely credible but at the same time if somebody from an MSL or a medical organization goes in and asks for business that is actually construed as selling a product. So, it is all about attitudes, perceptions, etc., etc.

Paul: Okay, anyone else?

Heather: I think that we need to look at the different levels of understanding and then it’s a concurrence between them that will give us a full picture because we only look at individual interaction that will only tell us so much. I think if you look at an individual interaction level, obtaining insights and account level way of gaining insights and finding out that account agenda or if you look at a community-based way of getting insight you get a bigger picture and with a qualitative and quantitative insight then you can check your assumption, you can check any biases that you may have had in your insights collection methodology and I think it’s the mix of all of these things that you’ve asked here about tractable matrix, attitudes and perception research on a population based as well as individual anecdotal insights that can give the picture that we need to find out how to add the best value. I’m not sure, I think a lot of commercial functions lately do this more naturally and participate in market research as well as individual surveys and I think it’s something we can encourage medical teams to do more or cross-functional teams to do more to get multiple layers of insight to check the depths of our understanding and check our biases as to what we’re doing and what the impact is.

Dirk: I couldn’t agree more with the last one you just mentioned because it’s related also to the first series of questions we started with today. It’s right inside but more importantly if you look the commercial teams are all using a CRM system how much data is sitting in there. If you ask in your organization already who’s using, who’s accessing this information from medical, from marketing, the brands etc. it’s astonishing to see how little this information is used. That’s why when I see the result there I’m even a bit surprised that this is quite high, the understanding of what our customers wants and that we really understand. The reason why I’m saying that is that I truly believed when I discussed during meetings like eyeforpharma with colleagues it’s still often too internally focused related to what we want to sell and that’s why we match it with some of the expectations of customers without going beyond even to see it in a broader perspective which would allow us to come with a lot better value proposition together with other companies. That’s my take when I see this.

Helena: Also, what you have been talking about is that yes it fails or the commercial organizations might have more insights and we use Viva more. We have done some attempt here at our company to see how we can show the value and benefits by introducing the finding in CRM system to finance department, to medical and to marketing. We have seen a high wish for information and also for them to be able to push what they want to see, but we also have another point and that is that I had my customers, those are my HCPs while medical might think that, “Okay, the QP leaders they are my customers.” Also, this kind of willingness to share information, not only that it’s gathered and siloed but also the willingness to share this information.

Kumaran: I cannot agree with this statement more because the one culture that we want to drive within the organization is nobody owns the customer. The customer is part of the organization. So, that protective behavior should be discouraged and also what we see here is more and more of a prelaunch activity. Even if you go into the prelaunch phase, pre-license phase there is a lot of emphasis and activities going on in terms of measuring customer shared voice and also net from other scores, so on and so forth. From that point of view, again there has to be that seamless sharing of information between the departments, of course within the rules of compliance and having a compliant behavior that has to be encouraged.

Heather: Absolutely. I agree as well. If you go back to that incentive things, so why would somebody say this is my customer? If they’re targeted on a certain number of interactions or something with that customer they’ll feel more protective of the customer and the time with that customer and may be feeling threatened by another function interacting with that customer that could take away from those personal goal. But that again if you can trick away that smaller level of goal for the customer it doesn’t matter who owns the customer, because you’re going for a better impact or outcome. If we’re talking about inspiring the customer they don’t care how many times we have talked to them. They want their problem solved and could be brave enough to actually go even higher than that that customer is not at anyone’s function or maybe not even one company. That if we’re acting as brokers to solve the customer’s problem then maybe we helped them reached to other collaborators if their problems not align to what our company can offer for solution. So, we’re really having our customer focus versus something that our company or anyone individually in the company can own, so we can strip away the behavior of owning and that goes to say for patients as well, functions say, “Oh, I own patient relationship.” I don’t think that’s true. I think that’s something everyone can participate in and in the same way. It’s some of the old-fashioned metrics or drivers we put in place that may be have caused some of that ownership behavior.

Dirk: It’s a contrasting venue that you were opening before. It’s related to this data and when I was listening also to Kumaran I was wondering why still in our own organization we are not sharing already all the data between the different teams and because we have CRM system, we have so many technology behind to where we easily could go there but that’s the first observation I would like to share. The second one based on what you just mentioned at the end, are we willing to start sharing data related to patient and HCPs across the industry to serve this bigger kind of purpose you just depicted within, of course, compliance and data privacy and so on and so forth. That’s an interesting to all of you too.

Kumaran: If you look at the way the CRMs are being built if you take markets like America which is completely different to the European market. The European CRM is built on a country basis. If you take many organizations across the industry CRMs belong to each of the countries. Let’s say for example the U.K. CRM sits in the U.K. server and so Germany and so is France, etc. We have isolated our, what I would call, island of CRM. The problem is how do we connect all these dots together for people sitting in the European and global function to have that 360-degree view of our customer activity and also of the insights that’s coming through and this is a constant question that I keep pushing, organizations that are selling CRM solutions to see how can you effectively build this coherent insight collection and break the silos within countries, of course within the GDPR and compliance rules as well.

Helena: Kumaran, I might make your day. That is already possible. We are creating those kinds of reports.

Kumara: That’s great to hear.

Paul: Can you explain more?

Helena: Yeah. I don’t know how much I can mention CRM company, but the CRM system that we are using… I mean a guy in my team he’s making those kind of report where we look into the regional data and see where we are, so it is possible.

Dirk: I agree. It’s the same at our site and I think it depends a bit on the kind of core you are developing. If it is coming from Global and that is taking down to regional and local or is it the opposite way around or you’re having one CRM across the globe or you’re having many CRMs. But I think technology is the answer there. It is there to help us and I’m sure that Michael from Qstream would say a lot of things about this. I think it all starts with willingness and even within one country it could already break a lot of boundaries.

Paul: Sorry, I’m just going to have to interrupt because firstly I want to apologize as it sounds like someone else’s conversation is somehow leaking into our conversation sometimes. Apologies for the audio glitch that you’ve been hearing. I have no idea how to stop it and I’m very sorry about that. I do just want to hold that thought, but I do just want to just read out a few audience questions. We’ve had quite a few audience questions and I feel like we’ve been neglecting our lovely audiences if I didn’t at least read out a few.

Going from obviously a few minutes ago, how does LEO currently ensure the free flow of bottom-up communication? That’s from Pauline. If the understanding more due to company culture and direction that the MSL is given what truly is the value proposition for patient’s engagement. We assume they want to be engaged but that just puts more responsibility in their hands when they actually prefer more proactive or hands-on support. Understanding customers depends on who the customer is. Do we define well whether that’s the HCP or the patient? That probably alludes to the previous question as well.

A comment to Dirk when you were talking earlier that what you’re saying was this is where a true cross-functional account management system is actually pivot of success and indeed that’s what we need.

A comment from Newton says, how much do we actually use the patient feedback or patient satisfaction index spacer to improve the patient experience with the product because a lot of people wanting us to focus on patients here. There’s a few more questions but I think I’ll leave it there just for the moment and come back to some of the more of them in a few minutes of time otherwise it’ll be too many. So, does anyone want to address anything they’ve just heard?

Kumaran: Hi, it’s Kumaran here. I can talk about the value proposition for the patients itself. The digital technology has allowed us to behave in a certain way, of course, within compliance reasons to reach out to patients directly when it comes to helping the way they manage diseases. For example, in Europe it’s forbidden to go and promote to patients, so direct to consumers is prohibited, but what we can do is to help our patients manage their disease better, whether it’s asthma or diabetes or so on and so forth. There are number of portals you could see from the industry where patients talk to their fellow patients in a very bloggy way and the industry is helping that blogs without… providing a bit of a framework for those blogs so that patients can help each other. That’s where I think the value comes from, not from directly saying, “You take this medication, you feel better,” or so on and so forth. How do we manage our chronic illnesses in a better way, learning from the fellow patients? That’s where the pharma industry is proud off in helping the patients and that why where we drive the value as well.

Dirk: I would like to use what you just mentioned to talk about these other points that has been mentioned by Paul and coming from the audience. The cross functional key account management because patients they have to go somewhere to get the diagnosis done and then the therapy started and the follow-up. So, how do we work together with healthcare institutions, the healthcare environment in helping them also better understand what patients are looking for, what their role is of the institution, what the role is of the HCPs and the role of us as a commercial organization. I think what we also have to learn from that is if we really want to be cross functional folks on clear conscience is that we have this, what I’d like call, cross functional ad hoc committees depending on the dossier, depending on the program, depending on the need from the healthcare entity sitting around the table with supply chain, with commercial, with marketing, with medical, for example, to really tailor made a solution to meet the needs with this hospital and to come to a mutual agreement that this is a plan which is suitable for them, is helping them to achieve their goals, their patient outcomes and our goals as an organization. This is easy to say. It really requires a whole change in mindset of the organization.

Heather: I agree. I think that the combination of both of those. I mean, if we want to keep the patients interest on the agenda it doesn’t mean we’re directly communicating with them but we’re making sure we understand their agenda, their whole journey and if we’re treating them as the end view or as the customer we look at every aspect of their journey through healthcare system, physical, emotional, etc. and see where we have interventions that make their life better to meet those goals and in that way we’re having a higher level impact. That relates to then how we are actually sharing that information of that patient agenda or the customer agenda as an HCP or the hospital or account agenda in looking at each of those levels about customer journey and including the patient defined as a customer and how are we making that move to customer including patients and that doesn’t mean we’re going against compliance in promoting to patient, but we’re looking for easier, better outcomes for them. I think you can achieve all of those goals by keeping the patient agenda in mind.

Paul: Okay. I want to move to another audience question if that’s all right. We’re getting through the time here. Take a look at your screen, this is all anonymous, don’t worry. Truthfully how well do you feel pharma’s goals are aligned with HCP’s goal? Yes, I’m sorry, we’re going back to HCP, but how well do you really feel that the industry’s goals are alive? We’re just going to do this one very quickly and then move on to the next one. So, is it already very well aligned based on the insights that you have and you feel that we’re heading in already the same direction; okay but pharma has a poor focus on holistic patient need that’s obvious just something we’ve just talked about, so misalign there; okay but pharma has poor focus on HCP needs, misalign there; or do you say poorly aligned yet convergent, we are actually moving together but today we’re not in a great place; or poorly aligned and divergent, actually we’re moving away from one another in terms of our alignment with HCP goals.

I’ve asked this question just the thoughts of take a little temperature gauge as to whether or not we actually feel like this alignment is going to be natural or not. So, once again about half of you voted, so three more seconds. Get your votes in, three, two, one. Thank you so much everybody. Let’s have a look at the results.

Okay, so 60% is already very well aligned that’s just actually lower than I hope to see. Okay but pharma has a poor focus on the holistic patient needs, so I think we were very right to bring in the patient department into the conversation just a moment ago. Interestingly, nearly 20% say poor focus on HCP needs, which of course is where we traditionally have focus as an industry. Then, poorly aligned yet convergent, so some optimistic people and 7% of people believe that it is actually moving in the wrong direction. Hopefully, minority will stay a minority.

Interested to hear your comments on that in a moment but what I’m actually going to do, I think, is actually move on to another question. We can actually talk about both of these questions when we come back to our panel. So, have a look at your screen once again: Where do you believe our focus should be when serving HCP? We’ve obviously talked about inspiration being the title of this webinar but is that actually where we should focus. What should our focus be? What should our priority be? Once again, I’m forcing you to choose only one of these: Is it product messaging as priority. This is pharma’s role. Our role is to produce products and distribute them. Is it that we should be inspiring our HCP showing them what is going to be possible going forward? Is it about education first, supporting the HCP’s understanding of disease? By the way, you could also replace the work HCP with patient in some of these instances as well. Insightful in supporting HCP understanding of patient needs. So, it’s about revealing perhaps statistics metrics, emotional responses that the HCP may not be aware of or finally, is it really impossible to say which of these do we need to be adaptable, perhaps personalized is another way of saying that and indeed have options for every single one of these, so interested to hear your responses to these. I’ll hold it open for three more seconds, three, two, one. Okay, thank you very much everyone.

Here are the results of this one. Nearly two-fifth of you say the bottom option which is adaptable. I hope that’s because you genuinely do believe that adaptation is possible and not just because you couldn’t choose between any of the other options. Interestingly, only 3% still say that product managing is the priority and we also have varying degrees in there. Inspiration, the title of our webinar stays in we are nearly 11%. So, education and insight are perhaps the priority there but of course we can have a mixture of all three.

Comments on both this and the previously graph which I can show again if you forgot what it looks like but I’d love to hear what our panel think.

Kumaran: Hi, it’s Kumaran here. May I take this question actually on focus? It’s quite interesting the way people have responded which I totally agree. It’s a combination of everything but if I have to focus primarily on the product messaging itself as being a priority that should also be one of our key priorities, because the messaging that we give to our healthcare professionals should be absolutely clear and straightforward.

This will aid appropriate use of medication, that’s what I believe. What we found through clinical trial program and structured research programs we have to have succinct approach in getting those messages out and that messages will have to resonate that such with the intervention itself benefiting the patient. That’s how I see this.

Dirk: It’s an interesting debater because if you look… I agree at the end we will talk about the product because it is a carrier of a solution but I think, like it is said here, the way we do it, I think first of all and also based on previous discussion we need to get to the right insights at what is the patient looking for, what is the HCP looking for, who do we have in front of us that’s at the adaptability. Every approach should be personalized. Where do we need to indicate and inspire and at the end for me and that’s the change that we as an industry have to make is the product is the carrier of the solution, nothing more and nothing less and it’s about creating an experience, maybe even more than the product itself. So, I think the shift away from all the other product focus is correct for me, so I’m happy to see this reflected in the survey outcome.

Paul: Anyone else care to comment on that or of course the previous? Maybe I’ll show you the previous one very quickly. Let me just get that back on the screen.

Michael: While you are doing that Paul, I’ll give some comment from Qstream side, what our experience is with our customers.

Paul: Please do.

Michael: It’s interesting, insightful and education those are the two things that our pharma customers are telling us, are important from a point of view of how we train and reinforce knowledge from the MSLs and the HCPs. We had a tangible example of this two years ago when one of our big global customers came to us and said the problem we have with our sales reps is that their doctor office visits are falling precipitously and when we research with the doctors why this was happening the doctors said, “Well, it’s because your sales reps are still focused on the old transactional model of just pushing drugs. We need them to commend to us and have value-added conversation. By that we mean tell us something about the therapeutic area. Tell us how your drug impacts the patients. Tell us what the side effects are. Tell us how all of that compared with the other drugs out there in the market.” So, our customers asked us, “Can you help our sales rep to transition to that?” So, we set up a number of Qstreams that focused on up scaling the sales reps on their, what we call, hard skills, their knowledge around the product, their knowledge around the therapeutic areas, their knowledge around the disease areas.

Within about six months of running these the feedback we got from our customers is that the doctors were more open to seeing the sales reps again and the feedback was that the behavior had changed. I think Heather alluded to this earlier as well. Behavior change here is very, very important from a point of view of how you deal with the HCPs today whether it’s the MSL or the sales reps, behavior change is a critical part of that.

Heather: Can I add to that as well, and this goes to Helena’s point about ownership. Example, the sales calls are falling low, there weren’t more holistically solving the customer issues where you could have solve that in a number of ways. So, train the sales rep, yes absolutely; get some more to say and give a holistic experience but there also could be a willingness of when does our sales rep triage solve that question or solve that problem or bring that problem into the office. Maybe can be more creative about who we’re deploying or even be brave enough to strip away the arbitrary role distinction and just simply focus on who has the right skill set in the organization to then deploy, ready to answer their questions so that it’s like a company facing interaction and not necessarily a sale facing interaction. So, we don’t necessarily need the sales people to feel the absolute ownership in that they have to solve the problem but that if we’re looking bigger when is the right time we train anyone who sees customers to reach out and get the right person to solve their problem.

Helena: Exactly. If might add to that one, Heather. It’s also that what need or we talking about, we are still talking about as if the need from the HCP perspective would be a product, a pill or an ointment, whatever but… I mean I have experienced many cases where really good reps or key account managers have tried to identify how can we make sure that the right patients are directed to your clinic, your department and making sure that patients that shouldn’t be there or should be diagnosed somewhere else or not referred to this specialist clinic? How can we make sure that that is not happening?

Sorry, now I’m a little bit ahead of myself. It is about making sure that we are addressing the right needs. Their need for the HCP perspective might actually be that I’m so overwhelmed, I’m so overworked, I had so many patients that shouldn’t be here, that should go to a GP or some other specialist, so I can’t even take anything what you are saying about a product because that is not my need. I think what we need to do as a company is to see what is the root cause, when are the HCPs really ready to listen.

Heather: Yeah, and finding that comes from a curiosity culture of everyone in the company to find out what the root cause is, because if the outcome is the right patient, the right time and the right treatment it may not be that doctor at that point in time and we have to look at a systemic view of their universe, and I’m not sure we’re collecting that holistic information right now or being as curious as we could be to find that out in the first place, let alone deploy the right person to help them.

Helena: And also have that willingness that even though the solution or part of the solution might not fit with me that I transfer that information further on in the organization so somebody else. It might be medical but might also be the IT department or something else that they chip-in. So, I feel that kind of ownership of getting a solution in place.

Heather: Then, the access of that information can get to anybody, yes.

Paul: Okay. Sorry, I have to break it up for just one second that’s all really helpful, but we’ve only got a few minutes left and I really want to make sure we cover one more topic before we finish and that topic is a very important one. I think in the first survey a lot of people chose incentives and KPIs as a reason why we haven’t got more better understanding of our customers, but it’s really measurement and how we actually assessing whether or not we’re doing this and actually making progress, how we’re actually ensuring that we’re not just measuring inputs and measuring the right kind of outputs and actually affects that ultimately filtered down to the patients.

Just very quickly let’s do one more final audience question. I think you all know the way which this works now. Which of the following do you regularly engage in to measure customer knowledge or perceptions but notice that you can choose more than one answer this time, I know, I’m being nice as we finished. So, please do choose which of these you actually use regularly, note the word there. So, after using perception research or surveys, assess knowledge before and after education promotion; looking at clinical behavior changes over time; looking at treated patients, i.e. what the clinician is actually doing with the patient and whether or not that is having an effect on this patients over time; or finally looking at whether or not HCPs are willing to publicly advocate your solution, so I guess that kind of alludes to MPS a little bit that final one which I know a couple of audience members have asked me about while we’ve been carrying on here.

I can see we’ve got about 40% of votes, so let me get the last few strugglers in and then I will open the conversation up for a final comment on measurement. So, three, two, one. Thank you so much everyone.

Obviously, these percentages are going to be higher this time because I let everybody choose more than one, but once again very even. You can see that it’s pretty much, well 37 the lower, 54 the highest, so everyone is within that… basically nearly half of people are doing everything here. I’m personally interested to see that 40% of people chose the looking at treated patients are actually going to that level of depth and I imagine a couple of you might be interested to hear what is happening and obviously feeling… I personally feel very emboldened by the fact with what’s happening. How about you guys?

Kumaran: Hi, it’s Kumaran here. This doesn’t surprise me at all. If you look at that 40%, looking at treated patients or looking at outcomes, etc. that is quite possible when you are looking at some real-world evidence. If that is what you are looking for then of course we look for patient outcomes over a period of time and also the combination of these measures entirely depends on the situation. If you are talking about, if you are running an educational program for healthcare professionals then you insist a knowledge or if you are talking about a prelaunch activity or a launch phase or whatever then you talk about or you assess the attitudes and the perception instead of why so on and so forth. So, it entirely depends on what situation we are in.

Paul: Kumara, let me just interrupt you there because we’re running out of time. Would you say that RWE robust measure of patient impact or patient outcome? I think it could be argued that it isn’t always.

Kumaran: Yes and no. The days have gone with where we would just be enough to have an RCP, a robust RCP. Now, we are in the era of RCP plus. We have to demonstrate value of the interventions that we are offering, the solutions that we are offering. In that case, the real-world evidence come in as one of the key tools in the armamentarium.

Paul: Okay, final comments from the others if that’s okay, as we’re running out of time.

Heather: I think the methodology of looking at treated patient comes over time can vary in a depth that you’re accomplishing this. And to give you an idea of a big study or you can easily look at a patient chart, and the change of a single physician who’s been exposed to an educational intervention and look at how he’s treating his patients with the chart review, which is a much lower burden way of looking at an impact or an outcome-based impact of pharma intervention. So, I think it’s a broad layered approach to how you can value those real-world evidence, impact measurement and how easily you can attribute them to a pharma-related intervention. I think you have to consider what one may or may not equal another.

Paul: Okay, final comment from Dirk or Helena and of course Michael?

Helena: I agree.

Paul: Thank you. Dirk or Michael?

Dirk: The only point I want to add and highlight is when you look at the result of the last question is how do we get to that and okay Kumaran mentioned real evidence data, or real world evidence data and I also think exactly third-party questionnaires at patient level and at the HCP level is critical for me to see how well we are doing what we think we are doing well. So to objectivize it.