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Aug 31

Almost all social media strategists recommend that companies and brands begin their journey into social media by “listening.” But how do you monitor the chatter on 180 million sites, including Twitter, the blogosphere, YouTube and Facebook? And more importantly how do you make sense of the aggregate data?

To answer these questions we used the most advanced, real-time social media listening platform available, ListenLogic. We monitored the social network activity for two competing insomnia products, Ambien and Lunesta, for the month of July, 2009.

Human analysts were used to train the listening platform how to disregard all the spam messages related to “get Ambien cheap” and how to determine if a comment could be considered positive or negative. While other listening platforms only achieve 60% accuracy on “sentiment analysis,” ListenLogic is able to achieve over 90% accuracy in this measure.

The questions we sought to answer were:

1)     What is the total number of comments for each of these brands?

2)     Does one brand have more social media activity than the other?

3)     Which sites generate the most chatter (eg, Twitter, Blogs)?

4)     Are there any people or sites that could be seen as key influencers in the online space?

5)     Overall, are people saying good or bad things about each brand?

6)     Is there a difference in the topics or issues that are being commented on for each brand?

7)     What do the some of the specific comments look like for each brand?

Here’s what we found…

Ambien beats Lunesta 7:1 in Share of Voice

After tracking 180 million websites and cleaning out the promotional chatter, we see that Lunesta had 764 total mentions and Ambien had 5265 mentions. Ambien has been on the market much longer than Lunesta, and in fact is now available as a generic, so it isn’t surprising that they may have more activity on the social networks. But the size of the gap is greater than expected especially given that the two products are roughly comparable in current sales. What would be interesting to see is if the total number of prescriptions for Ambien is seven times greater than for Lunesta-this is data I don’t have.



Twitter Accounts for the Majority of All Online Activity

The data clearly shows that Twitter by far carries more comments than any other social media platform.

Of the 5265 comments for Ambien:

  • 3666 (70%) came from Twitter
  • 226 (4%) came from
  • 89 (2%) came from
  • 78 (2%) came from
  • other

Of the 764 comments related to Lunesta:

  • 3666 (46%) came from Twitter
  • 70 (9%) came from
  • 25 (3%) came from
  • 24 (3%) came from
  • other

What’s interesting is that after Twitter, there is then a divergence in terms of what other sites are most important in terms of volume. And we can see that for the month we looked at, a full 3% of Lunesta activity occurred on the pharmaceutical rep gossip site

No Patient Opinion Leaders Emerge

We dug deeper to try to identify who are the most influential bloggers and Twitterers but no clear pattern emerged. In this particular drug case, in this particular month, there was nobody that emerged high on the “influence scale.”

Ambien Has More Positive Sentiment Than Lunesta

Not only are there a lot more people talking about Ambien than Lunesta, what they are saying is more positive too.

Much of what people say about a brand is neither positive nor negative, so it’s just classified as “neutral.” There are far fewer neutral comments as a percent for Ambien, 41%, than there are for Lunesta which has 84% of all comments being neutral.

For Ambien, 36% of the chatter overall or just over 50% of the non-neutral chatter is positive.


For Lunesta about 4% of chatter overall, or 25% of the non-neutral chatter is positive, with 75% being negative.


Comments Reveal DTC Ad Confusion & Pregnancy Questions

When reviewing the comments for Ambien, many consumers are seeking additional information and clarification.  Common topics:

  • Confusion by the Ambien TV commercial and all the side effects listed - with an ongoing debate over whether the ad announcer is saying “aggressively normal” or “more aggressive than normal”
  • Confusion exists over the safety of taking Ambien while pregnant, with chatter focused on “new mommy” blogs.
  • Others complain about the “Ambien Hangover.”
  • 5%-7% of posts discussed “what I did on Ambien” including sleepwalking and unintentional communications.


With less volume, it was harder to pick up trends in comments for Lunesta. What was noted:

  • Comments about Lunesta being less effective than Ambien
  • Lunesta leading to feelings of depression
  • And Lunesta reps (supposedly) chatting on blogs about how to push Lunesta to doctors



First, you must monitor. Our strongest recommendation is that every marketer use a listening platform to monitor social media comments. Marketers have long invested in 12 person focus groups or thousand person surveys; with social media monitoring, you can quickly and easily see the perceptions of a much wider cut of customers. In the case of Ambien you can literally listen in on over 60,000 comments per year!

Second, track macro results over time. With ongoing analysis you will be able to see:

  • Is our total number of mentions going up or on the decline?
  • Is our share of voice compared to our competition increasing or decreasing?
  • Is our positive sentiment increasing or decreasing?
  • Does a change in sentiment correlate to a new marketing strategy or tactic?

Third, review comments for actionable issues.
Not every comment or topic will require action, but using Ambien as the example, if a there is an ongoing debate over what the DTC ad announcer is actually saying, you have to wonder if many thousands of other viewers out there aren’t also unclear as to what is being said. This could easily be an issue not picked up by focus group panels, but is revealed when you can listen to 60,000 people.

Fourth, if you promote or engage on just one platform, make it Twitter. We suggest that brands can progress in social media first by listening, then by promoting (one way communication), then by truly engaging (dialogue and relationships). With limited time and budgets, this can seem like an awesome task (how do you respond to various blogs, user groups, YouTube comments, etc.). But we can see that Twitter accounts for the vast majority of user-generated comments. So if a brand is going to promote or engage, focusing on Twitter will cover most of the bases.

NOTE: For more information on the ListenLogic social media listening platform that was used in this study visit:

Social Media Faceoff: Lipitor versus Crestor coming next!
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Aug 25

healthwiseFor most health consumers, Healthwise is the biggest brand they’ve never heard of. Even though Healthwise content is accessed over a 110 million times a year, it is accessed most often through online health publishers, health plans, hospitals and disease management companies. Even though this company is over 30 years old, they continue to find innovative new ways to support patient decision making. I spoke recently with Healthwise Founder, Don Kemper.

Kevin Kruse: Don, why did you start Healthwise. It was back in the 70s right?

kemperDon Kemper: That’s right 1975.  During the time of the Vietnam war, I became an officer with the Commissioned Corps of the US public health service.  One day I went to a talk by Vern Wilson, Assistant Secretary for the US Department of Health and Human Services. He said “The greatest untapped resource in healthcare was the patient”. That just took hold of me and I decided that that was something I wanted to work on.

I had a baby at home at the time and somebody gave me the book by Doctor Spock on raising children. I started promoting the idea that we needed a Dr. Spock type book for the whole family that would guide people in how to take care of themselves… this led to the creation of Healthwise in 1975 and then later the Healthwise Handbook.

Kruse: Has the Healthwise mission changed since then?

Kemper: Well the mission hasn’t changed but the media changes. The mission has always been to help people make better health decisions. We did that initially through both the Healthwise handbook and workshop.  So we had a focus on education early on, just wasn’t as scalable as it is now on the Web.

Kruse: Healthwise online content is syndicated by most of the major health portals, how did you become an innovator with web technologies?

Kemper: We have a wind sculpture outside our building that’s devoted to our relentless innovation.  The base of it is solidly in the ground as is our mission which never changes, but that sculpture is always in motion and it means we are continually trying to find new ways to help people make better health decisions.

Kruse: Speaking of innovations, are you embracing social media?

Kemper: We certainly very supportive of the whole 2.0 movement and the social networks around health.  We think there are three sources of information that people need. They need to have information from their doctors, information that has a good solid evidence base, and then they need to hear from other people who have been in similar situations.

The piece that we focus on is the information that is really documented by medical research.  We are really trying to find the right ways to reach out to the 2.0 group, so that we can get those two sources of information collaborating on a more regular basis and I think that’s going to happen in many different ways.

healthwise21Kruse: Tell me more about your “virtual conversations.”

Kemper: Many people learn best through personal interaction with other individuals and we also know that psychologists have developed a number of techniques like motivational interviewing.

We can now model these interactive conversations by using software developed by Jellyvision, the makers of the computer game called “You Don’t Know Jack”

So instead of having the very obnoxious Jack run the game show we use a very supportive voice and individual called Shelley that guides the person through this interactive conversation.

healthwise3One type of conversation is around medical gaps mostly in chronic illness. For example the importance of the hemoglobin A1c test for monitoring and controlling your diabetes or the importance of aspirin to a person at risk for heart disease.

The other type of conversation is around wellness.  We don’t have a prescription exercise program, but we have the conversation that will help you make an exercise program work for you. It’s like having a twenty minute conversation with a psychologist around what is it going to take for you to be successful in your fitness program.

Kruse: Shifting to some business questions, how many employees do you have now? And you’re setup as a non-profit?

Kemper: We are a not-for-profit with 120 employees.

One advantage of being non profit is that nobody can come buy us, so that’s good. The not-for-profit approach allows us to play with everybody now because they aren’t concerned that their main competitor might buy us or take us over. We are now used by all ten of the ten largest health plans.

Kruse: What are you future plans for Healthwise?

Kemper: Our next big initiative that we are currently looking for funding and partners for is taking on the whole issue of late life care. We want to use interactive conversation technology to engage elders and their family care givers.  We have identified 26 critical moments in late life care ranging from the early days of just helping prevent falls to deciding when you stop driving, all the way to when do you need to move out of your home, when do you need to put in your advance directives, etc.

We think this will be a highly impactful program that will address what has got to be one of the biggest problems in American medicine; the program is called “Elder Talks.” I think it is going to be a one of our major legacies.

Kemper: Also we have 154 patient decision aids which is by far more than anybody else in the world. These guide the person through clinical treatment decisions like do I need the surgery, do I need this drug, do I need this test, etc.  We’ve had these for quite a while, but we are releasing a whole new generation of them.  The same topics but reformatted into a much more interactive and richer user experience.  Last year we had about 10 million uses of these decision aids, so that they are making a big difference.

Kruse: Great contributions, Don. Thank you.

Kemper: You bet.


Aug 20

Here’s a new video from Kru Research showing that the age of participatory medicine has begun.

Please share, forward, and RT. Enjoy!

Sources used for this video include:

  • Kao, Helen, Rebecca Conant, Theresa Soriano, Wayne McCormick. “The Past, Present, and Future of House Calls.” Clinics in geriatric medicine 25(1): 19-34.
  • Yawn, B., M.A. Goodwin, S.J. Zyzanski, K.C. Strange. “Time Use during Acute and Chronic Illness Visits to a Family Physician.” Family Practice 20(4):474-7.
  • Ley, P., “Memory for medical information.” British Journal of Social and Clinical Psychology 18: 245-256.
  • Rubin, Rita. “Doctors baffled by patients not taking prescriptions.” USA Today 29 March 2007.
  • Ferguson T, Frydman G. “The first generation of e-patients.” BMJ 328 (7449): 1148–9.
  • Herrick, Devon. “Web Replaces Doctors as Patients’ Top Health Information Source.” Health Care News 01 January 2009.
  • Fox, Susannah, and Sydney Jones. “The Social Life of Health Information.” Pew Internet & American Life Project June 2009
  • Fox, Susannah. “The Engaged E-Patient Population.” Pew Internet & American Life Project. August 2008.
  • Goetz, Thomas. “Practicing Patients.” New York Times 23 March 2008.
  • Keckly, Paul, and Laura L. Eselius. “2009 Deloitte Survey of Health Consumers.” Deloitte Center for Health Solutions. March 2009


Aug 17

Vibrant patient communities are the holy grail of health educators and marketers alike. While some organizations choose to throw up a Facebook group, others have decided to create their own destination site. One of the most successful of these is, the result of a collaboration between JDRF and Novo Nordisk. I recently caught up with the JDRF’s, Rachael Lewinson…

lewinson2Kevin Kruse:  Tell me about the Juvenile Diabetes Research Foundation (JDRF) and about

Rachael Lewinson: At JDRF our mission is to find a cure for Type 1 diabetes through research.  So traditionally all of our activities have had a very strong research focus, and in more recent years-although research is still our core mission-we’ve started to focus more on outreach, particularly to adults with type 1.

About two years ago we came up with this idea for Juvenation. The original idea was to provide new opportunities for our great volunteers to connect with each other more readily and freely, regardless of geographic location.  They are our most valuable resource, so we wanted to give them new and better tools to work with.

Kruse:  That’s great. So how did it actually come to fruition?

Lewinson:  We kept trying to get it going internally but we just didn’t have the resources. Then Novo Nordisk approached us after they did the DAWN Youth study, where they interviewed a bunch of young people with diabetes to determine their needs. They found that one of the biggest gaps for them was social and psychological support, so they started looking for ideas on how to meet that need. We had partnered with them on other things in the past, so they came to us thinking that we might be a good partner for that.  They loved the idea for Juvenation and decided to become the founding sponsors.

juvenation1Kruse:  How does the site work today?

Lewinson:  We just launched in November of 2008 so we are still adding features, but all the basic functionality is in place, which let’s you create a profile, join discussion groups and forums, accept friend requests and create and comment on blogs.

Kruse:  Who actually built the platform? Did you work with an outside vendor?

Lewinson:  We work with Ignite Health. We are very happy with the work they do.

Kruse:  It launched at the end of last year, what are the results?

Lewinson:  We currently have more than 6,200 members, just from announcing it to our e-newsletter subscribers, Facebook and Twitter followers, and website visitors.  We haven’t really marketed it to the “outside world” yet.

Kruse:  Congratulations.

“We currently have more than 6,200 members…”

Lewinson:  Thank you. And the members are very active on the site. We are approaching nearly 10,000 posts a month. Plus there are also about three to four times as many visitors as members on the site at any given time.

Kruse:  How did you promote the site or how are you getting the word out?

Lewinson:  Well, other than the original kick-off event on World Diabetes Day, it’s been all internal vehicles. We have three different e-newsletter lists that we have put ads in, and we also have an ad in Countdown magazine.  We also gave a challenge to our chapters in May to try and recruit 25 members by the end of the month in order to hit our goal of 5,000 members, and it worked.

We also send announcements through Facebook and Twitter.

Kruse: Other than traffic, have you measured any other outcomes?

Lewinson: Yes.  We have found that people actually improved their diabetes care just in the short time since we launched the site; they are taking better care of themselves.

Kruse: How do you know that?

Lewinson:  We did a survey of members in April.  For half of them, is the first diabetes community they have been involved in. Some of our findings…

  • more than half of the respondants have found the emotional support they were looking for
  • 69% feel the site has helped them significantly feel better about Type 1 Diabetes
  • 50% say it’s actually increased the attention they pay to their diabetes care.

Kruse:  Has Novo Nordisk been pleased with the results, too?

Lewinson:  Yes, they have.

Kruse:  Any lessons learned from the project or advice to give to others?

Lewinson:  For us, it was important to find a community manager that was already experienced in social networking and respected in the diabetes community. We chose Gina Capone to manage Juvenation because she founded and runs Diabetes Talkfest, another social network, so she is very familiar with the territory.  She in turn has “deputized” some of the more active participants on Juvenation to help her moderate certain groups and make sure we are responding to anyone with a more critical need, like depression or suicide. We have developed policies around those issues and others, and now have a full-scale training for volunteer moderators on the site.

Also, the more feedback you can get from your members and then respond, the better. When we surveyed Juvenation members about what they’d like to see in future versions of the site, most of them expressed frustration about trying to get their friends to understand what it was like to have diabetes. From that feedback we ended up taking a lot of the statements that they were making and made an educational resource center that they can share with their friends.

Kruse: This has clearly been a very successful health 2.0 project. Congrats and thanks for the interview.

Lewinson: Thank you.

Note: Rachael will be presenting the case and answering questions at the e-Patient Connections Conference in October.

To get more great articles, interviews, and white papers subscribe to the Kru Report at:


Aug 12

magi2Playing the young magic-user, named Oz, you dodge heat-seeking missiles, bombard a giant robotic dinosaur with spells, and freeze foes in gleaming blocks of ice. To win you’ll need quick wits, lightning reflexes and, perhaps most importantly, a solid understanding of diabetes management.

What? An understanding of how to keep blood sugars stable?

You see, in the upcoming video-game, The Magi and the Sleeping Star, your character isn’t just the descendant of a long line of magical heroes, he also has Type-1 Diabetes.

Adam Grantham, President of Game Equals Life and Magi’s creative producer, is a videogame veteran who’s also lived with diabetes for over 15 years. With Magi, he hopes not just to create a health education game, but to create one that stacks up favorably with the latest action hits. “The illness isn’t the focus,” says Grantham. “The game is about a hero who must battle armies of robots and giant monsters in order to save his world. But since this hero happens to have Type-1 diabetes, players must learn to manage the disease in order to be successful.”

magi3For example, keeping a stable blood sugar level is directly tied to the hero’s combat performance. Eating food restores his health, but if the carbs pile up, his selection of spells will become limited and his movements will become sluggish. Administer just the right amount of insulin, and perform regular blood sugar tests, though, and his magic will gain extra power.

“Diabetes management really is a system, and even though the rules are soft, and not always 100% predictable, it is possible to use the rules to manage the disease,” Grantham explains. “Games teach players things all the time in regards to managing systems and dealing within rules. You can ask anyone who frequently plays Role-Playing Games and Real-time Strategy Games and others. They remember from the game, what order to take actions in, what attacks to use on what enemies, what techniques to use in what kind of environments, etc. So Magi just takes this norm from video games and applies it to diabetes management.”

Game Equals Life, an independent design studio funded by private partnerships and investment, has yet to announce a release date for Magi. However, the project has already caused some buzz on various blogs and message boards. In an industry where young gamers are savvy and selective, Magi’s pedigree and polish are just as important as the health content itself in conveying a message of responsible diabetes care.

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