Impact on outcomes
Speaking of results, what are the key performance metrics on a program like this? "ROI and how you measure it is always an
important aspect...sometimes you can't tease out the exact lift [in prescriptions sold], and you need control groups," says
Seifert. "But we can measure where the physician is, how many access the simulation, how long they were on it, where did they
spend their time, how far did they go, et cetera," and then those analytics can be combined with in-house claims data and
the like, to measure results.
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If these kinds of metrics get frowns from upper management, Seifert says it's important that companies understand that for
complex diseases and best clinical practices, videos sometimes aren't enough. "A simulation program creates value for customers,
and if you leverage it broadly, measure the results, and earn respect through providing real clinical value, then selling
the brand becomes a lot easier," he says. "For these programs to be successful, they have to be positioned as part of the
fabric of the company's brand strategy, not just a tactic subject to budget cycles." Seifert says the technology's "wow-factor"
has staying power, citing a client that's been using one of the programs for over five years.
To get access to the simulation, physicians receive a link and a code, which can go out in professional marketing materials
(reps can hand out a "web code card," for example). The program is self-contained online so physicians can access it anywhere.
Codes can also be placed in journal articles, says Seifert, underscoring the educational element.
Learning by doing
Seifert's philosophy on learning, which is the catalyst for behavior change, is based on the idea that "human beings are pattern
recognition machines," he says. "We learn by recognizing those patterns and new experiences, and they can be virtual experiences
or not. We link those patterns to our existing patterns, and that's how we learn. If you look at didactic learning—the lecture
format—it's linear, and it has been demonstrated to have low retention levels. Learning by doing results in higher retention
rates, because you're placed in a situation where you need to make choices to achieve a specific outcome, whether those choices
are in a virtual environment or a real environment, and then you learn what patterns lead to the desired outcome. This is
powerful, and it works whether you're a physician trying to do a differential diagnosis and come up with the appropriate treatment
plan for a specific patient history, or if you're trying to do an analysis of the patient situation. The same holds true if
it's the patient trying to improve her health. I think that's the value and attraction of this learning tool."
Dunbar's number
Aygoto's Tamagotchi-style game rewards kids for checking their blood sugar. In-game currency builds with desired behavior.
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From Syandus's we move to Vancouver, British Columbia, where Michael Fergusson works as CEO at Ayogo, a four-year-old shop
that employs 30 people. The number of employees is important to Fergusson. His agency's work is founded on the principles
of Robin Dunbar, a British anthropologist and evolutionary psychologist. In his research with primates, Dunbar concluded that
the number of relationships any one gorilla (and human, implicitly) can sufficiently maintain, or "groom," in Dunbar's parlance,
is finite. In short, when troops of silverback gorillas grow to a certain size in the wild, they inevitably splinter into
smaller groups, because only a certain number of relationships between gorillas can be properly groomed. From this research
came "Dunbar's number," which is roughly 150 (more precisely, it's 148, Fergusson notes, with 150 representing the tipping
point).
Dunbar's number was popularized by the author Malcolm Gladwell to illustrate the limitations of large teams or organizations.
"When a company gets to be about 150 people, it should really start thinking about being two smaller teams. Neolithic farming
villages, the size of the Roman legions...these were all around 150 people," says Fergusson. There are only certain kinds
of information that a person will typically share with 150 people, however, and there are other kinds of information that
is only shared in smaller, intimate groups of between four and 12 people. What does all of this have to do with gamification
in pharma? Potentially a lot, it turns out, if brands are interested in leveraging social connections to reinforce behavior
change.
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