Search engine positioning (SEP) is a critical component of any online marketing plan. It is the art and science of increasing a website's visibility among major search engines and directories with a strategically defined set of key words.	

By using relevant phrases in the major search properties, companies can achieve the kind of positioning that will reach visitors looking for products and services. 	

This article outlines how pharma companies can build an effective SEP strategy to inform and educate an online audience and still satisfy FDA regulations.	

A Harris Interactive study demonstrated that 75 percent of adults who use the internet-amounting to about 100 million consumers-seek healthcare information. The Boston Consulting Group found that 65 percent of patients who look for health information online consult search engines. Yet, despite the evidence that the internet is the most cost-effective channel for creating consumer demand for prescription medications, most pharma sites are not fully optimized for search engines. 

Of the 65 percent of consumers who look online for answers to their health queries, 24 percent start with health portals and only 11 percent start with disease-specific websites. Those who favor particular health-related sites report that they initially found them through general search engines. Because most people who seek health information on the web are uncertain where to begin, search engines are the best tools to point them in the right direction. 	

Those data demonstrate a need for pharma companies to make comprehensive search-visibility strategies part of their online marketing initiatives. In the competitive pharma marketplace, individual product sites not only contend with direct competitors but also with medical portals, online pharmacies, and other health information resources. So, web-based opportunities to communicate all facets of a product and brand are also special challenges.	

Sending a balanced message about a product is one of the first hurdles. Companies must		

choose key words that are popular with consumers and best represent a site's content

write descriptions for, and submit a site according to, the written and unwritten guidelines of a search engine company. 

FDA views all pharma promotion in the same light, whether it's an online ad, a TV spot, a newspaper advertisement, or a brochure. Although all meta data are not publicly viewable, they are part of the overall website presentation, making it open to FDA scrutiny. So pharma companies must ensure that website meta data adhere to FDA guidelines.  	

Search engines have lead times of up to several months for indexing and refreshing their databases. Changing messaging or grappling with an incorrect listing in a directory such as Yahoo! is an arduous process. To avoid that calamity, getting it right the first time should be the goal. 	

Timing is also an important issue with directories. A listing with a human-edited directory is difficult to alter, because editors have backlogs of submissions. A company may submit a request for a listing with, say, Yahoo! and, despite a cost of $299 annually, the listing that actually appears in search results may look somewhat different. 	

Yahoo! guidelines have character limits for their descriptions, and each editor has a different style for representing websites  within a category. A listing could be detrimental to a pharma company if the drug's indications are poorly explained, leaving it open to FDA scrutiny. The company could be forced to pursue an appeal process with Yahoo!, resulting in a lengthy-and likely unsuccessful-campaign to have the listing changed.	

Paid submissions take precedence over requests to change a listing for free. Therefore, a request could be pushed off for months and, in some cases, never be addressed at all.	

Links are a vital factor in determining a site's value, according to search engine companies. Pharma companies must consider a host of factors, including 		

Although links pointing to a site can have a positive impact, there are cases in which they can be detrimental to a company's online reputation and invite FDA scrutiny. A health partner with appropriate content may be linked to a site that has gone out of business and let its domain registration expire. Many adult content website operators are quick to purchase expired IP addresses of well-known sites and fill them with salacious content. A reputable brand could be hurt by that association, and search engine companies may penalize a client that is affiliated with one of those sites, even through links.	

Meta data are an integral and often overlooked element of a website. Although primarily invisible to the user, the data are central to the presence of a website within the search engines. Meta data should be the first coding on every website page and should be considered food for search engine spiders, providing important information about a site, including	

a brief description of a site's offerings 

key words that can be associated with a page.

When search engine "spiders" visit a site, they automatically "grab" and place the most focus on the code closest to the top of the page. That code supplies the spider with what it views as the most important information about the page. If a site lacks meta data, it may be indexed with a description compiled from navigational links or source code rather than from a carefully written description targeted at users. 	

As of May 2002, FDA had not issued direct guidance regarding pharma's communication of prescription information over the internet. To date, the bulk of FDA action taken has been aimed at online pharmacies. In the meantime, as FDA draws up guidelines, pharma companies reaching out to online consumers through search engines must comply with the same offline regulations and guidelines that govern their product marketing.		

Ads for pharma products are required to contain "information in brief summary related to side effects, contraindications, and effectiveness." Current FDA guidelines dictate that promotional materials present a "fair balance" between information about the product's effectiveness and its risks. Additionally, all information must be communicated in consumer-friendly language. 	

Those requirements create special challenges for marketers and must be factored into all SEP marketing tactics. In the past, many of the elements with which FDA has taken issue have been related to presentation, and many site owners fail to realize that all elements of the website, including the hidden HTML code, are part of the overall presentation.                 	

Another misconception is that search engine positioning needs to be completed only once and the results will last. To ensure continued positive results, SEP involves many tasks that must be consistently performed, tracked, analyzed, and reassessed. The need to monitor and closely follow the workings of the major search properties is especially critical given the dynamic nature of the search engine industry. 	

A website might rely on a large amount of traffic from a particular search engine, for instance, but if that engine goes out of business, not only will visibility in that search field decline, but new traffic from it will disappear as well. 	

Through partnerships, search engines share databases. If there is an error in one database listing, it will be visible in the partner's results as well, leaving a company open for scrutiny. 	

A directory is different from a search engine in that meta data do not affect the way a site is listed in its search properties. A search directory, such as the Open Directory Project or Yahoo!, is a human-edited entity in which sites are reviewed and added manually to the database according to the editor's interpretation of the site's offerings. Listings within the major search directories are important because of the multitude of partnerships between search engines and directories. An open directory project, which is an uncommon search destination for most consumers, feeds more than 100 other sites, including one of the most popular search engines, Google. The relationships within the internet search space are ever-changing, mandating coverage in every possible arena. 		

Human-edited directory submissions are open to subjective viewpoints and errors. Because directories impose stringent limits on description lengths, website owners are left with few words to accurately describe a product, its efficacy, its use, and its possible side effects. It is challenging, to say the least, to create a description that is enticing for users, yet adheres to FDA's multifaceted guidelines. The best approach is to maintain fair balance in a manner that is both informative and appealing. 	

Given the many tasks associated with SEP, pharma companies should set guidelines in advance to prevent problems resulting from a backlash after the fact. As with most pharma companies, it is the internal medical review board's role to ensure that all related internet content-meta data, directory listings, and incoming and outgoing links-conform to FDA requirements. 	

A well-executed online SEP strategy provides positive returns for both pharma companies and site users. Although it is still evolving, the internet has proven itself a strong marketing vehicle with a significant ability to educate, inform, and guide worldwide audiences on innumerable subjects, including healthcare and pharma products.		

The initial time and resources that pharma companies invest in a comprehensive online search engine marketing strategy will reap long-term benefits. As the internet becomes a more useful health research tool for consum-ers, the need for pharma sites to be located by search engines will grow. Pharmaceutical companies must transform their search engine marketing efforts to make product websites a resource for patients rather than a source for FDA scrutiny.	

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Search engine positioning (SEP) is a critical component of any online marketing plan. It is the art and science of increasing a website's visibility among major search engines and directories with a strategically defined set of key words.

The Search Engine That Could

Many industries today are looking to mobile and wireless solutions or handheld devices to improve business efficiencies, create more effective customer interactions, and deliver business value.	

Those benefits are especially clear in the pharmaceutical industry, where communications are complicated by fragmented sales forces, broad product lines, dispersed caregivers and patients, overloaded physicians, and changing information. Mobile communication tools can unify a company and bolster sales, marketing, and operational efforts. But there are pitfalls to success that companies may overlook until it's too late. Often, managers are quick to rush into a new technology to solve a minor obstacle without exploring the underlying business issues and processes that created the block. But in the excitement that attends new technology, red flags such as a weakly defined business problem or lack of target metrics can pass unnoticed. This article outlines five common pitfalls to avoid when implementing mobile technology. 	

Without a concrete strategy and a well-defined business problem, a mobile communication tool is irrelevant. That tool needs to be part of a larger approach. Too many companies deploy technology for nonessentials and find themselves wondering what went wrong. Failure to clearly delineate a business problem when it first emerges can lead to a variety of difficulties, such as a lack of project ownership, lengthy implementations, low user adoption, and wasted investments. So, it is critical to define the business strategy before investing in new tools to solve a problem.				

With pharma sales forces, if the key issue is improving relationships and gaining mindshare with high-prescribing physicians, the corresponding mobile solution may involve providing sales reps with clinical knowledge, prescriber history, just-in-time product collateral, and call history-enhancing each detail and building credibility with doctors. If low productivity is an issue, then enabling reps to conduct administrative tasks electronically on their handheld devices during down time could be the most important part of the solution. Concisely defining a problem, such as workforce efficiency, asset productivity, cost control, or customer satisfaction will drive the design of an appropriate and effective mobile solution. Companies that do so will realize the greatest returns.	

 Business strategy leads mobile strategy.	

Assessing the impact of mobile technology on employees is critical. If improving information flow fails to motivate them, a mobile solution won't fix the problem. Eliminating paper-based processes or enabling better decisions can change user behavior and translate into real value. But simply facilitating information flow, without affecting employee behavior or field patterns, will never solve a specific business problem.				

When automating sample management, for instance, pharma companies must ask if the technology will 	

enable sales reps to spend more time with doctors 

provide management with a more complete view of sales data so they can recognize patterns quickly. 

If so, a mobile solution will certainly drive employee action and would be a worthwhile information technology (IT) investment. If not, then other investments may bring a higher return.	

In a competitive business environment, pharma companies can't spare resources for a mobile investment without a way to measure its value. Managers should clearly define benchmarks for improvement early, before they deploy the first handheld application.				

But there is no such thing as a "mobile metric." The impact of mobile communications tools should be measured using the same criteria that are fundamental to the core business. If mobility fails to affect at least one of the company's top performance metrics, then a critical business problem is going unsolved. It is also important to think through, in advance, the timeline for expected benefits. 	

A mobile sales application that increases information flow and management insight to field activity will likely be measured initially by call reporting quality and frequency, then by sales rep productivity-calls per day and numbers of physician covered-and ultimately by improved rep–physician interactions such as call completion, call duration, call frequency, physician satisfaction, and market share. Establishing those types of clear metrics up front will help steer a project toward success over time.	

Short-Term Decisions Equal Long-Term Pain

Getting lost in the "wow" factor of mobile technology is a dangerous, yet all-too-common, scenario. It is important to carefully consider information flow and an effective solution that will stand the test of time. By not considering the long-term implications, decision makers get into trouble investing in inappropriate mobile systems or devices because they are excited by the possibilities created by technology hype. Companies must ask:				

What happens when platforms or networks change? 

What happens when business processes change? 

Managers who make significant mobile investments in response to the need for a quick fix may find those tools redundant or obsolete tomorrow. Consider team selling: If one sales force uses Pocket PCs and another has standardized its systems on Palm OS devices, what happens if an organization's team-selling approach involves both groups in the future?  How will they communicate with each other and the back-end IT systems? Companies must factor in deployment, training, networking, and most important, the flexibility to maintain applications, support upgrades, and adapt to changes in business process and technology.  	

Finding the right mobile solution is much more important than getting on the latest bandwagon. Is instant wireless connectivity critical to the business? Will integrated PDA/phone combos drive productivity? Perhaps, but their effectiveness varies from vendor to vendor. The best approach initially is to set the technology aside and focus on understanding the users' workflow, the information they need,  and the format that will best drive effectiveness and productivity. The next step is deciding which technologies will meet those requirements. Services such as wireless data access may be unnecessary if most critical information is static during the day. The only guarantee is that business processes and information flows will change over time, and any mobile solution must have the flexibility to change with them. 	

  Roll out today with a plan for the future. 	

In employing a new technology, companies often ignore its effect on end users. That knowledge can have a great impact on the adoption of a new system. Nowhere is that more relevant than for a mobile solution, which, by its very nature, is critical to the daily workflow. Paying close attention to users' needs ensures that the mobile solution is practical and can be easily integrated into existing workflows.				

 User interfaces are particularly important. Well-designed ones will drive adoption and usage. Those that are poorly thought through-a common mistake is porting desktop applications to handheld devices-will result in disenchanted users who employ PDAs as costly paperweights. Most users won't master or accept extensive text entry on a handheld.  Enabling drop-down menus and eliminating scrolling to allow full information entry in seconds are important factors in driving adoption.	

Hospital management is a field rich in opportunities for automating and streamlining administrative processes. Prescribing medication can be more efficient through handheld devices, but doctors don't want to stand around tapping out the details. Instead, a well-designed mobile prescription application enables physicians to quickly check boxes or select from a drop-down menu to prescribe medications and manage rounds. But if using the mobile application takes longer than a doctor's existing process, it will be abandoned.   	

Understanding the end user is especially important with patient applications. Pharma companies that want to mobilize patient diaries to allow individuals to track medication compliance, side effects, or diet and lifestyle events, must understand how that information would otherwise be recorded. Chances are, patients are not sitting down at a computer to record the details each time they take a medication. More likely they are jotting down notes here and there, perhaps sticking a series of post-its on the refrigerator and undoubtedly losing a few details along the way. Successfully replacing that paper scenario requires understanding existing habits and making the user's transition to a mobile system easy and intuitive.	

  Mobile applications must be user-friendly.	

Corporate budgets have been hard hit recently, and the pharma and healthcare industries are no exception. Across the healthcare value chain from pharma sales and marketing to clinical trials, to patient care, to hospital operations, carefully planned and executed mobile solutions represent one of the most cost-effective investments they can make to enjoy a rapid return on investment and significant long-term benefits. But, as with any solution, the challenges can be complex and the companies that take a pragmatic, business-driven view will realize true value.	

Many industries today are looking to mobile and wireless solutions or handheld devices to improve business efficiencies, create more effective customer interactions, and deliver business value.

Winning with Wireless Solutions

To win consumers' trust and loyalty, pharma companies should look to the privacy regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to guide their direct-to-consumer (DTC) and web strategies.	

HIPAA provides the standard for using and managing individually identifiable health information. Its underlying ethical principles are based on the cornerstones of the Fair Information Practices Act of 1974: disclosure, authorization, and clarity.	

This article highlights HIPAA's basic tenets and how they affect pharma companies. It also discusses how companies can benefit from working with nonprofits that are dedicated to privacy compliance and accreditation.	

"Opt-in" is the standard ap-plied to collecting and transferring health information. That standard makes the company that tries to obtain and use the information responsible for gaining prior authorization. Even then, consumers must be clear about how the information will be collected and used before they can grant permission to use it. 	

HIPAA privacy regulations apply only to covered entities that electronically transmit or store individually identifiable health information. Typically, that does not include pharma companies. 	

So, why should the industry be concerned about HIPAA? Because business associates of healthcare companies that perform functions on behalf of the covered entity are affected, and many pharma companies likely fall into that category. More and more, pharma companies are becoming involved in patient care treatment programs and gaining increased access to clinical health information through clinical trials and online care management programs.	

The business associate rule gives pharma companies an important reason to develop comprehensive privacy policies: competitive advantage. After all, covered entities will be careful to align with organizations that won't put them or their reputations at risk. 				

HIPAA has two types of permission for use of individually identifiable health information. "Consent" is for information used in conjunction with treatment, payment, or healthcare operations. "Authorization" is for any other use, such as marketing or DTC advertising. How a pharma company initially obtains and ultimately uses individually identifiable information determines the type of permission needed.         	

The safest approach for pharma companies collecting and using personal health information is "opt-in" authorization-whether the information comes from an individual or a healthcare system, says Donald Kemper, CEO of Healthwise and chairman of Hi-Ethics, an organization that develops consumer privacy, security, and quality standards: "The elements of clear disclosure for that authorization should include the type of information, the purpose it's used for, who it is shared with and for how long, and how to revoke permission."	

Another good reason for pharma companies to embrace HIPAA precepts is the important matter of trust. Gaining personal health information requires building trust with patients. Pharma must create an environment in which consumers feel comfortable providing a gateway to their personal health data.	

The public wants to access a wide array of information from pharma websites. At the same time, they are skeptical about the information they find there. Jupiter Re-search reports that only one in ten consumers trusts pharma sites to provide accurate health information. And consumers are less than enthusiastic about giving data to pharma sites to institute ongoing contact.  				

To enhance consumer confidence, pharma companies might partner with third-party health sites. Through such intermediaries, companies can sponsor related content and provide disease management resources and community support activities while benefiting from the sites' expertise in building privacy trust with end users. 	

GlaxoSmithKline worked with WellMed to develop a health risk assessment specific to herpes for GSK's educational website, www.herpeshelp.com. Instead of creating online resources on established consumer sites, GSK designed its own patient education site with an assessment giving consumers a private, personalized report, counseling and support, treatment op-tions, and links to chat rooms.	

HIPAA also gives patients the right to control who has access to their health information and the right to correct errors in their records. Pharma companies can go a long way toward overcoming consumer skepticism by following the ethical principles inherent in HIPAA standards.   				

Jupiter Research suggests that pharma sites create privacy policies that incorporate key HIPAA provisions regarding disclosure, chain of trust, consumer control, and security. In doing so, companies would be smart to seek guidance from the many online health companies and self-regulating organizations that have worked for years to develop policies and security measures.   	

Those groups know that protecting individuals' privacy and confidentiality is key to their success. They understand the importance of a privacy policy based on the principles of disclosure, authorization, and clarity. Following in the footsteps of those internet trailblazers, pharma companies might develop policies that outline their commitment to privacy protection. Those policies should address:	

personally identifiable information and individual health information that the company collects from consumers

how the company makes use of personal consumer information, including aggregate data

the company's relationship to third parties

consumers' privacy choices, describing how they can change or remove personal information. 

Pharma companies considering the use of online technologies to support DTC marketing should do everything possible to ensure they properly obtain or use individually identifiable health information. For those who don't, the penalties can be severe. 	

Entities covered under HIPAA, or their business associates, are subject to criminal penalties. Even companies that fall outside of HIPAA run the risk of damaging their public images. The use of trusted online health intermediaries who have experience dealing with conflicting privacy regulations can help pharma companies avoid costly mistakes.	

To win consumers' trust and loyalty, pharma companies should look to the privacy regulations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to guide their direct-to-consumer (DTC) and web strategies.

Pharmaceutical Executive-08-02-2002

The Search Engine That Could

Winning with Wireless Solutions

Embracing HIPAA's Ethics