Cbi 8th Dsi Conference 19 May2011 Final Mitchell Copyrighted All Rights Reserved

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CBI’s 8th Annual Forum on Dissemination of Scientific Information17-18 May 2011 Philadelphia

Tools in the Medical Affairs Arena:

Perils and Payoffs

C. Latham Mitchell MDManaging Principal, Erudita Biotechnical LLC

Disclaimer and Copyright

•The views and opinions expressed in the following PowerPoint slides are those of the individual presenter and should not be attributed to Erudita Biotechnical LLC, its directors, officers, employees, volunteers, members, chapters, councils, affiliates, or any organization with which the presenter is employed or affiliated.•

•Information regarding for-profit or nonprofit entities in this presentation is non-exhaustive, and no such entity or other resource is endorsed by the presenter.

•These PowerPoint slides are the intellectual property of the individual presenter and are protected under the copyright laws of the United States of America and other countries. Used by permission. All rights reserved. All trademarks are the property of their respective owners.

2

Disclaimer and Copyright continued• The views, opinions, and information provided by the presenter

including that related to for-profit or nonprofit entities in this presentation is non-exhaustive, and -- while every effort has been made to make this presentation correct, fair, balanced, and non-proprietary, the presenter cannot accept any responsibility for any errors or omissions resulting from the use or misuse of this information.

• Every effort has been made to make this overview presentation correct, fair, balanced, and non-proprietary.

• This slide set and presentation is intended as information only, and is not a substitute for legal or other professional advice.

• All content is for information use only, and is not to be construed as a guaranteed outcome. Erudita Biotechnical LLC cannot accept any responsibility for any errors or omissions or any liability resulting from the use or misuse of any such information.

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Objective: Steer Clear of Perils, Realize Payoffs

• Big Conceptual Buckets for What Med Comm Tools Do•• 4 People Principles for Medical Communications’ Tools

Principles #P-1 thru #P-4– Tool Shopping

• Manager (Power & Funds)• Front-line User

– Tool Maintenance•• 6 Tool Principles for Medical Communications’ Tools Principles #T-1 thru #T-6

– Tool: Inherent Properties– Tool: Buyer’s System & How’s It’s Customized

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Divide Up Your Content World Into 2 Parts

CT=clinical trial; ePubs=electronic publications; medsci=medical-scientific; PM=performance management; reorg=reorganization; SOPs = standard operating policies & procedures; TL=thought leader

FOUNDATION

toolstool processeschanging them

“MedSci content is key for Medical Affairs since its output is effective communication of the scientific data.”

Personal Communication, May 2011PAUL E. BROCK, Associate Director, KMMedical Information and Services COEJ&J North America Pharmaceuticals Scientific Affairs

toolstool processeschanging tools or processes

But there’s more to the story…FOUNDATION =

Knowledge

What Tools Do in the Med Affairs Arena for the Knowledge Worker (KW)

8 Abbreviations: CRM = customer relationship management; medsci=medical-scientific

• client engagement = CRM• clinical knowledge management

– medsci repositories: finished work & resources– medsci KW new content outputs: documents (versions)

query responses; other (eg, slides, pubs, lit searches)– non-medsci resources for KW medsci work:

medsci project timelines; work-critical guidelines• enterprise management

– non-medsci info: other timelines; reports; contracts; other documentation (vendors; compliance/audit)

c o l l ab o r a t

i o

nw o rkf l ow

Categories to Think About (Non-exhaustive examples*)Document Managementw/Version Control & Workflow & Archive

• EMC Documentum• MS Sharepoint• OBA-IRMS

(w/Documentum, Siebel)

• OpenText (w/ SAP, Siebel, MS)

• Others

Customer Relationship Management (CRM)

• Oracle-Siebel• salesforce.com• ACT Sage (smaller

companies)• Many others

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SearchMS FAST (Sharepoint; Siebel|

Documentum|Lotus Notes| many other datasources)

Surfray Ontolica(Sharepoint)

Coveo(Sharepoint; Siebel|salesforce.comDocumentum|OpenText

Others

CRM=customer relationship management; IRMS=Information Request Management System (thin-client); MS = Microsoft; OBA=Online Business Applications

Noble J, Piddocke R, Bakman-Mikalski D. Pro SharePoint 2010 Search. New York: Apress Media LLC; 2011.

Ward P and McCabe M. Microsoft SharePoint 2010 End User Guide: Business Performance Enhancement.Birmingham, UK: Packi Publishing; 2011.

Click to edit Master subtitle style

yanag

you are not a gadget

JARON LANIER “YOU ARE NOT A GADGET, A MANIFESTO” Alfred A Knopf, 2010

yanag

Carol’s 10 Principles for Medical Communications’ Tools Toolshopper People Pr inc ip les 1 -4

#P-1 A tool is not a person

You Are Not a Gadget • patients, knowledge workers, & medsci content

FIRST and foremost• tools serve human beings,

not the other way around • a tool without a user is nothing

#P-1: yanag (you are not a gadget)• “Tools are only useful because people have the magical

ability to communicate meaning through them.”

• People are special: – nuance; the gray zone; the edge of mystery– neuroscience: cross-modal areas of the brain “abstraction”→

metaphor (core element of language & meaning)

• Human searching involves cross-model abstraction (parietal)– “Remembering complex, multidimensional information typically

requires strategic memory retrieval, during which information is structured, for instance by spatial- or temporal associations.”

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JARON LANIER “YOU ARE NOT A GADGET, A MANIFESTO” Alfred A Knopf, 2010;154.

de Rover M et al. Neural correlates of strategic memory retrieval:differentiating between spatial-associative and temporal-associative strategies. Hum Brain Mapp. 2008; 29(9):1068.

J LANIER PP. 1-12,171.

Rawley JB, Constantinidis C. Neural correlates of learning and working memory in the primate posterior parietal cortex. Neurobiol Learn Mem. 2009;91(2):129-38. Review

Brang D, Teuscher U, Ramachandran VS, Coulson S. Temporal sequences, synesthetic mappings, and cultural biases: the geography of time. Conscious Cogn. 2010;19(1):311-20.


yanag

frontliners to the 9s

#P-2 Frontliners, frontliners, frontliners

Knowledge workers know • Beta test w/KWs of different learning styles & generations (w/KW outliers too!)

• Listen to KW comparison & cost/benefit analysis

• Don’t be afraid to make the vendor work to address and fix KW issues

#P-2: Knowledge workers know•*Aunt C says: “Even if manager has veto power, don’t have too big a team: tool shopping team should be mostly KWs.” (KW : manager ratio ≥3:1)!”

•*Aunt C says: “If you ignore KW key reservations for moving forward, I will not be sorry for you if your project goes kaThunk.”

•Learn how to handle HIPPOs (Highly Paid People’s Opinions)

•IT often controls capital spend: business case that resonatesw/ Med Affairs management may not be the one that resonates w/ IT.

•IT responds to ↓ing costs: project that "consolidate“ systems w/scalability to broader user base ↑s likelihood of funding.

•*Aunt C says: “Managers, KWs should trump IT regarding helping to keep KW ergonomic injury prevention a top priority for project.”

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yanag

frontliners to the 9s

change as little as possible

#P-3 Consider non-positive effects of new tool

People & Software Change • Software changes people and reality

• Recent evidence for negative health impactwork strain

• Toolitis and possible morale effect

#P-3: Change isn’t all good• “The slightest change in something as seemingly

trivial as the ease of use of a button can sometimes completely alter behavior patterns.”

•• “..Extensive organizational changes including

..changed job tasks were associated with a small ↑ in work stress, disturbed sleep, incomplete recovery, and health complaints. ”

•

•16

Greubel J, Kecklund G. The Impact of organizational changes on work stress, sleep, recovery and health. Ind Health. 2011 Mar 1. [Epub ahead of print].

Stansfeld S, Candy B. Psychosocial work environment and mental health—a meta-analytic review. Scand J Work Environ Health. 2006 Dec;32(6):443-62. Review.

de Lange AH, et al. A hard day's night: a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue. J Sleep Res. 2009;18(3):374-83.

JARON LANIER “YOU ARE NOT A GADGET, A MANIFESTO” Alfred A Knopf, 2010;4.

Carol’s 10 Principles for Medical Communications’ Tools

yanag (Gadget) & yanaTool frontliners to the 9s

Change as Little as Possible

Spend as Little as Possible

#P-4 $$$$$$$$$$$

Spend as Little as Possible

Objective: Steer Clear of Perils, Realize Payoffs

• Big Conceptual Buckets for What Med Comm Tools Do•• 4 People Principles for Medical Communications’ Tools

Principles #P-1 thru #P-4– Tool Shopping

• Manager (Power & Funds)• Front-line User

– Tool Maintenance•

• 6 Tool Principles for Medical Communications’ Tools Principles #T-1 thru #T-6

– Tool: Inherent Properties– Tool: Buyer’s System & How’s It’s Customized

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First.. Faceted Navigation: Search & Browsing

• History of Web Search1.Navigational Search – iteratively narrow scope per fixed hierarchical

taxonomy (Yahoo! Directory, ODP) →

2.Direct Search -- “bag of words” (Google, other search engines) →

3.Faceted Search #2 + #1 ; (a la e-commerce); combining text search w/progressive narrowing in each dimension, thereby navigating thru multidimensional info; →→ semi-structured data, continuous dimensions, & folksonomies

– Faceted classification:multiple classifications per object, so info can be ordered in many ways(vs.1 fixed way in a taxonomy or tree-structure)

– Facet: “clearly defined, mutually exclusive, collectively exhaustive aspects, properties, or characteristics of a class or specific subject”**

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ODP = Open Directory Project, also known as DMOZ (from directory.mozilla.org)

**http://www.lucidimagination.com/Community/Hear-from-the-Experts/Articles/Faceted-Search-Solr * also, guided navigation or parametric search

http://www.lucidimagination.com/Community/Hear-from-the-Experts/Articles/Faceted-Search-Solr

First.. Faceted Navigation: Search & Browsing1. Navigational Search – iteratively narrow scope per fixed hierarchy/taxonomy (Yahoo!

Directory, ODP) →2. Direct Search -- “bag of words” (Google, etc) →3. Faceted Search – #1 + #2; (e-commerce); navigate multi-dimensional info combining

text search w/progressive narrowing of choices in each dimension; →→ semi-structured data, continuous dimensions, & folksonomies

Benefits users can refine search results, drilling down via facets and/or words until info found

• In-search feedback for searcher at-a-glance search results’ summary & breakdown

• Less “dead ends” users know how many hits match before they click(values with zero hits usually removed)

• No selection hierarchy imposed – users free to add or remove constraints in any order

• Tool can leverage end-user data (eg, views, downloads, roles, responsibilities, functional area, etc.) to increase likelihood of presenting options that align with user preferences then serve up recommendationseg See-also’s

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ODP = Open Directory Project, also known as DMOZ (from directory.mozilla.org)

**Source: http://www.lucidimagination.com/Community/Hear-from-the-Experts/Articles/Faceted-Search-Solr

http://www.lucidimagination.com/Community/Hear-from-the-Experts/Articles/Faceted-Search-Solr

Carol’s 10 Principles for Medical Communications’ Tools Tool Pr inc ip les 1 -6

inherent in tool

dependent on tool buyer’s system and/or customization

Searchable to the 9s

#T-1 Query/Escalation Answer Database

Searchable to the 9s • most important feature; text-word searchable !!• faceted navigation: user ↔ system dialogue• easily searchable via text and/or metadata• consider MeSH-only medical-scientific metadata(if you must, user-entered keyword by drop-down “pick list”)

#T-1: Searchable to the 9s• *Aunt C says: “If you can’t easily & text-word search your query

database, you have nothing!”

• Variables too great; speed too important

• End-user should drive how system uses search terminology, NOT vice versa

• *Aunt C: A “NO” vote for med info front-liner keyword entry (ends up a mess)

• *Aunt C: Buy contingent on search usability beta test: if managers & front-liners cannot easily find what you’re looking for, forget it

• Relevance of search yield: issue of user confidence

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Speedy & Freeze-free

inherent in tool


#T-2 Tool System Combined with Your System

Speedy & Freeze-Free • tool system – tool’s company servers

• your system -- your servers

• internal (US remote & non-hdqtrs) user speed

• external US and global user speed consideration

#T-2: A Tool That’s Speedy & Freeze-Free

• *Aunt C says: “If your med info tool is as slow as

molasses or freezes up, you have nothing!”

• Speed too important for remote, non-headquarters

users, global affiliates and global outsourcers

• **Aunt C: Do speed usability beta test: if remote

US users or rest-of-world internal or external users

have speed or freezing issues, get fixed or don’t buy

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Speedy & Freeze-free Scalable & Big Enough

inherent in tool


#T-3 Tool System Repository

Scalable and Big Enough • tool system – tool’s company servers

• your system -- your servers

• if it fills up, what are your options? $$ ?

• how soon will it fill up?

#T-3: Scalable/ Big Enough Repository

• *Aunt C says: “If your med info tool repository fills up,

you will need to spend more to expand it or buy a

new tool.”

• $$ too important to run out of space in a short time

• **Aunt C: Understand repository space needs

a) talk to others who have run out of room

b) make estimates & projections of what you’ll need

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Training-free

inherent in tool


#T-4 A Tool Without Training

Plug and Play • tool training is tedious, not intellectually stimulating,

the stuff of work strain, and diverts effort away from the medicine and science

• tool-itis fosters widespread (usually hidden) cynicism & disengagement among knowledge workers

• the more training needed, the lower Aunt C’s “grade”

#T-4: Med Info Tool Without Training – As Little As Possible If You Must

• *Aunt C: “Tool training mandated for front-liners not mandated for managers themselves gets a D-.”

• Time/$$ too important (negative cost:benefit ratio)

• *Aunt C: “Question ‘every tool needs didactic training’.”

• *Aunt C: “If >2 screen shots, look for another trainer.”

• Innovative approaches eg train-while-doing

• easy-to-use/intuitive NOT antithetical to powerful/effective

• 28



Training-free Walmart-esque

inherent in tool

customization-dependent

Scalable & Big Enough

Speedy & Freeze-free

#T-5 Floor Plans & the Power of Convention

A Sam Walmart State of Mind

• implemented tool’s fixed features eg, floor plan -- based on the tool & how customized – partly rational, partly arbitrary

• key to business process efficiency

• plan & stick to ‘fixed features’ like glue

#T-5: Drill is Good (& Efficient)

• *Aunt C: “Don’t let the new tool force you to throw the deck of cards up in the air.”

• Make new tool build on your conceptual floor plan & other fixed features

• *Aunt C: “Question ‘Our floor plan is better’. Answer: ‘Not for us, it isn’t.’ “

• *Aunt C: “Change as little as possible”

–30


Browsable to the 8s

inherent in tool

customization-dependent


Training-free Walmart-esque


#T-6 Browsability: Back to the Future

Making Search More Visible

• a la Marion-the-Librarian’s library – extremely searchable but “browsable” too

• challenge your vendors to show you this feature

• undeveloped dimension: giant mouseovers; mouseover sub-windows without leaving Kansas; robotic evolving drop-downs that auto-add metadata

#T-6: Browsability

• Faceted Navigation for Browsing

• See Coveo

• See Surfray Ontolica

• See MS FAST SearchServer 2010

– document thumbnails

– scrolling previews

– visual banners & applications to highlight key info

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The Future

A Sea Change At Hand• ↑’d Margin Pressures New Business Models→•

Patient Power/Regulatory Scrutiny

Payer Power

Prescribing Power

Pricing PowerMore treatm

entsMore patients

Less govt $$$

E7 PowerBRAZIL, CHINA, INDIA, INDONESIA, MEXICO, RUSSIAN, TURKEY

More chronic disease

Aggressive Marketing Power

Health Information Power≡ Global Medical AffairsDISEASE MANAGEMENT, PUBLICATIONS, MED LIAISONS

Health Economics Power

SystemSystemChoicesChoices

System System ChoicesChoices

Objectives

• Spring 2011: What’s Out There• Steer Clear of Perils & Realize Payoffs:• 10 Principles for Med Communications’ Tools• To Update or Not To Update• Change Was Good: Recent Research on

Detrimental Employee Health Effects and Change in Job Tasks

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Carol’s 10 Principles for Medical Communications’ ToolsPeople Pr inc ip les 1 -4 & Tool Pr inc ip les 1-6

35

References

36

1. Barch DM, Carter CS, Arnsten A, Buchanan RW, Cohen JD, Geyer M, Green MF, Krystal JH, Nuechterlein K, Robbins T, Silverstein S, Smith EE, Strauss M, Wykes T, Heinssen R. Selecting paradigms from cognitive neuroscience for translation into use in clinical trials: proceedings of the third CNTRICS meeting. Schizophr Bull. 2009;35(1):109-14.

2. Brang D, Teuscher U, Ramachandran VS, Coulson S. Temporal sequences, synesthetic mappings, and cultural biases: the geography of time. Conscious Cogn. 2010;19(1):311-20.

3. de Lange AH, Kompier MA, Taris TW, Geurts SA, Beckers DG, Houtman IL, Bongers PM. A hard day's night: a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue. J Sleep Res. 2009Sep;18(3):374-83.

4. de Rover M, Petersson KM, van der Werf SP, Cools AR, Berger HJ, Fernández G. Neural correlates of strategic memory retrieval: differentiating between spatial-associative and temporal-associative strategies. Hum Brain Mapp. 2008;29(9):1068-79.

5. Greubel J, Kecklund G. The Impact of organizational changes on work stress, sleep, recovery and health. Ind Health. 2011 Mar 1. [Epub ahead of print]

6. Karasek RA, Gordon G, Pietrokovsky C, Frese M, Pieper C, Schwartz J, et al. Job content questionnaire and user’s guide. Los Angeles: University of Southern California; 1985

7. Merritt DJ, Casasanto D, Brannon EM. Do monkeys think in metaphors? Representations of space and time in monkeys and humans. Cognition. 2010;117(2):191-202.

8. Noble J, Piddocke R, Bakman-Mikalski D. Pro SharePoint 2010 Search. New York: Apress Media LLC; 2011.

9. Rawley JB, Constantinidis C. Neural correlates of learning and working memory in the primate posterior parietal cortex. Neurobiol Learn Mem. 2009;91(2):129-38. Review.

10. Stansfeld S, Candy B. Psychosocial work environment and mental health—a meta-analytic review. Scand J Work Environ Health. 2006 Dec;32(6):443-62. Review.

11. Ward P and McCabe M. Microsoft SharePoint 2010 End User Guide: Business Performance Enhancement.Birmingham, UK: Packi Publishing; 2011.

Questions?

Thank You!

[email protected]

mailto:[email protected]

Add-On Slide 2: Terms List for Research

38

Activities of Daily Living Adaptation, Psychological Anxiety/etiology Behavior and Behavior Mechanisms

Motivation Achievement Aspirations (Psychology) Conflict (Psychology) Drive Hunger Thirst Exploratory Behavior Food Deprivation Goals Handling (Psychology) Instinct Intention Power (Psychology) Water Deprivation

Biomechanics & Human Movement Science Causality Change strategy Cognitive Ergonomics Collaborative Design Computing Methodologies

Software Database Management Systems

Depression/etiology Diffusion of Innovation

Technology Transfer Employment/*psychology Environmental Change and Disruption Ergonomics Ergonomics & Human Factors Group Processes Health & Safety Health & Safety Aspects of Computing Health Status Human Performance Modeling

Industrial Design Introductory Work/Organizational Psychology Internal-External Control Job Strain Life Change Events Occupational Diseases/diagnosis/epidemiology/*psychology Organizational Innovation Organizations Physiological Phenomena

Physiological Processes Stress, Physiological

Post-traumatic Stress Disorder Presenteeism Questionnaires Reliability & Risk Analysis Repeated Restraint Stress Risk Management Self Concept Social Psychology of Organizations Stress, Physiological/*physiology Stress, Psychological Stress, Psychological/*epidemiology/psychology Stress, Psychological/*etiology Stress, Psychological/*prevention & control Stress, Psychological/*psychology Stress, Psychological/complications Stress, Psychological/physiopathology User Interface Work

Work Schedule Tolerance Work & Organizational Psychology Work/*psychology/statistics & numerical data Workload/*psychology Workplace/*psychology

Add-On Slide 3: Term Formats to Limit

39

• *Activities of Daily Living -- articles w/topic as major focus

• “Stress, Psychological”[mh] --search as mesh heading w/subheading

•

•

Cbi 8th Dsi Conference 19 May2011 Final Mitchell Copyrighted All Rights Reserved

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