What Does “Being Strategic” Really Mean?

Rob: Medical publication professionals hear the word “strategy” all the time. But what does it really mean? How do we build publication plans with clear objectives? And how can teams stay aligned? And, by the way, what is the role of AI in all of this?

This is In Plain Cite, a podcast exploring the biggest questions and trends facing medical publication and communication professionals. I'm your host, Rob Matheis, President and CEO of ISMPP.

Today I'm joined by Amanda Tollen, Global Publications Lead  withAvalere Health, and Hicham Naimy, Director of Scientific Publications at Takeda. We'll explore what it means to be strategic in medical publication planning, why agency-client alignment matters, and where AI fits into the process.

Now keep in mind before we get into it, the views they share are their own, and don’t necessarily represent those of their employers. Let's get into it.

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Rob: What we're talking about today is really how to be strategic in the context of medical communications publications, and it's a term that's not often very well understood by many of our listeners.

So I thought maybe we'd just start from the top and really talk about what is the definition of strategy within the realm of publications and medical communications.

Amanda: Well, I think, Rob, if you remember at ISMPP last year, there was a roundtable on this topic, and the genesis of that was the disconnect that we see from an agency standpoint when we're speaking with clients, potential new clients, receiving feedback, trying to press boundaries, where we unpick that disconnect and the definition of what does being strategic really mean.

And over the years, we've realized it means different things to different people, and that can lead to challenges. I think in the simplest form, it's kind of knowing where you want to go and figuring out how you get there.

Rob: That's a good way to put it, is, you know, trying to figure out what that target is and then, finding a path to get yourself there. 

Hicham, do you have a different definition or– how do you feel about strategy?

Hicham: No, I think I can agree with this. I think being strategic is setting your objectives at the outset and building the frameworks towards reaching these objectives.

Now, these objectives should be grounded in specific questions that the team managing the strategy should be asking themselves around what are the educational gaps or needs in the disease area they were working on, what change in awareness or understanding, they want to support, who needs the evidence, to support their decision-making, and also when is the time to share this evidence.

You have these questions clarified, you can set the objectives and build an evidence generation workstream and associated data dissemination activities to support reaching these objectives.

Rob: So you both mentioned the endpoint as part of strategy, right? Having objectives, knowing where you want to go. Do either of you find that there is commonly misalignment? I know we talked about there being a disconnect, but do you find there is misalignment between agency and clients, when it comes to that endpoint?

Hicham: So in my experience coming from the pharma side, I see that strategy can be often misconstrued as a series of well-executed tactics. And many people interpret it this way. 

When this happens, the publication plan and the communication plan becomes more like a list of disconnected activities that are not clearly tied to the intended objectives and overarching strategy of a program, and the company.

So oftentimes, you know, like, this difference in interpreting the definition can lead to unmet expectations from the client sides, duplicated efforts, sometimes missed opportunities, inefficient use of time and resources because you need all this back and forth to reach alignment. And sometimes it reach to some kind of potential strain in the agency-client relationship

Amanda: I think one of the things we see too, and I believe we talked about this at the roundtable together, is sometimes clients want to keep their strategy kind of close to their chest and not give a lot of insight into the why behind what an agency is being asked to do, right? 

So agencies are most successful in executing a strategy when they are looped in, when they have all of those same strategic documents, when they're involved in the scientific narrative creation and evolution of that, really so you better understand the why behind all the different individual publications and how they relate and how they feed into the bigger story that you're trying to communicate over a year, two years, three years, you know, pre and post-launch.

Rob: Yeah, what you're both saying makes a lot of sense. If you have just a string of tactics and don't have a why or a rationale for it, then it really just is, you know, an unchained string of tactics that go out there. 

But it is interesting that sometimes when you look at the pharma-client relationship that agencies aren't brought into the fold with the actual strategy. I can think of a whole bunch of reasons why that could be the case, but should agencies even be involved in developing strategy along with their pharma clients, do you think?

Hicham: Yes, absolutely, Rob. Going back to Amanda's point, I think there is a big responsibility on the part of the pharma team to make sure agencies have the right context at the right time. Pharma teams should be sharing key strategic decisions that may affect the publication strategy in a timely and transparent way. The publication lead plays an important role in helping that information flow across teams. 

Where appropriate and permissible, the key strategic materials such as the medical plans, evidence generation plans, brand plans, can also help agencies understand the broader objectives and connect the publication activities back to the overarching strategy.

Also, I think equally as important is our regular touchpoints with clients through planning workshops and consistent agency representation in the internal publication groups. This helps keep everyone aligned and reduces the likelihood of unmet expectations.

Amanda: I agree. I think the most successful agency-client partnerships are the ones where the agency really feels like they're an extension of the client team. They are in the know, in the mix as much as possible, as you say, because sometimes there are, you know, sensitivities into what can be shared and with whom. But the more that the agency can be kind of, folded into all of those conversations, the better off the end product will be.

Rob: I can remember back in my pharma days, one of the biggest challenges we had was many of our agency partners letting me know that they just weren't involved enough in the strategic planning. And because they're not involved in the strategic planning, it really does lead to some of that misalignment.

So what do you guys think? What are some of the biggest dangers that can happen when there's this misalignment? Obviously, we don't reach the same goals, but what could tangibly go wrong when there's misalignment between agency and client partners?

Amanda: I mean, I think you can think about this in a couple ways. There's strategy for individual publications, right? So the agency team, if they're doing the majority of the writing, right, they need a clear brief. They need to understand the why behind that particular publication, what strategic objectives it supports, how it fits into the bigger plan, right?

And if you don't have that clarity, I think you can easily be off target in the things that are being communicated, right?

Hicham: I think probably the thing that can go wrong is that the agency would be executing without a clear direction, which would not support the goals and the objectives of the internal team.

And I think there's also some things that we need to be also thinking about that, if things don't have directions from the outset and agencies are just trying to guess what they need to do, there's also a time impact, a budgetary impact for redundant work, revising the work. So this type of consequences should also be considered.

Amanda: Absolutely.

Rob: So you guys have sold me on the concept of alignment when it comes to strategy. I think that makes good sense. But I want to dig in just a little bit deeper on the word strategy again, because, I mean, we throw it around so much. I remember in my pharma days, we all said, "I want to be strategic," and it was even like the basis of getting a promotion.

I'm going to be more strategic, so I'm going to be a senior manager now or a senior director because now I do strategy. But what is it? Like, what does it mean? What does it look like if I'm actually in the trenches trying to be strategic?

Hicham: There is no one-size-fits-all for a strategy.

Your strategy should be tailored based on different parameters, which, as I said previously, the information gaps, what data need, to be disseminated to support clinical decision-making, but also the stage of the product you're working on and the treatment landscape also help shape your strategy.

So let's think, for example, about working on a rare disease. This has a completely different strategy, compared to working in a more established disease area, because in a rare disease area, we need to be focusing more on building awareness and knowledge, where in the more established disease area, you may be shifting more towards what remains unknown, such as what specific disease subtypes or patient population remain in this, more established disease space.

Also, the product life cycle is a factor because if it's a new investigational product, focus should be more around the clinical safety, efficacy, mechanism of action. Whereas if the drug is already on the market, the focus may shift more towards real-world evidence, treatment sequencing.

Also, you should consider the landscape. If you're in a crowded landscape, you should be looking at differentiation, whereas if you're the only product on the market, this is probably not a factor.

So you need to be cognizant and have awareness of all these different areas to think strategically when you do communication and publication planning.

Amanda: I agree. I guess the other angle I would offer is if an agency is working with a new client for the first time, have that conversation of, "You say you're looking for a strategic partner, what does that mean to you?" Because it could mean different things to different people based on what, the company allows them to disclose.

It might mean, you know, in this day and age, planning for AI discoverability and a whole strategy around that, right? I've had clients where they say they're looking for a strategic partner, but really they're looking for highly creative expertise, which was a huge disconnect, right? And it took a while to unpick that.

Rob: Makes good sense. So, I'm thinking about our listeners out there, and I know, you know, this word strategy, coming back to it in a little bit more general of a term, doesn't always make sense. And I would bet some of our listeners are scratching their heads saying, "You know, my boss keeps telling me I've gotta be more strategic. Gotta be more strategic in my thinking. I have to get my agency partners to be more strategic." 

So I can think of a whole bunch of strategies. One of the most popular ones is volume, right? It's just plastering the walls of a congress, and that's my strategy is to have a lot of stuff out there. But for those who aren't really sure what to do with this word strategy, what are some other examples of strategies that could be used when it comes to medical publishing?

Hicham: In my view, I think, when you say strategy, you can publish a lot without hitting what is needed for the medical community, what is needed for decision-making by regulatory bodies, without addressing the area of evidence gap in the disease space. So volume, you can publish a lot without reaching the intended objective.

I think when you want to be strategic, if you want to ground your thinking in what is still needed in the disease space, what do your stakeholders need for their decision-making, be it the medical community, the regulator, the payer, and also what insight you can glean from your key stakeholders, to help them make decisions. So these are the key factors to think strategically and ground your publication planning and strategy.

Amanda: I agree, and I think it's quality over quantity, right? Is a good way to think about it. 

Rob: You know, in some ways it's almost like, you know, volume strategy is actually the opposite of being strategic.

It's saying, "Okay, I'm not just going to publish a lot of stuff, but I'm going to think about what the needs actually are." And Hicham, I loved where you were going when you were talking about, you know, issues with maybe it's HEOR, real world access, but recognizing that we need a market access strategy that's going to define the publication plan for a particular product.

I think that's really important, and if our listeners can take that to heart, then they can really start to think critically about what the needs are and not just publish for the sake of publishing. So really, really good points. 

All right, so we're going to dive into AI now. It's about time to get into the artificial intelligence part of this conversation, and I know our listeners want to know about how AI is impacting strategy. I mean, AI can do quite a bit now when it comes to finding patterns and summarizing data. Can AI generate strategy?

Amanda: I find that it's a good brainstorming tool. We don't have clients at this point who are using an AI system to generate strategic documents or publication plans or publication objectives or, or anything like that. 

Where I find it's helpful is, again, ideating different things, kind of arming ourselves with things that we can suggest, using it as an assistant almost, and a tool to maybe help us think a little quicker, think about things we hadn't thought about before.

You know, not necessarily taking what it gives us, but using it as a stepping stone to, continue to leverage human expertise for that strategic thinking piece

Hicham: Yeah, I also agree with that. I thinkAI is a support tool. It can efficiently identify recurring themes, emerging questions, and recommend actionable publications priorities. However, I think human oversight remains, essential because expert judgment is needed to validate the scientific accuracy and the clinical relevance and the appropriate interpretation of the AI outputs

Rob: Yeah. So what I hear you saying is we're, we're not at a point now where we're taking our clinical trial plan and CSRs and all our data, throwing it to an AI tool and asking for a strategic plan. We're not saying that, but we are saying it could be a tool to help us get there. Is that accurate?

Amanda: I think discrete tasks are still where AI is useful. So for things like literature summary or gap analysis, it can help expedite those types of things. Gathering information on competitors needs to be vetted, but it, it can help expedite 

Rob: Yeah, and I'm sure this is very comforting for a number of our listeners who, you know, may be thinking, "My gosh, AI can do so much. I don't know where my job is going to be in a couple years." But it sounds as though the human in the loop, as we like to say, is still critically important when it comes to developing publication, medical communication strategy.

Amanda: It's our hope for the future.

Hicham: I mean, I think AI is great, in making things more efficient and faster, but the publication professional, be it from the agency or from the clients remain accountable for the accuracy and the validity of all the recommendations made. So oversight is critical.

Rob: Yeah, that actually you, um, kind of asked my next question in sort of a way because I was going to ask you about governance and administration, things like that, workflows because it seems to me, I've had a lot of these conversations as you can imagine with a lot of people who are at different places on the AI adoption spectrum.

But one thing that's common is that quality control, so whether it's strategic planning or publication development. And so I, I often see like governance coming out as a part of our value proposition. Does that resonate with you guys?

Hicham: Yes, absolutely.

Rob: Amanda, do you, from an agency perspective, do you see governance as part of what you're doing for your client partners, or is that something that you see happening on the client side?

Amanda: It's starting to become more apparent that that is a need. There's a lot more legal involved in conversations now than there used to be. So I think that's an evolving area that, you know, in a year that will be-- it'll be a different answer that agencies are highly involved in the governance of implementing AI across the workflow.

Hicham: And Rob, on our side, from the client side, we are embedding responsible use of AI in all our standards and standing operating procedures, because this is going to become a daily activity using AI. So I think, people should first be familiar with it, but also know how to use it ethically and responsibly, especially in the field of pub-publication

Rob: And I guess in particular too, when it comes to strategy, that's critically important because you're really talking about your approach, your rationale, your why, and, and how you're going to get to where you're going, as you had said it earlier, Amanda. So, having that governance when it comes to strategic development I think is really, really important.

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