TrendSetters: Up Close With Dr. Daniel Palestrant, Founder and Chief Executive Officer, Sermo

Sermo is the online physician community where 100,000 U.S. physicians collaborate on difficult cases, share clinical observations, and gain a unified voice that allows them to influence healthcare policy. Sermo harnesses this collective insight for healthcare institutions, financial services firms, and government agencies to create a two-sided marketplace for information exchange. Sermo’s clients gain direct access to a fresh stream of actionable information on emerging medical trends—to physicians on the frontlines who put drugs, devices and treatments to the test every day. For more information, visit http://www.sermo.com.

By Paula Silverman

PM360: What community user trends do you see on Sermo?

Dr. Palestrant: Professional peer connection and discussion is central to the practice of good medicine. Yet, physicians increasingly practice medicine in small outpatient-based settings, and time-pressured doctors are unable to connect with their peers. I like to call this the House/Grey’s Anatomy paradox. I see two major trends. The first trend is that older physicians are among the heaviest users. We have confirmed this through many community surveys and discussions. The second trend is that as physicians get older, their knowledge base becomes more dated, and they replace their earlier physician peers and friends with non-physicians. So physicians’ need for the discussions that used to take place inside of hospitals has now migrated its way online to Sermo.

Which activities are most popular within the community? 
The “post model” is a critical feature of how physicians interact in the community. Our surveys and our clinical trial recruitments have almost 100 percent fulfillment. Our pharma offerings are very popular. There are two in particular which I would like to highlight. Ask Rx allows physicians to ask questions of participating pharma companies. The physician types out a question on one of the drugs that’s being covered, and within 1-2 days, the correct expert within the pharma organization sends a response back to the physician. Panels, our latest development, grew from our pharma clients’ desire for more effective and efficient private interactions with small groups of physician advisory boards. We built Panels based on feedback from pharmas and physicians. It enables our pharma clients to specify selection criteria and send out invitations to eligible physicians within 10-15 minutes. Then they have a forum similar to a private discussion with those physicians in real time, or over a series of days.

How did Sermo decide to invite pharma companies to participate in your community? Were doctors asking for this?
Physician community demand is one of the principle drivers. Other important stimuli emerge from our nations healthcare constituency, of which the pharma community is a major component. It would be naive to exclude them from these dialogues for a variety of reasons. Regardless, there are plenty of U.S. physicians with valid pharma licenses who are able to access the community. More so, you’d be blocking an essential constituency in the provision of patients good care. What we’ve worked so hard to accomplish is how to allow pharmas to participate in such a way that it doesn t dilute or pollute the community itself. We don’t allow advertising, and we have some really creative technologies that allow physicians and pharmas to interact in a mutually beneficial manner.

You mentioned access and dialogue as relationship strengths. What challenges are still to be met?
First, we always must be cognizant that this is a highly regulated industry, which has to resolve multiple complex processes, and which must consider many legal ramifications. We have invested a tremendous amount of time managing change with pharma clients. Let’s use the Ask Rx product as an example. The underlying technology, while significant, is reasonably straightforward. The greater challenge is to adhere to the pharma company’s internal processes for addressing all applicable legal and regulatory requirements, and to manage the response within 24 hours.

You have an ongoing relationship with Pfizer. One of the Pfizer partnership’s goals was to collaborate with the FDA to establish guidelines. Are the guidelines they have developed working to everyone’s satisfaction?
Indeed. We’ve had to work very closely with Pfizer to develop their community rules of engagement for pharma/physician interaction and to develop the same for physician/pharma expectation. What s unexpected is that, as we’ve worked closer and closer with various pharmas, we’ve found increasing evidence of products that have resulted from the partnerships. It turns out a lot of the physicians are very, very excited to have the opportunity to contribute and work with pharmas. They share many of the same goals. They both want the drugs and treatments, which are necessary for treating patients.

Another partnership worth mentioning is between Sermo and Bloomberg.
The Bloomberg relationship means that we’re sharing the data that’s coming out of Sermo’s physician community with the financial services, so they’re able to see that information in real time. For example, if a doctor on Sermo types out a piece of information saying that he’s having a unique experience or he’s having good results on a particular drug or treatment, the Bloomberg-Sermo technology maps that back to the disease state, the drug, and ultimately, the company and the ticker symbol. The Bloomberg company knows which people or terminals manage which stocks, and almost in real time, that person can get an alert, saying, Here’s a piece of relevant information about your drug.

That’s very personal, non-aggregate, real-time information. What about aggregate information?
We are able to do the aggregate in two ways. First, every one of our posts also has a question or a survey associated with it. The Bloomberg terminals are able to see that aggregate information. The Bloomberg-Sermo partnership is structured so that the terminal holders are able to push a button and say, “I want to survey 200 cardiologists. Here’s my question.” Wall Street is now carefully watching activity on Sermo, which has important ramifications for the pharma industry.

There’s a lot more interest and desire from our pharma clients around analytics and accountability. It seems as if there is a lot of aggregate frustration with the existing online physician, the existing ways for interacting with physicians online. What advice could you offer marketers in terms of how best to approach doctors? Which approach works best, and to what are they most receptive?
The best approach requires a really different type of thinking. I think that the real challenge that the marketers are facing now is that they have to move from a push to more of a pull, or a collaborative interaction with the physician community. Sermo works closely with our clients to develop these sorts of interactions. My advice is to develop a close consultative relationship with a partner company.