The Power of the Hashtag

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Robin Robinson

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The Power of the Hashtag

#Pharma uses #hashtags to organize the thousands of #healthcare Twitter conversations taking place #daily.

If you are Jimmy Fallon, hashtags can be funny, irreverent, and inappropriate. The comedian’s popular skit with Justin Timberlake about using hashtags in real-life conversations, which aired on NBC’s Late Night Show in September 2013, has earned more than 23 million views on YouTube. #butpharmacantbethatfunny.

The Oreo brand — a leading user of Twitter and social media — scored major retweets through a quick response to a real-time problem during the power outage at Super Bowl XLVII. Oreo’s social media team tweeted “Power Out? No problem. You can still dunk in the dark.” The message, with hashtag #dunkinthedark, got 16,000 retweets almost immediately and more than 20,000 likes on Facebook. #butpharmacantbethatglib.

In the pharmaceutical industry, however, hashtags are more like #seriousbusiness.

No humor, no puns, no brand names allowed, but still, the hashtag is a powerful tool for organizing the thousands of healthcare related tweets streaming the Twitterverse.

The Healthcare Hashtag Project, cofounded and curated by Thomas Lee, managing partner of The Fox Group and partner in Symplur, tracks more than 4,000 healthcare hashtags that cover 9,000-plus topics from a database of more than 430 million tweets. Symplur also tracks about 100 government Twitter accounts, the 200 most-widely prescribed drugs, and more than 150 pharmaceutical company Twitter accounts.

According to Symplur, there are about 1 million tweets relating to healthcare every day. The project has been ongoing since October 2010.

“We have a wealth of information,” Mr. Lee says. “If any healthcare topic is being mentioned and we are tracking that hashtag, then we have data on it.”

While industry is certainly using hashtags, regulations and general ethics mean pharma cannot use hashtags in the same ways that other industries would.

“Companies like Coke and Nabisco can use sassy tweets and hashtags to communicate with consumers about their products,” says Natalie DeMasi, research analyst, Cutting Edge Information.

Instead of focusing on a specific product, pharmaceutical teams often leverage hashtags to promote global awareness. For instance, Johnson & Johnson uses #GlobalMoms to discuss the company’s efforts in empowering women, and Amgen recently tweeted about an exposé the company held in honor of #WomensHistoryMonth, Ms. DeMasi says.

“For this reason, hashtags and Twitter in general are more relevant for corporate teams than brand teams,” she says. “In its recent digital marketing study, Cutting Edge Information found that 80% of surveyed corporate teams use Twitter, while only 50% of brand teams do.”

Regardless of the restrictions, pharma is definitely using hashtags to guide conversation threads as much as Oreo.

“Hashtags are absolutely relevant to life sciences and to all industries or anyone communicating online today,” says Elizabeth Power, director, global media relations at Novartis Corp. “They’re an established part of social online nomenclature and beyond that, have evolved into a community-owned digital commodity.”

The purpose of a hashtag is to organize conversations on the same topic into a single thread to make it convenient for information seekers to view and compare ideas. This is of particular importance in the healthcare field, where there are thousands of different conversations happening on Twitter.

The simple concept started in 2007, about a year after the first tweet was ever sent, by open Web designer and advocate Chris Messina, who proposed using the pound symbol for organizing groups on Twitter. According to several sources, this was the first hashtag ever used on Twitter.

“Hashtags allow people to follow topics rather than accounts, and find content that’s important and interesting to them,” says Ms. Power. “Using hashtags in our tweets helps enable that flexibility.”

Mr. Lee says hashtags enable individuals to find pertinent healthcare conversations on Twitter, create connections with like-minded people, and foster sharing ideas. These connected conversations are often the genesis for an online community based on interests.

“It is very difficult to find any tweets that are relevant to your interests without following a hashtag,” he says. “Hashtags can attract a more focused and much larger audience and help make consumer time spent on a platform like Twitter much more productive.”

For example, a patient living with diabetes who is searching Twitter for like-minded patients is not going to be interested in all the other healthcare information available, such as tweets on healthcare information technology, like #HIT. Instead, patients will search for hashtags that will bring them to relevant conversations around diabetes, such as #diabetes, #GestationalDiabetes, or #dayofdiabetes.

Using hashtags on tweets is also a benefit to the pharma company because hashtags specific to particular campaigns or groups will help companies reach the consumers they want without attracting people outside of their target, Ms. DeMasi says.

“In general, the more specific the hashtag, the more likely a company is to reach its target audience,” she says. “For example, #myeloma is used by people interested in multiple myeloma, but #MMAware, a hashtag devoted only to multiple myeloma awareness, will reach those involved in myeloma campaigns and support groups.”

Further, #BeClearOnCancer, which focuses on the NHS’ program about cancer signs and symptoms, is useful for companies wanting to promote early cancer diagnoses among patients. When companies want to enter industry discussions, they can reach the right audience by using industry-specific terms like #mHealth or #RiskBasedMonitoring instead of #pharma or #biotech.

According to Mr. Lee, Twitter has become the epicenter of healthcare conversations.

“There has been a lot of talk about how the use of Twitter has leveled off, but that is not the case in healthcare,” he says. “Use of Twitter is still rising at a rapid rate in healthcare, and wherever healthcare information is being shared first, whether on Instagram, Facebook, or LinkedIn, if it’s important and worthwhile, it will eventually end up on Twitter.”

At Novartis, all company tweets now contain hashtags. The @Novartis twitter channel launched in November 2008 and six months later it implemented hashtags. Since then, it has used hundreds of different hashtags.

“We’ve been using hashtags on our corporate twitter account since shortly after we launched the channel,” Ms. Power says. “We’ve increased both the number of hashtags we use and also the breadth of topics where we use hashtags.”

Novartis determines its hashtags based on the content of the tweets and the audiences with which it is trying to engage. A few categories are: disease education (#rarediseases), medical congresses (#AAD14), public events (#SpecialOlympics), corporate campaigns, patient communities, tweet chat hashtags (#BCSM), the handles and hashtags of third-party organizations and partners (#Malaria/@MalariaNoMore).

“On topics such as innovation and science we also use hashtags commonly used by the general public, such as #DidYouKnow,” Ms. Power says.

Brand and corporate teams may be limited in their hashtag uses, but regulations do not stop consumers from hashtagging the team’s product, Ms. DeMasi notes.

“Although companies cannot usually be involved in these branded conversations, this is a great opportunity for them to participate in social listening and reading what consumers have to say about their products,” she says. “Simple hashtag searches will allow companies to see how consumers perceive their products.”

There is one caveat though, she says. Companies will likely encounter adverse-event reporting associated with product hashtags. Companies that participate in social listening should be prepared to handle adverse event reports.

Extending the Audience

A vast number of healthcare hashtags pertain to conferences. At press time, Symplur lists 55,969 conference tweets and 11,419 conferences in its database. “A key area where hashtags are useful in life sciences is at congress meetings,” says Daniel Ghinn, CEO of Creation Healthcare. “Any pharmaceutical company contributing content to a congress or meeting can expect that healthcare professionals and others present will talk about their content via Twitter using the congress hashtag.”

Case in point, a spokesperson at AstraZeneca responded to our tweet about the company’s hashtag use with this message: “We essentially use hashtags around three areas: location (e.g. we’re collaborating in #Cambridge), events (e.g. we’re live tweeting from #ASCO14) or disease areas (e.g. we’re presenting data today on our #lungcancer research). We found our recent creation of a hashtag for an event we were hosting quite interesting: #CambsCSS.” Here is the tweet stream:

“Listening to, and taking part in, conference hashtags is a valuable way of hearing responses to what is presented, and even answering questions during the congress,” Mr. Ghinn adds. “Since congress hashtags are used all over the world during an event, the hashtag allows you to gauge worldwide reaction to what you, and other companies, present.”

A good example is the American Society of Clinical Oncology (ASCO) conference, he says. Last year, Creation Healthcare conducted a brief study of conversations among healthcare professionals discussing cancer during the week of the congress, May 30 — June 6, 2013.

“An analysis of key themes in all HCP conversation about cancer showed that the congress hashtag #ASCO13 was by far the most popular topic that week,” he says.

Mr. Ghinn adds that GSK has a Twitter channel dedicated just for conferences, @GSK_conferences, used by GSK team members while they are at conferences to engage participants at events. Most tweets from @GSK_conferences include hashtags associated with a particular congress.

“The hashtag has had a lot of impact on healthcare conferences,” Mr. Lee says. “Conference participants using social media and a conference hashtag create an explosive conversation that is happening in real time.”

In the old days — like eight years ago —conference discussions remained for the most part in the meeting room. A conference attendee would return to his or her place of business and share a few take aways from their notes, but in general, once the conference was over, so was the content. In today’s social media environment, conference attendees are sharing the event with people inside and outside of the conference via the hashtag in real time, allowing even those not in attendance to participate in conversations when otherwise they would not have had the opportunity.

“This creates an incredible dynamic and the conversation becomes so much greater than just what’s happening in that room at that conference, and the conversation tends to carry on far beyond the conference,” Mr. Lee says. “All in all, people are using more and more hashtags and are creating more connections where meaningful information can be shared.”

Eileen O’Brien, director, media and engagement at Twist Mktg, says she finds listening into conferences via Twitter is an effective way to discover new trends and hot topics.

“In addition to following key industry hashtags, I enjoy watching conference hashtags,” she says. “If I can’t attend in real life I can at least see the themes as they are emerging at the event.”

Ms. O’Brien also advocates the use of hashtags for aligning tweetchats — a Twitter discussion at a designated day/time on a particular topic.

“A few life-sciences companies have successfully used hashtags to host tweetchats,” she says. “The first was in February 2011 with AstraZeneca’s #rxsave chat on prescription savings programs. Recently, GE Healthcare held the #TacklingCancer tweetchat to mark World Cancer Day 2014 on Feb. 4.”

Physicians are also using tweetchats to review journal articles and studies with colleagues, Mr. Lee says. Called journal clubs, the chats have designated hashtags so that physicians can discuss a particular article or study, providing an opportunity for physicians of a common specialty to share ideas with experts all around the world.

Using this technique, tweetchats can be cost-effective ways to engage all stakeholders in an open dialogue.

“Hashtags allow companies to reach a broader audience and, ideally, attract new followers,” Ms. O’Brien says. “A good hashtag is one where people actually engage with each other in the hashtag stream, not just push out content. For example, the #SocPharm hashtag has users responding to each other and having conversations.”

Creating Communities Via the Pound Sign

Hashtags are a very effective microtargeting tool for finding just the right and most engaged audience for your message and it all starts with understanding who you are targeting and what their interests are, says Wendy White, founder and CEO, Siren Interactive.

“At Siren Interactive we focus on rare diseases so we are always looking for ways to help our clients find and connect with very small and widely dispersed rare disease populations,” she says. “Hashtags allow like-minded people to easily connect and follow discussions to engage around a topic that is meaningful to them.”

In his research at the Healthcare Hashtag Project, Mr. Lee discovered that patients are not shy about sharing their health conditions, issues, or questions.

“Patient activity is the one area that has surprised us the most,” he says. “We did not expect to see so many patient conversations happening on Twitter.”

Initially, healthcare conversations on Twitter were mostly conversations from industry insiders, like the chatter around the virtual water cooler, but there soon became a rapid rise in the proliferation of patients.

“Twitter is an open platform and completely public, and yet people are open to discussing what their diseases and conditions and experiences are and what they are doing about them,” Mr. Lee says. “The number of patient communities that have popped up was pretty surprising to us and one of the patient populations that is most relevant is within the rare disease community.”

Mr. Lee hypothesizes that through the nature of their condition, patients with rare diseases may be isolated and have fewer people to connect wit who share their condition.

“The use of hashtags help form an online community around that situation and patients create a virtual support group that they can relate to and share information with,” he says. “That has really been amazing as far as I’m concerned.”

Ms. White agrees that in the rare disease space, patients need virtual connections and support.

“This type of connection is arguably more important than in the package goods space,” she says. “Patients, caregivers, and advocates often take a hyperactive role in this space in order to build awareness, create a sense of community, as well as continue learning about their disease or condition.”

Genzyme provided a great example of a pharmaceutical company using hashtags successfully on Rare Disease Day 2014, which is always the last day of February, but generates lots of awareness activity for weeks in advance, Ms. White explains. Genzyme was extremely active in social media using the #RareDisease hashtag as well as its own #GenzymeRelay hashtag to provide updates on its global walk/run Relay for Rare Disease. Novartis is another great example. The company was also very active on Rare Disease Day using the #RareDisease and #RDD14 hashtags.

“Both companies did a great job showing that they were involved in the Rare Disease Day movement and committed to the patient community,” she says. “Both could have broadened their reach by tapping into the more prevalent and widely used #RareDiseaseDay hashtag, by combining this hashtag with the ones they were already using would have enabled their tweets to reach even more people actively engaged in the Rare Disease Day cause.”


“We found that 80% of surveyed corporate teams use Twitter while only 50% of branded teams do.”
Natalie DeMasi / Cutting Edge Information

“A key area where hashtags are ­useful in life sciences is in following the conversations at conferences and congresses.”
Daniel Ghinn / Creation Healthcare@EngagementStrat

“Hashtags are a very effective microtargeting tool for finding just the right and most engaged audience for your message.”
Wendy White / Siren Interactive

“A few life-sciences companies have already successfully used hashtags to host tweetchats.”
Eileen O’Brien / Twist Mktg @eileenobrien

“People are using hashtags more and more to create ­connections where meaningful information can be shared.”
Thomas Lee / Symplur


Hashtags Are Not Just for Twitter

Websites that support hashtags include: Diaspora software and social network
Gawker Media websites
Sina Weibo


#theGood, #theBad, and #theUseless

Experts discuss what makes an effective — and ineffective — hashtag.

The More Specific, The More Effective
Natalie DeMasi, research analyst, Cutting Edge Information:
A good hashtag is specific and clearly directed at its target audience. Putting a hashtag in front of a disease or a broad issue is not going to cut it. For example, companies that tweet #cancer will reach not only people interested in cancer research and awareness but also people interested in Cancer horoscopes and Zodiac signs. Similarly, #LabTalk interests clinical investigators, scientists, and people who love Labrador retrievers.

Don’t Hashtag Company Name
Wendy White, founder and CEO, Siren Interactive
Creating a hashtag out of your company name (unless it’s paired with a cause) is not an effective use of a hashtag. If people want to follow your company, they can just look up your name or Twitter handle. Creating a hashtag like this doesn’t really add any value as there is most likely very limited discussion going about a pharmaceutical manufacturer that isn’t already linked to the company name.

Do Your Hashtag Due Diligence
Thomas Lee, managing partner, The Fox Group and partner in Symplur
We get two to three dozen hashtag submissions per day and we reject about 70% of those. Common ­reasons for rejection include a lack of conversation around it; the hashtag is already being used for a very nonrelated conversation; and if it’s too long. If a hashtag is already being used, then an overwhelmingly amount of the stream associated with it will have nothing to do with the healthcare topic and your tweets get lost. So, if it’s not a clean tweet stream we don’t accept the hashtag.
Also, Twitter is about real estate; there are only 140 characters to work with. That being said, we have received some hashtags with as many as 60 characters. I am not sure if those were jokes, but pharma needs to think about being concise. My biggest piece of advice, though, is to test it first. Type your proposed hashtag into the search bar on Twitter and check that the conversation is appropriate for your topic.


The #godfather — Chris Messina

Hashtags are powerful little pound signs that unite like-minded people and create some semblance of order in the myriad tweet jungle of Twitter, and within the ­fractured messaging of other social media.

Hashtags were first used in Internet Relay Chat (IRC) — a system that facilitates transfer of messages in the form of text. I’m sure ­inventor Chris Messina, also known as the #godfather, had no clue that his idea would grow to such a meaningful extent.

And apparently neither did Twitter, as ­several reports state the company declined Mr. Messina’s idea as being “too nerdy.” #duh.


Fast Fact
On Aug. 23, 2007, Chris Messina (@chrismessina) launched the use of hashtags on Twitter by posting: “how do you feel about using # (pound) for groups. As in #barcamp [msg]?” wp-content/uploads/2013/09/tweet.png

Fast Fact
On March 21, 2006, Jack Dorsey (@jack) sent the first public tweet: “just setting up my twttr”


Bayer HealthCare @BayerHealthCare • May 1
Hi @pharmavoice, Thanks for contacting us. We use #hashtags in order to enable people who are interested in a topic to find our tweets that refer to this specific topic.

LillyPad @LillyPad • May 1 @pharmavoice #fakemeds is a commonly used hashtag on counterfeit meds. Here’s more on why talking ­counterfeits is important:


#Best Practices for Using Hashtags in the Life Sciences

Experts outline industry best practices regarding the use of hashtags.

Popular health hashtags are often associated with significant virtual communities with common interests, says Daniel Ghinn, CEO of Creation Healthcare.

“Don’t reinvent the wheel, look for existing hashtags used in conversations about topics you are interested in, and follow those conversations,” he says. “Listen to hashtag conversations well before joining in, to understand the community around that hashtag, its culture and values as much as possible.”

He also says consider how to add value to a hashtag conversation. Mr. Ghinn says there are several ways to add value: answer questions, retweet, or respond to the comments of others in the group.

“But don’t spam the community by posting irrelevant or out-of-context tweets carrying a particular hashtag, just to place your content in the conversation,” he says.

Mr. Ghinn says if the decision is made to develop a new hashtag, check whether that hashtag has already been used in other contexts to avoid creating confusion within your topic of interest.

Building a community around a hashtag takes time, but can be helped by encouraging others who are already influential in a particular area to use the hashtag.

“Consider partnering with other companies or groups, such as Boehringer Ingelheim’s #COPDChat conversation with Professor Andrew McIvor last year,” Mr. Ghinn says.

Research, Listen, and Read

Elizabeth Power, director, global media Relations at Novartis Corp., also advises that it is important to understand who and how a hashtag is being used, so research, listen, and read.

“This is especially important for hashtags you are creating or adopting; consider the tone of the hashtag and if bashtagging is likely,” she says. “Ask yourself what the point of using a particular hashtag is before using it.”

Ms. Power offers some practical advice, stating use one to five hashtags in each tweet, but don’t be spammy or overwhelm users by tweeting a ton of hashtags.

“Consider variations of hashtags to understand if there is a difference in using over another,” she adds. “Is one hashtag more ‘official’ than the other? A great example is #ASCO, which is generally associated with being queasy or nauseous, whereas #ASCO13 was a great hashtag to follow for the oncology conference you might have been looking for last June.”

To build a community, it’s important to consistently use a set of decided on core hashtags, especially around events and meetings, and to stay part of the conversation.

“We use hashtags across different digital channels, not just Twitter, to tie ideas and information together,” Ms. Power says. “We also incorporate hashtags into the message of the tweet when possible and avoid duplicating the same hashtag within a tweet. Don’t use corporate-speak terms as hashtags. And don’t use special characters or symbols in a hashtag, this breaks the link.”

Understand the Target Audience

Wendy White, founder and CEO of Siren Interactive, agrees that before creating a new hashtag it’s important to do the appropriate research, and listen and learn.

“Before getting started, it’s necessary to truly understand the terminology, attitudes, and concerns of your target audience, which will help you find the hashtags that are already being used,” she says. “For example, you’ll determine if there other hashtags already accepted by the community you are targeting. You can also determine if you can leverage the existing reach and acceptance of an already established hashtag to get your message out. If you do start a new hashtag, introduce it by pairing it with existing hashtags with which your audience already identifies.”

Relevance is everything, hashtags need to be relevant to the target to resonate and encourage use and sharing. When actually using hashtags in a post, tweet, or update, Ms. White says it’s important to keep them relevant to the topic and the audience.

“Using a hashtag just because it’s popular or has extensive reach isn’t enough if it’s not relevant to the people following that hashtag,” Ms. White says. “That type of usage could actually generate negative sentiment.”

She adds incorporating the hashtag into the text of the tweet is another best practice.

“This not only saves precious space — especially when used on Twitter — but ensures that the reader sees the hashtag and understands its relevance since it’s being used in context,” she says. “Hashtags should not be overused. Too many hashtags can render the tweet or post difficult to read. Likewise, creating an overly long hashtag is fine for personal use in a humorous way. But for professional use, long hashtags can be difficult to read and are a disincentive to sharing because they use up too many characters.”


“Don’t reinvent the wheel, look for existing hashtags used in ­conversations about topics you are interested in, and follow those ­conversations”
Daniel Ghinn / Creation Healthcare @EngagementStrat

“Before getting started, it’s necessary to truly understand the terminology, attitudes, and concerns of your target ­audience.”
Wendy White / Siren Interactive


Healthcare Hashtags
Trending April 2014
Source: Symplur


Disease State Hashtags
Trending April 2014
Source: Symplur

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