My college was challenged by a client when bringing up the concept of responsive design, and how specific mobile devices where not capable of supporting HTML/CSS/Java. My answer was simple, designers aren’t using media queries (and fluid grids and flexible images) to create platform-specific versions of their sites; they’re using them to create layouts that can adapt to many screen sizes on many devices …not just the iPhone, android, etc…

This leads me to thinking about the new challenges, and roles that a designer play in the interactive space. User Interface Design is template design, we make containers that changing content is flowing through. Along with selecting the appropriate aesthetic that supports the subject matter and audience, as a designer the goal is to create containers that fit character strings and media, scalable canvases and touch screen devices. Figuring out the rules to make that work is the challenge and is geekishly exciting to see the content beautifully formatted on the myriad devices and browsers that access it. These are the functional perimeters we face in the ever evolving medium.

In web, the design process is figuring out how to automate a fluid layout depended on screen size. The designers work is to step aside and allow the user be in charge. It’s not about control, it’s about making things happen for the user. By assemble the layout in a fluid way,  the reader ultimately makes the decisions of the controlled environment the designer has created.

Hi, and on behalf of my two partners, Shannon James and George Mountis, I would like to welcome you to the blog for Bespoke – our new digital strategy and design firm specializing in online health. We are three friends who met while working at WebMD where we spent a combined 25+ years helping take the company from its initial launch through its IPO and beyond.

We came together to form Bespoke because we felt that our complimentary skills of strategy/business development + product/project management + interactive design offered a more powerful solution together than apart. At Bespoke we hope to fill a void we see in the marketplace for a small team of very experienced, talented, savvy, and innovative executives with a deep background in online health. We believe that our team offers unique value for the right partner/client – whether that be a start-up looking to break into the online health space with a new product or brand, an established agency seeking some depth from a team with deep vertical expertise experienced in dealing at the “C” level with clients, or an existing online health firm looking to grow.

At Bespoke we are not generalists. And there is no “B” team of 20 somethings where we outsource our work. We are specialists and all our clients work with us directly. Period.

We are an outspoken trio who hold strong opinions, and are quite passionate about what we do everyday. Here at our blog we hope to offer our unique points of view on a wide range of topics – both in online health and beyond – and give you a forum to join in and express your thoughts as well. After all, we would much rather hear from others than do all the talking ourselves!

Finally, at Bespoke we are excited to be part of a community that is working hard everyday to create new, innovative solutions that will help transform the relationship between technology and consumer health. This industry isn’t about being slow, old, or bureaucratic. Its about being smart, aggressive, and innovative, in all areas of the business, and to us that makes it very interesting.

Thanks, and be sure to check back soon.

Josh, Shannon, and George
The Bespoke Team

Recently Citi analyst Mark Mahaney upgraded WebMD stock from a “hold” to a “buy” citing his expectation that the flow of new Pharma ad dollars online will increase significantly by 2010 (and that WebMD will be the major beneficiary). Mr. Mahaney’s upgrade comes a little more than a month after WebMD surprised many by lowering its 2008 financial guidance for the second time-this time citing a slowdown in consumer advertising amid a weakening economy. WebMD’s reduced forecast caught many analysts by surprise as online health advertising was assumed to be “recession proof”. And while this assumption no longer appears true, I believe Mr. Mahaney’s prediction of significant inflow of Pharma ad dollars will also prove unfounded unless the online health industry is better able to address the fundamental problem keeping large Pharma budgets on the sideline: the failure to deliver meaningful ROI for Pharma in the majority of online health advertising campaigns.

In looking at the online health landscape in recent months it is clear that there is a land grab of sorts taking place. Firms battle back and forth via press releases, touting that they have the most “monthly eyeballs.” In my opinion, this trend is nothing more than new competitors trying to force their way into advertising budgets largely reserved for WebMD. This strategy may be a short-term winner (and perhaps necessary for the smaller firms’ immediate survival), but it makes inevitable a long-term failure because it is indicative of “old” online thinking. While that kind of thinking may be making its way into online health, it is outdated nevertheless.
From my perspective the most important and compelling issue regarding the economics of online health advertising—and one that few of us are actually talking about—is the fact that, regardless of the number of monthly unique visitors, the ROI being delivered against most online health content is performing poorly, especially for Pharma.

Evidence of this problem surfaced recently from a closed-door session of 14 Pharma executive directors and vice presidents who, according to TGaS, the consultancy who led the session, “are still in the dark about the bang they are getting for their online buck. No one has been able to draw the direct line from online marketing to prescriptions.” (Pharma Exec magazine notes that Pharma reduced online ad spending by 5% in 2007 vs. 2006)

Even worse, Pharma is often seeing negative ROI on their advertising programs. As a hedge against this potential failure, Pharma has started to demand occasionally that their online ad agencies take on risk themselves. The problem of negative ROI seems to stem, at least partially, from a second “dirty little secret” in online health: the vast majority of the content and products found at most of the leading portals come from the same sources: that is to say they are licensed from Healthwise, Mayo Clinic, Harvard Health, Cleveland Clinic, et al. Excellent sources to be sure, but the end result is that consumers often find the exact same information across numerous topics, whether they are searching WebMD, Everyday Health, Yahoo! Health, MSN Health, Revolution Health, etc.

And that leaves the market chasing its tail. Everyone in the market wants to be big enough to demonstrate scale, while their largest advertisers only really care about performance, regardless of size. Advertising agencies are struggling to offer new or creative solutions for Pharma, but their best solution continues to be their old solution—purchasing cheap CPMs in order to get enough poorly performing ad impressions to try and meet the overall campaign goal—usually some action that moves a consumer towards getting a prescription for Pharma’s drug.

So where are we today?

• Big portals all offer much of the same “mile wide and inch deep” content along with poorly performing ROI and very high CPM rates.
• Consumers, frustrated by a lack of content depth and few new products or services, desperately pound Google to try and find “long tail websites” to quench their information thirst—(leaving Google the big winner in the online health space; not Pharma, not advertisers, not agencies).
• Pharma advertisers, frustrated by high CPM rates at the major health portals, are instead looking for those same would-be active and engaged long tail consumers (the frustrated ones pounding Google), but are unable to find them in any practical or scalable way.
• Long tail websites, meanwhile, are looking for Pharma dollars but often find that (a) they are too small to get on the ad agencies’ radar—which gives rise to aggregating health networks, and (b) when they are found, they still, under the current success metrics, face CPMs that are often too low to create meaningful returns.
• Pharma continues to fail in their attempts to convince consumers that any content they author, via their branded websites or otherwise, is credible and trustworthy.

With this in mind, it is my opinion that the long-term winners in online health will only be those firms that are able to offer innovative “next generation” products and deeper content that more meaningfully engage consumers while simultaneously offering marketers new, more efficient ways to make the direct connection between online marketing and prescriptions. This connection is especially significant today as the industry faces slowing Pharma pipelines and fewer new products requiring “introduction” (i.e. cheap CPMs) to the consumer health market.

So what potential solutions are ready to be tested with Pharma clients today? One solution is a “hybrid advertising model:” a CPM + CPA (lead generation plus direct measurable advertising) based model that substantially increases Pharma’s ROI while significantly reducing risk. Deep, unique, in-depth content will be required to make this model effective, and to place it at the heart of a tested product strategy.

And while most of today’s quizzes, calculators, and symptom checkers offer only a very basic level of interaction/personalization (if any), tomorrow’s products must deliver a far more interactive, in-depth, clear, and actionable experience for the consumer, while simultaneously gathering robust consumer data that offers Pharma new marketing opportunities that are more efficient, measurable, and actionable than any available online today. This experience will require a platform of significant software/algorithms that goes well beyond the technology powering today’s less complex products/widgets.

During my early days at WebMD, then-CEO Jeff Arnold spoke of our mission as a “golden triangle”—the unification of information between consumers, physicians, and payors. This dream is still unfulfilled, but I believe that the new golden triangle in online health has a different mission nevertheless—the unification of consumers, products/content, and advertisers.
Until the market is able to create new and innovative solutions to close this triangle, thereby increasing Pharma ROI, we will be unable to sustain and increase the trust of health sector advertisers in online health advertising. More importantly, we will continue to be unable to achieve a much larger objective—convincing Pharma to vastly increase their overall ad budget allocation to online health advertising.