The 2018 Annual Meeting of the Medical Affairs Professional Society (MAPS) was held in Miami, FL on 25–27 February. The theme of the meeting—reflected throughout a busy programme of keynote presentations, expert panel sessions, hot topics chat groups and workshops—was ‘Strengthening Medical Affairs Impact for Improved Patient Outcomes: Building our Future Together’.

The meeting was opened by current MAPS president, Kirk Shepard (Eisai), who provided a recap of the history of MAPS so far, beginning with the society’s formation in August 2016. MAPS was created in response to the need for an organisation that could act as an advocate for medical affairs within the pharmaceutical, biotechnology and medical device industries, as captured in the society’s vision statement: ‘Elevate the role of Medical Affairs to be a partner with its Commercial and R&D colleagues, and lead the industry in the education of customers on the safe and appropriate use of products for the benefit of patients’. MAPS has experienced rapid growth since its foundation, with its current global membership representing over 100 small, medium and large companies.

A key aspect of the meeting was the ‘Challenges and Solutions Workshops’, which are summarised below.

Building a medical affairs acumen tool to articulate functional value to business partners

New challenges in this time of change in the Life Sciences require bold thinking. Medical affairs (MA) are integral to industry’s long-term impact in terms of strategic acumen, innovative thinking and technical expertise, yet the importance of communicating this value is often overlooked. This interactive workshop demonstrated how MA professionals, in collaboration with their colleagues, can develop new tools to build recognition of their value by business partners and stakeholders.

The premise of this tool is to allow MA professionals to articulate the value of their expertise, ask the right questions and contextualise their roles for the business. Delegates were encouraged to consider who they interact with, which peers they should aim to influence and how well they communicate their value.

It was concluded that MA are at the centre of care and have an opportunity to reposition themselves as drivers of change in today’s environment. MA professionals should master talking points and triggers to drive conversations about patient outcomes that resonate with internal and external executives. This workshop laid the foundation for a valuable, practical tool to support the growth and success of MA, a tool which MA professionals can develop with colleagues by considering key value drivers. This tool can also be used to improve leadership agility and performance and crucially, can accelerate the success of MA in improving patient outcomes.

Capabilities and competencies in the new MA: A roadmap to success

In recent years, MA has evolved dramatically from a local support function, often embedded within the commercial organisation, to a fully-fledged strategic partner acting as the bridge between Research and development and Commercial. MA professionals have adapted well to meet the changes in the scope and expectations of MA function in pharma, yet they are faced with a challenge in terms of the new capabilities and skills necessary to maintain this momentum. This workshop explored the critical competencies now required by MA professionals on their road to success:

• learning agility
• business leadership
• strategic vision
• emotional intelligence and communication skills
• deep understanding of compliance
• scientific and technological thought leadership.

So, how can MA professionals develop these skills? Using the metaphor of a ladder, this workshop highlighted the importance of seeking transfer between divisions and functions prior to pursuing a senior leadership career. In other words, a career ladder is stronger with a broader base.

The importance of continued learning was also discussed. MA learning and development initiatives should be designed and implemented carefully, identifying and prioritising critical gaps to develop a medical capabilities framework curriculum. Important factors to consider are the suitability of venues for delivery of such initiatives, the use of virtual learning and audience-directed personalisation of learning. Engagement is key to all of these factors.

Overall, there are high future expectations for MA. Improved understanding of what the newly required capabilities and skills are, and their continued development through effective learning initiatives, will be essential for success.

Let’s get digital. A step-by step guide to building your next tech program: Best practices and unmet needs in MA

The challenges associated with the rapidly evolving landscape of MA was a key theme in these workshops, and this one tackled the somewhat-daunting availability of innovative technology solutions. Digital platforms can provide a novel approach to solving important problems in MA. However, they can seem complex and overwhelming to an unfamiliar user.

This workshop introduced learners to current and future trends in digital media consumption by healthcare professionals (HCPs) and the pharmaceutical industry. Equipped with this understanding, MA professionals can exploit emerging technology to engage key stakeholders and generate innovative ideas for valuable new programs. Delegates were encouraged to discuss unmet information consumption needs, both within MA teams and for key stakeholders, and to identify design programs to address these needs. These ideas were discussed in the context of best practices in digital delivery in MA.

To summarise, digital platforms in MA can unlock the potential to solve important problems and address unmet needs. MA professionals should be able to define their current practices and future state vision, and facilitate the rapid development of MA technology solutions.

Maximising medical science liaison (MSL) value with internal customers: Executing field activities aligned with corporate strategies

A corporate strategy is the ultimate goal, objective or target set by a company to achieve critical success factors. Aligning MSL activity with corporate strategy is important; this ensures the effective use of MSL resources and demonstrates the value of MSL activity to stakeholders. However, field-based medical teams are often disconnected — both physically and strategically — from ‘corporate’. In this workshop, delegates explored how to maximise MSL value though insight gathering with corporate strategy at front of mind.

MSLs hold critical strategic value as integrators between internal and external stakeholders, and are in a prime position to gain crucial actionable intelligence. Through their numerous activities, such as publication planning, market research and competitive intelligence, MSLs gain scientific, clinical, therapeutic and competitive insights, as well as insights into potential barriers to success. Using these insights, MSLs should provide input during the development of scientific message platforms (SMPs), which lay the foundation for communication strategies and are the heart of any product-related communications supporting a company’s product usage and value. SMPs define clear, coordinated and resonating communication points that can be applied to all tactics and are therefore a key component of corporate strategy.

Communication was a key theme in this workshop. MSLs should ensure that communication is not a one-way dialogue from the company to its external stakeholders; strategy alignment and stakeholder consensus can be achieved through early cross-functional communication. Furthermore, actionable intelligence obtained by MSL insight gathering must be documented and communicated to the right audience, and the internal audience must play in role in deciding how this information is disseminated. To conclude, if MSL activities are aligned with corporate strategy, are well documented and effectively communicated, the value of MSLs can be self-evident.

Global alignment in an era of complex therapeutic portfolios: Is it possible to achieve a borderless, unified, scientific voice?

This workshop was centred around the creation and communication of complex, multi-product, multi-indication SMPs that span across varied geographic regions and regulatory landscapes. The challenges and opportunities associated with developing a unified scientific narrative were discussed. Clearly, the complexity of scientific communications coupled with unique regulatory and cultural differences between regions can confound alignment across a global MA organisation. Delegates were introduced to best practices and encouraged to consider the value of early involvement of global stakeholders in development of scientific narratives in a global MA setting.

Facilitating the data journey in MA: Applying analytics and getting answers

Data, analytics and insight generation are transforming decision-making in the MA environment. This workshop opened with a discussion of the ‘analytics value chain’, whereby better decisions and improved outcomes can be driven by first asking intelligent business questions and then seeking answers in the data. In other words, while a project moves from left to right, our thinking must sometimes move from right to left.

Delegates explored applications of the ‘data to insight’ model, which encapsulates the fact that data have little utility in isolation, without interrogation or interpretation. Data must be optimised, processed and contextualised to generate information, organised and structured into knowledge and finally, applied to gain insight. It is important that MA professions are familiar with frameworks for identifying data, distilling it into useful information and generating insight. Furthermore, systems should be in place to ensure MA teams remain up-to-date with emerging data and competitor information in their therapeutic areas, such as using keywords or scoring mechanisms.

Learning is another aspect of MA that could be enhanced through the use of analytics. For example, the Kirkpatrick Model is a worldwide standard in evaluating the effectiveness of training and educational programs. Analytics are also valuable in the evaluation of scholarly versus online impact of a publication, the latter of which demonstrates important ‘social’ impact on clinicians, patients and advocates. Finally, analytics offer a crucial means of identifying key opinion leaders (KOLs) through the use of bibliometric and sociometric approaches.

The workshop concluded with a summary of the ‘Blade’ training tool: Begin with the end in mind; Look high and low for data; Analyse for meaning; Determine who benefits; Evaluate the outcome. MA professionals should utilise such tools to apply data-centric thinking in their work environment.

Thinking smarter: Multichannel communications and behavioural science – the perfect partners for smarter communications

Behavioural science gives an insight into how people interact, react, process data and make decisions. This workshop discussed how behavioural science can be applied alongside multichannel communications to promote positive behaviour change among stakeholders and to help establish or reinforce critical relationships. The take-home message was simple: smarter communications are the key.

Understanding the behaviour of HCPs, in particular with regards to decision-making, can have a real impact. The majority of our decisions are made subconsciously using ‘autopilot’, which helps us to act quickly and efficiently. However, clinical decisions made on autopilot can lead to errors and be based on natural tendencies of cognitive bias, such as following peers and existing beliefs, focusing on losses more than gains or thinking in the short term. Behavioural insights into these tendencies among stakeholders can be used to steer communications strategies. In order to personalise communications on the basis of such behavioural insights, it is essential to develop multiple personas for all relevant stakeholder groups. Numerous factors should be considered, including areas of interest, potential biases and communications channels utilised.

To summarise, MA professionals should rethink their approach to medical communications and harness behavioural science as a springboard to develop multichannel communications and engage all stakeholders. Communications developed with behavioural insights in mind should be smart, personalised and adhere to the ‘EAST’ principles: easy, attractive, social and timely. This strategy allows drivers of and barriers to decision-making to be identified and addressed, thus providing optimised conditions for positive behaviour change.

Payer perspective in use of real world evidence

Real world evidence (RWE) plays an important role in supporting access decisions by payers. For example, RWE informs assessment of relative value and facilitates evaluation of predicted versus actual use and outcomes. This workshop explored the evolving role of MA in market access-related payer discussions; MA are now involved throughout all three phases of RWE activities: evidence strategy, evidence generation and scientific exchange. Delegates were encouraged to consider, from the payer’s perspective, the roles that MA should play in leading or supporting the use of RWE. Three case scenarios were presented to facilitate discussion:

Case	Scenario
#1: Disease burden	A promising therapy for a rare paediatric disease that would only require administration every 10 years
#2: Change in access	Expansion of a drug used in a very narrow indication to a much wider indication
#3: Comparative effectiveness	Evidence is required to compare novel inhalers containing dual or triple therapy for chronic obstructive pulmonary disease

In case #1 (disease burden), MA could use or gather RWE to help payers understand how this treatment could impact on patients, such as from a quality-of-life perspective. For case #2 (change in access), in order to support forecasting, formulary and utilisation management and contracting, MA would need to pre-empt the types of evidence payers might request prior to FDA approval in the broader indication. Finally, studies to address case #3 (comparative effectiveness) would require a very high level of scientific rigor within a real world population. To help address this evidence gap, MA could support by providing key design- and data-related considerations.

These scenarios highlight the need for MA teams to strengthen their understanding of payer perspectives and their consideration of RWE in reimbursement decisions. Furthermore, MA should be able to apply an evidence development framework to evaluate the potential value of RWE programs to payers.

OK, so what’s next?: How MSLs can take charge of their career development

The availability of MSL career path choices, and the resources required to follow these, are key factors in job satisfaction and retention. However, MSL career paths are often indiscernible. This workshop outlined how MSLs can take charge of their career development using a career development plan checklist:

1. Conduct a critical self-appraisal to identify strengths and weaknesses
2. Categorise short term career goals (1–2 years) in terms of promotions, training and advanced opportunities beyond the immediate MSL environment
3. Identify gaps by evaluating competencies and seeking feedback
4. Address gaps in competencies by using the necessary resources and securing support from management.

Each of the above requires a thorough understanding of MSL competencies. The core MSL competencies are scientific or technical expertise, an ability to communicate effectively, strong problem-solving skills, self-motivation and flexibility. Advanced competencies, which have become desirable as the MA landscape has evolved, include the ability to interact with emerging customer groups, emotional intelligence and multidisciplinary expertise. For example, emotional intelligence — coined ‘EQ’ — encapsulates advanced self-awareness, self-management, social awareness and relationship management.

The career plan checklist above highlights a number of ways in which MSLs can strategically pursue career development. MSLs should conduct a frank self-assessment from the perspective of those responsible for promotion decisions. Obtaining 360° feedback from trusted peers is also important, particularly from those who have already travelled down a desired career path. Competency gaps identified using these approaches should be addressed by harnessing the power of networking and by using online information sources, such as job aggregator sites and MSL blogs. Finally, MSLs should ensure their management is in agreement with their aspirations; after all, direct managers are the single most important promotion advocate.

Measuring the impact of medical information: New metrics for the ‘Medical Affairs 2.0’ paradigm

The shifting of the MA industry to a new, data-driven paradigm has been termed ‘Medical Affairs 2.0’. Medical information is now readily available for key stakeholders to search for directly, 24/7 and across a plethora of digital resources, such as Wikipedia and Medscape. This has reshaped the way in which corporate R&D evaluate their pre-launch efforts. So, how is it possible to keep track of a digital pulse that is constantly moving, available in all major languages and spread across the internet? This workshop explored the new MA strategies and alternative metrics being employed to effectively assess the impact and reach of pre-launch scientific communications.

The metrics landscape has evolved dramatically. Metrics now go far beyond traditional journal citation metrics, and ‘interactive’ impact can be measured through web analytics and engagement with digital platforms, such as news and social media. These indicators of engagement with online research sources, termed ‘alternative metrics’, have assumed a critical position in facilitating impact assessment in digital spaces. For example, new approaches to gauging medical publication impact on social media domains include the use of Altmetrics and Plum Analytics.

The emergence of alternative metrics coincides with a core theme of MAPS 2018, which is to address opportunities and challenges in optimising communication and engagement. Alternative metrics go beyond traditional citation impact; not only do these metrics offer far quicker — sometimes immediate — timelines, they can also assess the impact on a wider audience, including patients and media. The potential MA utilisation of such metrics also extends to other areas, such KOL identification, share-of-voice analyses and information dissemination strategies.

Managing up/down boomers, genXers and millennials in MA

The landscape of our workplace is ever-changing, and the days of generational hierarchies are gone. ‘Boomers’ (1946–1964) have begun to retire, ‘GenXers’ (1965–1980) are progressing to senior leadership and ‘Millennials’ (1981–2000) are entering the workplace. In this workshop, generational differences and similarities in the workplace were explored, and the importance of identifying generation-specific motivations and attributes was highlighted for the optimal management of a multigenerational team.

Members of different generations grew up in eras associated with contrasting moods and messages. Boomers — the generation of post-war optimism, exploration and achievement — have earned a ‘live to work’ reputation but have been rewarded with delayed retirement. On the other hand, GenXers grew up in an era where autonomy and self-reliance were respected traits, and this generation holds family values and work–life balance in high regard. Millennials are considered to be high performance and high maintenance; technology is an integral part of their every-day lives, yet their upbringing has grown them accustomed to constant positive feedback.

To ensure a thriving, successful team, there is a need to appreciate the distinguishing values, expectations and motivations of each generation. Managers should aspire not only to manage but to lead by alignment in a more agile and collaborative manner. Tools should be offered to maximise efficiency and productivity across all generations within a team, while also retaining and attracting high-performing workers. Overall, rather than generation gaps being a source of stress or conflict in the workplace, the diversity of a multigenerational workforce should be harnessed as a source of creativity and productivity.

Data visualisation and multichannel delivery – let the numbers speak for themselves

The average attention span of an adult has been estimated to be approximately 8 seconds. In our digital age, data must be used to “tell a story” that resonates with the target audience in a concise, clear and engaging manner. Visual perception plays a key role in the interpretation of data, and different data sets and communication channels require strategic selection of visual formats to achieve the greatest impact. This workshop educated delegates on how best to visualise data in scientific communications:

• find a story
• only visualise data if it helps to tell the story
• use one story per table/figure
• always show a legend
• if a story has many chapters, guide the reader through them
• sections within a chapter should be broken into manageable chunks.

When translating data into a visual format, it is critical to factor in the desired impact of the take-home message. When is a scientific message best conveyed using a table? When is a graph preferable, and which type?

A picture doesn’t always paint a thousand words; if values need to be looked up or an intricate level of detail is required, a table is the best way forward. However, graphs depict messages not visible in a table and better showcase the ‘big picture’, trends and differences. Alternative graph types have specific pros and cons. For example, column charts are easy to read and clearly display patterns, but they can be visually dull and uninteresting. On the other hand, bubble charts are elegant and lend themselves well to colour but, like pie charts, can make value comparison difficult. Delegates were encouraged to think beyond the basics. For example, a 3D waterfall plot is an interesting alternative to portray tumour response data. Overall, the value of strategic data visualisation should not be underestimated in producing impactful scientific communications.

Your science communication platform has been built. So, now what?

Science communication platform (SCPs) are integral to scientific communications and serve as a repository of evidence supporting pre-clinical, clinical and value statements. An effective SCP has well-supported content that is grounded in the literature, is internally aligned with the core communication approach, assists in prioritisation and improves efficiency upon implementation. Once a strong SCP has been built, it is essential that all stakeholders are aligned with the content and committed to its use. This workshop outlined the steps that can be implemented to achieve such a goal.

Step 1: Encourage adoption. An SCP must warrant leadership buy-in, and it is important to consider the ‘who, when, what and where’. Leadership involvement should be invoked at the right time and obtain commitment from the right stakeholders through customisation for individual functional teams or geographic regions. Companion materials should be generated that define the strategy, strengthen the scientific statements and support downstream activities.

Step 2: Ensure relevance and usability. SCPs are ‘living documents’ and can be influenced by new data, changes in programs or shifts in the landscape. Updates should be performed at regular intervals to maintain relevance. Furthermore, SCPs should always be presented in a user-friendly manner that enhances learning.

Step 3: Train. Training should be rolled out to the right people, at the right time and in an effective format, ideally complemented by the distribution of quick reference guides. For ongoing training, a process should be defined and the responsible parties identified for delivering such training.

To summarise, these steps can reinforce the importance of an SCP throughout an organisation and crucially, can facilitate widespread and sustained SCP adoption

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By Aspire Scientific, an independent medical writing agency led by experienced editorial team members, and supported by MSc and/or PhD-educated writers

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