THE 15 YEAR EVOLUTION

THE 15 YEAR TECHNICAL EVOLUTION AND PERSONALISATION OF EPGONLINE.ORG

Published 13 Oct 2016

Chris Cooper, Managing Director, EPG Health Media

On September 11th 2001, I was driving back from Cambridge to my office in London, pondering a meeting I had just had with one of the software developers who was working on the ‘back end’ (databases) of a new software application we were developing for doctors. A separate group of developers were busy working in London on the front end (u/x interface). We were very close to finishing our work and sending the completed application (app) to the EMI compact disc factory. They were to produce the first batch of 10,000 CD ROMs, each of which would contain the finished software version of what today is epgonline.org, the website for healthcare professionals.

I’m sure many reading this will understand why I recall that particular day so well; it’s amazing how we can store and recall tiny details from so long ago, especially when the day coincides with such a tumultuous event (for generation X and Ys – the ‘Kennedy moment’).

Back then, I thought that the impending production of the CD ROMs in a factory that was more commonly associated with the manufacture of hit records (back when you could hold  recording physically), was the culmination of our work. The ‘our’ being myself and the team of technology and publishing enthusiasts who thought that – together – we would change the way doctors consumed information, and the way the Pharmaceutical industry both supported that information, helped create an educational narrative, and interpreted behaviour within that narrative (analytics). In reality, we weren’t alone in our ambitions – although it felt that way – and it was the beginning of the story, not the end. Eventually we would of course discover that it would be the doctors who changed the way they consumed the information, all we were doing was playing our part in enabling that change.

...it would be the doctors who changed the way they consumed the information, all we were doing was playing our part in enabling that change. 

I’d spent the previous 13 years or so working in publishing, selling advertising and advertorials in everything from consumer magazines and newspapers, to reference books. I was fascinated by technology and its potential application or use in communications media. I could see that print revenues were diving and, perhaps more importantly, that behaviours were changing. I was no different to the readers of the many titles I worked on. I wanted information right now, in the form I wanted it, be that in big or small chunks, snippets of what was relevant to me in the moment I needed it (‘on demand’). I’d already started using email at some point around the mid 1990s, and leafing through books and magazines seemed so last year – even then. 

Doctors were no different, surely? If you went into their office, you’d see shelves of dusty medicine books, and on their desk would be small heavily-thumbed books listing prescription medicines. 

So the idea itself was pretty simple; take the educational content from the bookshelf and join it with the prescription medicine information, make it searchable and ‘bingo’! You could have a set of search results showing you available treatments for any condition and, alongside that, a set of results directing you to guidance on how to manage and treat the patient. Wrap the whole thing up in a software tool and ‘bingo’ again! We’d change the way doctors work overnight.

There were a few complications with all of this, such as making the software work on any PC or Mac with a CD-ROM drive, regardless of the operating system. Making the same thing work directly from the disc (if the hospital or surgery system administrators prevented installation of software), dealing with foreign languages – I forgot to mention we’d decided to launch across all of Europe – and finally, establishing a process that would allow the software to update itself, connect to a central server to check for changes to the prescribing information, new drugs and changes to guidelines, and then pass back (to the server) a data packet telling us what type of drugs and treatments ‘Dr X’ most commonly looked for. Such simple ambitions!

...and then pass back (to the server) a data packet telling us what type of drugs and treatments ‘Dr X’ most commonly looked for. Such simple ambitions!

Oh, one thing, you might ask “Why didn’t you just build a website?” Well, I’d encourage you to rewind slightly to the dusty books and compendiums of medicine… Do you really think you’d find an internet connection in that doctor’s office?

Perhaps the most remarkable part of the story, is that, on a shoestring budget (the only form of true currency we had were ideas and enthusiasm), we actually managed to develop the software from scratch to launch, including prescribing information in seven languages, and make it do all of the above and more in 9 months start to end.

Can you imagine doing that today? Okay, yes we did have a little money; we’d convinced some forward-thinking marketers in Pharma, from companies like Pfizer, AstraZeneca, Abbott and J&J to sponsor some of the content, creating a revenue stream to help keep the developers in darkened rooms and supplied with doughnuts.

The birth of ‘EPG’, aside from those of my kids, is one of my proudest moments.

It turned out that – as I had hoped – the doctors rather liked the software, so much so that some of them started to email us, suggesting improvements. What a novel concept, users helping to shape the product. 

About a year later, and with exponential growth in internet access, perhaps comparable only to the growth of smartphone access in the last 5 years, we went online, adapting the software backend databases to work in a web server, and replacing the software interface with a website. In the ensuing 14 years, what is today www.epgonline.org has had perhaps 10 million or more users, and has adapted and changed throughout the years to accommodate tastes and contemporary form, along with more content, from guidelines to clinical trial information, continuing medical education, video, news and everything in between.

... In the ensuing 14 years, what is today www.epgonline.org has had perhaps 10 million or more users

What hadn’t really changed significantly in all that time, was how we organised the data and content.

For sure, we presented it differently over time, organising content around specialty areas (everything related to Oncology etc.), and then over time, the prescription medicines themselves (everything related to POM ‘insert name’), but the actual data content was fundamentally stored and accessed in the same way it had been since 2001/2.

Then, in 2015, with advances in technology and coding techniques, we knew the time had come to take another step forward. A very big step. So big in fact, that the challenges we faced made the original development of the software (and early website) look like child’s play. What if we took all of that data, hundreds of thousands of content elements, and took its curation logic even further; adding in diseases, along with specialties and medicines, as touch-points around which we could organise the content?

What if we went even further, and took the enormous and almost incalculable amount of user behaviour data we were gathering, and organised the content around that behaviour; informing the user experience for ‘one’, based on the behaviour of ‘many’?

What if we could personalise the entire user experience? Making it unique to the individual and their own interests? 

We knew this was a big task; that it would involve re-inventing the entire system, ground up, throwing away all of the technology and starting again, but leveraging our knowledge and experience from those 10 million users, along with our own market research to inform the design. 

Many who understood the original concept of epgonline.org (and the software before it), knew we were a little ahead of our time, certainly in healthcare. But to take this next step would again push us into a digital orbit way above our contemporaries. I, myself, considered some of the more prosaic issues. We’d spent so much time back in 2001, educating and helping others to understand the basic principles within which we worked, what we were trying to do, that taking such a step once more might involve another exercise in communicating our purpose. But would it? For this was a much more sophisticated digital landscape. Some of the terms we had used in 2001 such as behaviour analysis, analytics and curation etc. had now become commonplace, part of the digital vocabulary.

Some of the terms we had used in 2001 such as behaviour analysis, analytics and curation etc. had now become commonplace, part of the digital vocabulary.

We started work, and as before, some of the first tasks involved explaining to developers and others the scale of the task and the desired outcome. We conducted more research (link), asking our users what they want (and for that matter what they did not want – which is why you’ll see no advertising on epgonline.org today). The typical responses from developers et al was “that’s challenging, but we like a challenge”, “impossible”, “expensive”, “no advertising?!”.

Then later, when it started to take shape, “How did you do that?”, “Wow!”. But those responses all typically came from those, perhaps a bit like you and me, who were ‘in the know’; at least from a technology perspective.

As we beta-tested, we found that the users loved it and that it was “exactly what I was expecting to see” and “about time this came to healthcare”.

Well, I guess that’s the point isn’t it? Because, just as it was 15 years ago, it turned out that many of our users were just like me, and probably you. Normal behaviours from normal people, which is what doctors are, just like you and me (probably!).

They were used to having these types of experiences online in places like Google, Facebook, Amazon and even LinkedIn. So I must acknowledge that we haven’t disrupted digital with some incredible new and never-before-seen technology. But what we have done, is deploy our knowledge, our experience, our expertise, best practice and proven technologies from big data management to user-experiences, and given our users – in what is now the sixth iteration of epgonline.org – what they actually want today and tomorrow. So perhaps, although I’ll acknowledge it’s a grandiose ambition, I hope we have disrupted digital in healthcare.

  ...what we have done, is deploy our knowledge, our experience, our expertise, best practice and proven technologies from big data management to user-experiences...

It’s taken a little longer than we hoped, 6 months in the conceptualisation stage, 6 months of research, and 18 months in development and testing. But then, we needed to get this right, and there was the no-small-matter of doing all of that simultaneously with operating, managing and continually updating the existing website for the hundreds of thousands of users who relied on it every day (something we did not have to contend with back in 2001).

I’m pleased to say that, on 27 August 2016, global events weren’t quite as dramatic as 11 September 2001, but I will remember both dates as long as my own memory banks perform, partly because it’s the date we went to beta or ‘soft’ launch of epgonline.org, and partly because it’s my brother’s birthday.

With thanks to the cast and crew of the epgonline.org, yesterday and today.


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