Understanding US healthcare provider preferences for consumption of publication content: opportunities to leverage omnichannel approaches

Abstract

Objective

Understanding the healthcare provider (HCP) journey of discovering and consuming medical and scientific information is critical for optimizing publication reach. A survey was conducted in 2019-2020 to understand how HCPs in the United States discover, review, and share publications of interest. A follow-up survey was conducted in 2021-2022 to assess how HCP behavior in the United States has evolved over the past 2 years, including due to the COVID-19 pandemic.

Methods

Expanding on the survey completed in March 2020, a 24-question, online survey was conducted via SurveyMonkey. Survey invitations were sent via email list, social media, and personal outreach to practicing US-based HCPs with MD or DO degrees.

Results

Thirty-nine HCPs responded in 2020. Of the 33 HCPs who responded in 2021-2022, 67% were community practitioners; 45% had practiced for >20 years, while 30% had practiced for <5 years. Medical media channels (preferred by 73%) were the most common means of discovering publications of interest (vs targeted PubMed/Embase searches in early 2020). Sixty-seven percent of HCPs found supplemental digital information (also called publication enhancers) moderately/very useful for understanding article content vs 56% in the 2020 survey. When asked about pandemic-related behavior changes, HCPs reported increases in social media use (55%), medical media use (52%), direct reading of research articles (45%), accessing supplemental digital information (39%), and sharing/recommending articles to colleagues (33%).

Conclusions

These survey results suggest that how HCPs interact with publication content is evolving and that these changes appear accelerated by the COVID-19 pandemic. This evolution is important to understand, and be accounted for, in the framework of omnichannel publication planning.

Keywords:

• Publications
• surveys and questionnaires
• COVID-19
• omnichannel

Introduction

Omnichannel planning is an integrated, personalized approach that coordinates information across numerous interconnected channels using a consistent strategy to adapt to the individual consumer’s experience or preferences. Omnichannel planning builds on multichannel approaches in that the goal is to integrate and personalize the typically independent channels utilized in a multichannel approach¹. Omnichannel approaches have traditionally been used in the retail industry, and the digital age has accelerated the need to grow and adapt to meet the needs of the intended audiences^2,3. A similar digital transformation has occurred within medical publishing and medical communications. The internet age has brought about a transition from data being published only in traditional print journals to data also or exclusively existing in digital formats, which allows for new options for communication and sharing of data through new channels⁴. The increased variety of channels provides the opportunity to bring the latest medical research to new audiences but also may increase the possibility of physicians encountering unreliable information.

The increasing options available in medical publishing and communications allow for omnichannel approaches to be utilized for publication planning. Ultimately, the goal of an omnichannel medical communication strategy is to provide the effective, timely, and consistent communication of data to diverse audiences, using a variety of channels in an integrated and personalized manner. These channels may include more traditional means of communication such as abstracts, posters, oral presentations, and manuscripts, as well as relatively newer options in the form of publication enhancers (e.g. plain language summaries, infographics, video or graphical abstracts, audio summaries, and slide summaries).

Omnichannel approaches are valuable, as target audiences for medical information are diverse, with differing preferences. In the past, medical publications may have been tailored for the target audience of the journal in which the data were published. However, there is often a need to reach a broader audience segment, including nurses, physician associates/assistants, pharmacists, basic scientists, payors, and patients, in addition to physician healthcare providers (HCPs; defined here as physicians with MD or DO degrees). HCPs themselves can be diverse, with a wide variety of backgrounds, experiences, interests, and adoption behaviors that will influence their learning^5–8. Further, HCPs, especially oncologists, are increasingly time constrained^9,10. Taken together, there is a need to develop coordinated content that goes beyond traditional publications or congress presentations and that meets the needs of this increasingly diverse and time-stretched group of professionals^9,11.

Accordingly, the digital age has also changed the way that information is identified¹². Academic researchers have typically found publications of interest through standard search methods (e.g. PubMed and more recently Google Scholar). However, additional avenues for locating information are constantly being devised. Most journals now send table of contents and publication alerts through email, really simple syndication feeds, and dedicated social media accounts, in addition to getting potentially relevant material to their audiences through search engine optimization and article discovery platforms^13–17. Furthermore, many researchers communicate their own publications or publications of their colleagues through their personal social media accounts, which is often encouraged by publishers^18,19. Sharing via personal accounts can potentially include newer or less conventional outlets that may not have a well-established profile as a credible channel. Further, there are several well-established medical education/media websites, including Doximity, Sermo, and UpToDate, that HCPs may utilize that will direct them to a publication of interest. Use of these communication channels may differ based on the audience and their specific background and may have evolved as a result of the COVID-19 pandemic²⁰. Together, these factors begin to highlight the challenges of and need for developing an omnichannel communication plan that best enhances the reach of peer-reviewed publications and complements traditional search approaches.

To optimize the reach of medical publications, one needs a thorough understanding of the target audience and their journey to best understand which channels should be leveraged at each phase. For HCPs, a publication journey could include a discovery phase in which a publication is identified, a consuming phase in which a publication is read, an engagement phase in which supplemental content is accessed, and an advocate phase in which a publication is shared with others, leading to others discovering the publication of interest. Here, we focus on understanding the HCP segment of the audience for scientific peer-reviewed publications, including the evolution of their journey following the peak of the COVID-19 pandemic.

Methods

Healthcare provider survey design

Qualitative surveys were designed and targeted to HCPs, specifically practicing physicians in the United States. First, a 20-question online survey was conducted between December 2019 and March 2020, followed by a modified version of the survey with 24 questions conducted between November 2021 and March 2022.

These surveys were designed to be broad, with questions around publication enhancers and medical and social media. In both 2020 and 2022, video abstracts, infographics, lay summaries, and audio/video slide summaries were the supplemental digital information examples provided when describing publication enhancers within the surveys. For medical media, the 2020 survey provided UpToDate and WebMD as examples within the relevant questions. In 2022, the provided medical media examples were UpToDate, WebMD, and professional society websites. Examples provided for social media were Facebook, LinkedIn, and Twitter in the 2020 survey and Facebook, LinkedIn, Reddit, and Twitter in the 2022 survey. The 2020 examples were chosen based on the perceived likelihood of them being relevant to the survey taker. In 2022, the examples were expanded based on the 2020 survey results and to align with any relevant changes in the medical or social media spaces. The answer options around medical and social media also changed between 2020 and 2022. The questions were open response in 2020, but answer choices were provided, including “other,” in 2022. In 2022, the survey was expanded to include COVID-19–specific questions. Complete survey questions and multiple-choice answers are provided in Supplementary Tables 1 and 2.

Table 1. HCP demographics.

	2020	2022
n (%)	N = 39	N = 33
No. of years in practice
0-5	13 (33)	10 (30)
>5 to 10	8 (21)	3 (9)
>10 to 15	1 (3)	3 (9)
>15 to 20	4 (10)	2 (6)
>20	13 (33)	15 (45)
Practice type
Academic	19 (49)	11 (33)
Community	20 (51)	22 (67)
Professional social media use
Not at all	5 (13)	1 (3)
Not often	14 (36)	20 (61)
Often	11 (28)	8 (24)
Very often	9 (23)	4 (12)
Frequency of reading publications
Never	1 (3)	0
A few times a year	6 (15)	8 (24)
Once a month	9 (23)	9 (27)
Once a week	15 (38)	10 (30)
Daily	8 (21)	6 (18)

Abbreviation. HCP, healthcare provider.

Participants

Physicians in the United States with an interest in scientific literature were invited to respond. Invitations were agnostic to demographics, specialty, practice setting, or geographic location within the United States. Respondents self-identified as physicians.

Participant recruitment

For both the 2020 and 2022 surveys, the link to the HCP survey was distributed via direct email, LinkedIn, Twitter, and word of mouth. Surveys were conducted on the SurveyMonkey platform. No monetary reward or prizes were offered for participation.

Data analysis

Results for all surveys were descriptively analyzed for all respondents independently.

Results

Survey responses were received from 39 US-based HCPs in 2020 and 33 US-based HCPs in 2022 (full results, including poster PDFs and video abstracts, are available at https://www.nucleus-global-channel.com/ismpp2020/ and https://www.nucleus-global-channel.com/ismpp2022/). While there were no clear trends for demographic differences between the two groups, the 2022 group was generally in practice longer and was more community practice focused (Table 1) than the 2020 group. Overall, the HCPs represented a wide range of specialties in both 2020 and 2022 (Supplementary Table 3).

Discover: identify publications of interest

In 2020, PubMed was the preferred source by which HCPs identified publications of interest (preferred by 67% of HCPs), with 56% using a general search, 51% using medical media, 36% using a professional society website, and 26% using social media. In 2022, medical media was the most common way to discover publications (preferred by 73%), followed by PubMed (61%), professional society websites (42%), and social media (24%) (Figure 1A). Of the different medical media, UpToDate was most commonly used for discovering publications in both 2020 and 2022, indicated by 56% and 67% of HCPs who answered the question, respectively (Figure 1B). For social media users in 2020, Twitter was most popular (50%), followed by Facebook (28%), LinkedIn (11%), and Instagram (6%). In 2022, the most popular social media platforms were Twitter and Google (each 36%), followed by Instagram (32%), Facebook (27%), and LinkedIn (23%) (Figure 1C).

Figure 1. How publications are discovered. A. HCP identification of publications of interest. B. HCP medical media use. C. HCP social media use. HCPs were allowed up to three choices for their preferred method of discovering publications of interest. Per HCP medical media use: 17 responses were received in 2020 and 33 in 2022. The 2020 survey question was open response. UpToDate, WebMD, professional society website, and “other” were options in the 2022 survey. Per HCP social media use: 18 responses were received in 2020 and 22 in 2022. The 2020 survey was open response. Facebook, Google, Instagram, LinkedIn, Reddit, Twitter, YouTube, and “other” were options in the 2022 survey. Abbreviation. HCP, healthcare provider. ^aeg, UpToDate, WebMD, professional society websites. ^beg, Twitter, Facebook, LinkedIn, Reddit. ^ceg, Sermo, Doximity.

Consume: review primary publications

In 2020 and 2022, around 70% of HCPs stated that they “often” or “very often” read a publication once identified. However, in 2022, 57% of HCPs said that they “often” or “very often” would access publication enhancers instead of the publication. This represents a 26% increase over the 2020 survey results (Figure 2).

Figure 2. Percentage of HCPs accessing publication enhancers instead of the associated publication. Abbreviation. HCP, healthcare provider.

Engage: access publication enhancer(s)

Along with the increased use of publication enhancers by HCPs between 2020 and 2022, there was also a shift in the type of publication enhancer preferred. In 2020, video abstracts were considered the most useful by 57% of the HCPs who used publication enhancers. However, in 2022, only 38% of HCPs expressed a preference for video abstracts, with both infographic summaries (65%) and audio/visual slide summaries (58%) being more popular (Figure 3).

Figure 3. Most useful publication enhancers for HCPs.^a Abbreviation. HCP, healthcare provider. ^aMultiple answers could be chosen.

Advocate: share publication with colleagues

In both 2020 and 2022, the majority of HCPs agreed that they “often” or “very often” will share or recommend an article to their colleagues. Email was the most popular way to share publications, preferred by 61% of HCPs in 2020 and 64% of HCPs in 2022.

COVID-19 pandemic

In addition to exploring the steps of the omnichannel publication journey, the survey timings allowed for the assessment of the impact of the COVID-19 pandemic on publications. Additionally, COVID-19–specific questions were included in the 2022 survey. Overall, 55% of HCPs reported an increase in their use of social media, 52% reported an increase in their use of medical media, 45% increased their direct reading of publications, 39% increased their use of supplemental publication information, and 33% reported an increase in their sharing of publications. Additionally, 91% of HCPs would like to see the continuation of virtual meetings and presentations.

Discussion

Understanding the evolution of how scientific material is being identified and consumed is important for all who communicate and engage with scientific data. Overall, the survey results presented here support that a shift away from the traditional approach taken by HCPs of discovering publications on PubMed and then reading the publication is occurring. Instead, publications are increasingly being found on medical and social media, in addition to PubMed and other search tools. Additionally, once identified, many HCPs are choosing to skip the article itself and instead read or view a publication enhancer for key information, which may be indicative of how HCPs have become more time constrained and in need of short-form content. As such, these data support the use of more varied or omnichannel approaches to publication planning to ensure maximum uptake and understanding of key data points.

Medical journals have noted and adapted to some of these trends, which has increased the options to implement the tactics that can form an omnichannel communication plan. For example, of the 42 oncology journals listed in the Enhanced Publication Options Navigator, 40 (95%) have an option for enhanced publication content, including video/animated abstracts, graphical abstracts, video/audio posters, infographics, and author podcasts²¹.

Further, pharmaceutical companies have increased the usage of omnichannel approaches in medical affairs²². However, the adoption of this approach for publication planning and publications has been slower, despite the increased options and venues for publication enhancers²³. The survey results presented further indicate the value of omnichannel planning and respective tactics for publications. When considering an omnichannel approach, authors and sponsors need to consider several factors due to the time requirements and costs. First, are the data being reported part of a pivotal study, are the data of high strategic importance, do the data have the potential to impact clinical practice and/or patient outcomes, or are the data especially complex? Answering yes to any of these questions indicates that omnichannel approaches are worth considering. Further points to consider are how effective the primary channel is in reaching the target audience(s), whether access to the publication content will be limited, and what other means are being used to distribute the publication content. These questions and others are outlined in an omnichannel plan roadmap (Figure 4).

Figure 4. Omnichannel roadmap. A, a table to determine the need for and extent of omnichannel approach for a given publication (++ indicates a higher need than + for any given criteria). B, Steps to outlining an omnichannel plan. Abbreviations. MSL, medical science liaison; NP, nurse practitioner; PA, physician assistant.

Once an omnichannel approach is selected, authors and sponsors need to consider which measures they wish to implement. The measures selected will depend on the specific circumstances surrounding each article. For example, can online channels, social media, medical media, email, or person-to-person communication (live or virtual) aid in article discovery, or is the article being indexed on PubMed and searchable online sufficient? Additionally, will the utilization of additional channels improve uptake in the consumption of, engagement with, or advocating for a publication? And, ultimately, will understanding of the information within the publication be improved? The development of such a plan ideally would be considered before a publication is written and be used to assist in the selection of target journals. A template for an omnichannel plan can be found in the supplement.

Furthermore, the COVID-19 pandemic has impacted the consumption of publication content, albeit to a limited extent. Content that was formerly prepared for in-person–only events needed to be adapted for online or hybrid formats. While our survey indicated that most HCPs would like to retain hybrid congress options, with the reinitiation of mostly in-person events, many congresses still require the upload of electronic materials well in advance of in-person presentations.

In general, the implementation of omnichannel approaches will necessitate the increased use of different types of publication enhancers, which is already occurring. This increase is already reflected in the 2022 updates to the Good Publication Practice (GPP) guidelines²⁴. In GPP 2022, the development of enhanced publication content, including plain language summaries, is endorsed with the recommendation that they are planned for in advance and developed using the same principles as the main publication.

One of the strengths of our work is that we were able to conduct surveys before and 2 years into the COVID-19 pandemic. Possible limitations were that survey distribution was not random, respondents’ status as an HCP was not independently confirmed, the survey was limited to the United States preventing an extrapolation of findings more globally, and the number of respondents was small. We are also unable to determine how much overlap in responders there was between the two surveys, as respondents were anonymous. Further, the survey did not differentiate between public social media and the social media of colleagues and friends or between enhanced content that was part of a peer-reviewed package from a journal vs enhanced content from an alternative source such as a pharmaceutical company. Another challenge is the ongoing evolution of popular social media. While we modified the 2022 survey to account for this, including the addition of drop-down menu options, this makes some cross-survey comparisons more difficult.

Conclusions

Overall, recent years have seen the evolution of how publications are discovered, consumed, engaged with, and advocated for by HCPs, including a reduction in focus on PubMed and the reading of PDFs vs print journals. Therefore, the publication planning process needs to evolve as well. Omnichannel planning allows publication developers to take these changes into account, while ensuring optimal delivery of key scientific data. Key challenges for the future will be to ensure that the implementation of omnichannel approaches to publication planning is done in a fair and balanced manner without undue promotional influence and in accordance with good publication practices, as well as to better understand what drives physician preference for different types of enhanced publication content.

Transparency

Declaration of funding

This study was funded by Nucleus Global, an Inizio Company.

Declaration of financial/other relationships

All authors are employees of Nucleus Global, an Inizio Company. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors contributed to the study concept, analysis of data, interpretation of the results, and drafting and editing of the manuscript and approved submission of the manuscript.

Previous presentation

A poster containing the results of the 2019-2020 survey was presented at the 16th Annual Meeting of the International Society for Medical Publication Professionals (ISMPP; Virtual; June 16–18, 2020). A poster containing the results of the 2021-2022 survey was presented at the 18th Annual Meeting of ISMPP (Washington, DC; May 9-11, 2022).

Acknowledgements

The authors would like to thank their Nucleus Global colleagues who distributed surveys, contributed ideas, created design concepts, and analyzed online metrics for this body of work.