Power to the people: Make gains by focusing on health literacy

The concept of health literacy is actually fairly new. The term was first introduced in 1974, when Simonds argued that students could also be literate in health, just as they are in other subjects, such as maths or reading1. By the 1990s, the World Health Organization (WHO) had taken up the cause, culminating in the publishing of its own definition of health literacy in 1998’s Health Promotion Glossary2. As governments and health systems make pushes towards more patient-centered care that empower patients to share in making decisions about their treatments, the concept of health literacy has never been more important. Read on for an overview, as well as why pharmaceutical and medical device makers should be focusing on health literacy as part of an overall medical communications strategy.

Defining health literacy

Since the WHO brought health literacy to the world stage, the concept has continued to evolve, inspiring a multitude of research on health literacy in a variety of health conditions and contexts. Researchers are now seeking to integrate existing definitions and conceptualisations of health literacy “into an encompassing model outlining the main dimensions of health literacy as well as its determinants and the pathways to health outcomes,” so that health literacy can be better promoted and measured3. In 2012, researchers created a model that “identifies 12 dimensions of health literacy, referring to the competencies related to accessing, understanding, appraising and applying health information in the domains of healthcare, disease prevention and health promotion, respectively” (see Figure 1)3. This is a straightforward, comprehensive lens through which to view the concept of health literacy, so it’s what we’re referring to going forward.

Figure 1. Dimensions of health literacy

Fig 1a Dimensions of health literacy

The impact of health literacy

As management of chronic illnesses (e.g. diabetes, vascular disease) in particular has come to dominate the global conversation about healthcare, ongoing therapy is often necessary for optimal outcomes. However, health services and clinicians alone cannot be entirely responsible for this burden — patients must also be fully engaged in their care. If they cannot understand what their care regimen is, why a care decision has been made, how to participate in that care, whom to contact about their care, and when to carry out or pursue care options, health outcomes suffer. More specifically, poor health literacy results in:

  • Errors
  • Poor quality of care
  • Risks to patient safety
  • Inability to communicate in public and private dialogues about health, medicine, scientific knowledge and cultural beliefs
  • Lower quality of life
  • Decreased equity and sustainability in health systems3

Without a system-wide focus on health literacy, people with a variety of acute and chronic conditions may not understand health-related educational materials, making them arduous to self-manage. Without proper self-management, patients have a greater risk of developing many secondary health conditions. This can be a colossal expense for the individual and healthcare systems overall. Health literacy is a core foundation for a patient’s ability to self-manage and should be treated as such.

Approaches to health literacy

Low health literacy levels can broadly be addressed by educating persons to become more resourceful (i.e., increasing their personal health literacy), and by making the task or situation less demanding, (i.e., improving the “readability of the system”)3. That is, patients should have a wide variety of options to choose from, to suit their personal situations and learning styles, and these options must be delivered in a way patients can easily understand. More specific examples ways to improve health literacy for patients include:

Blogs — Written in conversational, easily understandable language, blogs are designed to be quick reads on a single aspect of a bigger topic. This approach allows patients to read about the specific information they’re looking for, and link to other related blogs, if they choose. Patients don’t feel overwhelmed by a paper that tries to do everything at once, which helps enhance information retention. The advantage for pharmaceutical and device-makers is that a regularly updated blog helps SEO optimisation, thus keeping the company at the fore of web search results — and at front of mind for patients and clinicians (who often direct patients towards patient education options).

Websites — A well-organised and well-thought-out website delivers a variety of learning modalities to patients. It’s easy to explain concepts visually (e.g. through infographics, pictures or medical illustrations), provide audio explanations for visually impaired patients, and embed videos that let patients follow step-by-step — or even hear stories from patients just like them. A page with downloadable resources lets patients engage in their education and care even when they’re not online. And a mobile-optimised website means they can check for answers to questions anytime, anywhere on their tablets and phones.

Patient education materials — These can be downloadable or more traditional printed resources. Straightforward language and clear visuals can be integrated to help patients, for example, prepare for surgery with a specific device, self-care after that surgery, how to administer diabetes medication, or how and when to take blood pressure readings.

Apps — Apps have the same anytime-anywhere advantage as websites, but they can take health literacy a step farther by making education interactive. Health literacy is not just about being informed, but about how patients are able to apply that information to their everyday lives and care. Apps can be developed to help guide patients through steps in their care — letting them get ‘hands-on’ experience before actually doing — and to integrate reminders about their care regimens and a place to record their care-related activities, for example.

Engaging patients directly in their own care in one or more of these ways positions companies as more than pharmaceutical and device makers, but as thought leaders concerned about patients’ overall wellbeing.

Health literacy never loses its importance

Too often, patient education materials are written at a readability level too advanced for the average patient. Writing medical information in an easily digestible format is not the same as ‘dumbing it down’. Rather, distilling information for patients requires in-depth knowledge of a therapy area or speciality, so that it can be conveyed in a way that is both technically sound and easy for the average patient to follow. has experts across the healthcare spectrum, experienced in delivering a wide variety of educational materials that can help you lead the way in improving health literacy. Remember: Acute and chronic health conditions can occur in all stages of life, to people of all education levels, and health literacy helps optimise outcomes and save lives.


1. Simonds SK. Health education as social policy. Health Education Monograph. 1998;2:1–25.

2. World Health Organization. Health Promotion Glossary, 1998. Accessed March 2016 at:

3. Kristine Sørensen, Stephan Van den Broucke, James Fullam, et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health. 2012;12:80. Accessed March 2016 at:


Make your product the star with medical storytelling

The best content tells a story, and medical writing is no different.

Stories make us sit up and take notice, they help us remember, they provide connections between simple facts and spark creativity in our minds. In medical communications, this means going beyond listing product features and data points to give clinicians and healthcare managers a more rounded view.

Think of your drug or medical device as the main character, and all the ways the product can affect hospitals and clinicians as the stories to be told. Storytelling is the key to creating awareness among customers, delivering value to them, positioning you as an expert, and connecting and engaging with current and potential customers. Read on to find out how.COM0043-2015121. Create awareness
There’s a reason oral storytelling survived so long — long enough, in fact, until the printing press was invented, and we could start recording those stories, many of which still survive today (think Grimm’s Fairytales). That’s because, quite simply, the human brain craves stories. In fact, research has demonstrated this time and again — our brains have to work to decode the meaning of data but, when they processing stories, the brain can skip the work of decoding and go straight to the retention of information. Therefore, it’s far easier for potential customers to remember information told by stories than that conveyed as a list of cold, hard facts, however well-organised. What’s more, 92% of consumers say they want to internalise information via stories. Leading consumer brands such as Coca-Cola have successfully adopted this method of marketing, and medical device and drug-makers can, too.


2. Deliver value
When you tell a story, you’re not just describing the ‘what’ of your device or drug. That is, it’s not, ‘Once upon a time, after many years of R&D, a product was developed.’ Rather, you’re taking the facts about your device or drug and communicating to hospitals and clinicians why the product matters to them. Author, business consultant and university professor Simon Sinek originated this concept, which he calls the ‘Golden Circle’ as a sales and marketing approach. When you focus on the ‘why’ of your product, your marketing plan must be multi-faceted. Journal articles and conference posters alone won’t cut it. You have to extrapolate that data — doing the work for the customer’s brain — and provide avenues by which to implement the desired change (i.e. buying your product) and convincing reasons for doing so. Therefore, your marketing plan should include health-economic data, clinical decision-making mechanisms (such as pocket guides and apps), downloadable tools for education and cost-efficiency calculations, and more. These kinds of medical communication, though slightly outside the norm, add value for customers while going beyond a list of product features or data to create the whole story of your product.

COM0044-2015123. Position yourself as an expert
Do you want to be ‘just’ a device- or drug-maker, or do you want to be a partner to hospitals and clinicians in the delivery of high-value healthcare? When you focus on storytelling and start creating value-added content for customers, you demonstrate that you share their concerns — and that you’re not just in it to sell, sell, sell. Of course, no one goes into business to not make money, and everyone knows that. But custom storytelling actually helps you make more: it’s ‘92% more effective than traditional advertising at increasing awareness, and 168% more powerful at driving purchase preference.’ That’s because, when customers have a problem, they think first about potential problem-solvers. With a story-telling approach to marketing, that would be you.

4. Connect and engage with customers
Storytelling gives you more space to answer your customers’ questions, and lets you be nimble enough to address new issues in healthcare as they arise. For example, adding a regularly updated blog to your website gives you the flexibility to tell various aspects of your drug’s or device’s story on an ongoing basis. Instead of trying to get all the information into one, long document, you can focus on bite-sized topics — such as how your product helps manage changes in healthcare regulations, enhances patient safety or solves a clinical problem — that customers can digest in a quick read. What’s more, because you’ve positioned yourself as the expert, they’ll become engaged with the content you’re delivering and return for updates. In addition, clinician experiences and patient case studies help you connect with customers, because they’ll see themselves in the content and have a ‘character’ to root for. Clinicians want to know how the products work (clinically, time-wise and economically) for people like them and patients like theirs, and storytelling helps you achieve those aims.

Building your strategy
When you consider how to put together all the parts of your drug’s or device’s story, it’s important to take a step back to determine your goals. Sometimes, the perspective of a neutral third-party can help pinpoint your aims — and how to achieve them. can help you craft the components of your product story, delivering storytelling that is straightforward and insightful about your product and industry, that adds a personal touch, and that ensures your audience will want to come back for more.

Visual Content Marketing: Illustrate the Point

The internet brought power back to the word but, somehow, the pencil got left behind. But now, it’s making a comeback. People are beginning to understand the importance of visuals in their content marketing and are illustrating their words with drawings, animations and infographics.

Visuals are important in not only getting your audience’s attention, they’re critical in getting them to remember you. There’s study after study which show we retain and comprehend information far better with visuals than we do with text alone.

One study has shown that we remember 65% of visual information, but only 10–20% of written or spoken information. YouTube is the perfect example of this as it’s the world’s second most popular search engine – clearly showing that we want to see our information.


Learning recall related to type of presentation

Presentation Ability to recall
After 3 hours After 3 days
Spoken lecture 25% 10-20%
Written (reading) 72% 10%
Visual and verbal (illustrated lecture) 80% 65%
Participatory (role plays, case studies, practice) 90% 70%

Adapted from: Dale 1969.


All this holds true for your content marketing. Yes, sharp copy is necessary for thoroughly conveying the details of research and other information, but if you neglect to include drawings, animations and infographics, your message may never get across. It’s time for a new rule of content marketing: Don’t tell, show.


More than a trend

This preference for visual communication is leading to more and more hand-drawn explanations, or ‘whiteboard animations’, on YouTube. One of the most well known, and most viewed, was created by The RSA, based on Dan Pink’s speech, ‘The Surprising Truth about what Motivates Us’. It has a not-insubstantial 14.5 million views to date.


“When words and visual elements are closely entwined, we create something new and we augment our communal intelligence … visual language has the potential for increasing ‘human bandwidth’—the capacity to take in, comprehend, and more efficiently synthesize large amounts of new information.”   – R.E. Horn, Stanford University


One study’s results showed that adding just one image to text improves comprehension by nearly 90%. That’s why infographics are increasingly finding their footing in visual content marketing. Infographics convey statistics, facts and processes, making content easier to digest by reducing the amount of text – or highlighting the key points from dense text – and balancing the black-on-white with visuals. Check out this example below:

11 Fascinating Facts About the Human Heart

human heart facts

We’re beginning to add illustrations to our content marketing, because they are shown over and over again to improve retention and comprehension. BUT. There’s another reason too.

Visuals delight.

Surprise and delight your audience

One company, despite interacting with billions of us every day, still manages to surprise and delight us with their use of illustrations: Google and their Google Doodle.

Who else is a little bit intrigued, a little bit surprised, when they see a Google Doodle on an otherwise-random day? Who hovers over the doodle, curious to see what special day it is, which discovery we’re celebrating, or whose birthday it would have been. It’s different. It’s interesting. It’s fun.
Untitled-2-02 copy

Taking an illustrative approach

Illustrations capture our interest and our imaginations. They help us to see beyond the words to truly grasp information. Illustrations complement content by aiding the reader in understanding and retaining what is being said, making the entire content package more effective, more interesting and, most important of all, more lasting than text alone.

Try illustrating your content and see if it helps you to illustrate the point.

Ready to rethink your content marketing? Here are some things you may want to consider:

1. Ask yourself the question: Would the reader understand more clearly what I’m trying to explain if I added an illustration?
2. Consider the content, the media and the illustration type. Some illustration types are better suited for some media and content than others. For example, a highly detailed medical illustration can perfectly capture a complex concept, or an animation could illustrate a lengthy process far better than a flow chart.
3. Think about what your words can’t do – however well they paint a picture. That’s what your visuals are for, and what their conception should be based on. know how to take complex medical and scientific information and turn it into understandable illustrations. Our medical illustrations range from hand-drawn drawings, computer graphics, mode-of-action videos and animations. If you need help putting pencil to paper, you can find us here:

Do medical device companies understand orthopaedic surgeons?

It’s relatively easy to create a brochure, website or exhibition describing your medical device product — list the technological innovations that make the device safer, easier to use and better-performing. Although these features are important, focusing exclusively on communicating them may not actually be convincing surgeons and administrators to purchase and use your devices. Websites, brochures, journal articles, exhibitions and more are all part of the marketing mix — and all can be excellent methods by which to get your message across. If your message is the one surgeons and administrators want to hear.

Read more

Increasing the perceived value of medical products beyond ‘features’

The medical device industry is characterized by a high level of technological product innovation. New, innovative features are being developed all the time, and it’s hard for customers — a group that increasingly includes hospital administrators and patients, as well as physicians — to keep up. In order to increase the perceived value of their products, medical device companies have to go beyond simply enumerating ‘features’ and present ancillary solutions to make a strong case for value.

The Hierarchy of Product Attributes

In the book Principles of Marketing, Philip Kotler et al 1 suggested that benefit-building for products started with viewing a product on three levels, to extract all the benefits your product offers. This strategy is variously referred to as “Total Product Concept,” “Augmented Product” and the “Three Levels of a Product,” among others. Here, we’ll call it the Hierarchy of Product Attributes. This marketing methodology, which provides insights into the level of differentiation of a product, comprises three layers:

The Core Layer
This layer represents the minimal requirements customers have for a product. These attributes are a pre-requisite for the right to compete in the market — customers expect them as standard.

The Expected Layer
Many products are strongly marketed based on ‘unique’ features, a brand or appealing packaging. Although these attributes are very important, they are basic differentiators and therefore vulnerable to commoditization.

The Augmented Layer
The strongest differentiating attributes belong to the augmented layer. These are often complex forms of non-tangible, ancillary product benefits that are mainly related to a company’s ability to enrich products — and, therefore, customers — with valuable services and support. Perhaps counter-intuitively, these ‘non-tangible’ benefits can actually be the deciding factors: They’re so useful to the customer, they provide a key reason for buying the product.


Medical device product attributes

Figure 1. The Hierarchy of Product Attributes

Attribute Continuum

Over time, customers’ wants and needs change, as does the market, rendering previous major differentiators to the other, less-differentiating layers of the diagram; i.e., augmented benefits become expected benefits. Therefore, managers have to actively plan future-differentiation strategies and foresee when product and service attributes, together representing the perceived value, will become commoditized.

Applying Product Hierarchy to the Medical Device Industry

The five core product attributes of medical devices are safety, quality, performance, features and ease-of-use. While these core product attributes are important, they all belong to the expected layer. That’s why medical device companies have to focus on communicating or providing other benefits or services — ancillary solutions and value offerings that will help patients, physicians and hospitals.

Product Example: Hip Prostheses

To understand how the hierarchy works in practice, let’s take a look at the acetabular bearing component, the so called ‘liner’, used in hip prostheses. The liner forms the articulating layer between the metal acetabular component (the hip ‘cup’) and the ball head of the prosthesis (the hip ‘ball’).

The table below shows the liners of four leading medical device companies, together with the main sales arguments. This information was collected from the websites of the companies, but the original claim texts of the four most important features of each product were simplified to allow comparison.


Medical device product attributes comparison

Table 1. Comparison of product attributes


Points of Parity
In all four, the core product attributes show a surprisingly high degree of similarity. All companies claim that their liners are made with the most advanced technology, reduce wear dramatically, are stronger and offer oxidative protection. Because the claims are so similar and solely product-focused, these are mere points of parity: Each company essentially matches its competitors’ claimed benefits.

Customers won’t choose one product over the other based on these attributes — but, importantly, they’d switch brands if those attributes weren’t present. For example, all suppliers of hip implants now provide XLPE liners, and a client would be surprised if a company did not.

As such the claims displayed in the table belong to the Expected Layer rather than the Augmented Layer and, as such, do not offer strong differentiation. Consequently, products are often perceived to be alike, which results in a lack of persuasiveness and eventual commoditization of the product segment, putting prices under pressure.

Points of Difference
There are many ways to strongly distinguish products from the competition. In the case of the acetabular bearing component, it would be more effective — though not necessarily easier — to focus on factors beyond the physical product attributes. To identify successful differentiators, managers should conduct market research to understand the wants and needs of customers, in terms of systems, processes, service and value for money.

For example, an orthopedic surgeon may ascribe more value to benefits such as continuing medical education or support for improving the clinical outcomes and the efficiency of his practice. When the attributes from the augmented layer are strongly associated with a brand, clients will be reluctant to switch to competing products. These attributes should therefore also be strongly ‘tied’ to the brand and communicated together with the physical product benefits.

Create the perceived business value by packaging the physical product attributes and ancillary services in your message. Not only is this more effective in persuading customers, a message layered with complex differentiators is difficult for competitors to imitate — and that’s how the hierarchy of product attributes can give you a long-term competitive advantage.



  1. Armstrong, G., Adam, S., Denize, S., Kotler, P. (2014). Principles of marketing. Pearson Australia.


Boosting medical device sales by communicating customer value

The physician is in favour of your product: it is innovative and has better outcomes than competing products, and there is a wealth of clinical evidence to prove this. However, the purchasing department didn’t see the value and thinks it’s too expensive, the physician says.

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