Are We There Yet? Reaching "True" Omnichannel with Merck's Deborah Cava

Deb Cava: Abundant is probably too little a word. It's overwhelming for our customers and I think we have to think, are we contributing to the overwhelm or are we helping the overwhelm?

Clay Hausmann: I'm Clay Hausmann, CMO of Aktana and host of Contextual Intelligence. Our guest today has a long history of driving commercial change in pharma at one company, 32 years to be exact. We're joined by Deb Cava, the US Oncology Portfolio Strategy Marketing Director at Merck, the company she's called home for her entire career. From the field sales arms race of the 90s, to the industry's current obsession with omnichannel, Deb has seen the commercial model grow in complexity from more vantage points than you'd think. We'll hear what's working and what's not working, and what the industry can do to simplify and improve the customer experience. Deb, welcome to the podcast and thank you so much for joining us today.

Deb Cava: Thank you for having me.

Clay Hausmann: So Deb, these days, it's quite rare for somebody to stay at the same company for 30 plus years. You've had a number of different roles at Merck. That's given you a lot of different vantage points. Can you tell us a little bit about your career path and about those roles and what you've learned from each stop?

Deb Cava: Yeah. So I started with Merck out of college. I went to UCLA for my undergrad, and I started out as a representative in Los Angeles. And then from there, throughout my career, I've taken many different roles on the sales management side, sales operations, brand management, AKA marketing management, etc. And then I was asked to in the early days of digital marketing take on a role to define what does digital marketing mean to a pharmaceutical company, and then from there, took on a variety of roles, really thinking about not only what does digital marketing mean to an organization, how does an organization structure a strategy? How do we really make that come to life as an important way to engage our customers and maintain relationships with customers through a multitude of channels? More recently, I've had the opportunity to really expand my career in the space of commercial strategies, more broadly speaking. And so part and parcel of that does include elements of customer engagement, etc.

Clay Hausmann: You've had a number of different perspectives in the commercial team. You've been on the sales side. You're obviously on the marketing side right now. So you've seen it from different vantage points. You've been in different therapeutic areas. How has that diversity of perspective do you think benefited you? And then would you recommend that for others as they grow their careers?

Deb Cava: Yeah, because you know what? You start to see some of the common truths across different roles. And I'd say the one big, common truth is you got to really understand the customer and you really have to be honest about what the customer wants and needs. I think sometimes being a business, there's certain areas where you can grow a business or you belong to certain departments where you really want to make an impact, but all those things fail if the customer doesn't want it. And so really getting honest about what the customer wants I think is central and critical. Otherwise, you're just really ultimately wasting resources.

Clay Hausmann: Yeah, for sure. So the industry has taken a number of different turns through the last 30 years. I'm curious, what would you say is the single biggest shift you've seen in the industry with regard to the work that you've done throughout your time at Merck?

Deb Cava: I think there's really two big shifts. One is the role of data and technology, and when I think about data and technology, especially in healthcare, I'm thinking about it from the clinical perspective. And then I'm also thinking about it from the commercial perspective. So, you see the advent of technologies that can process vast amounts of data. You have AI that can help you make smarter decisions as a relates to therapeutics, as it relates to diagnostics but then the second big area is around the commercial space. How do we consume vast amounts of data about our customers? How do we understand what motivates them? How do we use and leverage AI to predict what's going to be meaningful to them and what's going to make a business difference? And so I think data and technology has just been transformational. When I think about when I started in the company, the data and technology is not anywhere near what it is today. I mean, it's been a profound change, not just commercially or clinically, but in everyone's everyday life. So I think that's one place and then the second place, at least in the healthcare industry has been about how those shifts in data and technology influence other areas. And I'd say in the commercial space, one of the more profound areas is the role of the representative. When I started in the company, the representative really was the sole and primary channel to convey information about our products. Now customers are engaging online and they can get probably a wider variety and depth of information very quickly. They're not going to just wait for the representative to show up, or they may not allow the representative in for different reasons. So I think about how is a role of the representative shifting? Again being honest, what does the customer need from them? And it may not necessarily be your traditional clinical information so to speak, because they can get that elsewhere and much more quickly.

Clay Hausmann: I have a feeling you're alluding to this, or you're setting up my next question a little bit, but what do you think is the single biggest shift the industry still needs to make then, in order to be more successful in serving the customer better?

Deb Cava: I really think it is about at least on the commercial space, we have a wealth of data, we have a wealth of technology options. I think the next big transformation is going to be about how do you use that effectively to optimize your investments, to engage your customers more meaningfully? I'd say, as an industry, we're in a very nascent stage. I've seen this problem. Maybe problem's not the right way. It's a learning curve. So companies have sat on a wealth of data for many years. Now you've got technology that can process it. Do we really know how to maximize for the business what that opportunity is for us? Are we asking the right questions? Are we providing the right structure? Are we enabling the right organizational processes and people to really optimize the capabilities that are out there? My hunch is that we're really not. We may buy capabilities, we may buy data, but are we really leveraging them to its fullest potential? I think we're not, even with what we have today. So I think that's the next big horizon, is organizations seeing what they're sitting on and then starting to think about gee, how do we structure differently to really maximize what can be really competitive advantage if we get it right first?

Clay Hausmann: I'm almost positive you're going to say both to this question, but if you think, you had a theme in there about structure and which is more important and more influential in terms of achieving greater success here? Is it about how you structure your data to be able to use it more effectively, or is it about how you structure your organization so that the people who are utilizing that data are set up more effectively to partner and to serve the customer?

Deb Cava: It is really both. You have to have the right data, you have to structure it the right way. You have to structure the right people, from the people who are getting the data to know what to get, how to get it, how to consume it. And then most importantly, what are the right insights that need to be garnered from it? Or what are the right technologies the different data feed, so that the capabilities can do its magic? I think both are really, really important in order to get to that optimal state. I mean, I think most companies are still pretty far behind as far as having it all come together.

Clay Hausmann: For sure. It's an unfair question. There's no way you can separate those two, the data that you're utilizing and then the teams that are utilizing that data, they both have to be structured in the right way. So let's talk about omnichannel for a minute, because we can't have a podcast on this topic without talking about omnichannel. It's obviously a huge focus for the industry as a whole, but if we flash back to 2008, you are Merck's multichannel marketing director and you're responsible for developing global multichannel programs. So this is 13 years ago. So when you see the industry's fascination with omnichannel right now, do you kind of smile, roll your eyes a little bit? Say, " I was working on this nearly a decade and a half ago?" Do you say, " No, this is exciting to see the momentum finally speeding up and we're getting there more quickly?" What is your reaction when you see this enthusiasm over omnichannel knowing that some variation of this term has been around for quite a long time?

Deb Cava: I'm relieved, because I very much remember the early days of trying to convince stakeholders across the organization that they should just invest in digital also, from simple emails or videos that can be sent digitally. I'm relieved because to me, that progression, it's like when people use the word omnichannel, what I'm thinking about is they're looking at all channels as an option, whether it's a personal channel, a customer- facing representative, or if it's a digital channel. To me, omnichannel is they're looking at them all as having equal shots at engaging the customer, delivering the information or the solution or service that the customer's looking for, and it's not about separating a Salesforce versus digital channels. So in a way, it's a big relief people are looking at engagement channels more holistically, because that in my mind is a big part of what is meant by omnichannel. It's looking at the whole set of things, whole set of channels you could use to engage a customer. It may be other thought leaders, and maybe it's not exclusive to your own sales representatives. It's what are all of the ways holistically you can engage a customer. And then also thinking through what's that overall experience that the customer wants, being able to know that, to define that, and then to be able to live up to that across your engagement options.

Clay Hausmann: So you defined omnichannel correctly in my mind, which is all the channels, but I find that often in our industry, omnichannel's used as a term anytime you're talking about multi-channel. You're talking about a number of channels two or more, and my question to you is you've worked on this a lot longer than a lot of other people in the industry. Do you see omnichannel as in every touch point, every channel, every actor in the process being a feasible goal, is it near or is it enough that we are making progress towards multi-channel? Towards digital touch points versus in- person and sales and marketing collaborating? How do you see the definition and the reality of trying to pursue what in the truest definition of omnichannel could be quite ambitious to pull off, but still very important?

Deb Cava: I mean, I think omnichannel is a North Star. Nobody's really completely there. So I think in really realizing omnichannel, you have to start with the customer and an N of one, because they have different preferences and tolerances, for the extent to which they will accept a representative or accept very specific channels or vendors, or just want to be informed by their colleagues on certain things. It's going to depend on what's the type of information the customer seeks, and what's the channel agnostically that the customer wants to receive that information through or get that information through? And I think the part of the Herculean exercise is to be able to define that across your customer base and then smartly segment your customers based on the way the customer wants to receive information. And what is that information, and then being able, and this is the second big Herculean piece, work with the different stakeholders across an organization that are responsible for those different areas, whether it's a Salesforce or the digital marketing group, or the people working with thought leaders, or the people working with conventions and professional societies, to be able to very clearly define, " Here's your role," with that specific customer. And then to be able to execute against that. I think that's the omnichannel North Star, but there's a lot of steps to that.

Clay Hausmann: And how is that progressing at your company? So that alignment so that the teams, the individuals that need to work together to make sure that there is the alignment, so that the messaging that arrives, the experience that arrives for that N of one customer that you mentioned is consistent? Have you seen the measurement, the incentives, the structural design improve over the last several years, so that you're now seeing the ability to deliver upon that very consistent experience?

Deb Cava: Yeah, I mean, definitely the intent is there and I think organizations have been stood up to help us get there. We have quite a journey ahead of us, but I'd say over the last decade and a half, most companies are probably trying to put the right things in place, the right pieces. I think the next big step is how do you integrate it all? And how do you have really a cohesive way of developing the strategy across omnichannel and being able to work as an orchestrated organization to execute that?

Clay Hausmann: Where would you say your company is on the curve as we try to assess the impact of what we've just gone through in the last 18 months on the commercial process, on the interaction with healthcare providers? Are you starting to figure out what your go- forward plan will look like, and get settled on that? Or are you still assessing the shifts and waiting before you make those kinds of commitments, trying to stay nimble, I guess so to speak, because it has been so unpredictable lately?

Deb Cava: Merck is at an advantage because it started its journey about 15 years ago, and I think investing in data and technology that gives us a competitive advantage. So when COVID hit, we weren't trying to figure out how to do digital for the first time or figuring out how to structure the right engagements for different customers. So I would say post- COVID, we've had to be nimble I think as an organization. We've shown we've been able to be nimble and respond to some of the different obstacles that have been thrown our way, but in an effort to realize true omni-channel, as we were talking before, I don't think we're ever done. We still have I think a lot of opportunity ahead of us in parallel.

Clay Hausmann: One thing that we spend a lot of time working with our customers on, and I'm sure it's very similar for you, especially the different roles you have is striking that balance between global and local. So there's obviously great advantages to standardizing on different processes or different tools or technologies globally, because you can share best practices. You can gain efficiencies, but the local teams know their markets and their customers best. And you don't want to shift so far in the direction of standardization globally that you lose that local competitive advantage. What kind of perspectives do you have and have you developed over your time at Merck in the different roles, in terms of striking that balance most effectively?

Deb Cava: That's a great question. And what I've come to learn is different organizations, global organization's remit can be a little bit different. So in some organizations, that global is the centralized place, whereas in other organization's global more works to understand what's the common denominator across market, so we don't have redundancy on those things? But then any extension beyond that, it becomes really the local market's responsibility. To me, in reality, that's played out, so if you look at some of the commercial capabilities, even data, what's allowable from a data perspective can be very different market by market. So you can't really process it centrally for the whole world. Access to sales data, we have that in the US, but in a lot of markets, you can't get that at the customer level. And that becomes really valuable in the market like the US right? You do X, it has Y sales impact. If you can't have that sales impact data, then you're really restrained. And I wouldn't want us in the US to be restrained by legal limitations in other markets. I don't know if different markets have different limitations on technology, they probably do on the boundaries to which you can leverage a technology's capabilities. So I do think when all is said and done, global can play an important role in maybe making a central buy of a capability or technology, but then how it's used in the market is often determined by the local rules, but then also commercial strategies may be different in different markets. So this is where the capability, its use has to be translated by the market.

Clay Hausmann: Yeah, that makes perfect sense. And is obviously an important dynamic to get right, because you do get the best of both worlds with the efficiencies, but also the local knowledge and application of strategy in that way. You as we mentioned at the outset are the Portfolio Strategy Director in Oncology in your current role. How long have you been in Oncology right now?

Deb Cava: This'll be my sixth year total in Oncology.

Clay Hausmann: So a very basic question to start, what did you learn in that shift as you entered into oncology that maybe surprised you in terms of how you needed to adapt your experience and your approach to what is a very unique part of the market and the way that commercial teams interact with HCPs?

Deb Cava: I would say the complexity. I mean, throughout my whole career, working in both primary care and specialty, I've never encountered the complexity of Oncology. We sit on a brand that helps many patients as the result of being indicated for many different tumor types. We have to engage a lot of different customer sets, and so the complexity of trying to figure out how to go to market across the complexity of having so many tumors and said another way, you have so many tumors who want to tell their story to a single customer. But again like I was saying, you have to flip that equation backwards or upside- down and say, " Well, what does the customer want to know about?" Just because it represents a business opportunity for one tumor, if that tumor only represents 2% of the customer's business, was it really worthwhile to deploy that content versus the five other tumors that represent 90% of that customer's business? So how do we prioritize for the customer? And as I was saying in the beginning, get honest about what's important to the customer, whether it's your tumor, whether it's the type of information they need, whether it's the type of channel they want to engage with. I think that's where the magic is, but it's challenging to get there sometimes, because we have such a huge portfolio of opportunity.

Clay Hausmann: Yeah. And it's only natural that obviously, the way a company is designed and the way a team structure is designed, if it's around indications or tumors, then they have a motivation to try to achieve their goals for that particular area. But to your point, the most effective approach will be to flip it 180 degrees and think about the customer's priorities and needs, and then design programs to match that. So Deb, one thing you described to me when we talked last week was around the complexity that is growing all around the end customer, and yet the end customer isn't becoming any more complex. It's still an N of one customer that is trying to provide the best possible care that they can, but everything around them in this commercial engagement process is growing in significant numbers. Can you describe a little bit about how you summarize that and how that is really the challenge that the industry needs to get on top of?

Deb Cava: I think it's one of the most profound challenges. You had asked me earlier about the oncology space and I have never in my 32- year career seen an area just exponentially explode like oncology has. And I mean, it's great for patients, but what the reality is is you may have a single compound, like at Merck, we have Keytruda. It's a single compound with many indications, with many more to come. And new mechanisms of action that are going to come to market as well. And the combinations of these different entities generate more solutions for patients, which is the good news. But as we try to market multiple promotions, multiple brands and all the information, the net result is an enormous amount of content and tactics hitting the customer. Now I have a view of what it looks like within Merck, and I think Merck is really great in that it's fully trying to be honest about what is it that the customer needs, but I think about what we're doing times, every other company trying to engage that very same customer. And if you're walking in the shoes of the customer, you're waking up, you're assessing the patients that you have to see that day. You're working with that patient. You're working with their family. You're trying to make those decisions. They cannot consume the volume of information, and we hear from customers, they are overwhelmed. The rapidity at which oncology is evolving is so fast and the information, and abundant is probably too little a word. It's overwhelming for our customers and I think we have to think, " Are we contributing to the overwhelm or are we helping the overwhelm?"

Clay Hausmann: Well put, for sure. Well, Deb, I'd be remiss if I didn't ask you, what does the next 32 years of Deb Cava's career look like?

Deb Cava: Oh my gosh.

Clay Hausmann: As the first 32.

Deb Cava: I don't know if I'll be alive. That's question one, will I live 32 more years? God willing.

Clay Hausmann: I think so. Maybe we won't be recording this on your 64- year anniversary at Merck, but-

Deb Cava: Oh, you're so sweet.

Clay Hausmann: Let's transition into a section we call... We're going to call it for this episode obviously, Deb Cava In Context. I'm going to ask you some questions about personal influences and interests, that's going to give our audience a little more context, a little more profile about you and what shapes your views on your career and the world. So Deb, who has been an influence on your career that might surprise us?

Deb Cava: Probably my mother, because number one, her strong work ethic, her ability to get through a challenge, and I've made it very known that I actually love the white space. It's not fulfilling to just go into a role where it's well- known what to do, how to do it, what its remit is. To me, what's exciting is creating new value for an organization. And I've found my mom often just faced with challenges in coming up with creative ways to solution. And so I think her influence on me has just carried through in what I become passionate about. It's like, I love having just a white space and figuring out how do you create value for an organization in an undefined path?

Clay Hausmann: If money was not a factor, what career would you most like to pursue?

Deb Cava: Probably working with children. I love children, and I think the common thing between what I love now and when I reflect on why would want to work with children, I think one of the most fulfilling things as a parent for me was teaching my children how to read. You start with the As, and you learn the sounds. And then all of the sudden, they learn to read a word. It clicks. And to me it's like, that brain was the white space, and you made something happen. And so it's probably the same sort of sense of fulfillment where you're showing an organization how to read value out of something they really didn't see before, or connect before.

Clay Hausmann: It is fascinating. It's probably not a great topic for me to dig into right now, as I take my son to the airport tomorrow to go back to college, I'm feeling very nostalgic as you see, how they evolve, the kind of people they become, but it is fascinating. What profession would you most not want to pursue, no matter what it paid?

Deb Cava: IT or accounting, because I'm not a detail- oriented person. And if you'd have to code the right way or crunch numbers in an exacting way, I'm sure I would entirely fail.

Clay Hausmann: Would your IT colleagues be surprised by that, or would they endorse that?

Deb Cava: They would endorse that. They should endorse that.

Clay Hausmann: All right. What is the best book, film, or show that you've enjoyed recently, and why?

Deb Cava: You know what? I won't say recently, but I'll tell you a book that I think had a really profound effect on me was Emotional Intelligence. So this is going back many, many years ago, but especially growing up Asian, you're very much wired into get good grades, when you work, do the best job, work really hard. I think that whole emotional quotient factor was something that was entirely lost on me. And so that book, that single book probably had the most profound effect on me to understand like your ability to build relationships, the ability to build trust is really cornerstone to long- term success in any field and every field. And it's not just work, it's in every aspect of life. So that would be I'd say the most influential book. To be honest, I don't get to watch TV or go to movies much. Between work and my children, that's really it. I'm just in that crazy phase of life.

Clay Hausmann: I love that answer about the Emotional Intelligence book. We could do an episode entirely on EQ and the importance of it across industries, our industry, and any industry, as you were pointing out. Okay, you're at a family gathering and your eight- year- old niece asks you what you do for a living. What do you tell her?

Deb Cava: I have a role called marketing, and the heart of my role is to help our customers understand how our medicine can help their patients.

Clay Hausmann: That is a great answer. Very, very clear and very, very much focused on the most important part of it. I love that answer. Last question here, then you're released from the personal inquiry. Your ultimate dinner party for four, who is in attendance and what are you serving?

Deb Cava: Oh my, so this is reflective of my stage of life, but honestly, if I can get my husband and my two children sitting at dinner, that's four, in the same time at the same place, that is nirvana for me. I'm just in the stage of life where my kids are so active, and I feel like man- on- man coverage. I usually take my daughter. My husband usually takes our son, and we're like ships passing through the night all the time. So it's a real gift for the four of us to be able to just sit and have dinner together and catch up, and as far as what would be served, I love ethnic food. So anything ethnic would be amazing. I'm Korean. So whether it's Korean food, or I love, love Mexican food, having grown up in California. I love Indian food. I love Japanese food, and I'm adventurous. So if there's a food I haven't had, I'm all in. I would love to try it.

Clay Hausmann: I would imagine on your family answer if you're like us, you're like, " If the whole family's at the table, I don't really care what's served as long as somebody else has made it and I didn't have to make it."

Deb Cava: That's true. Pizza is always fine.

Clay Hausmann: That's right. Deb, it's been a real pleasure to have you on. I really appreciate you taking the time and sharing your perspectives with us.

Deb Cava: Thank you. It's been so much fun.

Clay Hausmann: That's it for this episode of Contextual Intelligence. I'm your host, Clay Hausmann. You can find all our episodes on Apple Podcasts, Stitcher, Spotify, or wherever you get your podcasts. And please, leave us a review or a comment or a question or all of the above, so we can make sure that this podcast brings the proper context to your work. Thanks everybody for joining us.