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The Strength of Weak Ties in HCP Networks

Braydon McCormick
Objective: In this article we discuss a new addition to the Strength of Weak Ties model and apply it to the relationship between healthcare and life science companies and healthcare professionals, opening new methods, initiatives and outcomes when leverage the sharing of scientific content between these groups.
TL;DR: Narrowing and clarifying CARES (Context, Alignment, Reputation, Expectation of Effect, Signalling) within a social graph increases the ease and rate of information transmission across the graph, leading to stronger knowledge alignment and relationships.
Note - the original strength of weak ties model pertains mostly to the mapping of the relationships between tightly knit primary networks of people, rather than focusing on the definition of the tie between dyads of individuals. Here, we modify the theory to add further definition to the tie between individuals and explore the impact on transmission of information across networks within a work setting,_      _to help understand the impact of those ties on the transmission of scientific information and clinical practice sharing between life science companies and HCPs.

What makes a (strong) tie, and how is Life-science affected?    

In a work setting, the tie between two individuals (known as a “dyad”) is more specifically defined than in the standard view of a dyad (which is usually based on time and quality of time spent and contributions to the relationship) by including more focused elements of the dyad: context / event of the relationship, the alignment and overlap of the skills and backgrounds of the members of the relationship, the relative credibility and status of the individuals in the relationship (“reputation”) and the perceived possible (positive or negative) effect on the relationship. Also by adapting the network model to include two-mode measurement, in which there is both the dyad of actors intersected with events in which those actors participate, provide a stronger relationship model to assess and facilitate network information transmission.
Generally, we say that a tie in a dyad is stronger when these elements have a higher degree of overlap. Taking those elements into consideration and the overall purpose of work as a goal-oriented activity, the strength of any given tie must be considered only in relation to a work goal and the perceived desire of the dyad to participate in the goal.
Life Science companies can increase the rate and ease of transmission of key messaging and positively impact clinical outcomes by gaining the trust of HCP’s through better aligning their content, channels and communication strategies with semi-structured HCP networks.

CARE: Categorizing work-driven, HCP Network Formation:

Foundationally, the goal of a work-based activity has a desired outcome and requires actors to complete it. In the context of a network, actors form dyads where there are two actors connected. While it is possible to connect more, the most effective human transmission appears to be between individuals. And as these are shared human endeavors, each goal requires one or more actors to participate in the completion of the goal. The appropriate context, skills, background/experience, credibility of the actors and their perceived ability to affect positive outcomes of the goal are all important to gauge the impact of a relationship tie.
To understand the strength of a tie in a work relationship, we must consider the following categories below. Each category can be scored high (3) medium (2) or low (1), for the tie itself. The aggregate total indicates the level strength for the tie - relative to the goal of the usage of the tie. _Note that the score is related to the tie of the dyad, not the individuals. Note also, that there are methods to reduce the subjectivity in assessing each category._
Context: The degree of specificity of the context of the relationship. For example, do the members of the relationship share the same functional role, or share the same industry environment? We can "finger in the air" measure this as high-med-low:
Alignment: The degree of alignment in the skills and experiences of the dyad: For example, do the members of the relationship have similar work backgrounds, or education? We can "finger in the air" measure this as high-med-low: _Note: First order skills are the ones that are the hard skills of a profession: e.g. surgeon using a scalpel or a programmer writing code in C+._
Reputation: The relative credibility of the members: For example, does each member have a high regard for the credibility of the other, or in lieu of direct experience, do the socially accepted norms of credibility apply to the relationship (e.g.: Medical Doctor vs a layman). Can be measured for each context, but not for the individuals themselves.  For example, a HCP may not have a high reputation for IT work in an IT setting, but may have a high reputation in a surgical theatre. Rank high, medium, and low.
Expectation of Effect: The perceived effect of the relationship: For example, does each member have a strong belief that the relationship could have a positive effect on their personal context? Rank high, medium, and low.
Signal: The degree of indication of intent by the individuals in the tie. Meaning - to what degree has intent to take action been indicated? E.g., Rank high, medium, and low.
The development of the ties themselves for HCPs can originate from a wide variety of sources including educational environments (both early and CME based), clinical and scientific projects, conferences and symposia, industry Ad Boards and speaker programs. There are many others of course, but the degree of context overlap in these scenarios seems to lead to higher rates of tie strength.

Some scenarios to illustrate how tie strength works:

Scott and Mary (strong tie): One is a paediatric neurosurgeon, and the other is a paediatric oncologist - in different hospitals. Their medical residencies overlapped, and they have performed surgeries together at a visiting hospital. They respect each other’s first order skills and educational backgrounds. They refer patients to each other and recommend each other for giving presentations at other hospitals. They see each other once or twice a year at most, speak infrequently, and outside of work have no friendship or family relationship.
Francine APRN and Joseph (weak tie):  Mary is a APRN anaesthetist focusing on neurological needs, while Joeseph is an on-site help desk technician in the hospital system where they both work. Their educational backgrounds are very different, their work context is very different, their skills are very different, and they have no social overlap.  For “computer questions”, Joseph’s credibility is strong for Mary, but for medical related questions, his credibility is very low. For Joseph, Mary’s credibility is high for medicine in general, but he knows little about the specifics of her work.  Joseph has been in and out of Mary’s regional office for tech support on a normal, regular basis for a couple years, and they have a friendly rapport – enough to know each other by name.
Mike and Jane (possible moderate tie):  Mike is a Family Practice Physician who owned and ran a small family practice of 3 HCPs and 8 nurses for over 20 years. Jane is a 32-year-old Radiologist who, before she was certified in radiology, worked in real estate, but now she wants to start an outsourced radiology company that she thinks could be a new way of providing radiological screening outside of the hospital setting.  Their educational backgrounds are very different, their first order skills are different, and their work environment (on the surface) is very different.  They recently met when Mike was having a bone densitometry screening.
⁠

Evaluating ties on goal outcomes:

Goal and outcome 1: Medical Device Sales: Mary and Scott: Mary has encountered a medical device sales rep who is attempting to sell a new laparoscopic surgical device related to paediatrics. She would like to get more, non-sales information related to it. She turns to Scott for his input - they agree to demo and test the device together on the next appropriate surgery.
Goal and outcome 2: New Home Theatre installation: Francine and Joseph.  Francine decides she wants to install a new home theatre to get the most out of the new Star Wars shows on Disney streaming.  She knows nothing about home theatre or technology but remembers that Joseph is always so helpful with computers.  The next time she sees him, she asks if he could help her.  He does not know much about home theatre but remembers his friend Frank does – so puts them in touch – Frank helps Francine build her system and they watch the Mandalorian, Season 3 together and then get married. How sweet.
Goal and outcome 3: A brand new business: Jane and Mike.  Jane does not really know how to start or run a business. While Mike is not an expert in Radiology, he does understand the ins and outs of a medical practice and offers to guide Jane. Jane is grateful and takes Mike’s advice – the practice gets off the ground with Mike as a key early investor.  Jane up-ends the industry and wins innovator of the year.  Mike gets a nice card every Christmas along with a fat dividend check.
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HOWEVER.... If you were to apply the goals to the other scenarios - then the obviousness of the importance of the context becomes apparent:
Goal and outcome 1: Medical Device sales: Mary and Francine: Mary asks Francine about a laparoscopic surgical device she is hearing about. Francine knows nothing, suggests instead they scan the device, then grab a beer and enjoy the warm weather. Mary never tries the device. The rep gets fired for poor performance.
Goal and outcome 2:  Home theatre: Francine and Mike: Francine wants a new home theatre and, knowing how successful Mike has been, asks him for help.  Mike is a luddite, but feeling silly, scoffs at her, so Francine decides to try it herself. She drops a $3k TV on her foot and must go to the hospital. Thankfully Joesph is there for a colonoscopy, so he recommends Frank to her.
Goal and outcome 3: Starting a new business: Jane and Joesph Jane wants to start a business but does not know where to turn.  She remembers Joseph from when she was at hospital, and he seemed savvy.  She asks him for help. He googles a bunch of business materials and helps her write a business plan.  It is not great plan, and she spends her life savings on a strategy that fails. It is tragic really; someone with more experience would have been helpful.

Why ties are important and how do we use this information?

To take advantage of any given work relationship, it is critical to correctly align the properties of goal with the properties of the ties in the relationship that most closely positively impact the goal. Considering external cultural factors of influence concerns, for the purposes of improving the alignment of a Life Science company with healthcare professionals, it's even more important.

What makes a (strong) tie, and how is Life-science affected?    
CARE: Categorizing work-driven, HCP Network Formation:
Some scenarios to illustrate how tie strength works:
Evaluating ties on goal outcomes:
Why ties are important and how do we use this information?
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