Development of a Digital Media Communication Strategy

Executive Summary

Rockfield Medical Devices (RMD) Ireland, founded in 2014 is an organisation committed to improve the mobility of the life of enteral tube feeding patients. They specialise in production of tube feeding pumps and tubes which are energy efficient, mobile, easy to use and user friendly. This report focuses on the identification and evaluation of the digital marketing channels for Rockfield Medical Devices. This report analyses the competition, validates the market, recommends the most profitable channels of marketing in the US market for Rockfield Medical Devices.

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In order to achieve the primary objective, extensive research was undertaken. To draw recommendations for the company, a comprehensive social listening to the competitor’s digital marketing channels was undertaken. An interview was conducted with (Company X’s Employee) who provided live insights into the target market of the Rockfield Medical Devices i.e. The US. For this interview, a semi-structured questionnaire was prepared and pretested rigorously to ensure optimum reliability and authenticity of the first-hand information obtained.

As per the research conducted, Cardinal health USA, makers of the Kangaroo Joey Pump can be seen as the main competitor with its features and market share. Cardinal health has been in the US market since 1971 and as of 2018, its revenue stood at $136.80. The products primarily require electricity to work and an IV pole which give rise to a set of problems like inconvenience due to battery life, burden of carrying the equipment around and lack of discretion. The number of home enteral nutrition dependants skyrocketed in the US from 463 per million population in the United States in 1995 to 1385 per million in 2011. The competition does not have a strong social media presence from its side Most of the content and awareness comes from third party sources, mainly influencers.

The Mobility+ has plenty of scope owing to the fact that it offers mobility, discretion and doesn’t rely on an external source to work. The competitors rely on suppliers and influencers to spread word through social media.

It is recommended that RMD should actively reach out to tube feeders through its social media pages. It should communicate with potential influencers and rely on suppliers to spread word about the product offering. RMD’s key features are first of its kind and clearly differentiate it from existing brands which it should use as a trigger to enter the market.

Section 1 – Introduction

1.1 – Rockfield Medical Devices

Incorporated in 2014 with 7 employees, RMD is an Irish firm with a goal to make enteral tube feeding more mobile and provide certain quality of nutrition. The main objective of this is to make products which are mobile and run without a power source, which gives its users the feel of normal people and not that they are bound by some condition which hinders their mobility.

The target market Rockfield intends to enter is the US market, with around half a million of users requiring tube feeding. Plus, Rockfield () says that the products currently sold in the US are complicated, cumbersome, offer less mobility to the users and they do not feed the patient discreetly (A sound of whirring or buzzing of the electric motor can be observed).

1.2 – About the Product – Mobility+

The Mobility+ Enteral Feeding System is a portable, lightweight, non-electronic, disposable enteral feeding system intended to deliver commercially available standard* liquid nutrition formula to a patient using a standard, previously implanted gastrostomy tube with an ENFit connector in the clinical or home care settings. The Mobility+ Enteral Feeding System will comprise of 3 components; the food pouch, a filling set, and a giving set.

The Food Pouch will serve as the Mobility+ System’s combined reservoir and pump. It is a foil container with an internal silicone elastomeric pouch. When the pouch is filled with feed by the user, it will inflate. This inflation creates a mechanical force that will subsequently dispense the feed in a controlled manner, without any external energy source or need for gravity. The nominal volume when full will be 500 ml. The food pouch design is based around mobility for the user and freedom from a static position.

The ‘Filling Set’ is tubing that connects to the Food Pouch and allows for filling of the pouch with feed.

The ‘Giving Set’ (also known as ‘feeding set’ in the US) is used to connect the Food Pouch to the gastrostomy tube and regulates the rate of food dispensing. The end connections between the pouch and the sets will use ENFit enteral feed connectors (a standard connector type for use in enteral feeding devices). The 3 components of the system will be supplied in one procedure pack, with the system designed for 24-hour use before disposal. In addition, an ENFit 60 ml syringe will be required to be used to fill the system. A set of 30 units will be equivalent to 1-month supply. Users may choose to wear the system in a bag (e.g. handbag/cross-body bag) on the body, or in an undergarment with a pouch that can fit the system

Figure 1 Drawing of procedure pack containing Food Pouch, Filling Set and Giving Set

Source: Rockfield Medical Devices

1.3 – Background

As Rockfield’s primary objective is focused on the US market, which  takes up 38% global enteral feeding device market, this report offers suggestions and recommendations to Rockfield in order to float their Digital media on the American web, communicate the Mobility+ to American users and develop its brand awareness. The researchers examine the digital media communication strategies of the companies in the US which manufacture tube feeding devices in order to propose a Digital Media Communication Strategy for Rockfield Medical Devices.

After examining the digital media communication channels of the companies in the US, the researchers felt the need to propose a new strategy, and to make the users of enteral tube feeding devices aware that there can be a new product with better features and characteristics.

Rockfield Medical Device’s products offer mobility, secrecy and user-friendliness which the researchers considered as unique features which can be communicated through digital media to the users, their caretakers and the other budding entrepreneurs who wish to specialise in the same products.

1.4 – Objectives of the Research

The primary objective of the research was to Develop a Digital Media Communications Strategy for Rockfield Medical Devices. As the primary target market is the US, the competitors in the market and their digital channels were studied to reach this primary objective the following secondary objectives were undertaken:

The researchers identified the number of enteral tube feeding patients in the target market and also the number of types of tube feedings on which the patients relied. In order to launch Rockfield’s product into the US market a competitive analysis with Kangaroo Joey Tube Feeding Pump was conducted, and after finding the gaps, value was proposed to Rockfield’s products. While analysing the competition, their digital marketing channels and digital media available over the web (through the company or through the third-party) was examined in order to get an explicit picture of ‘What’ content is used and on ‘Which’ platforms.

1.5 – Report Overview

In section 2, the GAP analysis undertaken by the researchers will be discussed in detail to ensure proper understanding of the gaps and how can Rockfield’s products can fill the gap. The opportunity for Rockfield Medical Devices in the US market, the data collection method and analysis technique adopted by the researchers in writing this report are discussed in detail in section 2 of this report. After discussing the above components of the research, the researchers have listed out the findings, drawn conclusions and provided recommendations to Rockfield Medical Devices on ‘Developing a digital media communication strategy’ in the following section 3 to 6.

Section 2 – Research Methodology

2.1 – Research Scoping

There are around half a million people in the United States who lack the minimum required nutrition and have to rely on tube feeding. Many of them have swallowing or digestion conditions. Some of the patients have a temporary tube for tube feeding while the others have a tube surgically attached to their stomachs. Home enteral nutrition, also known as HEN, is a common practice observed nowadays wherein the patients tube feed themselves through their devices at home and they do not have to rely any caretakers or nurses. For the ones who rely on tube feeding, it means that they can have an active role back again, which was once threatened by malnutrition or certain condition leading to tube feeding.

In the past decade, there have been significant improvements in the tube feeding devices available in the market. First the gravity bags, which released the feed through tubes by gravity. Then came the automated pumps, which enabled the users to have the tube feeds without holding the feed bag on a height. The automated pumps though, rely on electricity to pump the food through the tubes. Let it be gravity bags or automated pumps, the users felt trapped by sitting in one place to have tube feeds. Though many modern features were there, certain features like mobility, compactness and discreetness were not observed in these products.

These variations in enteral feeding tubes and pumps gave rise to a need of a more mobile, compact and sleek device which fed the users discreetly. A tube feeding patient (regardless of the condition) feels the need to be active in their life like anyone else.

2.2 – Problem Definition

Internet being a useful invention of the 20^th Century, is used by 48% population of the world. Producers of Tube feeding devices have less proclivity to float information or communication effectively on digital platforms, which in-turn leads to unawareness of the users or their caretakers. Description of the device, usage guidelines, feedbacks, etc. should be easily available over the web so that the reliance on documented user manuals can be prevented.

After an extensive desk research through various online platforms to check the digital media publishing by these tube feeding manufacturers, the researchers reached the decision to set ‘Development of digital media communications strategy’ as the primary objective and to reach the aforementioned primary objective, the following secondary objectives were undertaken;

• Identification of the number of tube feeding patients in the United States, which enabled the researchers to;

• Understand the number of patients who rely on tube feeding in the US

• Value proposition for Rockfield Medical Device’s products in the US by;

• Understanding the existing product, its features and its awareness.
• Find the gaps in between the competitor’s products and Rockfield’s products.
• Propose value to fill in the gaps found.

• Analysing Competition and their digital communication strategies to;

• Understand the product range of the competitor/s.
• Examine their digital marketing handles (Facebook, Twitter, LinkedIn, Company Website, etc.) to see the content related to tube feeding.
• Select appropriate channel for Rockfield Medical Devices to digitally market their product and to release content related to tube feeding for the education of the patients and their caretakers.

2.3 – Research Design

The researchers adapted an exploratory design of research to explore the unavailability of the digital content related to tube feeding. The researchers observed and felt the need to explore this area of the tube feeding device manufacturers.

2.4– Data Collection

2.4.1 – Secondary research

The researchers conducted rigorous secondary research by accessing and examining the online content of the existing tube feeding products in the US market. The information regarding the products and the specifications was available on the company website as well as the product user-manuals or guides which were available on the website. For the digial communication related research, various digital media channels such as YouTube, Facebook, Instagram, Company Websites and Online Discussion Forums were examined. Special attention was given to the fact that whether the digital media is made available by the company through their social media handles and websites or are there any third parties who published content for the company i.e. users or influencers who post on social media about their experience of using a specific product.

• Review of academic literature –

The focus was to investigate the number of patients in the United States of America who rely on tube feeding. The researchers made use of the NUI Galway Library database to search for Journals and Articles to support the academic literature. Journal for Parenteral and Enteral Nutrition (JPEN) by The American Society for Parenteral and Enteral Nutrition was referred to extensively throughout the research.

• Keywords:

1. Enteral Nutrition
2. Tube Feeding
3. Home Enteral Nutrition (HEN)
4. Percutaneous Endoscopic Gastrostomy
5. Gastrointestinal

• Review of industrial literature –

The focus of this research was to understand the product specifications and learn about the traffic of digital content on various platforms. A comparison between Rockfield Medical Devices and Cardinal Health USA was carried out to understand the specifications of the product in order to propose value for Rockfield Medical Device’s product in the US market.

2.4.2 – Primary Research

The researchers conducted an interview with a nurse who has worked for enteral tube feeding patients. The questions of the research were emailed to the nurse. The questions were mainly focused on product description and benefits and side effects of the tube feeding products in order to get to know ‘What’ discomforts a patient of enteral tube feeding faces and design the study to show ‘How’ the Mobility+ is better in that perspective.

A semi-structured questionnaire was designed by the researchers to conduct surveys with the tube fed patients or their caretakers in order get the exact pragmatic state of the products available in the market and their usage.

2.5 – Data Analysis

Content analysis method was used to analyse the data researched by the researchers because, the primary focus of this report is to develop a digital media communication strategy. A competitor analysis was done between Cardinal Health and Rockfield Medical Devices to understand the current standing of Rockfield. Then a SWOT analysis of Rockfield Medical Devices was conducted to unveil the internal and external factors.

The researchers selected Cardinal Health Kangaroo Joey Pump as the primary competitor for this research study because;

Other enteral feeding products in the US market possess similar features to that of Cardinal Health. Some of the features include Reliance on power source, bulky device, maintenance, etc. And Cardinal Health is in the US market since 1971 and the Revenue is $136.80 Billion as of 2018. Hence, to compare with an established company and provide effective recommendations Cardinal Health USA was decided as the primary competitor for this research study. (Market, 2019)

2.6 – Limitations of the Research

• The researchers were not able to conduct the face-to-face interview because the target market of the company is in a different geographical location and the researchers were not able to reach it physically.

Section 3 – Tube Feeding in the US

Around half a million Americans with swallowing or digestive problems manage tube feedings – also called home enteral nutrition – on their own. Some have temporary feeding tubes, while others leave the hospital with feeding tubes surgically placed for the foreseeable future.

Veteran users or “tubies” accept long-term feeding tubes as the best or only way to nourish themselves. Many resume school, work and social lives that were once threatened by severe weight loss and malnutrition. For them, getting a feeding tube means getting their active lives back. (FEEDING TUBE AWARENESS WEEK, 2019)

• Types of Feeding Tubes –

Feeding tubes can be temporary or longstanding. Nasal tubes and gastric tubes are the two main types.

A nasal tube, which is usually temporary, is nonsurgical. Nasogastric tubes enter the body through one nostril and run down into the stomach. Another nasal tube, called a nasoduodenal tube, goes into the small intestine, or duodenum. A nasojejunal feeding tube goes into a farther part of the small intestine, the jejunum.

A gastrostomy tube, or G-tube, is often the choice for people who need longer-term feeding tubes. Surgeons use an endoscope to place the G-tube directly into the stomach. The surgery creates a stoma, a visible opening that connects to the feeding tube outside the body. The feeding tube allows people to take specialized liquid nutrition directly into their stomach.

Gastrostomy tubes are often referred to simply as PEGs. Specifically, PEG means percutaneous endoscopic gastrostomy. The visible portion of the feeding tube is permanently attached. However, people can transition to other options.

• Home Enteral Nutrition –

Enteral nutrition administered to outpatients by a tube is known as home enteral nutrition and may be an option for patients who require life-sustaining nutrition care with a long-term alternative to oral nutrition but are otherwise able to live outside of an acute care hospital facility. The home enteral nutrition is dramatically increasing in the US from 463 per million population in the United States in 1995 to 1385 per million in 2011. (Leah Gramlich, 2018)

Section 4 – Value Proposition for Rockfield Medical Devices’ Products based on the Competitor analysis and SWOT Analysis

The following is the analysis of Competition and Strengths, Weaknesses, Opportunities and Threats between Rockfield Medical Devices and Cardinal Health USA;

	Rockfield Medical Devices	Cardinal Health, USA
Target Customers	Patients	US Hospitals, Health Services Agencies
PRODUCTS	MOBILITY+	Kangaroo Joey Pump (Pump and tube separate)
Competitive Advantage	Mobile and Compact Device	Market Share and Customer Base
Sales Channel	NA	Offline supply to hospitals
Strength	Product features and quality	Brand Awareness
Weakness	Unawareness about the brand	Product features and quality
Opportunity	New product market	E-Commerce
Threats	Competitor’s market share	New entrants into the market with better quality products

Table 1 – Comparative Analysis of between Rockfield Medical Devices and Cardinal Health USA

Figure 2 – Photographs of Mobility+ filled with enteral feed with giving set attached

Source: Rockfield Medical Devices

Figure 3 – Peristalic pump, portable in Rucksack

Source: Rockfield Medical Devices

• The above table clearly states that the product Rockfield intends to launch in the US market is new and has better features than the existing product by Cardinal Health. Some of the features of Rockfield’s product are;

1. Mobility
2. Compactness
3. Discreet Feeding
4. No extra power source required
5. Durability
6. Maintenance free
7. Remote monitoring

• It is true that the awareness of Cardinal Health among the US customers will be very high because the brand is in existence for decades. But the product is not that feasible compared to the Rockfield Medical Devices product.

• Tube feeding products’ main goal is to provide nutrition to the patients, but at the same time there are some factors to consider from a patient’s perspective such as, Mobility, Compactness and Discreet Feeding to ensure that the patients do not feel a burden of tube feeding.

Section 5 – Publishing Digital Content Related to Tube Feeding

The following is an analysis of the content related to the Kangaroo Joey Pump of Cardinal Health by the company itself and the third parties;

Table 2 – Online communications regarding KangarooTM Joey Enteral Feeding Pump

• The Kangaroo™ Joey Enteral Feeding Pump owned by Cardinal Health, whose team has developed a series of videos on Youtube regarding use instruction since 2019. Although with more than two thousand views, its channel has few interactions from users.
• the Shield Medical of Medtronic, the previous owners of this product, accumulated numerous followers by constantly publishing content on Youtube and interacting with their customers since 2013, and suspend activity since it was acquired in 2017.
• Influencers, namely, Yours Truly Karrisa, Mount Carmel and Brenda Radzinski have also posted content related to the tube feeding pump of Cardinal Health, and the engagement is pretty high than that of the Cardinal Health itself.
• It was found out that patients or their care takers try to reach out the influencers or third-party companies, say the suppliers to get to know about the product through the digital content they already have available or posted on their social media handles.

Section 6 – Conclusions and Recommendations

6.1 – Conclusions

• Given that the Kangaroo Joey pump which has a stagnant position in the US market, does not have features like the Rockfield Mobility+, RMD has strong sales potential due to its key features which can offer advantages that the competition does not.

• As found, the strengths of Rockfield Medical Devices are Weaknesses of Cardinal Health and vice-versa. Taking this into consideration, Rockfield can brand itself in such a way that it cannot only gain a significant amount of market share Cardinal Health has, but it can also establish a new benchmark in the US market.

• The competition in the medical device industry is high but the products lack the features Mobility+ has. Ireland being the second largest exporter of pharmaceuticals to the US, Rockfield Medical Devices has a market to diversify and modify.

• Digital content is not posted by Cardinal Health itself in a greater frequency and the users rely on its suppliers’ digital channels or influencers’ digital handles to get educated about such content. Here, digital content refers to texts, pictures, videos, walkthroughs, etc.

• Cardinal Health has a social media presence, but the content related to Enteral Tube Feeding is not observed and by this the researchers conclude that this is the GAP which Rockfield Medical Devices Can fill.

6.2 – Recommendations

• Rockfield Medical Devices should use the platforms like Facebook, Twitter, Instagram and YouTube to post the communication related to the enteral tube feeding devices because almost all of the age groups are now using the aforementioned platforms, and, to increase the awareness of the brand these are the best platforms to showcase themselves.

Example which can be taken to determine the course of action of Rockfield Medical Devices: The team of Bolee Bag which is owned by ‘U Deliver Medical LLC’, has initiated frequent communication on Facebook since 2018 and accumulated 820 followers. Among its posts, the stories about users, especially about children, are most popular. Besides, the company also introduced its product on Oley Foundation, PR Newswire and Pinterest.

• While marketing their products, Rockfield Medical Devices should use emerging forms of marketing such as Hashtag (#) Marketing to create a trend on social media.

Example which can be referred to is: Make a wish’s hashtag #SFBatkid or Coca-Cola’s #ShareACoke

• Rockfield Medical Devices should introduce online promotions by providing discounts to the buyers who approach them online on the social media channels and who in turn help to promote the brand over their social media handles.

• Rockfield should use the features of its product (Mobility+) while marketing because if such features are showcased in an appropriate way then gaining customers will be easier. Rockfield should use their strength (which is the weakness of its competitor) as a trigger to gain market share.

• Rockfield should use some of the testimonials of current patients to create informative posts and spread awareness about their product. Or it can use the same patients to work as influencers on social media to market the product. (Influencers play a vital role and if those influencers are the current patients then the customers feel the business is carried out transparently and it becomes easier to gain their trust).

• If Rockfield enters the US market with the current product Mobility+ then the following marketing approach can be adopted’

1. Cause Marketing: Rockfield products can be marketed to support a social cause of giving a better quality of mobile life to the tube fed patients.
2. Internet Marketing: To showcase and market the uniqueness and characteristic features of the Rockfield’s product on various platforms such as Instagram and Facebook to make sure the awareness is created in all the age groups.

References

• Leah Gramlich, R. T. H. J. J. M. S. M., 2018. Home Enteral Nutrition: Towards a Standard of Care. Nutrients 2018, p. 1.
• Homecare Services. (2009). [ebook] Michigan: The Regents of Michigan, pp.1 – 16. Available at: https://homecare.med.umich.edu/Content/Documents/HomeMed/kangaroo-joey-manual.pdf [Accessed 24 Sep. 2019].
• ePump (2019). Kangaroo Joey ePump :: Enteral Nutrition :: Kendall. [online] Medresourcesinc.com. Available at: http://www.medresourcesinc.com/Catalog/Product/16102/Kangaroo-Joey-Epump [Accessed 17 Oct. 2019].
• Cardinalhealth.com. (2019). Cardinal Health: Healthcare Solutions, Logistics & Supplies. [online] Available at: https://www.cardinalhealth.com/en [Accessed 8 Oct. 2019].
• Vygon | Value Life. (2019). Catalogue – Vygon | Value Life. [online] Available at: https://www.vygon.com/catalog/enteral-feeding-pump-easylit-6_1312_0VEPL6 [Accessed 3 Oct. 2019].
• Healthline. (2019). Enteral Feeding: Definition, Types, Procedure, Indications, and More. [online] Available at: https://www.healthline.com/health/enteral-feeding#procedure [Accessed 14 Oct. 2019].
• Feeding, ​. (2019). ​Kangaroo Joey Pump: Home Care Enteral Feeding. [online] USA Medical and Surgical Supplies. Available at: https://www.usamedicalsurgical.com/blog/kangaroo-joey-pump-home-care-enteral-feeding/ [Accessed 17 Oct. 2019].
• Inspire.com. (2019). kangaroo connect enteral feeding pump review? – Home IV and tube feeding – Inspire. [online] Available at: https://www.inspire.com/groups/oley-foundation/discussion/kangaroo-connect-enteral-feeding-pump-review/ [Accessed 19 Oct. 2019].
• Vitalitymedical.com. (2019). Kangaroo Joey Pump – Enteral Feeding | Covidien 383400 | Vitality Medical. [online] Available at: https://www.vitalitymedical.com/kendall-kangaroo-joey-enteral-feeding-pump.html [Accessed 6 Oct. 2019].
• Market, E. (2019). Enteral Feeding Devices Market Insights, Trends | Industry Report, 2024 | MarketsandMarkets? [online] Marketsandmarkets.com. Available at: https://www.marketsandmarkets.com/ResearchInsight/enteral-feeding-device-market.asp [Accessed 3 Oct. 2019].
• Science, N. (2019). Compat®. [online] https://www.nestlehealthscience.com. Available at: https://www.nestlehealthscience.com/brands/compat [Accessed 20 Sep. 2019].
• FEEDING TUBE AWARENESS WEEK. (2019). Press Release. [online] Available at: https://www.feedingtubeawarenessweek.org/for-the-media.html [Accessed 2 Oct. 2019].

Appendices

Appendix 1 – Infographics

Figure 4 – The growth of Enteral Feeding Pumps Market in 2017 and its forecasted growth in 2025

Source: https://www.alliedmarketresearch.com/enteral-feeding-devices-market

Figure 5 – The growth of Enteral Feeding Nutrition Market in 2018 and its forecasted growth in 2025

Source: https://www.alliedmarketresearch.com/enteral-feeding-devices-market

Appendix 2 – Interview Script

Q1. What are the discomforts faced by the tube feeding patients?

Due to the bulky product and reliance on power source a patient has to stay in one still position and by being in one position sometimes the tube may get blocked which may in turn result in redness and itching around the tube insertion area near the stomach.

Q2. What does a tube fed patients expects from the device they are using?

A compact and mobile product which can enable them to continue their routine while getting