Medical Affairs Focus

Thoughts on Global Medical Affairs

Topic2: Global Coordination – Methodologies

As discussed in the previous post, MA organizations take different approaches to what they choose to coordinate on a global basis.  Similarly, organizations follow different methodologies in terms of how to coordinate globally.

In today’s blog post, we will be discussing three different methods for global coordination, when theyt may be appropriate, and their associated strengths and weaknesses.  We will be looking at:

  1. Bottom Up Coordination
  2. Top Down Coordination
  3. Hybrid Coordination

It is important to note that a single MA organization may employ multiple methods.  For example, it may do Top Down Coordination for it publication planning but Bottom Up Coordination for its budgeting.  And, of course, none of these methodologies are ever implemented without some exceptions or refinements.

Bottom Up Coordination

Description:  Bottom Up Coordination places the initial emphasis on the various affiliates or regional MA organizations to propose their approach to a topic and then the global MA organizations collates the inputs, finds commonality and negotiates the differences between the MA organizations’ plans.

Example: Budgets are often developed following the Bottom Up Coordination.   The individual affiliate or region proposes what its budgetary needs are for the upcoming period, then the global organization gathers the collective needs, compares it to the global priorities and available resources, and proposes an alternative budget which is finally negotiated into agreement.

When Appropriate:  Many organizations that are transitioning from local control to a global coordination start with a Bottom Up Coordination method, because the local groups are accustomed to setting their own priorities and have the processes in place to do so.

Strengths:  This method does a great job feeding the voice of the people “on the ground” into the discussions at a global level.  By starting with this approach, the needs of the local affiliates or regions are more likely to be me.  And, as noted above, it is an easier transition to the start of global coordination.

Weaknesses: This method is highly inefficient.  Many times the priorities of one or many regions does not match global priorities, so the work they do to develop and explain those priorities is “lost” when they are rejected as not matching global priorities.  It also places the global organization in a position of always “denying” the local affiliate or regional organizations some of their priorities, which can easily turn into an Us vs. Them mentality over time.  Finally, the negotiation required for this model is highly inefficient requiring significant time commitments from all involved.

Top Down Coordination

Description:  Top Down Coordination typically consists of the global MA organization determining a range of priorities and then communicating those priorities to the local affiliates and regions so that they can develop detailed local plans to execute.

Example: Publication plans are often developed in a Top Down manner.  The decisions about what will be published, where and when are often made centrally, then communicated to the local affiliates or regions for related preparations.

When Appropriate:  This is most appropriate when a global MA organization is just starting out and developing local affiliate or regional MA organizations.  In these circumstances, having strong central control ensures that the new organizations are aligned strongly.

Strengths:  This is the most efficient method since the least people make the most decisions.  It ensures global consistency and the ability to seamlessly share processes and systems between global MA organizations.

Weaknesses: This method allows for very little local control and, thus, can put the company at a severe disadvantage is unique requirements of a particular country or region are not being addressed.  This is also a generally dis-empowering approach, leading to less feeling of ownership by the local affiliates or regions.


Hybrid Coordination

Description:  As the name implies, this is a mix of top down and bottom up coordination.  Typically, the top works the representatives of the local affiliates or regions to agree on a series of global priorities and the process for establishing priorities for the year.  Then the local affiliates or regions develop their own suggested approach within that framework.  Finally, the recommendations are collated by global MA and any tweaks needed are made.

When Appropriate:  This is most appropriate in mature organizations that want to evolve past a bottom up approach but don’t need the command and control nature of top down.  For this methodology to be successful there must be trust between the global and local affiliate or regional organizations and a culture of shared responsibility must be developed.

Strengths:  This approach overcomes the limitations of both the top down and bottom up approaches.  It is highly empowering while also allowing consistency on a global basis.  And it encourages strong cooperation between global and the local affiliates or regions.

Weaknesses: This method takes good planning and time.  The group need to meet to establish global priorities and that must be done in advance of all other planning, so planning itself needs to start sooner.  Also, it takes time and resources to follow this approach that some organizations simply do not have.

There are an almost infinite number of permutations of these three approaches, but these represent simple examples.  What has your experience been in this area.  Leave a comment below.



2 responses to “Topic2: Global Coordination – Methodologies

  1. Pingback: Topic2 Introduction: Global Coordination In MA « Medical Affairs Focus

  2. Pingback: Topic2: Global Coordination – Challenges and Best Practices « Medical Affairs Focus

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