There was a ritual to collecting leaflets and booklets over the course of a congress, with a commitment to read them all that endured until check out and the realisation that taking them all home would entail a hefty excess baggage charge.

Accumulating handfuls of content-packed USB sticks replaced the avalanches of paper, but most ended up in the depths of rucksacks or jacket pockets.

They were a by-product of congresses and the human contact that energised knowledge-sharing and collaboration – much missed during the isolating years of the pandemic that necessitated rapid, and often clunky, migrations online.

Virtual congresses have come of age since those hesitant days of throwing content online and wearing out the word ‘pivot’ to cover the obvious shortcomings. Uplifts in production values and ease of access have made them a potent force for engagement and dissemination.

Delegates have been flocking back to face-to-face congresses after the pandemic’s drought but hybrid events are becoming the norm by offering healthcare professionals (HCPs), academia and industry staff the ability to attend or connect vir-tually and tailor their consumption.

There is little sign that in-person events are fading in popularity. A look through the calendar for the next few months shows delegates coming together for conditions ranging from Alzheimer’s through to cardiology and urology, and journeying from Amsterdam to Vancouver to attend meetings. However, the word ‘hybrid’ remains a focus as organisers seek to offer the best of both mediums.

Aaron Hall from Purple Agency emphasises that virtual conferences have refined every aspect of their performances since the pandemic forced a scramble online. “There was an immediate panic to get everything online; doing the bare minimum to upload – here’s some educational material and here’s some promotional. It was little more than a direct transfer,” he said.

“But over the last few years we have seen product sophistication grow to provide genuine value. There will always be people who want face-to-face time, just to get out the office in many instances.”

Hall, Associate Creative Director (Healthcare Copy) at Purple Agency, the international marketing agency, which is a part of HH Global, believes that the virtual element of congresses now offers compelling levels of engagement and interaction.

‘Virtual congresses have come of age, with uplifts in production values and ease of access making them a potent force for engagement and dissemination’

“The technology and its application have advanced so that you can pretty much get the same experience as in-person attendance,” he added. “You have networking forums, you can watch symposia, access a lot of content and take part in Q&A sessions. A lot of clients have really upped their game in terms of providing activities and dynamic opportunities virtually – a lot have recreated the booths they have at a conference in 3D for an online audience to walk around.

“The digitisation of that physical experience lends itself to data gathering and insights in a much easier fashion. Feedback surveys, evaluations and Q&As often involve filling in forms on clipboards or you come away with pieces of paper you lose or throw away at in-person events, whereas just entering information on a computer is no trouble. I ran symposia in October last year and we were able to build a survey and evaluation forms that fitted smoothly into the proceedings. The questions fed in seamlessly rather than having awkward moments at the end trying to get feedback.”

Not only has the virtual offering changed, but the healthcare constituency has transformed its allegiance to technology. Digital tools and protocols, so prevalent in daily life but lacking in healthcare, are now welcomed rather than treated with caution.

“These type of engagements are all around us in retail, finance and commerce, and we are now far more open to seeing them used at congresses,” said Hall. “The technology is no longer alien and the benefits are far-reaching. Education, collabo-ration and communication are global, so shifting to virtual actually gives you more reach than an in-person congress.

“Delegates can create profiles to tailor what they engage with from the agenda and from that, companies and societies can get deeper insights into what they are interested in. Some HCPs want to know a lot about how a drug works while others need more on its efficacy and safety, and others are only interested in what it means for their particular patients.

“You can profile someone online by the searches they do and what they’re looking for, which gives industry more insights into who their customers are and what they’re interested in, and it enables them to stratify them in ways where they can target specific information and data to different people. This also then improves the experience for HCPs as they’re not being bombarded with things they’re not interested in.

“This mutual benefit has actually led to an increase in attendances at congresses, taking into account virtual and in-person attendees. There will always be investment in the human contact element but the ease, convenience and better, more targeted engagements means that hybrid events have become established.”

Another issue that is influencing in-person attendance is the sustainability and carbon footprint burden of travel and, although congresses are using more sustainable materials and off-setting.

Hall believes it is contributing strongly to reduced attendances. “We’ve definitely had people questioning whether it is abso-lutely necessary that they attend because of environmental concerns, particularly when the virtual experience is much more environmentally friendly,” he said.

The pandemic acted as a firebreak on congresses and promoted the opportunity to reflect on their impact on the environment and global healthcare.

Stephen Marchant, MD of Bedrock Healthcare Communications, part of the Resonant Group, believes the rise of hybrid congresses allows the sector to examine and recalibrate its approach to sustainability, as well as offer more textured engagement.

“Should I fly to Chicago for ASCO or Paris for ESMO and put as much carbon in the atmosphere from a flight as I would do driving a ten-year-old Volvo for the rest of my life? This is important stuff when you think of the role of pollution in global health,” he said. “I hope that face-to-face meetings don’t come to a screeching halt, but the barriers to travel are building while hybrid events have a significant benefit from a sustainability and social responsibility perspective.

“A key factor is the egalitarian nature of hybrid meetings. Face-to-face meetings were the mainstay of engagement and dissemination of data for a long time, but it was a select club, especially at the bigger meetings when it was senior people or members of significant institutions that attended and they were generally from distinct socio-economic and demographic backgrounds. They were Western and affluent.

“To a large extent, people from the Asian sub-continent and sub-Saharan Africa couldn’t afford to go. Hybrid congresses are more democratic because of the reduced requirement for travel and they allow for broader dissemination of data and ideas. The dissemination of best clinical and scientific knowledge should be a right for all and, with a more hybrid structure, we have the opportunity to really drive that as best practice.”

A study underscored the point, with analysis of attendances at 112 conferences revealing that only 4% of events were held in Low and Middle Income Countries (LMIC) and only 39% of those delegates, whose affiliations were disclosed, were from LMICs. The report stated: ‘“Conference inequity” is common in global health, with LMIC attendees under-represented at global health conferences. LMIC attendance is limited by systemic barriers including high travel costs, visa restrictions and lower acceptance rates for research presentations.’

“With the ubiquity of internet access around the globe and the cost reduction built into hybrid events, we have created a fairer playing field for medical experts from developing nations and that can only be to the good of medicine, to the good of healthcare and for the good of the pharma companies,” said Marchant.

“In the pandemic, you would probably have the plenary session on your computer and be getting on with emails at the same time. I have no data for this, but it seems there is more genuine engagement online that is reaching the levels of in-person attendance. Congresses have had to work harder to make the content accessible across the world and time zones with such features as video snippets and round-ups, and it enables data to be disseminated broadly and efficiently.”

He added: “Being there, being face-to-face, and having the opportunity to meet in the rooms or having chats in the corridors, is fantastic but I think the virtual experience is now delivering around 80% of the in-person experience – with good agencies working with pharma and congresses building this experiential approach into the programme development.

“The technology in the room functions so much better now and organisers are thinking much more about the experiential content for people there in person and those attending virtually in real time or posthoc, and this drives value. Getting an enduring message and engaging with a wider audience than just those present in a symposium hall has a demonstrable return on the investment in terms of engagement, clicks, understanding and dissemination of messaging and data.

“From a pharma company’s perspective, a well-constructed and considered hybrid event is the best of all worlds.”

But don’t write off in-person events too swiftly. The 2023 events calendar has bounced back strongly and the gold standard of knowledge sharing in person is still gleaming brightly.

Emdy Rahman, Client Services Director at SynaptikDigital, part of Nucleus Global, observed: “From our experiences and feedback from clients and suppliers, there is a hunger for face-to-face congresses and many people are going back to that, while virtual is clearly not as dominant as it was.”

SynaptikDigital, a global team of creatives and innovators working across medical communications and education, has a depth of experience in live, virtual and hybrid events and Rahman added: “There is a place for both, of course, but we are witnessing a real appetite for the human contact as restrictions on travel and meeting have lifted.

“It has taken time to emerge fully from pandemic restrictions so face-to-face meetings are still new to a lot of people who have been unable to attend over the past few years. Meeting, particularly in large groups, is still novel.

“The technology has improved since the early days of the pandemic when everyone was scrabbling to get presentations up online. That did improve and midway through the pandemic it became easier and smoother to get onto a meeting platform and everything was more integrated. There are now platforms available that do a great job of replicating the face-to-face plenary experience. But they cannot, yet, replace face-to-face networking and immersive small-group workshops where you hope to see fluid knowledge sharing and organic, unscripted collaborations that can be formed off-agenda, unscripted.”

The principal challenge Rahman identified is the need to match the right medium – virtual, hybrid or in-person – to the audience and congress objectives.

“Congress organisers really need to think about their formats in terms of what they are trying to communicate. They need to ask: is there really any benefit in getting 1,000 people into a plenary lecture to view a didactic presentation? If it is just data dissemination, isn’t that more efficiently achieved virtually?” he said. “We should be drilling down into what makes face-to-face congresses beneficial, how that networking and those informal discussions break down the barriers between the expert and the audience, and how we can help people to learn from each other.  Having the right topics, the right mix of speakers and right formats is critical to attracting people to a congress.

“Maybe in the future, plenaries can be streamed virtually and the agenda will be more condensed and focus more on interactions through workshops, breakout sessions and clearly defined networking sessions. Organisers will have to work harder to ensure the technology and programme can deliver a rich experience, but there is clearly a strong future for face-to-face congresses.”

Rahman believes that congress content and performance will continue to develop both on- and offline and virtual reality, AI and the metaverse will have a role to play.

“The sector will continue to change and evolve. One of the great things we saw during the pandemic was that attendee numbers shot up and not from the usual suspects,” he added. “There was a much broader and democratic audience, both in terms of geography and background. With hybrid, you can connect with a particular high-interest presentation at your convenience rather than attending for four days, just for one or two sessions. They have definitely broadened out events to a wider audience.

‘The best congresses will maintain a hybrid model and improve it, and those that don’t could well lose influence in global healthcare’

“We also perceive much more pressure in terms of the work/life balance people want to achieve post-pandemic. Four days away from your family, often involving two days travelling, is less attractive than it was before the pandemic-enforced crash course in remote working.”

Ben Gallarda, Head of Scientific Services at EPG Health, feels in-person congresses, certainly those without a hybrid arm, are in need of an infusion of dynamism if they are not to slip into life-support status.

“We can all see the appeal of them because they provide an amazing personal experience. Congresses that stay in person only will still appeal to their core members, but they won’t have any expansion beyond that,” he said.

He believes that all congresses have to raise their game to meet expectations from audiences accustomed to rapid, targeted delivery in every aspect of their lives.

“The best congresses are those with crystal clear programmes and abstracts that are up early so you can look through them. I think some societies tend to rest on their reputation and assume that people will come whatever. But the real opportunity for societies is that you can broaden your appeal phenomenally by having a forward-thinking hybrid model with a lot of early information,” he added. “Early information can attract even more people to come in person and attend virtually because registrants know what they are going to get.”

EPG Health, with its reach into multi-stakeholder research and experience connecting HCPs and life sciences companies, has a front-row view of the changing dynamics of congresses and Gallarda points to a range of advances that are powering the appeal of hybrid events.

“The best examples are in a live Q&A where the moderator will bounce between the live audience and chat Q&As to incorporate anyone watching it on a stream,” he said.  “We run both congresses-related symposia and non-congress-related webinars. and having that ability for the audience to ask questions is a great way to increase engagement and get a feel that the people not in the auditorium are still participating.

“I think presenters and speakers are getting more used to this and realising that the questions may come from all parts of the world and all angles, and they are more prepared to handle that.”

Gallarda added: “I conducted some interviews with oncologists from less developed parts of the world and they don’t have an option to go to a live European congress, or maybe once every several years at most. But if they can attend every year virtually then they can ask questions related to the intricacies and limitations of their healthcare system directly to world experts in a way that absolutely increases access for members of our health community globally.

“The best medical societies, those that recognise the overlap of sustainability and healthcare, concerning both environmental detriments of health and the amount of energy wasted in healthcare, will provide a suitable hybrid model that acknowledges the dual priority of getting the right people there in person and providing expanded access globally. They will align a hybrid model with priorities of access, improving healthcare and the equal opportunity to access this information.

“They will do this by using effortless, seamless technology that will make the content more available.”

Gallarda sees congresses evolving with more fluid content-sharing across the year and easier access to tailor-made sections for reduced registration fees. “Doctors have a real high priority for congress information but they cannot attend every single one, so there is a way to serve that demand by making spotlight sessions or the most important takeaways free. If interested, they can go deeper and access more information,” he said.

“Doctors are finding their information from third-party websites that provide convenient access to congress news and key highlights, along with expert analysis. We find those are immensely popular across our readers. We produced more than 100 articles from 14 congresses last year and it proved to be super popular content on our Medthority platform, matching our research with physicians; they really value enduring congress information.

“The best congresses will maintain a hybrid model and improve it, and those that don’t could well lose influence in global healthcare.”