October 1, 2011 
For those of us that have ever worked in IT, the idea of a waterfall based design always implies a less than optimal strategy. But, I’m beginning to see an applicability of this framework for communications.
Let’s look at a scenario for a prescription refill where you’re trying to optimize for the lowest cost intervention.
- Identify targets for an intervention
- First push a message to all those that have downloaded your mobile application (~10%)
- Second push a message to all those that have opted into your SMS reminder system (~6% with some overlap)
- Third push a reminder to those that you have an e-mail address on file
- Fourth send a reminder using an automated outbound call with the option to refill during the call
- Fifth (maybe) use agents to reach out to the patient
As you go through this “communications waterfall”, there are several things to think about:
- How do you leverage permission-based or preference-based marketing here?
- How do you integrate your channels so that if you send an e-mail which isn’t opened after 48 hours (and the message is important) that it automatically escalates to the next channel?
- How do you cross-promote across channels to drive greater use of the self-service channel?
- What permissions do you need to use each channel?
- What are the HIPAA / PHI limitations within each channel?
- What is the correlation between preferences and behavior?
- If you know that certain segmentation and messaging increase the likelihood of action, how do those insights manifest themselves in each channel and does that change your interest in using a particular channel?
- What data do you want and can you get from each channel to understand the response curves?
Enabling Healthy Decisions 
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