Communication Chicken And Egg

You hear a lot these days about preference based marketing.  The idea is that consumers (or members or patients) select how you interact with them.  In healthcare, this means things like:

  • What types of communications do you want to receive?
  • How do you like to be communicated with – letter, web, live person, automated call, text message?
  • When do you like to be communicated with – day, time?

Of course, companies then have to figure out what rules to use in terms of when to trigger communications.  The next question is how to personalize the communication.

So an interesting question is…does the company have a responsibility to their members to use their data to drive them to actions that are in the member’s best interest?

Do companies always do what’s right…probably not, but I do believe that they want to do the right thing.  They want to drive successful outcomes.  They want patients to be healthy.  They want patients to save money.

Now, my chicken and egg analogy is which comes first the selection of what my preferences are or experiencing the communication.  How do I know whether I want a refill reminder if I have never received one?  How do I know which channel I prefer if I haven’t experienced each of them?  And, since each communication can vary based on messaging and many other variables, can one good or bad experience bias my selection?

2 Responses to “Communication Chicken And Egg”

  1. Uh, does the first comment have anything to do with your post? We have seen within our 3.2M population that most people prefer email, with a small percentage opting for text and voice messaging – with 72% receiving more that 1 reminder, ranging from daily medications, script refill, doctor’s appointments and vital stat monitoring.

    These of course are driven by the user, not by a data trigger – although we do have that capability. With one user in particular, she was getting a call at 7 am for one medication, two texts 11 am and 1 pm for another, and an email at 4. The patient has the flexibility to choose what delivery platform works best for them – with the option of changing within a 15 minute window.

    Medical adherence, whether it is taking your meds, or checking you stats, benefits everyone, yet, as you know, 1 in 2 patients does not follow their doctor’s orders.

    Each patient is different and it has to be determined how and what needs to be communicated to them. Are you a type 2 diabetic stay at home dad with hypertension who smokes? Very different from a female diabetic traveling salesperson on insulin. Yet so many companies will view them as the same: a diabetic. The communications and delivery need to be tailored to the individual. There is also the question of privacy and cost: I don’t want to get emails at work, and I don’t want my rates to go up if I do not refill my scripts.

    And then there is patient engagement. Do you intervene even though the patient does not want to receive anything? One third party company sends information to a patient once they fill a script from pharma or a health plan about their condition. That person did not want that information and feels violated and confused about the information.

    I think that yes, companies do have a responsibility to reach out to their members, but it should be on an opt-in basis. If I get blood work showing my cholesterol level is high, should my health plan send me diet and exercise tips on how to lower it? If I do not refill my script, should they remind me? I think yes, but only if I want it. If I am not willingly engaged, it goes into the trash or just becomes noise.

  2. The Damage of Legalized Lying

    Amazingly, with the pharmaceutical industry as an example, the amount spent by them on marketing is far greater than the amount spent on research and innovation, as it approaches 30 billion annually spent on their marketing efforts, as this presently takes priority over the research and development, so it seems. This includes 5 billion that is spent on drug reps, who implement the tactics created by their marketing departments. Some biopharmaceuticals place double the amount of revenue into their R and D than typical big pharma corporations.
    Marketing in some form exists with every business regardless of the industry of the business and its purpose. Essentially, marketing in itself is a complex activity- consisting of many specialty elements of various areas and levels, typically of an aggressive nature. However, with the pharmaceutical industry, marketing needs to become more specialized and altered due to the delicate nature of health care in order to prevent harm and ensure quality health care for all. Tactics that ignore such caution and consideration possibly could cause harm to patients in a number of ways, as this occurs presently. And recently, the marketing exposure of the drug industry has become an unfortunate issue for this industry for many reasons that remain a reality aside from what drug PR firms may try and tell us, as presently it seems as if the pharmaceutical industry, once viewed as very ethical, are now viewed as motivated by profit and greed. Such unwise and irresponsible methods include:
    1. Advertising directly to the consumer. This method of bypassing what should entirely be decided by the heath care provider, as disregarding the determining factor of the heath care provider can possibly lead to inappropriate prescribing upon demand of the viewer of the advertisement, usually greatly unqualified to dictate their own medicinal treatment, yet makes such a demand simply on belief of a visual medium that clearly lacks accuracy and completeness. Furthermore, it potentially removes the discretion of the provider regarding the best treatment for the patient through such frequent methods of marketing to potential consumers by such advertisements directly to consumers, as the doctor-patient relationship historically has not been one of unbalanced debate.
    2. Assessment of a patient by a health care provider is required and necessary, most believe, in order to determine the best treatment for a patient, as well as the provider considering their patient’s complete medical history as well as other variables necessary to consider the best course of any possible treatment initiated by the provider. Ignoring this premise could be damaging to the patient seeking treatment through marketing in this form. DTC advertising is now occurring in doctors’ office as well. Pharmaceutical companies pay a company what may be a million dollars a year to have a TV in a doctor’s waiting room that constantly pitches primarily the sponsor’s desired product.
    3. Clinical evidence is the ultimate determining factor for treatment selection, as long as this evidence is proven to be authentic. This is followed by drug sample availability, yet a correctly informed health care provider is the one who will provide the best care to their patients, along with their experience from a historical perspective in their practice.
    4. Education not only trough sponsored doctors paid by a drug company, but more authentic methods should be discovered, which mean from the doctor’s own research and review of literature, but also dialogues with the colleagues of the doctor. The Medical Letter is an example of acquiring information free from what may be dangerous bias, regarding pharmacological treatment considerations.
    5. As an ex seasoned big pharma drug rep, I can assure you that education is not the purpose of a pharmaceutical company, and they have no interest in this valuable area as demonstrated by their marketing being the apex of their objectives. Offering various inducements to others tops the list, though, with their marketing efforts. Perhaps research of novel and innovative medications should instead be the sole purpose and focus of pharmaceutical companies.
    6. The over-saturation of drug company sales reps who in the past have initiated questionable tactics upon the direction of their marketing department of their drug company employer, regardless of the validity or legality of such tactics that are normally not questioned or known by the drug reps in the first place regarding the legality of some tactics, further complicated by the public being largely unaware of how big pharma in particular really operates. Such forms of manipulation developed by some drug companies include questionable inducements for the health care providers. This is allowed to happen as well as forced to occur by the pharma company representatives regardless of whether or not it is legal. As a result, many medical establishments are progressively prohibiting the activity or presence of drug reps at their locations. With the pharmaceutical company, sales reps are required by their employers to follow the direction of their marketing departments without exception. And the questioning of these directives is not tolerated by their employers. Because of this, the drug company’s image becomes more damaged as a result, as this is the case presently. To further illustrate this drug rep description of what they are forced to do, their employers require them to spend huge amounts of money annually to spend for doctors or to doctors that is void of any benefit for the patients, as the representative is typically void of any medical training or experience necessary to be a true asset in the medical community.
    In the past, the pharmaceutical industry was viewed as research-driven, innovative, and patient focused- entirely for the benefit of patient heath. This is why the industry was at a time viewed as an ethical one. Clearly, this is not the case today. Instead, many view this industry as one with their primary goal is to initiate market-driven profiteering, regardless of the attempts of the industry to convince the public otherwise, as stated previously by the industry’s supporters, who have attempted to place value to the medical community as the goal of the pharmaceutical company. So the view by the public of drug companies has been damaging to what should be a concerning degree because of their tactics and deception. So the pharma industry seems to be in great need of repair and re-evaluation of their purpose. This should performed by action instead of empty statements by the industry. It is the author’s opinion that actions by this industry for the sole benefit for the patients are displaced if they exist, unless my interpretation and perception are flawed greatly. The repair can only be done by the refocus of the industry towards convincing the public of the industry’s concern of their restoration of the patient’s health in several ways. One way is to always make the medical community aware and with conviction that their products are solely for the benefit of the patients, which is rarely discussed in full detail with such people. Fortunately, medications historically have been for this reason and are often necessary for the restoration or benefit of the health of those in medical need. The need should be more clearly defined by those who determine this, and these are the health care providers, who are caregivers, and not marketers. In summary, the medicines now available to us are for the benefit of the patients, and not the developers who should create these medicines for this reason.

    “Marketing is the act of making something seem better than it really is” — Suso Banderas

    Dan Abshear

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