Enabling Healthy Decisions

I have had a note to write on this for a while and then read an entry on the Medical Connectivity Consulting blog about this.   It is a key point in understanding how to drive patient behavior.

Some people respond to rewards or positive motivation.  For example, this will save you money or this activity will make you healthier and extend your life.  Other people respond to negatives (i.e., loss aversion).  For example, you just wasted $20 by choosing this prescription or don’t forget to get your annual checkup.

This is where the real difficulties of communications occur.  How do you segment and target individuals to address messaging, medium, timing, frequency, etc.?  It isn’t easy and mostly comes through experimentation.

I have not advanced my blogging as much as Matthew Holt has on the Healthcare Blog so I am going to “re-purpose” one of his interviews.  One of my consulting clients is a company called Silverlink (which was also a vendor of mine at Express Scripts).  I continue to be impressed with the technology and the ability to find more opportunities to use their voice technology to replace letters and increase response rates to communication programs.

In a meeting today with JD Powers, they revealed that almost 30% of the satisfaction scores for healthplans is attributed to communications.  That should make you research what you do and how to improve it.

So, if you are interested in a dialogue about Silverlink and what they do, read Matthew Holt’s interview with Stan Nowak (CEO of Silverlink).

“for our flu shot reminder we’ll have a client tell us that it was as effective as using humans and saved them 65% of the cost. For health risk assessments it was two times as effective as their alternative mode of delivering those health risk assessments and it was 50% less cost”

Booz Allen Hamilton has been writing good pieces on healthcare and the trends. Here are a few items from their interview back in March of David Cordani (president of Cigna Healthcare).

CORDANI: “The industry’s winners will be those that differentiate by engaging, educating, and enabling their members to navigate the health-care system independently. We define consumerism broadly and have identified four critical elements that will make it work: financing vehicles, which incorporate new health plans; choice and convenience, which will be the key to making services easier to access through a variety of channels, whether it is online, through mini-clinics, or otherwise; member engagement, which is the linchpin of consumerism; and, last, information transparency around the quality and cost of services. These give consumers the insight into the market forces that they need to make informed decisions.”

I think this is a great quote on what consumerism is – financing, choice / convenience, member engagement, and transparency.

The article also talks about Cigna’s segmentation of patients and their mapping of 264 different touchpoints that they have with the consumer. A great first step.

Assured planners represent about 34 percent of the population. They are relatively thoughtful and make sure they have what they need. Price isn’t a driver for them; what matters are comfort, security, and even status. They are also the most affluent.

Enlightened shoppers make up about 16 percent of the population. They do their own research online, read Consumer Reports, and figure out exactly what they want. They then spend time and energy finding the best deal. They’re also likely to experiment with alternative medicine, as well as other new products and services.

Steady contenders make up 28 percent of the population, and they tend to be content with what they have and would prefer to stick with it. They need a very compelling reason to change.

Cavaliers want nothing to do with health care. They’re the most likely to smoke and are in the worst physical condition. Cavaliers account for a little more than a fifth of the population.

If you are an analyst or strategist in the healthcare space, they have a few must reads that I will highlight here for you.

Here is a blog entry from the research site on wellness incentives.  It is a good piece.

Perhaps targeting on how to drive wellness needs an atribute of the segmentation model to be career path or industry…food for thought.

Anyone with prescriptions knows there are different pharmacy types – independent, online, mail order, grocery, and chains (e.g., Walgreens).  Each have different attributes.  The biggest question is always why one choses one over the other, whether there is a difference, and who is the most probable to chose one over the other.  In February 2005, Drug Store News put out what is probably one of the best studies on this.  It shows segmentation, reasons people chose one pharmacy over another, and other good data.  The graphical version is available as a PDF for $5 here.  Otherwise, you can read the plain text version.  One of the central points is that as consumers want convenience and chains implement drive-throughs then they are playing into the mail order trend.  They are disintermediating the pharmacist-patient relationship.

“In general, one of the things we’re seeing is that consumers are spending less time overall interacting inside the store,” Wilson said. “Not only is mail pulling them away, but [as] these drive-throughs increase dramatically … customer interaction seems to be shifting away from a more personalized approach to more time-saving and convenience methods.”

Abroad (from what I understand), the pharmacist and pharmacy play a more central care role with regards to the patient.  I think pharmacists that have time try to do that today, but the model is not set up for that.  This might be a model that CVS pursues with the blending of Caremark and MinuteClinic.  The study said that only 11% of people know the first name of their pharmacists.  Do you?  Mine are Renee and Mark.  I know them both well.

Here is one of the charts you will find that shows some variance across pharmacy type.  It didn’t show any statistical values so I don’t know if the differences are meaningful.

The more I learn about automated call technology the more I wonder why people don’t use it as much as letters.  Obviously, there are telemarketing laws.  And, I think many people think of calls as only being done by humans and being expensive.

But, imagine the following differences and benefits:

1. Lower cost then letters
2. Able to customize the messaging (think e-mail personalization)
3. Able to change your campaign real-time (i.e., our response rate is lower than expected, let’s change the messaging to say this)
4. Able to track lots of data – who picks up, when they pick up, how much of the message they listen to
5. Able to collect data immediately
6. Able to interact with the participant (e.g., give me your BMI…that is 10% higher than last time…are you following your diet)

Obviously, e-mail is the cheapest medium, but our culture is rapidly becoming overwhelmed with e-mail.  You have some of the same benefits, but you can’t modify during the interaction.  And, in healthcare, there is limited information you can push to a patient.  In most cases, you are asking them to click through a link to go to a secure website to receive information.  With letters, you assume it is secure since it is addressed to them.  With automated calls, you have them verify who they are based on a few points of reference (name, DOB, member ID).