May 25, 2010 
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As someone pointed out to me today, there is now a character called Dr. Obvious which is featured on the Medco site – www.medcopharmacy.com. He’s also on Twitter and Facebook. So, who is he? What’s the twist here? What’s the Institute for the Incredibly Obvious?
You might get some idea by watching the video on Facebook or some of the videos on YouTube.
Here’s one on automated refills (which is the push for most pharmacies – retail and mail).
May 5, 2010 1 Comment
When I think of the current generation that is coming into the workforce, I think of people who:
I think the more typical perception of many of them is an overly privileged generation who can’t focus on one thing, expect everything (money, position, title, responsibility) regardless of whether they deserve it, don’t follow basic protocols (like a thank you after an interview), have been coddled their whole life, and have no respect for what others have done. But I think every generation thinks that of the next generation.
I guess the official definitions are: (see good presentation)
The Millennials are also called Generation Y, GenNext, the Google Generation, the Echo Boom, or the Tech Generation and are 76M strong. With immigration they are likely to surpass the Baby Boom generation in the 2010 census. [Note – Comments derived from reading an exerpt of The M Factor by Lynne Lancaster and David Stillman in the May 2010 Delta Sky Magazine.]
Their book – The M Factor – is focused on this generation. They talk about the fact that this generation is talking about and searching for “meaning” in their work. They’ve been raised by working parents that struggled with life balance and want more out of work for their kids. They see how work has become so engrained in our lives with Blackberries and other tools.
More than 90% of US Millenials said having opportunities to give back thru their company was somewhat to very important when considering joining an organization.
51% of young workers surveyed as part of the Kelly Global Workforce Index were prepared to accept a lower wage or lesser role if their work contributes to something “more important or meaningful”.
The question that a lot of this drives at is how do you leverage the passion and tech savvy Millenials as part of your workforce. They are going to drive changes. They are going to be innovators. And, they’re not going anywhere. Here’s a good blog on Generation Y.
It reminds me of some mock interviews I did a few years ago at my business school. I was stunned by some of the accomplishments of these people. They had founded companies and businesses. They had volunteered in the community. They were well read and had passion for things that I didn’t care about at their age. I was glad to have made it thru school with my peers. But, on the flipside, I talked with my friends who are the Dean of the School and run the Career Center to point out that not one of those people wrote me a thank you or sent me an e-mail. None of them ever asked me to help them find a job leveraging my network.
The article talks about this Millenial generation growing up at a time when the divorce rate had dropped and parents spent more time with their kids and transformed from authority figures to mentors and friends of their kids. This whole concept of “helicopter parents” has been explored in other areas and still amazes me. [Are you a helicopter parent test.] For example, 11% of US Millenials said they would feel comfortable involving their parents in salary negotiations. [If I had the option legally and a parent showed up with their kid for a salary negotiation, I would rescind the offer. If they can’t do that by themselves, how can I trust them to drive my business in pressure situations?]
In healthcare, the best example I always use for a company focusing on this generation or the “Young Invincibles” is Tonik Health which is a Wellpoint brand. I’m always surprised how few people know them. Take a look at their website (below) – the colors, the words, and the positioning is all so different than how most of us think about our health insurer. Here’s a good blog entry on the “millennial patient“.
Why is this relevant to my healthcare communications blog – because segmentation is so key to effective messaging. You have to understand this generation and how to engage them and drive them to take care of their health. Traditional language, modes, techniques, and messages may not work. The article (from the book) talks about their focus on feedback and scoring. They are used to constant [positive] stroking and having a score to evaluate success. They grew up being rewarded for everything. How does that manifest itself in a wellness system that tracks their good deeds (exercise, diet, preventative actions), provides them with rewards, frames their effort as contributing to the greater good, and integrates technology (e.g., connect devices)?
Only 3% of the people they surveyed said that Millenials handled negative feedback well. They haven’t been allowed to fail. This makes me think about one of my favorite quotes from IDEO – Fail Often To Succeed Sooner. You have to understand how to try, fail, learn, and try again to make improvements.
Here’s some recent research we’d done at Silverlink on the “young invincibles” and “Why I Have Health Insurance”:
April 29, 2010 0 Comments
I just came upon this infographic based on information from almost 1,000 people in the depression community on CureTogether.
April 20, 2010 0 Comments
Edelman recently published the results of a survey of over 15,000 people across 11 countries.
The study is interesting in terms of people’s opinions. Here’s a few highlights.
So, what do people mean by how businesses should engage?
One of the things that interested me was the slide about what motivates people to get active in their health.
While 58% of people use some form of digital media to research health, the majority use Google or some search engine. 34% of them (globally) use health company websites. [If this were limited to health plan or PBM websites in the US, that would seem high.]
I wasn’t surprised that fighting cancer was the most important issue, but I was surprised that privacy of information was the least important.
March 3, 2010 0 Comments
Yesterday, CVS Caremark announced an expansion on their research partnership with Harvard to include three people focused on behavioral economics and social media. The focus of both these efforts is around prescription compliance (an almost $300B problem).
The work is going to be focused on three areas:
February 4, 2010 0 Comments
I found some of the new stats from Pew very interesting.
Maybe I’m reading too much into it, but as you look at the stats, it seems to me that some of the hype around things like Twitter and other uses have stabilized with usage outside of the teen groups. I suspect a lot of that is the corporate world embracing some of these modes.
And, if you haven’t seen Paul Boag’s great graphics on Internet use (see example below), you should.
January 20, 2010 0 Comments
We all find lists and good graphics interesting. This one caught my attention. The article is in Advertising Age. Their timeline is pictured below:
January 6, 2010 0 Comments
Here’s the next set of articles that I flagged as interesting and hoped to blog about, but I never made it to.
January 3, 2010 0 Comments
If you’re like me the answer is “of course”, but I realize that it isn’t always true for people. Look at the people who get sucked into things like SecondLife or people who play games for hours on Facebook. That certainly isn’t efficient time.
An article “The Internet Ruined My Life” by Pat Regnier in Money Magazine (Jan/Feb 2010) makes some good suggestions.
“When work got stressful – pretty often in this economy – it was all to easy to click over to Facebook.”
He points out that for Americans working over 50 hours per week:
I’d say what about the fact that it’s easier to multi-task and watch your kids soccer game during the week and stay in touch.
He makes a few suggestions (all relevant for getting into the new year):
November 29, 2009 1 Comment
There is certainly lots of talk in healthcare around incentives. What incentives will drive people to behave healthier – peer pressure, cash, non-monetary incentives, competitions (e.g., The Biggest Loser), or lower copays and deductibles.
There is also lots of talk about social media. There have been lots of studies showing the power of your friends to influence your behavior – smoking, weight loss.
Separately, I continue to hear more and more stories about agencies and lawyers using social media to find out about what people are really doing. For example, my friend’s mom was recently on a jury of someone suing a physician for malpractice. She claimed she had limited use of her legs. But, the physician’s lawyer accessed her facebook page and saw her talking about all the stuff she was doing now that she felt better. Oops.
Before I paint my future scenario, let me toss out one example that really got me thinking. Burger King recently created the “Whopper Sacrifice” application for Facebook. You received a free Whopper if you would delete 10 of your friends from your Facebook account. 23,000 users did it before they took it down.
So, if people would “sacrifice” their friends for a Whopper, what would people do for a 10% reduction in their premiums [or some siginificant savings on healthcare]? Could companies get people [and use social media to track it] to spend more time with their thin friends that don’t drink or smoke and regularly exercise and get 8 hours of sleep a night? Assuming the research is true, this would dramatically reduce costs and make those people healthier.
November 19, 2009 0 Comments
A good presentation from Digitas Health.
October 26, 2009 0 Comments
Will the habit of “status updates” be a good thing for healthcare? We are encouraged to keep food journals, to track medication, to track facts about our conditions, and to report on many other aspects of our life. Those things can be very helpful for patients in their discussions with their physicians.
So, as people increasingly become used to track and reporting what their doing, will that make it more normal to track these healthcare statistics?
Here’s some recent facts from a Pew report on Twitter and Status Updating:
October 6, 2009 0 Comments
I’ve been playing with this medium now for a while. While I was originally a skeptic, I’m becoming a convert. Here’s a few things I’ve tried recently:
September 29, 2009 2 Comments
There is a great “cartoon” at the end of the recent Fast Company magazine that gives an example of how using information can lead you to a wrong decision. It’s one of the reasons that I always point out the difference between someone who has provided services to an industry and someone who has worked in an industry. It’s not the same. Sometimes, you need to truly understand the nuances and how decisions are made.
It also made me think of a great Facebook example of how using social connections can lead to bad business decisions. Given all the talk about making peer-to-peer recommendations based on your social network, this is a slippery slope to watch. We are still new to this area and mistakes will happen. One of the bigger ones that I have heard occurred in Facebook where they allowed advertisers to use member’s pictures. Well, how do you think people felt when they saw the advertisements that say “Meet Singles In Your Neighborhood” with a picture of their spouse. It didn’t go over well.
Great idea. Interesting technology. Bad application.
This will happen in healthcare. The question is who will be first to stub their toe in the new world.
August 1, 2009 0 Comments
I found this article – Nature’s 10 Simple Rules for Survival – on biomechanics and biomimicry interesting (Fast Company article). It looks at how nature has survived all these years and translates that to lessons for business. This is worth more pondering, but my Saturday morning thoughts on applying this to healthcare are in brackets.
- Diversify across generations. [We need different strategies for different segments. One size will not fit all.]
- Adapt to the changing environment — and specialize. [We need a US centric healthcare model not a model from Canada or the UK.]
- Celebrate transparency. Every species knows which species will eat it and which will not. [Be clear on incentives and roles. Set up a win-win not a win-lose. Don’t try to get government to run an efficient business which it never has.]
- Plan and execute systematically, not compartmentally. Every part of a plant contributes to its growth. [A technology infrastructure and shared decision making across a care continuum is important. The medical home concept has merit.]
- Form groups and protect the young. Most animals travel in flocks, gaggles, and prides. Packs offer strength and efficacy. [Social networking and leveraging peer-to-peer education and support will improve health outcomes.]
- Integrate metrics. Nature brings the right information to the right place at the right time. When a tree needs water, the leaves curl; when there is rain, the curled leaves move more water to the root system. [We need home monitoring and predictive metrics for preventative care. Using genomics and other measures should save lives by allowing us to act early.]
- Improve with each cycle. Evolution is a strategy for long-term survival. [Big bang improvement to the system won’t work. Pick one problem at a time – e.g., un-insured – and solve for it.]
- Right-size regularly, rather than downsize occasionally. If an organism grows too big to support itself, it collapses; if it withers, it is eaten. [Healthcare is inherently local.]
- Foster longevity, not immediate gratification. Nature does not buy on credit and uses resources only to the level that they can be renewed. [We need to address the issue of hyperbolic discounting. People want immediate value, but lots of healthcare improvements take time personally and systemically.]
- Waste nothing, recycle everything. Some of the greatest opportunities in the 21st century will be turning waste — including inefficiency and underutilization — into profit. [Don’t overcomplicate the solution. Sometimes the obvious can improve the difficult.]
July 30, 2009 1 Comment
I was with my kids at the Jonas Brothers concert in St. Louis the other night. They put on a great show, but my healthcare takeaway for the night was that Nick Jonas has diabetes and is a great spokesperson on the topic.
As seems to be more and more common these days, he (as a public figure) is out talking about his health and management of his condition. I think this is a great way to help kids learn about diabetes from someone they adore. It also normalizes the condition so patients don’t feel they are alone.
I also like his concept of giving guitar picks to his “diabetes buddies” or people he meets. I could see a Facebook application where you can get a virtual guitar pick from Nick Jonas.
“To newly diagnosed kids with diabetes, Nick would say, ‘Don’t let it slow you down at all. I made a promise to myself on the way to the hospital that I wouldn’t let this thing slow me down and I’d just keep moving forward, and that’s what I did. Just keep a positive attitude and keep moving forward with it. Don’t be discouraged.’ ” (article)
During the concert, they stop to let him do a piano solo to the following lyrics from their song “Don’t Know What You Got Till It’s Gone”. During the song, he pauses to talk about how he made a promise to not let it hold him back and all the things he has accomplished since being diagnosed.
Got the news today
Doctor said I had to stay
A little bit longer
And I’d be fine
When I thought it’d all be done
When I thought it’d all been said
A little bit longer
And I’ll be fineBut you don’t know what you got
Till it’s gone
And you don’t know what it’s like
To feel so low
And every time you smile or laugh you glow
You don’t even know
No, no
You don’t even knowAll this time goes by
Still no reason why
A little bit longer
And I’ll be fine
Waitin’ on a cure
But none of them are sure
A little bit longer
And I’ll be fineBut you don’t know what you got
Til it’s gone
You don’t know what it’s like
To feel so low
And every time you smile or laugh you glow
You don’t even know
No, no
You don’t even know
No, no
You don’t even know
No, noYeah
But you don’t know what you got
Til it’s gone.
Don’t know what it’s like
To feel so low, yeah
And every time you smile or laugh you glow
You don’t even know
Yeah oh
Yeah oh
Yeah yeah
You don’t even know
No, noSo I’ll wait ’til kingdom come
All the highs and lows are gone
A little bit longer
And I’ll be fine
I’ll be fine
July 25, 2009 0 Comments
Regence Group recently put out an interesting website – www.whatstherealcost.org. It takes an unorthodox (for a health plan) approach to delivering several important points. It reminds me of what Wellpoint has done with Tonik or some of the things Humana is doing at HumanaGames.
One of the things I found interesting and very straightforward for patients to think about were their 5 questions:
Imagine if every time we were asked to take a test or start a new therapy that we (patients) asked these five questions of our provider.
May 4, 2009 0 Comments
A friend of mine just formed a new group in LinkedIn which I found interesting…”Life in a Six Word World“.
From the group description: A friend recently asked if I could describe myself in 6 words. I couldn’t… Could you? Could you describe your business value in 6 words? Well in our new Twitter society you just may have too. This group is about sharing your Six Word “whatever” as well as asking for help and discussing how communication is changing.
I am not sure I can come up with one, but here are some:
May 1, 2009 0 Comments
“There is a lot of media, a lot of news, a lot of rumor – the sooner you can get correct and accurate information to consumers, the better – otherwise people will look to other sources that may not always be accurate.” (Jan Berger, President of Health Intelligence Partners on podcast)
We have been hearing a few things from our clients and have put some information up on the Silverlink website. Some of the comments have been:
At a minimum, everyone is adding information to their websites. Many consumers are Googling the topic or following updates from @CDCEmergency (on Twitter).
Healthplans, PBMs, and population health companies are at the heart of this. They need a coordinated strategy to inform people appropriately as this issue continues to be top of mind.
We recorded a podcast last night with the Medical Director from Healthwise and Jan Berger who is the former Chief Medical Officer from CVS Caremark and is now president of Health Intelligence Partners. In here, they answer some general questions about the situation and what companies should be doing to educate members.
The two standard solutions Silverlink is offering clients are:
As with all our communications offerings, these can be customized (messaging, channel, targeting, etc.) to meet client requirements. Additionally, since one of our technology advantages over others in the space is our flexibility, we can work with clients to keep these messages up-to-date as the situation changes and as new information has to be added.
May 1, 2009 0 Comments
(picture from http://www.myfox8.com/lifestyle/health/la-sciw-swine-masks28-2009apr28,0,4461177.story)
It’s amazing how this has dominated traditional media and blown away the online media.
I few things that stick out for me:
One of my favorite pictures that goes right to the health literacy issue is the following.
NOTE: This is not what H1N1 flu is about…hence the dropping of the “swine flu” term.
(picture from http://cuteoverload.com/)
April 28, 2009 0 Comments
Here is a good presentation by John Sharp of the eHealth blog:
April 27, 2009 2 Comments
I was thinking this morning about how communications evolve. Here are a few examples from the past few years:
1. Caller-ID replacing voicemail.
2. E-mails replacing memos (and getting much longer).
3. SMS and Twitter replacing e-mail.
4. Scanning replacing faxing.
5. Facebook replacing online photo albums.
6. Evite replacing invitations (with mixed success).
7. Twitter beginning to replace news clipping services.
8. Craigslist replacing newpaper listings.
9. Websites replacing brochures.
10. Virtual conferences eroding attendance at physical conferences.
April 25, 2009 0 Comments
I have been a skeptic (and am changing my tune), but for all of you out there that think “what can I share in 140 characters”, I suggest you frame the question differently.
Ask – Should I have a Twitter account?
Even if you don’t want to tweet about yourself, you should have a Twitter account to serve as a news feed. As I saw from the WHCC 2009 and the Health 2.0/Ix Therapy conference, you can learn a lot by using Twitter simply to follow people. And, with more and more companies jumping on board, it’s a great way to keep up with information.
If you find the right reporters, news sources, companies, and bloggers, you can use this as a news summary of relevant events.
(Obviously, I am not the only one struggling with this as another media as evidenced by Josh Seidman’s post the other day.)
April 24, 2009 0 Comments
This is a good presentation on using Twitter, etiquette, etc. For more on Twitter in Healthcare from Mayo Clinic, you can go here.
April 21, 2009 3 Comments
As we have been working with a lot of PBMs over the past year, the question has come up many times – “where do you see the industry going?” After bouncing some ideas off a few of you, we have pulled together a whitepaper with the Silverlink Communications perspective. Certainly, each area of the whitepaper could have been its own chapter, but rather than turn this into a thesis, we are publishing it.
As I have said in a few recent articles including the one in HCPro, I think the Express Scripts acquisition of NextRx will likely accelerate a few of our predictions here.
The executive summary of the whitepaper is below. The final whitepaper is available here.
I would welcome any comments you have…
Executive Summary
In the next several years, we believe that three changes will drive the pharmacy marketplace and ultimately change the business model for PBMs. These changes will be accelerated by the current financial crisis which may drive further consolidation in the short-term. Consolidation which we believe will accelerate the “race to the bottom” where the traditional model of scale has been maxed out with parity achieved among the large PBMs.
1. The need to better engage the consumer in understanding their benefits and ultimately responsibility for their care;
2. The effort to automate and integrate data across a fragmented system and across siloed organizations; and
3. The shift from trend management to being responsible for outcomes.
Consumer Engagement
The industry-wide movement to consumerism will continue to affect plan design, but it will also thrust PBMs and pharmacies into the critical path of member engagement. With pharmacy being the most used benefit as well as the volume and accessibility of retail pharmacies, they will play a critical role in driving adherence and helping consumers understand healthcare. This will renew the focus on cognitive skills, medication therapy management and ultimately drive the desire for a more traditional “corner store” approach that can be scaled using technology.
Combining this with the macro-economic forces that are driving ubiquity of technology through mobile media and the evolution of the Internet from a pull media to a push media will also challenge the PBMs and pharmacies to innovate. They will be required to look outside of healthcare models to identify the right communications to drive behavior. PBM’s and pharmacies will have to leverage behavioral economics and personalization technology to get the right message to the right consumer at the right time through the right medium.
Automation and Integration
The consumer engagement challenges will only exasperate some ongoing challenges within the PBM and pharmacy community. This will include the lack of staff to provide more cognitive services and the general fragmentation of data across organizations and functional silos. Figuring out an overall “single view of the patient” which shows all the touch points and offers a coordinated multi-channel strategy for inbound and outbound communications will become a major focus.
In addition, in order to make these solutions efficient, the development of predictive models, much like the clinical and underwriting solutions being used today, will become the norm across the industry. As these models are fine tuned and the promise of e-prescribing becomes more of a reality, the channel for engaging physicians in the member’s care will finally exist. PBMs and pharmacies will be able to use data to allow physicians to understand when patients aren’t being compliant and when there is an opportunity to drive change.
From Trend Management to Outcomes
The traditional business model for the PBMs has been based on large scale negotiations to drive rebates and efficiencies within mail service – cost to fill and acquisition costs. At the same time as those efficiencies reach a maximum discount, the traditional tools for managing trend will have run their course. Although plan design won’t “die”, comparative effectiveness may reduce (or eliminate) the need for formularies, and in general, the ability to shift cost to the consumer above the 25-30% level will be difficult.
Both of these challenges will push the PBMs and pharmacies into a role where they are focused on driving health outcomes and being part of the bigger solution across the industry. They have a strong footprint to drive this change and as theranostics (or personalized medicine) evolves there will be an opportunity to find cost effective solutions to change the prescription landscape.
April 15, 2009 1 Comment
I had an opportunity to sit down with Ed Batchelor from Humana yesterday. He has an interesting role driving the Stay Smart / Stay Healthy program for them as part of his Corporate Web Strategy role. From what I could tell, it’s a program done for the greater good of educating consumers about key healthcare topics. To accomplish that, Ed has a direct reporting relationship to the operating committee at Humana and was brought in from outside the industry.
Here is an example of one of the videos that they are pushing out on YouTube. I really like the whiteboard communication approach.
Some of the big takeaways from my discussion were:
One question that I had was how to get away from the “healthcare speak” so that consumers could actually understand it. He talked about 3 things:
The other thing we talked about is that pull through that they are getting around employers and brokers. They are pulling the videos in (like here) and re-using them.
This was a program they were highlighting in their booth and one of the public areas here so I appreciated the opportunity to sit down and learn more.
April 11, 2009 4 Comments
I have not been a big fan of Twitter from the perspective of using it to provide a reality show on my life. And, I have struggled a little to find the productive use of it as a business tool. Blogging has fit much better. That being said, I see it being used so much more by people so I am going to give it one more try. I have a few ideas on how to use it. I have added my feed to the blog page on the right, and I am going to give it a month to see if it is interesting or not.
April 3, 2009 0 Comments
This was also an interesting look at online consumers and their influence versus brands.
WSJ Health Blog Drug Channels KevinMD Blog Health Populi e-Patients
Contact me at gvanantwerp @ mac.com.
Enabling Healthy Decisions 