8 9 10 11 12 13LETTER TO OUR READERSThose of us in healthcare have an awesome and inherent responsibility – the ability to supportothers in living healthy lives.And healthy living begins with healthy decisions. Whether it’s a decision to walk a few extrasteps each day, quit smoking, get a cancer screening or simply to take our medications asprescribed – when we receive the right information at the right time, the right results often follow.At Silverlink, we’re fortunate to have unique insights into the positive role that communicationscan play in delivering the right health information at the right time. Every day, sometimes asmany as a million times a day, we communicate with consumers and support them in makingbetter decisions about their health. This is our passion!Now, more than ever, we in healthcare need to re-learn how to reach people and engage them intheir health. In this book, we’ve compiled 13 common pitfalls that we often see in healthcarecommunications. We hope it opens up a dialogue within your company, and ultimately, withthe healthcare consumer it is our privelege to serve. George Van Antwerp Jan Berger, MD, MJ GM, Pharmacy Solutions Chief Medical Officer Silverlink Communications Silverlink Communications Enabling Healthy Decisions Blog firstname.lastname@example.org Twitter: @gvanantwerp
“If you can’t measure it, you can’t manage it.” Speciﬁc- The Balanced Scorecard by Kaplan and Norton Measurable Attainable Relevant Timely
ONEPitfall: Not knowing how to declare successBefore you start a health engagement program, do you know whatoutcome you are aiming for? That has to be step one.Traditionally, marketers have struggled with measurement and how tocalculate the ROI (return on investment) of programs. The first step increating a communications program is to understand objectives andhow we will define and measure success. One measurement frameworkwe often begin with is SMART.
“The best way to drive loyalty is to create consistently compelling and authentic experiences.”- Paul Adams, Think Outside-In Blog http://www.thinkoutsidein.com/blog/about/
TWOPitfall: Limiting design based on company constraintsOne mistake we’ve all made is designing outreach based on what is easyto deliver. Instead, we need to put ourselves in the consumer’s shoes andthink about serving up great experiences. We need to assess the trade-offsbetween ease of implementation and consumer experience as an importantdesign step.To understand what the consumer will see and feel, ask yourself: When willthe message be received? How will it be interpreted? Is it easy to respond?What questions will it create? And don’t forget, there’s not a perfect answer.
“Health literacy is about mutual understanding. Providers (or anyone on the giving end of health communication) and patients (or anyone on the receiving end of this communication) each need to communicate in ways the other can understand.”- Helen Osborne, President, Health Literacy Consulting
THREEPitfall: Forgetting about health literacyThe majority of adults in this country have basic or below basic health literacyskills. If you add in the complexity of our healthcare system, we have amajor communications challenge. Patients don’t always understandprovider’s instructions. As a result, they may have trouble sifting throughhealth information in order to take appropriate action. And often, patientsdon’t know who to ask for help.Take health literacy to heart. Help your patients understand by making surethat all your health messages are clear, simple, and easy to follow.
“We have an expensive plethora of uncoordinated, unlinked, economically segregated, operationally limited micro systems, each interacting in ways that too often create suboptimal performance.”- George Halvorson, Chairman & CEO, Kaiser Permanente as cited in “Why Now is the Time to Enact Health Care Reform.”
FOURPitfall: Not understanding the entire processA lot of times, we solve for one problem without fully understanding theimplications both upstream and downstream. Unless we understandeverything from the initial query through final outcomes along with allof the steps in-between, it’s almost impossible to optimize engagement.Don’t get stuck in your silo. Walk through the process as if your mother orfather or neighbor was experiencing it. Does it work? Where are the pointsof conflict or confusion? Then think about what can be improved to makethe process seamless for the consumer.
“I was shocked to learn there were 337 languages spoken in America today. How can I be the voice of the customer if I only know two and only have one set of experiences? People are different. Ask them. They love to tell you why.”- Ingrid Lindberg, Chief Experience Officer, Cigna Corporation
FIVEPitfall: Thinking you represent the consumer“I would never do that.” Have you said that before? Of course. It’s an easypitfall. You think that you represent the people you are trying to influence.Generally…you don’t.We often ignore facts and instead base decisions on our own experiences.In designing engagement programs, ignore your opinions and try to seehealthcare through the eyes of the consumer. Does the communication fitwithin a consumer’s personal framework? Remember that marketing, liketreatment, needs to be evidence-based.
“Too many consumers make healthcare decisions by looking through their windshield. Appearance and proximity win if messaging isn’t personalized.”- Rob Webb, CEO of OptumHealth, from 8th Annual World Healthcare Conference in Washington DC on 4/4/11
SIXPitfall: Creating generalized strategiesHave you ever received a ‘Dear Resident’ letter? Does it make you wantto engage? Of course not. We want to be important. We want people tounderstand our needs.Health is very personal. We need to personalize every communicationand make our outreach as timely and relevant as possible. To avoid being“just another outreach,” use segmentation and personalization to createpassionate consumers.
“Health is a very emotional subject and emotional decisions aren’t always rational. We can convince ourselves that we’ll quit smoking, eat better, or workout ‘tomorrow’.”- Peter Hayes, Healthcare Consultant, Principal Healthcare Solutions
SEVENPitfall: Assuming people are logicalBehavioral economics teaches us that people aren’t always logical and canmake irrational decisions. We react twice as strongly to a $100 loss than toa $100 savings. We overestimate the likelihood of winning even though weknow the odds. And placebos work even when we know they are placebos!So, as we design our outreach, we should understand the powerful toolsthat behavioral science has to offer – nudges, social norm messaging,active choice, and other core principles.
“Incentives are there to shape specific behaviors for a specific group of individuals. Thus it is critical to think about and design the frequency, intensity and duration of the incentives to fit with the desired behavior.”- Lee Borlo and Joshua Klapow, Ph.D. as cited in “Using Employee Incentives to Drive Wellness Programs.” The World at Work, the Total Rewards Association.
EIGHTPitfall: Forgetting about the ‘why’Another aspect in designing health engagement programs is to understandWIIFM (What’s In It For Me – with ‘me’ being the consumer). Sometimes,the value proposition is clear and immediate. Other times, there is a delaybetween action and reward.One strategy to consider is the use of incentives. These can be carrots,sticks, or intrinsic motivation. For example, we’ve even had a client give awayhaircuts in a successful blood pressure program. There are lots of options,but – incentives need to be tailored to the audience and the action.
“The local “ecology” of health care—local capacity, local social norms and the current payment environment— profoundly influences clinical decisions.”- The Dartmouth Institute Brief: Health Care Spending, Quality, and Outcomes, 2/27/09
NINEPitfall: Not going localLocation…location…location. The local health environment is important tounderstand. That means understanding the patient-physician relationshipand also the environment, and patterns of behavior and culture within thelocal community.This becomes critical in designing solutions. What branding do you use?What tone? What incentives? What voice will resonate? Don’t make themistake that many multi-national companies make when they take a USstrategy abroad. Get local.
“People’s appetite for behavioral data is so big today that there’s a danger of abuse. So design your study carefully - if you do it right, it’s gold.”- Kinney Zalesne, New York Times Best Selling Co-author, Microtrends
TENPitfall: Blindly trusting survey dataWe love survey data. But we have to be careful. Sometimes people don’tknow what they don’t know, and not every survey is of equal quality. And,attitudinal responses can vary from actual behavior, especially in healthcarewhere consumers say one thing but do another.We need to carefully craft our research and experiments. In some cases,it is valuable to get into the field and augment our attitudinal researchwith observations and ethnographic research.
“We randomly assign people to placebos in cancer trials. Surely, we can assign people to no intervention in a marketing campaign.”- Tom Davenport, President’s Distinguished Professor of Information Technology & Management, Babson College; Best-selling author, Competing on Analytics; Analytics at Work: Smarter Decisions, Better Results
ELEVENPitfall: Not assigning a control groupThe downside of data is that it can be misleading if you misunderstandit. What does the data tell you? Does it indicate correlation or causality?Is your sample size statistically valid? Do you have a randomly assignedcontrol group?To really understand what works, you have to create a “champion”intervention process and continually test “challengers” against it. Tosucceed, you need to isolate variables to understand what impact eachhas. And, never sit on your laurels. There is always room to improve.
“Good fortune is what happens when opportunity meets with planning.”- Thomas Edison
TWELVEPitfall: Not planning for scaleWe’ve all been part of a project that works well for a pilot and then failswhen we try to launch it nationally. Why does this happen? We don’t planfor scalability.Post-hospital discharge is a great example of outreach that works at asmaller scale. If we want to reach all recently discharged patients in atimely manner, we need to think about augmenting nurses with technology.When you think about your programs at scale, automate where possible.
“To move from today’s one-off approach to a more integrated model, plans will need to beef up member profile data, create cross-channel oversight, and take metrics to a new level of granularity.”- Elizabeth Boehm, Principal Analyst, Forrester Research
THIRTEENPitfall: Not integrating across channelsAs you design communications, there are numerous ways to reach andengage consumers. What channels can you use? How do you escalatebetween channels? What’s the sequencing? And what are the variationsthat are channel specific (voice, fonts, and branding, are a few).The consumer sees all your outreach as a single brand. So be consistent,emphasizing your brand and a passion for engagement. And, make sureto build on each successful engagement. Learn what works, and seamlesslymove from one mode to the other.
At Silverlink, we get that health and healthcare costs – which are enormous, both in size andsignificance – are actually the sum of millions of individual decisions. When one person decidesto smoke, another gets a cancer screening, a third abandons diabetes medication – these arethe individual behaviors that taken together make up the state of our nation’s health and thecosts associated with it.That is why, when Silverlink set out to transform healthcare, we went right to the individual.Our entire focus, our mission, and our method are about helping our clients move individualpeople in small, healthier ways – the cumulative effect of which can save millions of livesand billions of dollars.To learn more about what makes Silverlink the leader in consumer health engagement, pleasevisit www.silverlink.com, email email@example.com, or call 1.781.425.5700.