It all started with a simple question one day, and grew into a trusted health relationship a few short months later. Sarah was very busy at work that crisp fall morning and had only a few minutes to log in and ask about her daughter’s diabetes medication. Sarah was comforted by the response and a bit intrigued when her Health Assistant Harriet introduced herself and explained that she is a resource to help her and her family with any of her health questions or concerns. They began a conversation about her daughter’s condition and a trusted relationship began.

Later that week Harriet made a follow up call to see if Sarah was able to pick up her daughter’s medication and asked how everything was going. Sarah mentioned that she finally got her daughter’s pills and confided that she was completely overwhelmed. Sarah shared that she was recently diagnosed with breast cancer and that her husband was often unavailable as he traveled constantly for work. She explained that she had a hard time getting to her treatments. After their call, Harriet explored and evaluated resources, and scheduled transportation to help Sarah get to her next appointment. Harriet put the appointment confirmation into Sarah’s patient portal and set up a reminder, including date and time, about the ride to her next treatment.

This may sound like fiction in the current healthcare environment, where services are siloed and patients are burdened with making their own decisions around healthcare – often complex and costly. Sarah is relieved to have this service today. She first learned from her employer about the Accolade platform and health advisor service last summer. It wasn’t until she reached out with a simple question to her health assistant that Sarah experienced the true value of having a healthcare advisor on her side.

A 2016 Harris Poll reveals that 84% of working families placed a value on having a single, trusted resource to help support their healthcare needs. Busy families have limited time and resources so they appreciate having one place to go to help them understand their options and sort through their healthcare decisions. 

Personalized Patient Experience

With the Accolade Health Assistant as the single point of contact for her family, Sarah is able to reach out to Harriet for guidance all along her and her family’s healthcare journeys.  Accolade integrates high tech and high touch to deliver a superior patient experience with lower healthcare costs. 

Accolade Health Assistant Harriet accesses the Accolade platform to interact with and personalize her support for Sarah:

Preferred Communication: Harriet engages with Sarah and her family based on their communication preferences. Sarah likes phone calls and email through the Accolade online portal. Sarah’s husband Sam prefers secure text messages since he can send quick messages and follow up later during his business trips.  

Personalized & Proactive Experience: Harriet’s interactions with Sarah are driven by rich patient profile information, which contains contextual information, social determinants of health and service utilization. Sarah and her family’s profiles are updated with data collected over time and more than 150 data feeds integrated into the Accolade platform. The HIPAA-certified approach creates profiles that are continuously analyzed through sophisticated algorithms and health assistant reviews, which allow for personalized conversations around individual health needs, care gaps and obstacles.

A recent Accolade platform trigger prompts Harriet to reach out to Sarah’s husband Sam when she notices that he is still refilling this pain medication many weeks after his knee surgery.  Harriet sent a text to Sam to inquire about his knee surgery. After a text exchange, Harriett suggested that he see his doctor to discuss his persistent pain.

Patient Education & Connected Health: Sarah and her family can access educational information and recommended health apps. Before Sarah’s husband knee operation, Health Assistant Harriet texted Sam with a link to a video and suggested questions to prepare for his surgery and provider discussion. 

When Harriett spoke with Sarah about her daughter’s diabetes appointment and care plan, Harriet informed Sarah about the Livongo mobile diabetes application available through her employer’s health plan. Together, they review the Livongo app, which can help Sarah and her daughter better track and manage her diabetes. With Accolade and Livongo, Sarah is able to share information from the mobile app with her daughter’s doctor, giving him insight into her problems with controlling her A1C levels.

Continuous Connection to Clinical Resources and Support:  Harriett asked Sarah if she would like to speak with an oncology nurse to help prepare her for her upcoming oncologist appointment. Margaret, an Accolade Clinical Health Assistant and RN, joined them on the line and offered empathetic support by asking more about Sarah’s diagnosis, where she was in her care plan with her doctor, whether she had a support network and what was planned for her next appointment. Margaret provided Sarah with questions to ask her oncologist and recommended a follow-up discussion.

Intelligent Engagement: Harriet and her Health Assistant team are continuously alerted by the Accolade platform. On an ongoing basis Accolade gathers, aggregates and models de-identified data to trigger alerts and guide Health Assistants in further personalizing their interactions with their clients.  Health Assistants are prompted to ask questions about health behaviors and emerging symptoms, applying specialized training and skillset. 

Patient Experience Success Measures:

Paul Csigi, Director of Benefits at Philadelphia- based Temple University Health System (TUHS), rolled out the Accolade solution in 2015 and has over 7,000 employees on the platform today.  “So much of healthcare is getting people to the right place at the right time. Accolade has created an experience where our employees build a relationship with an assistant that gives them what they need, when they need it. Accolade takes a single problem that the patient has called in about and creates a relationship to support the family on an ongoing basis. With all of the information about our employees, Accolade addresses the whole person, connects the patient with clinical resources, and continues to reach out. This helps treat our employees sooner, which is less expensive for our organization.”

In addition to financial measures, TUHS monitors qualitative feedback from employees. With the Accolade platform outreach (phone or online), TUHS is able to capture the patient’s experience engaging with their Accolade Health Assistant:

“I'd like to thank Temple for the Accolade program. We have been going through some really tough times…..my health assistants have been a big support and a big help to my family in helping to guide us to the right doctors to help with family issues and illnesses. I really appreciate this program. Without it, I'd really be lost.”

With two years of the Accolade solution under their belt, Paul Csigi and his team are considering new ways to support TUHS employees. “I have an employee population with diabetes and heart disease. I am interested in learning more about Accolade’s partnerships to bring patient data into the platform to support these populations.”  Csigi sees the benefit of bringing in data from patient devices and smart applications. Integrating this data with the patient’s medical record gives new insights to Accolade Health Assistants, empowering them to deliver even better support and drive improved outcomes.

mHealth + Telehealth World 2013- World Congress

July 24- 26, 2013 in Boston

Innovative healthcare organizations are developing comprehensive engagement strategies to support consumers across the care continuum. They are aggressively testing and learning about how to effectively use mobile technology to guide, motivate and support consumers for better health outcomes. 

During this session, you will learn about: 

• Evolving Consumer Engagement Landscape & Trends
• Engagement in Action and Insights from Innovative Providers & Payers  
• NeHC Patient Engagement Framework & Examples at Each Step
• NeHC Consumer eHealth Readiness Tool powered by HealthCAWS- Assessment & Path Forward 

Speakers:

Sherri Dorfman, MBA, CEO & Consumer eHealth Engagement Specialist, Stepping Stone Partners

Rose Maljanian, MBA, Chairman & CEO, HealthCAWS 

Regence Program Rewards Transformational Activities 

Regence started on a new path to consumer engagement back in 2005.

After seeing a recent presentation outlining their consumer engagement framework, I reached out to Torben Nielsen, VP, eBusiness Strategies and Services at Regence to learn more. Torben shared their past journey as well as their future direction with me.

Here are the 4 steps along their consumer engagement path. Regence is currently at Step 3 and has a conceptual view of their next step which will continue to evolve as the market landscape fills in around them.

Consumer Engagement Step 1: Know Me

Regence’s first step focused on the passive cardholder, giving them value as they logged in. The cardholder saw all of their claims, benefits and provider information. This was back in 2005. Prior to that “it was not a good experience” since the member only saw some of their claims information and the list of providers “did not even indicate whether each one was inside or outside their network”.

Consumer Engagement Step 2: Engage Me

Beginning in 2008, Regence decided that they needed to get to know their members in order to effectively engage them.

Instead of linking the member over to their health or wellness program vendor’s website, Regence decided to keep the member within their portal to capture their online behavior.

Around that time, Regence launched their Rewards Program which awarded points to members for “tranformational activities”. These activities were rewarded because they “informed, empowered and educated the consumer”, including looking up content around a health issue or participating in a wellness program. Regence decided not to reward members for “transactional activities” such as looking up a claim or searching for a provider.  Regence really needed to keep the member on their portal to track their online behavior in order to reward them.

Next Regence started their email program, sending out relevant electronic communications to bring members back to the site. Although many health plans have an interest in emailing members, I hear all the time that they do not have their email addresses. Regence collects the member’s email address during their site registration process. “We can’t engage with out email. It would be a missed opportunity to get in front of the member”, Torben emphasizes.

In addition to generating additional portal traffic, health plan communications can also strengthen their member’s satisfaction scores, which is more important now than ever with the increased market  competition.

Consumer Engagement Step 3: Connect Me

Over the past two to three years, Regence has been moving faster down the path with consumers.

“Connect Me” goes beyond the “member to health plan” relationship. According to Regence, this also includes strengthening the “member to member” bond through social community and the "member to their care team" bond through ACO efforts.

One important way for Regence to strengthen the “member to member” relationship is by getting consumers to contribute more content online through conversations, ratings/reviews and suggesting local events in their geography.

Another aspect of “Connect Me” addresses the cross communication channel experience since members are increasingly accessing and engaging through their mobile devices. “We’re connecting the data that we’re sitting on to provide a more personalized experience for our members”, explains Torben.

Consumers are engaging with Regence!

• 67,000+ patient reviews have been submitted by members, of which 90% are favorable (i.e. the member  would recommend the physician/facility).
• 63,000+ posts in the Community section of myRegence.com, written by more than 6,000 unique content creators.
• 346,000+ have opted- in for member electronic communications (e.g. updates and alerts, account information, etc)
• 260,000+ subscribers signed up to receive the bi-weekly myRegence.com email newsletter

Consumer Engagement Step 4: Partner with Me

As they look down their Consumer Engagement path,  Regence has determined where they want to be directionally. Regence wants to be relevant to the consumer’s every day life. Something consumers need to check as part of their daily routine. Their starting place to look for information to meet all of their health needs.

Although it is challenging to know exactly where the market is going, Regence will remain in touch with their users to help guide the way.

In fact, Regence has over 400 users that help advise them by providing ongoing feedback to potential directions. [Note: Innovative companies have consumer advisory boards as a best practice. Increasingly, these consumer advisory boards are managed in a private online area and the insight captured is used to guide product and marketing decisions.]

Regence is co-creating with this growing group of consumers to define and refine online capabilities. When Regence asked for feedback about “patient reviews”, members felt they needed to see more than the reviewer’s screen name. Users wanted “the ability to connect with their peers in order to get advice when selecting a provider”.  In the latest patient review experience, the screen name is linked to the reviewer’s Community profile page, where to learn more about who they are, where they’re from, what they do for a living and members have an the opportunity to make a friend request.

Regence’s Results Realized

Due in large part to Regence’s consumer engagement strategies, myRegence.com experienced the following results in 2011 over 2010:

• 30% increase in the cumulative number of content creators (i.e. those who have left a patient review, posted in Community or both).
• 88%  jump in the number of $25 gift card redemptions through the Rewards program 
• 76% increase in the Consumer Engagement Index (CEI) which measures the user adoption of transformational features
• 26% open rate for targeted email campaigns, nearly 2x the industry benchmark of 14%

Regence has also noticed that their segmentation efforts for email have been effective in engaging consumers. For example, by sending a Patient Review email to previous reviewers, Regence realized a 38% open rate.

As Regence moves onto step 4 in Consumer Engagement, they are conceptualizing new ways to reach out to their members with relevant information from their plan, community and care team. And they will be innovating with and listening to their users throughout their journey.

At the recent World Congress mHealth Summit, I led a panel called “Personalizing the Mobile Experience to Drive Consumer Engagement”.

Why is mobile so important and why does it need to be incorporated into all consumer health & wellness engagement strategies?

Pew Research’s May report found that “83% of US adults have a cell phone, and 42% of them own a smart phone”.  As mobile phone ownership grows so does the consumers’ expectations about using this device to plan, manage and monitor their personal lives. Consumer- driven companies across financial services, retail, media and entertainment are designing creative ways to engage the consumer through a valuable mobile experience.

Within healthcare, mobile is a cost effective and efficient way to not only generate but also sustain consumer engagement.

Here are several strategic considerations that I presented while introducing the panel topic.

1. Segmentation & Customization. Once a company moves beyond enabling mobile access for all target users, they must think carefully about the varying needs and mobile usage profiles of their different consumer segments. Consider consumer segments which have high mobile technology usage.

Pew Research found that over 87% of minorities such as African Americans and Hispanics have mobile phones and they are more likely than whites to send/receive text messages, use the internet on their mobile phones and have smart phones. What about a mobile texting program educating them about their health condition or motivating them to engage in preventative care?

Frequent business travelers stay connected to their company, customers and family through their mobile phones and tablets. A recent Columbia University study showed the association of business travel and cardiovascular disease. According to the study, this may be caused by their poor diet, lack of exercise and sleep as well as stress. Imagine how mobile can be used to help these travelers manage their health issues and make better decisions while on the road.

Over 75% of teens have a mobile phone and more than half are texting every day based on Pew research. Can you send mobile messages to teens to educate them about staying fit or informing them about ways to manage their diabetes? There is also opportunity on the mobile apps front.  I recently participated on a project envisioning mobile solutions to support the mental health of (college) students to avoid depression.

How is Highmark approaching segmentation? Highmark utilizes Forrester’s Technograph Segmentation to prioritize their mobile initiatives. Panelist Lisa Fitting, Director Client Engagement mentioned that when Highmark conducted segmentation research across their member base, two key segments emerged-- “Connectors who use their mobile phone for work and are productivity- oriented” and “Communicators who regularly use SMS” and often use other digital communications. Highmark is using this insight to define mobile initiatives based on these preferences. They also plan to come out with mobile applications targeting specific needs such as “fitness, weight management, diabetes, medication”.

2. Multi-Channel Experience. As consumers move about their daily life, they move from channel to channel. Teens put down their mobile phones when they pull out their laptop computers. When they are through interacting via their computer, it is important that their next mobile interaction reflect their latest online activities.

Humana conducts user experience research to better understand how different types of users interact with their Humana Fit application through their mobile phones and computers. Panelist Tony Tomazic, Director of Consumer Innovation at Humana explains “we understand the strengths of mobile. Through research, we have learned how consumers want to use their mobile phone for tracking and communications regarding personal health and fitness (e.g. saving episodes of activity, receiving reminders and alerts), whereas consumers prefer to use their computers to manage more complex and visual planning of their goals and gather information from their other external devices.”

3. Personalization in Context. While carrying their mobile devices, consumers can use them to receive reminders, review educational messages, track information (e.g. mood, pain levels, fitness and nutrition) as well as search for information to make decisions while on the go.

"Healthline brings both personalization and contextualization to the consumer", explains panelist Ryan Tarzy, VP Business Development. “Aetna members view search results that are both contextual to the issue they are researching (e.g. diabetes), but also personalized based upon their personal health record, location, and covered benefits”.

As you develop your mobile health and wellness strategy, think about the needs of your various consumer segments and their mobile technology profiles. Consider their multi-channel experience of which mobile is only a part. And determine how you can design a mobile strategy which brings new value to the consumer through personalization within the context of their current health, plan coverage and location.

Have you read the Seven Mobile Health Engagers?

While attending health care conferences, I often hear presenters describe their pilot programs and share what they have learned from new and expanded engagement initiatives delivered through online (social communities, social media, portal), mobile phone, telephone or email channels.

Many companies are in the “experimentation” phase. They are determined to discover the effectiveness of each channel in generating consumer awareness, interest and participation in their health and wellness.

When discussing their channel plans, I tend to hear companies say “once we have learned about how the channel can be leveraged, we will be ‘operationlizing’ it into our programs”.

During my conference panel last week on multi-channel engagement, I emphasized the importance of incorporating an interim phase to “Consumerize” the channel strategy before moving into the operations phase.

“Consumerizing” entails understanding the needs of each priority consumer group or segment (e.g. adult patients with diabetes, children with asthma) and determining how mobile for example can be utilized with other channels to meet their needs.  Specifically, companies need to determine the “role” that each channel plays such as enable access, educate, motivate, guide decision making, deliver emotional support or help with care collaboration.

With a clear understanding about the set of channels and how each one brings value to the consumer segment, providers/plans/employers can effectively orchestrate consumer engagement for maximum results.

Channel Challenges

This is not easy to do.  Channels are converging. For instance, consumers are using their desktop to upload pictures into a  social community and then getting messages on their mobile from the community.  They are receiving an email with a link into the online portal for their lab test results. Consumers are viewing mobile messages about preventative care with an option to click to connect for appointment scheduling.

With this convergence, the channels are becoming intertwined and integrated which brings complexity to planning, implementing and evaluating channel initiatives.

• Channel Planning:  Many organizations have separate committees for each channel (e.g. mobile, online/social media) planning their own strategy. Instead of looking at one channel, organizations need to take a more strategic and holistic view by starting with a consumer segment and understanding their channel preferences and behaviors in order to define the role that each channel can play in meeting their needs.
• Channel Implementation: Companies tend to spend more time thinking through the internal processes for sending content over these channels and not enough time thinking about how the consumer receives and interacts with it. They need to consider the information that is presented and captured within each channel and how it is shared across channels. All channels must be connected and synchronized to deliver the best consumer experience.
• Channel Evaluation: Although many organizations are still looking at engagement one channel or campaign at a time, it is essential to evaluate the effectiveness of the channel at the consumer segment level. Each channel needs to be evaluated based on the role it was designed to play for that specific segment.

Consumer- Centric Channel Strategy

Companies outside of the health care industry have a big head start. They have an established consumer segmentation approach. Consumer centric businesses in the financial services and hospitality industries are overlaying their channels onto their segmentation to deliver a relevant and meaningful consumer experience. These companies are also focused on driving consumer engagement. A colleague at a large financial services firm told me about the “O2O” trend and how they are focusing on optimizing the “online to offline” experience (e.g. using targeted social media to drive card members to an event).

There is so much that health care organizations can learn and they are beginning to look outside of the industry for new strategies.  Health care companies are starting to realize the powerful role that new channels and approaches can play in motivating consumers to take on more responsibility in managing their health and wellness.