Building an Effective Digital Health & Communication Strategy

Building an Effective Digital Health & Communication Strategy

Webinar Transcript:

Joshua Meyer: Hi, thanks to everyone who’s been logging in. Our webinar will be starting shortly, we’re just going to give others a chance to join us as well before we get started. For those of you who joined us, thank you for logging in. We’re just giving some folks a chance to continue logging in and joining, and then we’ll get the webinar started in another minute or two. Thank you. It’s about three minutes after the hour, and it looks like the logins are slowing down a little bit. So I want to be respectful of everyone’s time and I think we can get started. So good afternoon, or good morning, depending on where you are today. And thank you for joining us for our webinar. I’m delighted to be joined by two awesome Segal colleagues today, Joanna Balogh-Reynolds is a registered nurse and Segal’s director of clinical consulting, with 15 years of clinical experience. She’s also our well-being solutions leader and has specialized expertise in catastrophic case management, transplant and oncology, wellness programs clinical program development, and clinical prevention including a focus on social determinants of health.

And Dr. Sadhna Paralkar is senior vice president and Segal’s National Medical Director, with over 20 years of experience. She leads Segal’s medical management consulting and has specialized expertise in on-site clinics, wellness programs, and medical management programs to optimize health improvement while containing costs. While that’s her day job, since the pandemic started, she’s spent a great deal of time researching various aspects of COVID-19. It’s spread, disease progression, tests, treatments, vaccines, and long-term effects. Hopefully that’ll start to lessen, but I don’t know, I think it’s going to be with us for a bit.

And I’m a senior consultant, Josh Meyer, in the Segal Benz Communications Practice, with over 25 years of strategic communications consulting experience. I’m based in New York, currently out of our playroom in our house and work nationally with our clients in the multi-employer public sector and corporate markets. I’ve helped clients develop and implement communication strategies around explaining major plan changes as well as developing brand identities, websites, videos, and other print, in-person and electronic communications. So today, after a brief overview of Segal Benz and Segal, we’re going to talk about digital health care and digital engagement, how COVID-19 has changed how we think about and use digital health care. Things plant sponsor should think about when incorporating digital health care into your benefits programs. Ways to promote digital health care, and we’ll conclude with a brief discussion about wearables.

At the end, we’ll answer as many of your questions as we can. To send them to us, please use the Q&A feature in Zoom, there should be a button at the bottom of your screen with the Zoom menu. Your questions will go straight to us, the panelists. Feel free to send them in throughout the presentation, we may wait until the end to answer them, but you can send them in at any time. And finally, we’re recording today’s session, and we’ll send you a link afterwards. Before we get started on the presentation, we want to talk briefly about our organization. Segal Benz is a full-service communications agency. Our mission is to help great organizations inspire people to improve their health, their finances and their futures.

And Segal Benz is part of Segal, the largest and oldest privately held employee benefits and HR consulting firm in the US. Our mission is to provide trusted advice that improves lives, all three of us. And frankly, all our Segal colleagues are passionate about benefits and helping our clients and their participants. And now I’ll turn things over to Sadhna, to get our conversation started by talking to us about digital health care.

Sadhna Paralkar: Thank you, Josh. And yes, this is my favorite slide. I always talk about it as, I actually put this together, as I just threw all these names on one slide. And our graphics department did a wonderful job with it. So I like to start with this. You can see the combination of words on this slide. Usually help, one solution, virtual care, telehealth, digital care, telemedicine, virtual medicine, what is what? It was very confusing at first, because we know telemedicine started 10 plus years ago, with tella.now. I think in inception since 2012. We’ve been talking about that to our clients, but then they just started talking about digital therapeutics, then the point solution and what is what? So we thought we will simplify that approach today. And I can tell you, what that means, it should not be as intimidating or daunting as it sounds sometimes. But it is a very valuable solution when it’s used correctly. So the next few slides I’ll talk about what are we talking about.

So next slide. What is digital health care? It’s a combination of all of these things, okay? Why is it called digits? It’s because it’s a computational terminology, the binary digits, the zero and one that makes up the computer code. So anything that uses a computer software, and that makes up your website, the apps and the software, that supports any clinical decisions, doctors make every day using even artificial intelligence, or machine learning, this is what digital technology is. And that is driving a revolution in health care. That’s what we are here to talk about. Digital health tools have the vast potential to improve our ability to accurately diagnose and treat disease and enhance the delivery of health care. And we can see some examples in our later presentations.

The wearable devices, we are going to spend some time on that. Which is really the sensors that now track, including some of you are probably wearing the Apple Watch. But there are other devices like the Fitbit and other trackers and sensors that athletes have been wearing for other purposes. But it really tracks all your biometrics now, including, well it already has EKG and pulse oximeter, but the next generation of Apple Watch I hear is going to start also incorporating blood pressure and blood glucose. Yes, one can argue they’re not as accurate as your other devices, but you know what? Technology will get there. I have full faith in that.

Eventually it will get as accurate as those. The telehealth and telemedicine as your old fashioned. I call that old fashioned now, but it’s really seeing the doctor on the screen and having consultation that way. And then really personalizing that medical tree because it is ultimately a personalized or precision consulting as Joanna calls it. I really like that word. So Joanna, I borrowed it from you. But she’ll probably talk about that in her part of the presentation. So next slide, Josh. What are digital therapeutics? So it’s really virtual therapeutics like I said, it uses all of the software and smartphones and tablets and computers to deliver care as if it’s in person. What we particularly like about that is it does address the social determinants of health.

And Joanna may talk more about that later in her part, but it really one of the three that I like to talk about is access to primary care, access to quality health care, and health literacy. The digital therapeutics try to address all of those, all at once, because you will have to worry about this region not having access to enough primary care physicians or enough behavior health professionals, or having the lack of quality. And then just by the nature of that, because it is a virtual tool that you can actually populate with the right information, it becomes a great educational tool, thereby increasing your health literacy. Next slide continues along the same lines of digital therapeutics, this really also addresses other factors of the social determinants, which could be the lack of transportation of somebody not being able to go to see their doctor in their doctor’s office, because now it’s all virtual.

It has a much broader reach in this information-centric than the inflammation-centric wellness apps it has. It actually tries to look at your readings and modify the treatment based on what that particular biometric reading might be. And that’s usually done by the glucometers or the wearables that collect the vital signs for the patient to manage their health condition better. So in having spoken of all the advantages, I’m going to talk some more of that. What happened and what brought it to the attention of everybody is COVID-19. It really brought that to the forefront. In fact, I’m going to read one, it’s not part of the slides, but I came across this article from Kaiser Family Foundation, just two days ago.

The article was COVID was a tipping point for telehealth. And it is definitely here to stay. And they have a fantastic graph that showed from April 2020 until May 2021, as the pandemic surged, the COVID-19 related telehealth visits not only went up, but now with the COVID-19 sort of on a decline, the telehealth visits are still staying pretty high. So a year later, telemedicine accounted for more than 10 times the share of patient visits than it did in March 2020. Very eye opening statistics from that article that I thought it was worth mentioning. So it does, I talked about access. So with shortage of clinicians and specialties in certain areas, it does meet that requirement. You can provide that customized therapy or that precision messaging that can be individualized and customized based on the demographics and user preferences.

And just because of that, you get better patient engagement. Because now you’re certainly reading something that you like to read, which is appealing to you, which is what customization is all about. And I think Josh will get to that later in the presentation on how communication is changing based on these things. I have few more points of the advantages. So because engagement is higher, outcomes are better.

This next one I particularly like, the new medical knowledge and therapies, you can actually want that information instantaneously. If there is a new therapy or new drug or new sensor that’s coming in the marketplace, you can update your information right away. Think about this, when it was a mail-in communication materials. Or a phone call that used to come from some random disease management vendor’s office. And that information for it to be updated into that messaging, used to take us months. So just by doing that, you can share the medical knowledge very quickly. All of that does work towards reducing the cost of care, because the scalability definitely takes care of that. And then ultimately, it is all about enhancing the well-being, because it’s really a core component in helping consumers proactively manage and maintain their health better. So I think Josh is now going to talk about what do we mean by digital engagement?

Joshua: Thank you, Sadhna. So now that we’ve talked about digital therapeutics and what they are, how do we get participants to use these services? How do we engage them? What does that mean? Some of you may have heard the term the digital front door. If you haven’t, it’s a health care concept and it’s a strategic approach to extend access beyond the providers facilities, to where their patients live and to support the various points in the patient’s health care journey. Using this strategy offers health systems unprecedented efficiency and access, and patients the kind of flexibility and convenience they’ve never experienced in health care before. It’s the difference between having to set a reminder to call the clinic in the morning when it opens and having the ability to schedule an appointment in the weekend or in the middle of the night.

It’s a multi-channel approach. You’re engaging your participants all throughout their journey. You’re using technology that they’re already using. Their cell phones, their computers, their wearables. And the goal is to increase productivity, satisfaction, utilization, and engagement. This strategy recognizes that patients, make that people, we’re not limiting it here, will always choose to do the easy thing. Today this means trying to access everything online, on our phones, or just going down the street, finding whatever’s closest. That’s why the convenience of urgent care clinics is so appealing and disruptive to traditional health care. A digital front door strategy creates easy access points, including online self-scheduling, mobile pre-registration or check in, paying online, surveys that beat online reviews and automated reminders for follow, up because it’s easier for patients to be reactive and proactive, while making it easier for them.

I saw an article in the Wall Street Journal, I think last week, about how waiting rooms in doctor’s office are being rethought and transformed by digital tools. You don’t need to arrive early anymore to fill out forms, because you can do it on their app before you get there. You can book follow up appointments that way, too. You can get insurance company costs estimates for your treatment. You can even when you arrive, get a heads up about the nearest parking space to the front door. And if you’ll get alerts when your doctor’s running late, along with tips for what you can do nearby. Know find a local coffee shop or bookstore while you’re waiting. And retail businesses with health care clinics like CVS will even give you the opportunity to shop in their store online while you’re waiting to be seen.

So everything’s changing in health care. And health care’s digital front door has come about largely as a result of innovations from other places like Amazon, Twitter, Facebook, Apple, Netflix. Companies, who they redefined how consumers are interacting with their brands and organizations beyond storefront walls. It’s all about providing easy access, giving participants tools to help them make better choices and acknowledging that health care should be treated like other services, banking, e-commerce, entertainment. So in this era of digital transformation and with patients looking for more control and choice, often through virtual, digital and self-service channels, this enables them to not only interact with providers and health care organizations, but also changes the way that which the services themselves are accessed.

Convenience, personalization, trackable data at your fingertips, technology, choice and control. They’re all just driving the consumer experience. People are even looking for health care the way they look for a restaurant, movie or car. They’re using online surveys and reviews and social media. In a survey conducted by health care consumer insight and digital engagement, 75% of consumers said online ratings and reviews influenced their choice for the provider. And the top choice, 57% for sharing a physician/hospital experience was through Facebook. And a total of 48% said they’re influenced by online reviews when choosing a doctor. That’s come a long way from what it used to be.

So why do it? How does it help? Having an integrated multi-channel communication strategy has the dual benefit of both convenience and more effective data management. This in turn allows providers and plan sponsors to triage more effectively and further enhance the fluidity of the participant experience. So it’s all about self-service, meeting the consumer expectations, engaging them, improving their experience and then in doing all that, you’re then also building longer lasting experiences and finding more ways to help them. This goes back to what Sadhna was talking about too.

So that’s what a digital front door is in the world of health care and why so many providers and plan sponsors are starting to use it. And now we’ll go back to Sadhna to talk a bit more about how COVID has impacted digital health care.

Sadhna: So, those of you who may have attended our previous sessions, I have a slide, serve on a funny slide I call it, which asked a question that has three choices. Who led the digital transformation for your company? The answer is CEO, or the options are CEO, CTO, or COVID-19. 100% of the answer is almost COVID-19. COVID-19 lead the digital transformation of our living basically. So it definitely changed how we access health care. Numbers to paint a picture and I did talk about the Kaiser survey from two days ago. These numbers are also quite eye opening, 81% of the consumers, they said they have fundamentally changed the way they seek telemedicine. 59% were the first-time users last year. 80% of physician provided virtual care. So this is important. We actually have to have some data on physician specialties.

Previously, it used to be only primary care and to some extent geriatric care. We used to use telemedicine and behavior health was just catching up. But specialties like gastroenterology and rheumatology, started using telemedicine during COVID-19 and started actually using that 100% for their follow up visits. Because they realized that they really did not need the patient to come in, by doing a three-hour commute to see them when it’s a follow up visit for like a chronic condition, like Crohn’s disease, or a chronic arthritis patient. Because mostly it was just asking for symptoms, and then some of the palpations and things that doctors do to ask where the pain is, they learn to ask that on the screen. Like "Go three fingers below your last rib on the right side and tell me where it hurts." It’s very important that doctors actually learned how to use that communication virtually.

92% of physicians say they plan to use telemedicine into their regular care going forward. And then obviously the percent of people increasing intending to use it for their health care. So you see the statistics on the right side, March 2020 versus March 21. Fewer than 20% had experience. Now it’s more than 61%. So the first steps are some of the telemedicine companies who are public, they say that they projected tele visits rates that were in 2030 predictions. So that’s 10 years from now, they’re already seeing that in 2021. That’s how far we accelerated the utilization of telehealth. Back to you, Josh.

Joshua: Thanks, those numbers are pretty incredible, right? Huge changes in just a year. It’s changed how we communicate too. We want, we need to hear from our leaders. Not just politicians but CEOs, managers, union leaders, fund administrators. There’s nothing like a global pandemic to help people focus on the need for health benefits. We’re already moving toward communicating more frequently and in small, easy to digest nuggets. And these techniques are now more important than ever. Changing to working remotely almost overnight has really forced us to experiment and try new technologies that might have otherwise taken years to adopt. I don’t know about you, but I think all of these things will be with us going forward. We won’t be backtracking when this is all over. So just like the telemedicine visits, the way we’re communicating, we were already doing it. But we’ve jumped forward much faster than we would have and this is all going to continue going forward. So now I’ll turn things over to Joanna.

Joanna Balogh-Reynolds: So just getting into a little bit how plan sponsors can incorporate digital health providers into their plans. And what’s really important is that there’s a broad category of digital health partners and solutions that exists in the marketplace. And looking onto the next slide, we can show you some of the categories that exist, where digital health has played a role. Now, what’s important to think about here is where do you need to connect back into the human health care system? And where do we see digital health really taking over that area? One area that Dr. Paralkar and I talk about all the time, is behavioral health and substance use.

Whenever we think about the lack of access prior to the pandemic for behavioral health services, it got even worse with a pandemic at 50% capacity, unable to get appointments. We do see that this is somewhere that digital health will really help fill in that gap that existed, not having enough practitioners to treat individuals that need behavioral health, but also provide services to individuals when they’re subclinical or before you’re actually needing to take a medication or have intensive therapy. We can actually see where this area is going to continue to grow and really be supportive to a lot of people. Some other areas, whenever you think about maybe cancer, cancer might be more of a second opinion, but it’s not really going to replace your actual treatment.

Digestive health is something that is really advancing and new in this area as well. But then we have these other areas of self-management around diabetes, hypertension, weight loss, cardiovascular diseases, that really has a way to simplify how you manage your care at home, but then how you can actually download that data for your physician to be more intuitive on how to prescribe your medication or alter your treatment plan. Now how do we really keep up with what’s going on in the marketplace? There are a ton of vendors in the marketplace. A lot of funding went into developing additional services and tools during the pandemic. And there’s a lot of partnerships being forged here. Mergers and acquisitions are happening, so this is a constantly changing field. And what we really want to focus on is what services are really advantageous for your membership? And what’s going to last in the marketplace?

So you want to make sure when evaluating a vendor or a partner that you’re going to implement, is asking yourself that question. Now something that evolved in this space over COVID-19 was certainly primary care. Now, prior to the pandemic, primary care was, we did have Teladoc, MD Ley, some of these were baked into your health plan, but probably not a lot of utilization. Maybe certain age groups were utilizing it more than others. And it was more focused on urgent care services. So you have an ear infection or UTI. And you can call and get examined no matter where you were in the country, and then go pick up a medication for that really acute phase or need. This is really evolving into primary care and holistic health, and just listing a couple of the services that are vendors that we saw there.

What’s happening is technology is making it much easier for primary care to be serviced at home. So Josh and Dr. Paralkar talked about the digital front door. So maybe that is the first step. You are then triaged and then how can you examine through the system and then get back connected back into your physician if it’s something that needs a physical exam? So what we’re seeing is 50 to 70% of visits that can be seen in the doctor’s office can be seen remotely. Now, Dr. Paralkar, what do you think? Do you agree with the 50 to 70%? Or do you see that in a different range?

Sadhna: I think that’s a pretty good range in terms of us predicting that this is actually a good number. Because just yesterday, I read something on every, it could be replaced by remote monitoring, primary care especially because 65 cents of every $1 we spend on health care is somehow touched by primary care. So just using that stat, I think we are right in the middle of this 50 to 70% range. So thank you for asking that.

Joanna: Well, and some people get nervous about that. But hearing from an actual doctor I think helps understand that these services can be safely performed at home. And then coming back in for the more intensive services. I think a great example is I have a bad thyroid. And we have to adjust my medication pretty often, I used to have to go in every three to six months after they would draw my labs. And that was, I don’t want to say a waste of time, but I was just going in having my labs looked at and then my medication adjusted. These could be serviced virtually. Now whenever we think about the trackers that are listed at the bottom, and the Apple Watch announced a couple of weeks ago that they’re going to start having blood glucose measured through your Apple Watch as well.

If you have some of these smart devices at home, they’re tallying all of these results. And then your physician can actually see it virtually and like I said, be more intuitive about how to adjust your medication. I think I was telling a story to a client this week, talking about the old glucometers and sitting down and trying to teach a patient how to use an old glucometer. And then actually getting a steno notebook out and drawing a chart for them with time. So whenever you check your blood sugar, you check your blood pressure, you should write it all out and then bring this in for the doctor to read. That was only five years ago. So we’re now at this place where we have the smart devices more intuitive, more precise medicines, we talked about precision, but is becoming more personalized and precise.

Now the other thing that we’re seeing at home are the at-home biometric tests. You can actually, let’s get checked this is a slide from them. You can test a whole host of disorders, diseases, lines of infection, at home, send it in, mail it in and get your results pretty quickly. Versus you actually having to physically go to an actual lab draw or at your doctor’s office. And what we’re seeing is a lot of services that come out like this, like COVID-19 testing was also something that, through LetsGetChecked you can get done at home. It’s more convenient, more personalized, more precise. And I think I’ve asked you this before Dr. Paralkar too, but maybe for this group, how do you feel about patients doing these tests at home and knowing more about their own biometrics?

Sadhna: I think it’s great. It’s just that the whole, because we are bombarded with all the information and communication from just social media on these things. Everybody’s aware of these things, so let’s have them take some responsibility for their own health care as well. So for them to understand these numbers, and these companies like LetsGetChecked, and I see Tom is on the line here. So they don’t stop at just sending you the kit and taking it and then "Oh yeah, here is what your readings are." They actually have people that can help you interpret those results. And then they tell you, if this results are in this range, which are alarming, you should see your doctor. And that doctor could be a virtual doctor, but it’s something that they can actually, they won’t stop at that. So that’s one thing and two is actually this is very timely, in terms of you stopping at this slide because I see it’s not a question but it’s a comment in the chat box that virtual care does not replace the physical checkups, when doctors can find a tumor or growth.

The answer is yes and no. Okay? So yes, tumor and growth where the doctor is actually doing let’s say mammography, that used to have to go for a machine. But something like a colon cancer or something like what can be done by liquid biopsy, which is a very brand new technology that’s hitting the marketplace with some of the tumor markers that can be checked in blood. So colon cancer, you already have a test, like the Cologuard, and that’s really sending a sample to a lab for checking the colon cancer rate. And there is an argument about how is the colonoscopy still a viable solution or a better solution? Yes, it is. However, if your Cologuard has comes into an alarming rate, then you definitely need to go in for the actual checkup. So this, like I said, technology is simply promising in all of these areas.

Joanna: Yeah, it’s very exciting to see the liquid biopsies in the future of diagnosing cancer before it’s even showing any signs or symptoms and actually potentially curing some cancers that used to be a death sentence. So that’s pretty exciting technology. Now, if we think about some of the other areas that have been in the marketplace, metabolic disorders and coaching for diabetes, hypertension, weight management, this is a pretty expansive field. So just to give the history about over 10 years ago, the CDC created a diabetes prevention program. It was physically on site, you had a support group and you were working through lifestyle changes together. So what was so important about that is not only did you have a peer, that somebody that was working through it with you, but it was also very localized and regionally based. So you had culturally appropriate dietary changes and physical activity that actually met your social determinant of health. Which means where you live.

So did you have a park available? If not, what’s the different physical activity you can do in your city or your town? That was then digitized by OMATA. And they created a virtual diabetes prevention program. A lot of other companies, Livongo, Verta, all these other companies have created a diabetes prevention program, focused on lifestyle changes and weight loss. Trying to prevent or stave off that actual diagnosis of type two diabetes. None other companies, like I said, created those really great digital glucometers, Livongo was one of the first ones in the marketplace that created that. And through that digital glucometer, you now have a connection into an application that is tracking. Did you eat this morning? What did you eat? Did you have physical activity? So it’s becoming like I said, more intuitive to how you manage your daily life and can provide precise feedback to you to say, "Here’s maybe what you should tweak."

Then we had Verta hit the market talking about diabetes reversal and remission and you have companies like Onduo that are talking about that as well. And UnitedHealth care has a level two program where they’re really hyper-focused on if we change your lifestyle, and at the same time prescribe insulin, could we actually put diabetes in remission or reversal? And the ADA has supported that as medical nutritional therapy, as frontline therapy versus putting someone right on medication for diabetes. Now you actually see in that photo a wearable device, so that is your continuous glucose monitor. Many of you probably saw during the Superbowl there were a lot of commercials around CGMs, this is now becoming more of a device that’s being used in type two diabetes. So it was initially for type one, especially individuals on an insulin drip needed to know real time what their blood sugar always was.

Now it’s being piloted or tested more in the marketplace around type two diabetics for two weeks. You wear the device to then be able to see, not only what your lifestyle is doing to your blood sugar, but then also are you on the right medication. So is there an opportunity to dose optimize your blood sugar? So this space we think is very interesting and around hypertension and weight loss as well. All these digitally connected devices, then provides you real time feedback on things that you can do to improve your overall health. Another field that we think is very important is musculoskeletal. It’s a top driving trend for most clients. And if you think really about where physical therapy has been is, you are injured, you have a chronic joint pain, you go physically to a physical therapist, you get examined, maybe they do some heat and ice, but then they give you an activity to do and move on to their next patient while you’re doing it.

So they’re not actually physically moving your body or really watching you the entire time because they have multiple patients they need to see. Additionally you’re to take time off of work and pay a copay. And that tends to add up. And think about this way too. How many times has physical therapists given you a sheet of paper and said go home and do this exercise and how compliant were you with that actual exercise? So what happened is a few years ago we had a couple companies come to play where they have wearable sensor technology. You actually physically put it on your body, Sword, Hinge Health, Kareo, Feasera, all these different companies created this technology where you have a video visit with a physical therapist, they do the examination, you wear the devices during your exercise in front of a tablet, and real time feedback from the device tells you if you’re doing it right or not.

That all then feeds in your profile and then a physical therapist will then see, are you not just compliant, but is that working for you. Or is this activity too difficult, too easy. And they can step up and step down. Pushing that a little bit further, some of these companies have created an end-to-end clinic. So how do we address overall weight management? Are you sleeping? Is this impacting your activities of daily living? Then they can hook you up with a sleep coach or a different type of physical activity. And coupling that with a musculoskeletal Center of Excellence around second opinion, you now have a full comprehensive approach to really tackle cost. And the last piece of this I always let Dr. Paralkar jump in, because I love how she explains it, is how do you also manage pain while somebody is going through this physical therapy or this acute event?

Sadhna: Yes, so we saw by last month or two ago Hinge Health acquiring a device called Enso, which is a tens, which is that high frequency stimulator that they put subcutaneously and it actually helps relieve pain. And previously, that was available for literally inpatient neuromodulator, where the neurosurgeon actually or neurologists actually goes in and implants that. And now they had that technology has almost become wearable. We had not thought about that 10 years ago, that it could become wearable. But that wearable sensor works really well in addressing that localized pain. And think about how many opioid savings that you get, and not just savings, but the avoidance of addiction, because otherwise doctors would just say, "Hey, your shoulder hurts, here is a painkiller." And that happened to be an opioid in the last 20 years or so.
So a lot of these very, very advanced technologies that are going to, or coming in the marketplace and helping us address the point solution needs. Really, that here is the appropriate word. This is, point solution is where you don’t have... It is a solution that fills in the gap when you don’t have a continuous end to end solution.

Joanna: And the pain device is really great too, because whenever you’re wearing it, then you can actually do the physical activity that you need to do to build the muscle up around that joint. So it’s not long term, but it’s really meant to help you do what you need to do to get better. So virtual mental health is another area that we talked about earlier. And what we’re seeing is, we started with Employee Assistance programs. And then behavioral health visits did go virtually during the pandemic. And what we see now is all kinds of different therapies that are available to people, Cognitive Behavioral Therapy, that are, like I said pre clinical or subclinical. So how do we help individuals create the right coping mechanisms? So when something happens, they have that capability. So we really think that all of the above are capable of being virtual. And one of the therapies that we’ve talked a lot about recently is text based therapy.

If we think about the age groups of individuals that are working, and how that’s shifting, and how virtual everything has become, text based therapy is something that we think is going to break down a lot of barriers for individuals to get, seek and get the help they need in the privacy of their home, on their phone, where they feel most comfortable. So this is really helpful to see individuals engaging in tech space therapy, like I said before a catastrophic event might happen. And now they have these coping mechanisms built up. So I think from there, we’re going to talk a little bit about what US planned sponsors need to consider.

So like Dr. Paralkar said, there’s so many point solutions out there to consider and everything is ever growing. And really what works? And then in a year, are you going to have six different vendors attached your health plan? And then how do people navigate through that? So what’s really key is to sit down and consider what are the one or two areas that you want to truly focus on. And where are you going to get the most engagement. And then the most return on your investment, the highest return on your investment. So this is where we sit down and help you stratify what are the areas you want to focus on. And then who are the key players in that marketplace? And what maybe do you have already available in your benefit ecosystem? It’s like we said, which digital therapeutics are most promising. We really do believe that virtual physician consultation and evolving into primary care focusing on the whole holistic experience of that individual, is something that’s here and it’s not going anywhere. It’s here to stay.

Chronic condition management, like we talked about diabetes, weight management, hypertension, all things that you need to do in the comfort of your home, but then can feed back into the physical health care system. That musculoskeletal therapy and the end-to-end solution, bundling that with your center of excellences and then virtual counseling. So we do believe that these are the key areas of focus, that as planned sponsors you might want to take advantage of when considering a digital therapeutic partner. Now, of course, we’re always concerned about security and keeping data secure. And so when adding a digital therapeutic, you want to ensure that data security is happening. So that HIPAA Privacy and Security assessments may be necessary on your behalf. And you want to evaluate any cybersecurity protections.

So how are the individuals logging into that application? How is it staying safe on their phone and their data is not being shared externally? So things to look for in a digital health partner. How are they going to prevent, manage, or treat that medical or behavioral diagnosis? So it’s fantastic to get data and track numbers, but what are they pushing that individual to do, to then improve their overall health? Are there best practices and clinical protocols based in evidence that is evidence-based medicine? So there are some services out there, or digital health partners that you might see that look great on a slide. But then whenever you actually start to get into the application or using the service, it’s really not based on evidence, and it just becomes a tracking device.

Engaging the user. So how are they actually tracking engagement and trending that for you? Standing on a scale isn’t actually engaged in the service. So you want to actually see that, yes, they’re utilizing the devices, but they are making changes or tracking progress towards a goal. And then that becomes meaningful clinical outcomes. Review and approved by regulatory bodies. So we talked a lot about making sure that the data’s secure, but then also they are certified by some sort of regulatory body, whether that might be an NCQA certification. Making claims appropriate. So a lot of these bills through claims as a medical claim and preventive service. So you have to do consider, especially if you have a high deductible health plan, do you need to do a compliance review to make sure that is it first dollar coverages? Is it not? So as you’re setting that up? Those are the type of things to consider?

And then you always want to analyze the data to see who’s engaged in the program and are you getting actual outcomes? So what is the path forward for plan sponsors? So we really think that you should sit down, determine what goals you want to achieve, taking inventory of your current offering. So start at base and say, "What are all my programs that I have in place?" Evaluate the engagement, are they working? Then look at your benefit ecosystem. So a lot of health plans are resellers of these products, that they might have it integrated, and it could be a simple turnkey solution for yourself. Your pharmacy benefit manager might have their own program or a partnership with some of these. Like I said, that could be very easy.

But, you always tend to get a better rate or engagement if you’re actually doing a direct contract. So if that’s something that you as a plan sponsor would like to do, evaluate the marketplace. Do an RFI, do an RFP, look for that single vendor solution that can meet your needs and that is also putting in the right clinical performance guarantees for you. So if they’re not reaching engagement, if they’re not actually making true clinical outcomes, then can you put in a performance guarantee to get some of that feedback? And then always, once you implement you want to measure and evolve that program. Or is that truly still working? Do you need to then push the vendor to do something a little bit different? And when you’re implementing, this is where obviously communications are going to come into play?

Joshua: Thanks, Joanna. That’s a lot to think about for planned sponsors. So what does this all mean? Why is it important? And what does it mean for engagement? And how do we open the digital door to engagement? But before we give you the solutions, I’m going to talk about some obstacles first, the things that may stand in the way of some progress and things to think about as you’re going forward. First, we’re up against status quo bias, which explains how our emotional preference for the way things are makes any change from the baseline emotionally upsetting. We don’t like change. Another large barrier to action is also simply not understanding what’s being communicated. Or how to decipher all the information we’re receiving, especially when it’s around health care benefits. With all of these options and tools and programs, you want to make sure that the participants know how to use them and how to access them.

Hedonistic tendencies. By that I mean, we want to do stuff that feels good now, not things that we know we need to do in the future. It’s the difference between trying to get my kids to eat broccoli, or giving them a cookie. And finally, we’re just bombarded with so many messages from so many sources. And that makes competition for our attention fierce. So we need to find ways to make our communications more effective, so they capture our attention. So how do we get past these barriers? There’s a pattern to what most successful organizations do. And we’ve distilled that into 10 keys. These 10 keys, when used properly, create incredibly successful benefits communication. And they can easily be applied to digital engagement.

We think of them in three groups, your foundation, how you market your benefits, and then having the resources you need to make it all happen. We’re going to talk about some of these 10 keys today and how they can help us think about digital engagement. Let’s start off with strategy. Having a communication strategy is crucial, especially when you’re trying new things. Developing a communication strategy is a cyclical process. Let’s start in the left side of the slide, on this chart, question and listen, then you define your goals, identify your audiences, map out your tactics, develop the look and feel of your campaign, launch, measure your results, and then start the process all over again.

Developing and implementing your strategy will likely involve a little trial and error. You need to assess your results and refine your strategy regularly. True communication is an iterative cycle. You send out a message, you get feedback. And you respond based on the feedback. And asking for input also builds trust and makes people feel valued in where you’re going with your program. Your strategic communications plan should serve as your touchstone. You want to refer back to it to make sure that you’re still on message and that whatever new technologies and new channels you’re using makes sense. When you have a communication strategy, it can help you achieve your goals and get the most bang for your buck. You’re spending all this money on your programs and the tools, you want to make sure they’re actually being utilized.

So you also want to make sure you understand your audience’s. Who they are, what they need, how they want to communicate, who are they. Employees or participants, dependents spouses, children, adult children, retirees, benefits are fun to office staff, trustees, managers, C suite leaders, local union officials, employers, providers. And so many more. And even those groups can be broken down. For example, you have new younger participants, those married with young families, empty nesters, those approaching retirement. They all have different needs and different interests. And with the way things are changing these days, you have to be careful about making assumptions about what your participants are dealing with and who they are. Things that used to work may no longer work.

People are having children at any age these days, financial issues, caregiving for a pet parent can span age group, and demographics. So some of these issues are affecting people in different ways than they used to. And as benefits professionals, you’re also what we call choice architects. Professionals who design how choices can be presented to impact the decisions people make. A little behavioral economics. The decisions you make around the programs you design influence in the employees’ actions, and you need to make sure you’re getting your people to take the right action at the right time. More intentionally designing your benefits and your communications will help you achieve better results. You want to think about how easy it is to access your resources.

Are you reaching dependents too? Are you using more than one channel to communicate? Are you using the right mix of channels? Are you leveraging your resource and the those of your vendors? Are there gaps in your communications infrastructure? Do your participants respond when you send them messages? What are the limitations you’re facing in the channels you’re using? We’ll discuss some ways to solve for these issues as we go forward. So first, how are your participants accessing your resources? How are they using the digital front door? Do you have a website? Do they call you? Or do they just use the physical front door and come to your office? The same questions apply to the way they access resources and tools from your vendors. And how all of these things fit together?

To reach your audiences, you want to understand and use your entire communications ecosystem. We’re fortunate today to have a wide range of media at our disposal as you can see on this chart. We’ve got traditional print, digital media, emails, websites, video, social media, mobile solutions. Over the last year, many of us have had to try new channels. For example, if your participants work in a plant, and you usually communicate using things like posters in the lunchroom, or in person meetings, what happens when you can’t use those media anymore? You need to reach your people where they are. And that may mean emails, website information, social media, texts, tweets, snail mail. So looking at your overall communication system, we recommend that you invest in digital communications. That’s certainly the way we’re moving now and the way of the future. But we recommend that you also continue to use the more traditional tools.

Print still works. It’s still effective, it can get people’s attention, especially when they’re getting hit with so many emails and texts and other messages. So you can really cut through that. And it’s also a great way to get their families and dependents involved and help them get involved in the decisions by sending something home to them through the mail. And websites are a really crucial part of digital engagement. Your website is in effect, your digital front door. It’s the bridge to your participants, and it ties together all of your digital resources and those of your vendors. When you put your benefits information online, you’re giving participants and families a single destination to act on their benefits or to find answers to their questions anywhere, anytime.

For your participants, an accessible and easy to use benefits website will help them find the information they need fast. Minimizing frustration, enhancing their experience, and inspiring their trust will also help them see their benefits holistically, rather than just as a patchwork of providers and administrators. Spouses and dependents will be able to access benefits information too, allowing families to make more informed choices together. Finally, a benefits website provides a platform for your ongoing communications. Access, convenience, technology. The benefits of your digital front door, all coming together on your website. And here’s another look at your communications ecosystem. And how it can be used throughout the year.

You want to maintain regular communication, use multiple channels, and keep your communication simple. Note that this combines print and digital communications. By next year, or maybe even later this year, I’m hoping we can add back in the personal, in-person meetings that we used to have, shown on this slide. And you want to use your digital tools to market your benefits, to target your messages, and to create digital connections with your participants. You can use email to get your message out. You can send out a blast email to the whole company or all planned participants, but you can do a lot more with it than just that. We’ve created online tools for clients that allow participants to sign up for emails to tell you their preferences, their goals, topics of interest, how frequently they want to hear from you and more.

You can let your participants decide what they want to learn about and when and how, instead of just pushing out messages to people who may or may not be interested. And you can set it up all in advance. So the messages go out automatically, and the messages are consistent. Finally, since it’s an electronic tool, it’s easy to get data and track how your communications are working. This is a way to improve participant experiences by putting them in control of preference-based communications and targeting content and channels based on their preferences and profiles. Again, it’s about finding a way to open the digital front door to provide access and control to your participants. And you have more digital tools and channels at your disposal.

Over time, you can expand beyond email and go to texting or even social media channels. You want to find the right digital front door for your participants. And remember that it won’t be the same for all of your participants. Finally, video is a great digital engagement tool. Like the mobile solutions we talked about earlier, video is a preferred channel because it’s so much a part of our daily lives. I don’t know if you know this, but some of the stats I found when researching this, 300 hours of video are uploaded to YouTube every minute. And almost 5 billion videos are watched on YouTube every day. It’s amazing productivity has stayed where it is, or maybe it hasn’t. When you think about it, we’ll watch a video to learn how to make a recipe or fix something around the house or to learn a new skill. So why not leverage that technology for your plan communications as well?

Video has the advantage of taking complex concepts and distilling them into a simple visual format, and can be really entertaining. You can take an eight- or 10-page brochure and turn it into a two-minute video instead. Or do both so your audience can choose the medium and the level of detail that they prefer. Videos can be animated, they can be live action, you can have talking heads, testimonials, it’s a variety of styles. And it doesn’t have to be highly stylized or produced either. People are really comfortable with cell phone videos, they’ll watch YouTube, Instagram, and TickTock and be perfectly happy with that style. And you can work that into your benefits communications. And videos also help support the needs of diverse audiences. You’ve got visual learners, people with different language preferences, and given how complex benefits information can be, video can be a really useful tool to help overcome low health or financial literacy issues.

Now let’s turn to your external resources. We encourage you to leverage your vendors and make them work for you. Think about all the touch points that they have with your participants. And think about the ways to integrate them into your digital communication strategy. As your communications are generally very good explaining their own programs, but they’re not always so good at tying them back into your overall benefits messages and goals. And that we’re into other programs. That’s why we want you to proactively tie them back to your programs. If you haven’t already, we recommend considering hosting a partner summit, getting all of your vendors together in one place. All of your vendors are, or at least should be working towards the same goals, your goals.

So if you get them together to talk about it and coordinate strategies, they can collaborate and really schedule communications better and make sure you’re not sending out repeat messages about the same things and even conflicting messages from different vendors. You can align all of your resources and tools and bring them together to help your participants. Because your participants have this whole array of tools and information being thrown at them, you can help curate their experience and make sure that their understanding what to use when and coordinating with your vendors can help that. So you can leverage your vendor sites content and tools, you want to make sure you’re familiar with what your participants are seeing and have access to. So you want to check out what your vendors are showing them. You can point participants to these external resources, but be their hub. Make sure they come to your house to expand the digital frontier analogy. And that they don’t go straight to the external resources bypassing you. You want to be their primary point of entry and access where it makes sense.

And now as we head into the homestretch a little bit, we’ll talk about how you can capitalize on the popularity of wearables. One of the things we’ve learned over the last year is that technology isn’t just a disconnector. Some people may put on their headphones and bury themselves in their phones, technology and apps, and then turn themselves off from what’s going on around them. But you can use this technology, apps, wearables to bring people together. And with more and more people using wearables, there are ways you can take advantage of that. But first, you want to understand what your participants are using, why they’re using those apps and wearables and what they think of them.
What is your participants’ experience? And how are you architecting that experience? Are they using your vendors at tools and apps? Or are they third party tools and apps that you don’t necessarily have some control over. You can partner with your vendors to promote these tools and tie them back into your program of benefits. You can think of wearables and mobile apps as yet another set of access points or digital front doors to your benefits and your benefits communications. Again, you can be the hub that connects your participants to your vendor apps and tools. You don’t need to have an app yourself, unless you want to and it makes sense for your organization and your participants. But you can be the connector or the doorway to these apps and tools.
And wearables can do more than just provide information and track activities. They can actually help build connections and community too. These are some examples that we’ve seen over the last year, year and a half, when people have been working remotely. Several of our clients held virtual challenges during the last year. Instead of having a walking club at lunch or having a race one weekend, they set up online challenges to get their participants moving and healthy. And to build community. People sent in photos and videos as well as tips and some even engaged in some friendly trash talking. And in the middle, between these two unrelated superhero events, and we can talk another time about how superheroes have taken over everything, is a page from another fan’s website.
This fan partnered with a wellness vendor, to offer incentives for people taking part in various activities. They provided discounts for wearables, and they were promoting this online through their website and their social media channels. Really, it’s a way to reach out, get people involved, get them to help make healthier decisions, and to participate in your benefits. And make their program successful. So I know we’re coming up on the hour, we’re happy to stick around and answer some questions for everyone. Anyone who wants to stay with us, we have some questions in the chat.

Sadhna: So we do have a few questions on the chat. And I did try to group them together.
As in they were multiple questions on the test, the at-home tests, like the LetsGetChecked that we talked about, are they covered by insurance? So LetsGetChecked per se are not, but some other tests are. For example, Cigna launched a campaign with Pixel by Labcorp, which is an at-home nasal swab test for COVID-19. So that will be covered. So it’s the likes of the at-home that is when vary by insurance ranges. Same with Cologuard, I know so many self-insured plan sponsors cover Cologuard, regardless of whether the actual large carriers do or not. Medicare covers it. So it all varies. It goes bits and pieces. So that was one global question I had about the coverage of at-home tests.

There was one question on the value based payment arrangements, and how do we make sure the digital health is part of that? It actually absolutely is. So any of the new programs that even the insurance carriers are rolling out like the level two by UnitedHealth care. That is one great example of it is a value based diabetes management program, digital program, where they are taking full risk for making the results or showing you the results of your diabetes patient. So that can easily be integrated. There was one question on how do plan sponsors capture the evidence based data on the efficacy of digital solutions?

Well, I’m going to make the blatant overt advertisement procedure, that’s when you hire us. And we will do it for you. Because we are on top of these vendors. And we know, we have vetted them and we have very good evidence of what works, what doesn’t work. So that’s my spiel. Are there any other questions that I have missed? I know people are probably dropping out because we are at the top of the hour, we can certainly follow up by email as well.

Joshua: If people have left their names, with their questions, we’ll do our best to get back to you with answers.

Sadhna: Yes.

Joshua: Anything else you wanted to jump out that had universal appeal on the questions?

Sadhna: I’m just seeing a number of people dropping. So, it was one question on the wearable and how many doctors are able to receive digital data? If the doctor is part of that digital solution, they will be. So we cannot expect every primary care physician out there to be on top of every patient’s wearable, but they have to be enrolled in a specific program to be able to do so. So eventually it will become a norm. I think that’s them all.

Joshua: Thanks to everyone for joining us today. As I said, well, we’ve recorded this presentation and we’ll be sending everyone who joined us today a link so you can re-watch and we’ll... for questions that we didn’t get a chance to answer, if you left your name, we will do our best to get back to you. So thank you all for joining us today.

Sadhna: Thank you, everybody.