October 23, 2020
By Julie Gould
Matt Dickson, vice president of product strategy and general manager of communication solutions at Stericycle, discusses what providers can do to relay health information to common patients while ensuring high-risk patients receive their tailored health care communication, and how they can improve health literacy to ensure groups comprehend vital information.
What are some of the major challenges in communicating with patients across various demographics and needs in an ongoing pandemic world?
We have seen a rise in the use of digital health tools and services, such as telehealth, during the pandemic as health providers adapt to providing as touch-free of a service as possible. What this has highlighted though is a broader access challenge in underserved populations, which have experienced a drop-off in care for chronic conditions since the pandemic began. Most telehealth platforms use English as a primary language and require privacy and a laptop with internet connectivity or a smart phone—this leaves out those living in poverty, some elderly patients, minorities, and those with low technology literacy.
Another area of concern is in mental health. The No. 1 predictor of a missed appointment is the number and severity of mental health conditions. During the pandemic, we are seeing even more mental health concerns arise adding to the challenge. With patients not able to connect virtually due to socio-economic barriers, and those missing appointments due to mental health status, patients just aren’t being seen when they need care, even for serious conditions. We’re hearing stories of people who have had strokes, heart attacks, and issues managing their chronic conditions avoiding the ER and failing to seek appropriate care. This is a pending disaster.
Can you discuss what providers can do to relay population health information to common patients while ensuring high-risk patients receive their tailored health care communication?
- Send broad messaging across all channels letting your community know what you are doing to help them through the pandemic and keep them safe when seeking care. It’s critical to be prescriptive with these communications. For example, “Please social distance in our facility” isn’t as prescriptive as “Please stand six feet apart from all patients and health providers when possible, and wear a mask or face covering.” Using social channels is a great way to promote the steps you are taking to keep patients safe, but keep in mind not everyone has access or uses social media.
- Conduct targeted analysis in key areas such as post-discharge compliance to help inform strategies. Ask questions about what that population looks like after treatment. For example, what is the rate of patients in the ER with a stroke? Are they adhering to a treatment plan? What is the financial impact?
- Tailor communications based on patient risk scores. Identify the highest need patients using risk analysis and digital triage. Health risk assessments are a good tool to use for self-triage. Have certain patients missed appointments or are they not self-reporting their vital information? In these cases, you need to chase the patients to get them in to care. Send a positive message to lay the foundation and express concern with a personalized message about why it’s important for the patient to come in. At the same time, and in a very pointed way, point out the things that providers and health system are doing to keep patients safe (e.g., telehealth, virtual waiting room, separate entrances, masks, etc.). Additionally, consider all demographic information when tailoring communications. Does changing content impact no-show rates? Low overall literacy may impact health literacy and may require simpler and more positive words to positively impact adherence.
- Run A/B tests to begin to detect behavior. As the organization collects more data, determine which set of methodologies (cadence, method, etc.) gets people to take action. Use very specific messaging based on data points. The more personalized the better. An 82-year-old patient with cognitive or mental health challenges is going to need a very different patient engagement strategy than a 30-year-old healthy patient.
Why do providers need to take into account the primary channels of information consumption certain demographic groups use over others and how can they improve health literacy to ensure these groups actually comprehend this vital information?
People are bombarded by messages across all channels, receiving anywhere from 4,000-10,000 a day. But the average human can only process 100 messages per day. If your communication isn’t resonating with your audience, then it’s wasted.
We need to think beyond “channel of choice” and begin talking about the channel of activation. Choice or preference is generic and hypothetical and is subject to change based on the area of health being presented. As patients navigate the journey and health conditions and needs change, their preference will likely change as well. And if channel of choice isn’t motivating an action, then what’s the point? For example, I may prefer a text message to remind me of an upcoming appointment. However, I guarantee I don’t want to discuss a scary diagnosis such as cancer or diabetes via text. I would prefer a phone call in that case.
Providers and health plans need to expand education to boost health literacy. In general, low health literacy leads to poor outcomes. While there are programs available to help with specific health conditions, such as diabetes, many times the patient isn’t even aware of this benefit, nor do they take advantage. We need to inform patients of their options and encourage them to take steps to learn about their diagnosis and how to improve their odds. If the solution is through healthier eating, then partner with charities helping to address food scarcity and cost.
What tips do you have for improving communications between health plans and patients?
In addition to helping to educate patients as mentioned above, health plans are in a great position to partner with health providers to keep the patient on track with their care plan. They are sitting on a data gold mine related to the patient condition. They know if they are filling prescriptions regularly, following up on referrals, and taking advantage of preventative screenings.
The same tips apply for communication with patients. Broader messages to large groups need to include prescriptive and helpful communications. Tailor individual messages in the channel of activation instead of channel of choice, using data as a guidepost. Learn what motivates the patient and focus communication there. High risk patients may need to be reached through multiple channels until a response is given.
Is there anything else you would like to add?
As an industry, we need to find ways to connect primary care and mental health to better support patients. Right now, they are two separate tracks on their health plan, and mental health isn’t always reimbursed in the same way as general health care. I’m looking forward to seeing more collaborative mental health communications from primary care doctors with mental health providers engaged in the messaging. Using AI chatbots and avatars to ask screening questions of these patients is a first step to get a view into what might be going on. Some people tend to be more transparent when chatting with an avatar instead of a human and we might engage them in time to get them the care they need. Mental health has a big impact on adherence to treatment, and we are only starting to see the mental health impacts of the COVID-19 pandemic.
Matt Dickson, vice president of product strategy and general manager of communication solutions at Stericycle, is a versatile leader with strong operational management experience and expertise providing IT, product, and process solutions in the health care industry for nearly 25 years. Today, he oversees the Communication Solutions service line at Stericycle, which offers comprehensive patient engagement solutions that help health systems tackle their greatest challenges to patient access, action, and adherence.