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Driving In Traffic » Healthcare

Healthcare


OK– I admit it…on a challenge of two friends I have ventured forth into Second Life. A Double Dog Dare– is more like it. I’ve honestly found the whole experience a little flat. Perhaps I’ve been going to all the wrong places.

Anyway, in an effort to expand my experiences in SL, I’ve been trying to find a meeting to go attend. So wow… now I’ve found a healthcare conference to attend. But call me a cheap skate… there is no way I’m forking over $4700 Linden Dollars to go– especially when I have no idea who will be speaking or even who is organizing.
Are there really enough healthcare wonks out there who are into SL enough to spend some decent RL dollars to go to a conference like this?

Help me here… I’m obviously missing something.

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I had the pleasure of meeting Nick Jacobs at the Healthcare blogging summit.  I heard him speak about his philosophies and practice of running a healthcare system.  I had to pinch myself to make sure I wasn’t dreaming.

You see-  to him healthcare is about caring– plain and simple.  Caring enough about your patients, community and employees to do your best at all times and when you fall short of your own expectation be honest and forthright. Furthermore, his model breaks the traditional mold of the ivory tower of administrators and the us (clinicians) vs. them (admin) mentality that works to only harm the patients.  It seems that he fervently believes that if the leaders don’t care then there is no way for the organization to care.  Ultimately, this will burn out employees and translate to patients not getting what they need and deserve.  The clearest and most inspiring articulation of this was his post over at Hospital Impact.

Nick also has his own blog at Windber.  He definitely gave me a glimmer of hope that one day, if we get back to what matters, we can fix this mess.

During my Christmas break, I had a few moments to sit down and indulge in some absurd hours of quality TV time catching up on all of my missed episodes of Poirot and Midsomer Murders. During that time, commercials came, were muted and then I was returned back to my indulgent, guilty pleasure of doing nothing and watching TV.

At that time, one series of commercials always scared me and made me gasp– even after the second and third run. I have not seen them since, but I still remember the company and product. They were Volkswagon commercials where there are a car full of people driving along talking about mundane things (the funniest being the men talking about the side effects disclaimer of DTC advertising of ED medications) and then from out of nowhere– CRASH! Head on, side impact– in the filming the other car just appears. Then the commercial closes with everyone out of the car, shocked but ok— illustrating the safety of the vehicles. Click here and select “Like” to see one of the ads.

In a new spin on using the unexpected, State Farm has started the “Now What” ad campaign. They are using a series of short films where bad things unexpectedly happen to people’s property and then you see the logo and webaddress for the “Now What” campaign. Which — in no longer than it took to fire up old bessie, had me typing in the web address and seeing what all of this is about.

Why does this work so well and how can we use it in healthcare?

In Chip and Dan Heath’s book, Made to Stick: Why Some Ideas Survive and Others Die, they spend a whole chapter on explaining why surprise works in marketing. One reason why the unexpected works is that it grabs a person’s attention and stimulates an emotion within the person. Such is my experience with the VW ad.

As for the “Now What” campaign, it worked for me because it surprised me and then left me hanging. The Heath brothers explain this in the terms of The Gap Theory of Curiosity- originally articulated by George Lowenstein of Carneigie Mellon. Simply put– this theory states that curiosity occurs when we perceive a gap in our knowledge. These gaps produce subjective discomfort that requires some sort of action to dispell — similar to having an itch that we need to scratch.

This theory likely explains why I love to luxuriate in mystery TV marathons. Those shows expertly tap-dance on my curiosity buttons and I keep watching because I want to gather more information. I suppose secretly, I think I can best Poirot or Barnaby in figuring out who-done-it.

In healthcare, we can really use this tactic to our benefit. One’s individual health is a very personal and emotional issue to most. So–like I am obviously are a sucker for having my curiosity stimulated, most people have a sensitivity to being engaged in anything that relates to their own health interests. I think the statistics about people seeking health information on the internet speak to the validity of this notion.

By using surprise and creating a perception of a gap in knowlege, we can increase the likelyhood that individuals will be “drawn” to us as resource. What we then need to focus on is creating an environment (virtual or live) that will encourage and educate seekers to take action/ implement behavior changes that can have a positive impact on their health.

If done well and people are able to find the answers they seek, then the subtle emotional experience of that is that ‘we’ care and are able to meet needs. This, in turn, can increase reputation, provide content for word-of-mouth referrals, increase the subjective perception of wanting to be one of ‘those people’ who get their care from THE BEST and otherwise get people in your door to see what you are about. If the quality of care they receive is consistent with the perception, you are on your way to creating loyal customers that no longer need to be ‘won’.

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As my mentor and friend Toby Bloomberg says: “Blogging is about relationships and community.” After a 16 months participating in the blogosphere, I have been able to meet and get to know a host of others who share my interests and who have taught me a few things.

One of those people is Nedra Kline Weinreich. She’s smart, witty, creative and has a good heart, to boot. She has a real knack of communicating social marketing how-tos to inspire positive changes in behavior with the goal of improving health or creating social change.

Nedra is holding a training session on March 28-30 in Washington DC. She has set up a Squidoo Page to give information about the agenda and the content. If you can’t go, then consider purchasing her book from this page– as squidoo will donate a portion to a charity of Nedra’s choice. Plus it will get you started thinking in a whole new way!

Held in conjuction with the George Washington University School of Public Health and Health Services, some of the training highlights of the seminar include:

  • How social marketing uses commercial marketing tools to create behavior change
  • How to think like a social marketer
  • How to develop a strategy using the 8 Ps of the social marketing mix
  • How to design effective messages and materials
  • How to work with the media to get your message out through news and entertainment programming
  • How to use cutting-edge technologies to put the new media to work for you
  • How to get the most out of your social marketing budget — even if it’s small

Given all the work I’ve got piled up for the non-profit I’m a part of and my other blog, I wish I could go. However, right now significant travel is just not in the budget (time or money). However, if Nedra comes to Atlanta— I’m so IN! and I’m dragging some friends! Hint!!! Hint!!!

However in the honor code of BBF-edness (Best Blogging Friends) and fellow RUSH fan-edness (The Band not the simpleminded pundit–no google juice for him!), Nedra has generously created a cool coupon so that DIT readers can get a little savings if they can attend. You get $75 off of registration if you register and use the code: DIT75    Cool Huh!!!

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The quotation of the week overheard in our office as a doctor was giving some Rozerem samples to the patient:

“What! You want to give me a drug advertised by Abe Lincoln and some ratty-ass rodent? Come on now doc!”

John Mack over at Pharma Marketing Blog has been quite critical of the ads for Rozerem (a new sleep medication) which is made and marketed by Takeda Pharmaceuticals.

Honestly, I didn’t like the ads and I was getting tired of seeing them EVERYWHERE, but I did not find them as offensive/stupid as Mr. Mack. After visiting Japan a year ago, I had just thought that Takeda had used the Japanese trend of using furry characters to advertise the medication. (For those of you who have not been to Japan, you never see anything advertised without an animated little Pikachu thingy with a high pitched voice).

lincoln.jpgHowever, now it seems that this advertising campaign is losing whatever punch it had. It never was something that generated a positive emotional response to the product, but the creativity did garner attention.

Now– the ad seems to be having a detrimental effect. It was too obtuse— the average guy was never able to figure out the symbolism, the above average guy was not moved by the symbolism. Now the insane frequency of the ads are annoying people. The lack of any sort of content that would enable people to ‘identify’ with the product is now coming back to make people doubt the efficacy of the medication and the motives of the company.

Takeda really needs to re-think their strategy. Afterall, at least in our office/state, the drug requires prior authorization for most insurances to pay for it. So— add a stupid, annoying ad that turns off patients with increased administrative nightmares for the prescriber and you get a medication that nobody will prescribe because patients don’t want it enough to warrant the hassles (20 minutes on average per patient) of doing the paperwork.

I suppose that to date there has always been a good ROI on DTC advertisements. I guess people think that it is pretty much of a slam dunk that can’t be messed up. Instead, the Takeda/Rozerem story may go down as the textbook case of where things went terribly wrong.

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Photo credits: Leedy-Voulkos

This weekend the TV has been tuned to the Barrett-Jackson Auto Auction. You see the Hubby and friends are quite the car enthusiasts but I must admit that watching the auction proceedings was a bit addictive. I suppose it is just my age, but I was a bit aghast at the crazy money that was paid for cars I distincly remember double dating in.

Anyway– for those of you who did not tune in or who are not regularly subjugated to its proceedings– there was an interesting sponsor of the events— Ford Motor Company.

Yes… here in the Southern US there is much debate over the best domestic car maker among some. In fact, Ford Motor Company has been the butt of many jokes… FORD= “Found On Road Dead” or :Fix Or Repair Daily.”

However the sponsorship of the Barrett Jackson was a brilliant piece of branding. There were banners with the logo, large block of FORD only commercials, a charity auction of a 2007 Shelby GT Fastback Serial number 001 to benefit Carroll Shelby’s Children’s Foundation, workers with the Ford Emblem on their shirts, an appearance of Edsel Ford, and extra time spent on the TV coverage of any vintage Ford. It was simply a brilliant branding effort. Afterall what could be better than extended TV coverage of insane money being spent on vintage Fords to emphasize the quality, staying power and completely ‘cool factor’ of Fords.

After having to tip my hat to the brilliance of the corporate marketers and branders at Ford, I got to thinking about what lessons could be taken away from this in regards to healthcare marketing. Well….

If you use the auction as an example, many of the cars that rolled across the auction block had been salvaged from ruin. With some love and attention, these vehicles were made beautiful again. Then their beauty was celebrated in front of a huge crowd and the restorers hard work was lauded. If you think about it, the restoration process for a car is very similar to that of restoring someone to health. The one big difference is that in healthcare, short of the patient and their families, there is no one out there to really laud the healthcare professional’s or facilities knowledge, expertise and hard work.

Stories and anecdotes are key ways of conveying the path to recovery, wellness and restoration. They grab attention, create connection and provide inspiration. Healthcare marketers can use these stories to weave a connection with the community as well as create an emotional response that can morph into increased brand recognition, brand value and loyalty.

So what stories are you telling? What stories are being told by others about you? How does this reflect on your brand?

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I had a weekend reprieve from the insurance questions, but just after a long Monday, I find that there seems to be an endless number of faces and voices that need help or explanation.

All I have to say is— Gee… I wish employers had done a better job educating their employees about the changes afoot in the health plans they were offering.

Honestly, I can’t really blame patients for their frustration. For years, they have mindlessly sought care, paid their copay and not even wondered about contracted rates, discounted rates, co-insurance, deductibles and etc. I even had one lady bring in her EOMB to me and ask me to explain it. She was SHOCKED that eventhough the doctor billed $125 for her med check, that he only got $60 plus her $6.00 (10% of the contracted rate) copay.

Yep… there’s a lot people don’t know.

In the hope of compiling a list of resources to hand out, I took a few moments last night to travel around to various sites that have come up in the last few months who are seeking to help patients navigate this maze in which they have been unceremoniously dropped.

1. Vimo: Probably the most mature of the products I toured. This is really focused on helping people shop their insurance and physicians. However, their “Learn” section did provide a good primer on essentials of these new health plans.

2. RevolutionHealth (in Preview) will be available soon. They seem to be focusing on helping people become more engaged in their health. They have a fair number of wellness promotion tools and they support SimoHealth’s medical bill tracking tool and and help you estabilish personal health record ‘portfolio’.

I haven’t opened up a SimoHealth account (despite the 30 days free offer, $39 after that), so I don’t know if SimoHealth offeres some good explanation of the basics of the CDHC Insurance game.

3. MedBillManager. I’ve been through several tours of this product, thanks to an invite from Christopher a few months ago. I’ve offered some (sometimes stern) feedback on their product and they have always taken it and turned the comments into thoughtful functionality. It is still a pretty green product, as their alpha status indicates, but it is a pretty good start. The cool thing is that it is free for up to two people.

Here again, this is a tracking tool to help people understand where their healthcare dollars are going. MedBillManager does not really explain CDHCs or insurance basics in layman’s terms, but it does provide a cost effective tool to become more educated about your own personal healthcare expenditures.

Since it is free — drop by and try it out. Also give Christopher and the guys copious amounts of feedback. They don’t have enough to do… ;)

Update:  Unity Stokes over at Organized Wisdom has conducted a podcast with Christopher at MedBillManager.

While I’m updating— please check out Organized Wisdom as a community to help people to get information on the various treatment options for certain diseases.  It also helps individuals to gain support and ‘been there– done that” knowledge and education on specific diseases.
Feel free to add to this list through commenting. I’d like to learn more because I will definitely pass it on to the patients (of course after trying it out myself).

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With the turn of the New Year, I’ve just finished the rounds of the “umpteenth annual” Christmas and New Year parties that have become a real tradition with my set of friends. Actually in our busy lives we look to these traditions to set aside time to get caught up on the accomplishments, goals and other mundane news. When discussing what I’ve done in the past year, the responses were quite interesting. Specifically, it is interesting that when I mention my “Medical Marketing” column I got one of three responses:

  • a puzzled look
  • a “I’m not sure I like the idea of doctors and hospitals marketing to me” or
  • a “Great…Those weight loss advertisements and pharmaceutical commercials are bad enough. I’m getting tired forwarding through those ads when I’m catching up on my Tivo-ed shows.”

Those comments have really stuck with me and I’ve tried to figure out what’s going on to create the confusion, aversion and annoyance. I’ve got a number of hypotheses as to why the thought of medical marketing did not receive a positive reaction from my friends. Taking from further discussion with my friends and for the purposes of this post, I’m going to focus on the impact of pharmaceutical marketing on the aversion to doctors, practices, and hospitals focusing on marketing.

In a nutshell, I think that medical and health marketing gets grouped into the same genre as pharmaceutical advertising purely because it is the most prominent type of health-related marketing. I think there are several things that contribute to this phenomenon:

  1. The plethora of pharma ads and their penetration into almost every aspect of our lives. TV, magazine, internet, direct mail, newspaper, NASCAR and other sporting events, — the list goes on and there is really no escape from their reach.
  2. The local nature of marketing activities of providers, hospitals, and practioners. For the most part, these individuals are not focused on garnering a national audience. Instead, they want to reach people in a finite and well-defined community around them.
  3. The growing frequency and reach of advertisements for herbal medications and supplements. My group of friends sees most of which with skepticism because they fear being the “fool” more than almost anything.
  4. The huge number of spam e-mails (not to mention spam blog comments) for medications that clog up inboxes and annoy everyone. While these are not pharmaceutical marketing endeavors. These emails do rely heavily on pharmaceutical branding efforts and brand recognition to get attention.
  5. The current trustworthiness problem of the US pharma industry.

According to the 2006 Edelman Trust Barometer report of its US respondents, the pharmaceutical industry ranks very low in their trustworthiness to ‘do what is right.” The only industries that rank lower are the media/ entertainment and energy industries.In fact the report goes on to say that in the US, the trust level of pharma industry is an unimpressive 48%.While the Edelman report tries to discuss the complexities of the trustworthiness problem, the fact remains that, according to their report, people only trust the pharma industry to do the right thing 48% of the time. It’s just really hard to spin that into something good.

I did a short little survey at work and with my friends. I asked them “What would you think about a person that is only trustworthy 48% of the time? How would you describe that person?” Some interesting responses I received were”

“If going on vacation, I’d probably trust them to pick up my paper and mail, but I surely wouldn’t want to rely on them to feed my cat.”

“Anyone under 50% trustworthy is not trustworthy.”

“Well, that person is just as likely to lie as they are to tell the truth… that’s giving them the benefit of the doubt.”

“I would never ask them for advice and if they gave it, I probably would think long and hard before taking it.”

“Actually, that sounds like my teenager.”

“Incompetent. On the short list for firing. A nuisance to all his or her coworkers.”

So… if hospitals, physicians, and practices are starting to develop a marketing plan or refine one already in existence. It is important to factor ways to differentiate yourself from the pharma industry.

I’m certainly not saying that the pharma industry is the only obstacle to public acceptance of medical and health marketing. Actually, I’ll be the first to admit that pharma is an easy target because it was really the first healthcare-related industry to strategically market. Thus, as a leader, it is the easiest to analyze (and pummel).

Thankfully, the Edelman report also states that doctors and healthcare professionals are highly credible spokespeople. The only spokespeople who are better are peers or a person like you. Here again… successful healthcare and medical marketing seems to be coming down to relationships – either having one or being perceived as having the ability of developing one that has a quality of caring, compassion and understanding.

wphillips.jpg“Revolutions are not made; they come.”

— Wendell Phillips, 1811-1884, Harvard Lawyer

It is interesting that the Wikipedia biography for Mr. Phillips says that he was a great advocate of the virtues of plain talk. And after the last two days, I think he’s right.

Are more bad days coming?

Coming back from the holidays, I fully expected my first days back to have to help out with all the traditional stuff that gets piled up in a growing psychiatric practice when it is closed for several days. Appointment requests, medication refill questions, medical record stuff, etc. However, I was under no illusion that my main role (as the insurance expert in an office filled with doctors, nurses and therapists who want to have nothing to do with anything remotely related to such things) would be to be the bad guy that had to remind people that they were going to have to meet their yearly deductible once again, therefore the payment for the days services would be considerably more than their December appointments.

What I did not expect was the considerable numbers of patients who have had SIGNIFICANT changes in their coverage (as in going from a moderate copay —as outpatient mental health benefits are never equivalent to medical benefits— with small or no deductibles to large deductibles plus a healthy percentage of the contracted rate).

Whoa! Screaming, wailing and gnashing of teeth. Not to mention accusations that I’m just plain out wrong. If it wasn’t that, then it was emploring questions seeking an explanation— “Why is it like this when they take so much out of my pay anyway?” Boy— its hard to offer comfort to people when they ask that!

In an effort to find some simple explanations that John and Jane Q. Public could grasp and understand (lets not hope for agreement— my goal was to just give them something to chew on), I did a little digging in hopes of finding some words of comfort from people who understand this phenomenon well.

Its not gold, but I think its worth something.

When I opened my e-mail this morning, I found a press release from VIMO. While I’ve been getting stuff from them a for a little while now and given their focus on the consumer/patient I thought the report they were releasing on healthcare spending accounts might be helpful.

While I had and will continue to have to struggle not to offer the information as a platitute aimed to passify (although, not a bad outcome when you are dealing with the 15th person for the day), I think the report makes some very salient points.

Private health insurance spending is also a cash flow that should rightly be viewed as a significant national asset….Private health insurance premiums are not–at the moment, at least– packaged into securites that are tradable in a fincancial market. The poing of this exercise, however, is simply to drive home the magnitude of private health insurance preimums as a source of wealth.

OK– this is a completely new way of looking at that section of your paycheck for most people. —- But that and $2.00 gets me a small coffee at the local cafe.

The main point is that employers are having to look at new ways to structure their health insurance because they are not able to bear the brunt of the costs and they understand that their employees cannot either. Subsequently, this shift in plans is the first step in creating a system that can take advantage of triple tax savings that were created with the implementation of the Medicare Modernization act. This is summed up well by the report by saying:

The moral of this story has two fundamental points.

1. Health insurance is a large and growing part of compensation and therfore;

2. Anything that affects the value of health insurance benefits offered to employees will have an especially large impact on compensation since the wage and salary components of compensation are relatively stagnant.

Yeah— I know, it is still a hard sell. The people I worked with today, still aren’t really buying it. However, I am always amazed at how a little education and an effort to understand does soothe the soul. The news may not be good, but trying to connect and understand the problem does a lot.

On the flip side, I don’t really think that the people I talked to today realized that they had come of age, so to speak. Today, they made the great leap from passive patients to consumers, from whom action is now required. No doubt when they realize that, another wave of irritation and anger will emerge.

Right now, they surely don’t the changes they are seeing, but perhaps they will develop a tolerance once they have the “simple speak” knowledge and tools that take a lesson from our Mr. Phillips and give consumers a better handle the demands of these changing times.. Lets hope those get here quick or else I’ll have many more bad days ahead.

Beginning January 1, 2007, the handful of members of the International Federation of Pharmaceutical Manufacturers and Associations will need to comply with the latest effort to self-regulate pharmaceutical marketing practices. See the pharma.jpgIFPMA Code here

When reading the document, I was transported back to reading the PhRMA’s Code on interacting with healthcare professionals and the OIG’s Pharmaceutical Compliance Program “guidance”.  So — really there is nothing new here

—In a nutshell, you can pay or reward people or organizations for prescribing medications.  Additionally, when marketing medications, a company must stick to the scientific facts and avoid discussions of off-label uses. 

I appreciate the IFPMA’s efforts to globalize this movement of ‘compliance’ in hopes keeping those greedy pharmaceutical marketing professionals (not everyone falls into this category) from inappropriately promising efficacy they cannot deliver and to keep them from finding similar devil prescribers who are just looking to line their pockets versus really focusing on providing quality care.

I also had to laugh when I read what would happen if the guidelines were breached.

If a member company is found to be in breach of the code, the IFPMA will “publicly announce the company’s name and obtain the company’s written agreement to end the objectionable practice(s) concerned,” the organisation’s director commented in a statement.

Yea… that should work. 

Really, all snarkiness asside, given the small number of IFPMA members (who by their membership have agreed to comply), I feel this effort lacks any real potential of doing anything to further reform or keep dishonorable companies from keeping on with their business as usual.

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