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How Leading Payers, Providers, Pharmacies, and Population Health Organizations are Adapting to this Flu Season

America is about to experience a return to “normal” that won’t be as pleasant as the others we’re all hoping for. This fall, the push to get as many Americans vaccinated against influenza will, as usual, become the primary public health issue in the country. And since the average 20 million illnesses and 400K hospitalizations in mild flu season would hit our healthcare system at a time where capacity and focus must remain squarely on COVID-19, the stakes are higher than years past. 

This year bring new challenges and obstacle to vaccination that care organizations must work to understand and overcome. The typical assistance from vaccination pushes in schools, workplaces, houses of worship, and other community resources will be absent or reduced. The usual challenges of apathy from young/healthy members, concerns about getting the flu from the vaccine, health education gaps about vaccine safety and importance, and access and awareness barriers will return. But this year they are joined by new obstacles from misinformation about COVID risk from vaccination to worries about entering healthcare facilities. Each individual’s calculation on getting a vaccination will be different this year. The burden for healthcare organizations will extend beyond the typical awareness campaigns – we have to understand each person’s barriers to vaccination and help overcome them. 

Leading payers, providers, pharmacies, and population health organizations are already adapting their approach to encouraging vaccinations in their populations. Their strategy has shifted from reminding and nudging to educating and activating. New approaches to building health literacy and more engaging content types are already being used to address new and heightened obstacles preventing people from seeking vaccinations. Technology is also playing a powerful role in connecting specific and tailored content to the people that it will impact the mostmPulse’s partners have seen success in solutions that effectively identify and overcome barriers to medication adherence and gaps in care closure. Now they are leveraging our Conversational AI technology to do the same with new flu vaccination challenges caused by the COVID-19 pandemic.  

Understanding a person’s barriers to action is the first step to helping overcome them. Our approach at mPulse is straightforward: we start with a conversational reminder delivered across mobile channels, and we follow up with questions that either confirm vaccination or simply ask the person what is stopping them. We take answers they give – no transportation, the flu shot gave them the flu once, they aren’t going into doctors’ offices during a pandemic, the vaccine makes COVID worse – and process them in real time using Natural Language Understanding (NLU). We match the individual’s barriers with configurable content that the plan, provider, or other organization chooses to address that issue: safe rides to a clinic, fotonovelas on vaccine education, locations for drive-through vaccinations, whatever the organization needs to connect to the member with that specific challenge. The barrier assessment creates additional opportunities to educate members and drive action, while generating actionable, real-time insights about what is keeping your specific population from getting vaccinated. 

Getting some individuals barriers to vaccination does more than just help connect them to resources – we can use data and identified barriers to understand the broader population and align strategies to help them. When we compare identified barriers with key data like member age, location, engagement history, health status, demographics, preferred language and culture, we can help organizations begin building personas that likely share common barriers. This allows for tailored content even to members that do not engage at first or have been previously hard-to-reach by provider or payer outreach. So responses that identify barriers for a portion of members can help improve the vaccination outreach to the rest.  

Whether it’s using the mPulse solution or taking a more manual approach with live callers, a conversational strategy will be key this flu season. Simply reminding your population that it’s flu season and vaccines are important will not be enough. When a member or patient who might typically get vaccinated, but is hesitant this year, can express their worries and receive relevant follow-up, they feel heard and they are more likely to act. And a younger, healthier member who may skip flu shots normally may be much more aware of the importance of building community immunity this year, and just needs to know where to go. Tailoring content to them, based on what they tell us is stopping them, gives us the best chance to help. The task of getting people vaccinated against influenza is familiar, but this year’s new challenge of understanding how individuals are reacting to vaccination strategies during COVID s will require this kind of conversational approach. 

Digital Fotonovelas for Flu Engagement: A New Approach for a Unique Year

The 2020-21 flu season poses new challenges in addressing COVID-19 alongside traditional challenges driving flu vaccination. Flu season for most adults typically begins around November and plans push reminders to have members schedule their flu vaccination. However, with COVID-19 as an ongoing concern, healthcare experts are suggesting getting the flu shot as early as September 2020, to at least quell the brunt of one virus while trying to manage the other. In addition, members who take precautionary measures early-on will alleviate pressure on hospital systems that have been carrying the weight of COVID-19.

Organizations must enhance their flu engagement strategies to address new concerns and barriers to vaccination this year and educate members quickly on new topics. With the right tools, health plans can take a multi-angled approach to member outreach that will help address and overcome several barriers at once. mPulse has been working with our customers to roll out new content and technology to help handle the challenges of this flu season—read about our 2020-2021 Flu Engagement Solution here. The solution incorporates digital fotonovelas. These are typically a 6-frame comic-style story portrayed with lighthearted graphics, that deliver important content to across demographic segments at scale. The story-style graphic can deliver vital educational flu resources directly to members’ mobile devices, through SMS and link-to-web, using members’ preferred language. This tool has been used in key healthcare use cases in the past, (e.g., value of HPV vaccines and diabetes self-management) and has proven to be a complementary route of communication when utilized with a text messaging approach to member outreach.

mPulse Mobile first deployed fotonovelas as a bi-lingual visual tool during the onset of COVID-19 as a part of the COVID-19 Rapid Rollout Toolkit solutions. The goal was to adapt a traditional and effective style of print media into digital format delivered through SMS, to help overcome health literacy barriers during a time when the spread of healthcare information was urgent and needed to be disseminated quickly at scale. The 6-frame graphic style of communication, paired with a series of check-ins via SMS, helped our plan and provider partners build health literacy around social distancing, basic hand hygiene, and keeps multi-lingual populations informed with accessible and coordinated outreach via mobile channels. The goal of this capability was to successfully assess members’ health risk and respond through text dialogue and educational fotonovelas appropriate for each member’s situation, in their preferred language. We’ve seen that when matched with strategic member outreach, fotonovelas can be a tool that offers an access point to fill in gaps in knowledge that drive healthy behavioral change even during a time when many are hesitant to seek out healthcare in person.

Fotonovelas also present an opportunity to address individual-level barriers and inaccurate health beliefs related to COVID-19, and flu vaccines in general. They can help address education gaps surrounding available flu vaccination resources during the pandemic while promoting health literacy. Paired with text message dialogues, plans and providers are able to uncover new barriers that may have prevented members to seek flu vaccinations early and match members to follow up content, including fotonovelas, that addresses those specific challenges.

During the 2019-2020 flu season, mPulse powered over 15,000,000 flu vaccination touchpoints across Medicaid, Medicare and commercial plan populations. The solution achieved a 2x increase in recorded flu vaccination rates in a large Medicaid population*. This year, as the flu season approaches with the added layer of COVID-19, plans and providers will need to more agile and responsive than years before.

For that reason, fotonovelas have become one of the core capabilities in our Flu Vaccination Solution for 2020-21. Fotonovelas engage a range of core population groups, including key multicultural segments with configurable content and versioning that enables matching to specific personas and demographics that can be updated over time. They can be a touchpoint that alerts members of appointment reminders, vaccination site locations and educational services. But the most powerful aspect of this form of outreach is the ability to tailor content based on an understanding of members health beliefs, in members’ preferred language and through their preferred channel. By listening to member responses to automated text conversations and understanding what they need to hear in order to get vaccinated, health care organizations can gather insights and deliver tailored and engaging outreach at scale. Because the solution is available on SMS and Link-to-Web it has the ability to reach a wider population at scale, meeting members where they are, taking pressure off of the member to seek out information during the height of the pandemic and flu season.

In a year of “unprecedented situations” the 2020-21 flu season is yet another that will require healthcare to evolve its approach. The reach, engagement and rich content provided by our fotonovelas strategy is a natural fit for the unique challenges of this flu season. Healthcare organizations know they have to do more this year than a strategy of 1-way reminder outreach and reliance on employer, church, or school vaccination drives. By creating conversational touchpoints around flu vaccination and supporting members with differentiated and rich content, they can elevate their engagement strategy to support the populations they care for.

Managing Influenza in 2020: Cutting Through Pandemic Confusion

It probably won’t come as a surprise to hear that flu season is just around the corner. Nor that it promises to be all the more challenging due to COVID-19. This season is also taking on a new urgency—as the potential for serious complications ramps up if patients contract flu and COVID-19 at once.

Flu season is tough to manage at the best of times. Developing effective vaccines is an educated guess that doesn’t always pan out. Further downstream, inherent skepticism among a large minority doesn’t help. Last year, almost 40% of adults (including 19% over 60) said they wouldn’t get a flu shot. Perceived side effects and lack of efficacy were major reasons cited.

Now, on top of these challenges, consumers are looking for answers to a host of new and sometimes complex questions. Answers that require an added measure of reassurance and explanation. Even the 60% who typically welcome vaccinations might not be a shoo-in this flu season. A flexible and adaptive approach to communications and education may be needed to persuade healthcare consumers.

This year a premium should be placed on personalized education. Consider avoiding or modifying purely prescriptive communication that could fail to capture unique concerns. A more discursive, interactive type may better address confusion and misconception, guiding customers to pragmatic resolutions that leave them pacified, satisfied and prepared.

What is one of the first concerns a provider might need to address (whether verbalized or not)? “Can I trust your advice?” This may sound odd at first glance, but it shouldn’t be dismissed when developing a flu engagement strategy. In the wake of COVID-19, it’s been widely reported that trust in healthcare has been damaged. This is already leaving its mark. Overall vaccination rates declined nationwide during the pandemic’s first wave.

Anticipating another top-of-mind question (Do I have flu or COVID-19?), CVS Chief Executive Larry Merlo recently told Reuters, a news agency, that “If we can eliminate…people getting flu symptoms [by giving them flu shots] and [thereby prevent] their first reaction being ‘Is this the seasonal flu or is this COVID,’ it can take demand off of COVID-19 testing.” In addition to helping providers manage capacity by persuading customers to get inoculated against flu, this limits scope for “flu versus COVID” confusion. Especially among those most vulnerable to catching both viruses such as the elderly, immunocompromised, and those with respiratory conditions.

To complicate matters for all—consumers and providers alike—we’re expecting this flu season to be more aggressive than usual.  Manufacturers are ready to boost vaccine production by 20% above norms. For healthcare systems to avoid being overwhelmed, supply is not the only prerequisite. A premium should be placed on education to activate preventive-care behaviors and timely action by customers, such as persuading them to get a flu vaccination. Even giving a willing customer a flu shot, however, has potential complications this year. If they have symptoms like a temperature for example, their flu shot might need to be delayed pending COVID-19 evaluation. Be ready to answer: “Why can’t I get a flu shot if I have a temperature?—It’s never been an issue before.”

Also be prepared to address issues like “Do COVID precautions help with flu?” Evidence from the Centers for Disease Control and Prevention (CDC) suggests that social distancing can help prevent flu transmission. Reinforcing this and other preventive behaviors could slow its spread. To gain compliance, however, you may need to counter “COVID fatigue.” This emerging state of mind expresses the sense that “enough’s enough.” It reflects an overwhelming need for some to return to normal life, and in the process dismiss health risks—perhaps flu among them. This mindset might be one reason COVID-19 has surged again recently, and why August 12th saw nearly 1,500 COVID-19 deaths—the most in a single day for three months.

Many other qualms and questions add to this flu season’s unique challenges. Some reflect the potential impact of a flu-COVID double whammy wave.  Considerations include whether infection with one makes getting the other more or less likely, or if they are more or less damaging if caught concurrently. And, whether you can have a natural immunity to flu or COVID-19 (from T Cells for example). Or even if the bad flu season predicted could edge out or tamp down COVID-19 (a phenomenon called viral interference). Whatever the question, be prepared with engagement strategies that offer the right answers, and route care accordingly.

The takeaway? During any flu season—this more than others—tailored education and agile communication is important. These can help customers make sense of a complex healthcare landscape and decide if they need to seek care. Good luck!

mPulse is pleased to help. Details of our Flu Engagement Solution may be found here.

mPulse Mobile Announces Closing of Series C Funding of more than $16 Million, Led by Optum Ventures

New investment will support mPulse Mobile’s engagement and outcomes strategy through Conversational Artificial Intelligence

mPulse Mobile, a leader in Conversational Artificial Intelligence (AI) solutions for the healthcare industry, today announced more than $16 million in funding. The round was led by Optum Ventures and includes existing investors HLM Venture Partners, OCA Ventures, SJF Ventures, Echo Health Ventures and Rincon Ventures.

Powering more than 300 million personalized, automated consumer healthcare conversations annually, mPulse Mobile’s solutions help consumers and healthcare organizations achieve better health outcomes by increasing engagement and improving communication through meaningful, tailored conversations. mPulse combines behavioral science, artificial intelligence and an enterprise-grade platform to assist healthcare organizations guide consumers to adopt healthy behaviors.

mPulse Mobile has more than a decade of healthcare consumer engagement experience, serving more than 100 healthcare organizations. The Series C investment will help mPulse Mobile further enhance solutions that deliver positive consumer experiences on behalf of its customers.

“We are excited to have the support of Optum Ventures and all of our current investors as we execute on our strategic roadmap to improve health outcomes for consumers and our customers through improved communications,” said Chris Nicholson, CEO of mPulse Mobile.

“This new investment recognizes that scale and solution performance are key factors in successfully engaging consumers in their healthcare, and we will use it to expand our consumer conversational AI capabilities, enhance our client engagement analytics platform and expand our engagement solutions across healthcare verticals.”

“mPulse Mobile enables valuable connections between healthcare organizations and consumers, while addressing a significant market need for better experiences,” said Laura Veroneau, Partner, Optum Ventures. “We believe mPulse’s innovative approach to consumer engagement can play a key role in improving health outcomes and lowering the total cost of care.”


About Optum Ventures

Optum Ventures is the independent venture fund of Optum, a leading information and technology-enabled health services business dedicated to helping make the health system work better for everyone, and part of the UnitedHealth Group. Optum Ventures invests in digital health companies that use data and insights to help improve consumers’ access to health care services and how care is delivered and paid for, and that make the health care system more reliable and easier to navigate. For more information, please visit

About HLM Venture Partners

HLM Venture Partners is a leading venture capital firm and one of the nation’s oldest and most experienced in the tech-enabled healthcare services, healthcare information technology, and medical device and diagnostics sectors. Seeking dynamic, emerging-growth companies, HLM invests in the industry’s most innovative companies, including Phreesia, Teladoc, AbleTo, Regroup Therapy, Nordic Consulting, meQuilibrium and ClearDATA.

About OCA Ventures

OCA Ventures is an early stage (Seed, Series A, and Series B) venture capital firm focused on equity investments in companies with dramatic growth potential, primarily in technology and highly-scalable services businesses. OCA invests in many industries, with a preference for technology, financial services, cyber security and healthcare technology. Founded in 1999, the firm is investing out of its fourth fund in companies spread throughout the United States. Learn more at

About SJF Ventures

SJF Ventures invests in high-growth companies creating a healthier, smarter and cleaner future. Its mission is to catalyze the development of highly successful businesses driving lasting, positive changes. We are experienced venture capital investors who have been at the forefront of impact investing since 1999.  We are passionate about generating extraordinary results, creating positive changes, and partnering with visionaries who combine these two.  Our team has invested in over 70 companies during the last 21 years, bringing time-tested perspective and expertise to partnerships with entrepreneurs.  For more information, visit

About Echo Health Ventures

Echo Health Ventures invests to build and grow great health care companies. Echo Health Ventures seeks to drive systemic health care transformation through hands-on, purpose-driven strategic venture capital and growth equity investing. As a strategic collaboration of Cambia Health Solutions and Mosaic Health Solutions, Echo Health Ventures works closely with its parent entities to catalyze the development of its portfolio companies and accelerate their innovations to scale nationally. For more information, please visit

About Rincon Ventures

Rincon Venture Partners, as well as its successor firm Bonfire Ventures, is an LA-based seed-stage venture capital firm that invests exclusively in B2B software businesses, and typically leads or co-leads a startup’s first priced round.  We back extraordinary founders who are seeking to build world-class market leaders, and aspire to serve as those founders’ most trusted advisors. Investments made by the firm’s founders include The Trade Desk (IPO), Burstly (acquired by Apple), Edgecast (acquired by Verizon), Datapop (acquired by Criteo), MessageLabs (acquired by Symantec), Orbitera and Bitium (each acquired by Google), EmailAge (Acquired by LexisNexis), TaxJar, ChowNow, Rainforest QA, Invoca, Honk and others. For more information visit