Request a Demo

Category: Conversational AI

Activating Healthcare Consumer Behavior Change: Make it Personal

Posted on by Gabe Kratzer

Key takeaways from our interview with Solome Tibebu

In the last decade, behavioral health has grown from an ancillary service offering to a critical component of health services and care delivery. According to an OPEN MINDS Market Intelligence Report, spending on mental health services totaled $225 billion in 2019, up 52% from 2009. Companies like Talkspace and BetterHelp, founded in 2012 and 2013, recognized this spike and made it their mission to increase the availability and accessibility of mental health services to those struggling to access and navigate care. Behavioral health has continued to evolve, and it is incumbent on all healthcare organizations to adopt new methods of providing care to vulnerable populations. Learning from innovative companies and forward-thinking leaders is vital to building an effective care strategy for the one in five U.S. adults living with a mental illness.  

mPulse sat down with Solome Tibebu, a pioneer in behavioral health technology and innovation, whose passion stems from the care gaps that have existed and still remain in mental healthcare. At the early age of 16 years old, Tibebu started a non-profit online resource, Anxiety in Teens, to offer education and support for teens and young adults who were struggling with anxiety and depression. After ten years, she began working in startups and consulting, continuing to advocate for the role of technology in advancing behavioral healthcare. 

This year in June, Tibebu will be putting on her third annual Going Digital: Behavioral Health Tech summit, a conference where health plans, providers, health systems, employers, investors and startups convene to discuss the evolving landscape of behavioral health. The virtual (for now) event is a great opportunity to share best practices for implementing digital resources and innovative technologies to improve access to mental health services. We are proud to be a sponsor for the second consecutive year, and we look forward to contributing to discussions around how healthcare organizations can implement solutions to tackle barriers and make mental healthcare more accessible for all.

Improving Access through Technology Innovation

COVID-19 created an array of challenges to advancing mental health access, but it also sparked a digital transformation that brought innovation to the center stage. With more consumers staying home, “tech has exploded as a response to the pandemic,” Tibebu prefaces. Technology plays an important role in understanding and addressing the social dynamics that affect each person living with mental illness. Some of the challenges that plague mental health accessibility require more than simple one-way consumer interactions, however. 

Talking about health plans, Tibebu emphasizes, “stigma is a huge barrier even after they’ve procured some kind of solution, so they need to have a strategy around how they’re gonna address stigma, and engagement of the member.” Stigma can produce feelings of worthlessness and lead to social isolation while social determinants of health (SDOH) like transportation access or income level can prevent consumers from seeking care. To tackle barriers like SDOH and stigma, it is necessary to utilize technology to understand consumer needs and preferences. 

Conversational AI and Natural Language Understanding power the capability to deploy behavioral science strategies at scale when communicating with vulnerable populations. For instance, incorporating a strategy like Affect ensures that messaging is based in empathy, increasing motivation to engage with sensitive healthcare outreach. Social Proof is an effective strategy that helps assure consumers that they are not alone and can help reduce social isolation caused by mental health stigma.  

Applying behavioral science and identifying SDOH in conversational outreach enables a deeper understanding of consumers. Once individual preferences are captured, healthcare organizations can efficiently tailor relevant content to each consumer and activate meaningful behavior change. 

Delivering Tailored Content at Scale

Incorporating clinically validated behavior change techniques helps with understanding the needs and preferences of consumers. Tibebu asks, “now all of these payers have implemented their telehealth solution but it’s the next level – how do we get something more customized, personalized to their respective populations?”  

Plans and providers can drive deeper engagement and self-efficacy by adopting tailored engagement strategies that lift utilization of the programs they’ve invested in. Conversational AI enables the orchestration of programs and resource delivery across preferred consumer channels. Natural Language Understanding helps capture important data from consumer responses to help route them to the appropriate digital resource. 

A one-size-fits-all care model fails to meet the needs of each consumer, while customization empowers healthcare organizations to intervene with meaningful content that drives behavior change. “How can you identify the consumer’s need and triage them to the right end solution?” Tibebu reiterates. Certain individuals who prefer a visual learning experience may benefit from a course like Living with Anxiety & Depression, while those who respond better to audio can be directed to a podcast like Mental Health Matters. 

Providing on-demand, curated content can motivate consumers to take control of their health and execute healthier behaviors, leading to improved outcomes and a better consumer experience.

Impacting Beyond Mental Health

We asked Tibebu why personalization in mental healthcare should be important to payers specifically. She responded, “because mental health is at the vortex of all health…for all of these other conditions, expensive conditions, that are impacted as a result of poor mental health.” Consumers who are negatively affected by mental health are more likely to develop chronic conditions, which piles up costs for both the consumer and the organization providing services. This creates an opportunity for plans and providers to adopt innovative solutions that promote well-being through tailored engagement. 

MagellanRx Management serves a complex population and recognized the need to incorporate well-being content for their members who were experiencing loneliness and anxiety from COVID-19. They partnered with mPulse to deploy digital fotonovelas, which use culturally sensitive stories in a comic-strip format to improve health education and activate diverse populations. The program drove impressive outcomes, yielding over a 38% engagement rate and a 90% member satisfaction score. 

We questioned how organizations outside of payers and providers can “step up” to make mental healthcare more accessible. Walmart Wellness is a nationally recognized brand whose goal is to “help customers raise their hand and more easily access their hubs,” Tibebu clarifies. Walmart partnered with mPulse to implement SMS solutions along with streaming health education to drive their customers to the right well-being resources. The program included custom learning plans across several wellness topics and produced significant improvements in customer engagement. 

After chatting with Tibebu, we are reassured that mental healthcare should be the focal point of an effective engagement strategy. Innovative companies can promote mental well-being and health literacy by leveraging technology that personalizes outreach. Educating consumers with tailored content through timely and convenient engagement builds self-efficacy and lasting behavior change.

Learn more about Conversational AI and streaming health education here. 

 

CareSource Activates Hard-to-Reach Members with Conversational Outreach and Streaming Content

Posted on by Gabe Kratzer

COVID-19 Accelerating Digital Engagement

It is no secret that COVID-19 has changed the way healthcare communication is delivered to consumers. The uncertain nature of the pandemic has forced healthcare organizations to incorporate digital strategies to continuously update their members on important COVID-19 information. Just this year, health plans have had to respond to the new mandate requiring reimbursements for at-home COVID-19 tests.  

Gaps remain in other facets of COVID-19 communication, like driving behavior change to increase vaccinations. Across the country, states are seeing lower vaccination rates among Medicaid beneficiaries. In California, the Department of Health Care Services (DHCS) released a January 2022 report indicating that 81% of the general population had received one dose of a COVID vaccine compared to only 54% of Medi-Cal (California’s Medicaid program) beneficiaries. Significant disparities in vaccination completion such has this have developed in states beyond California as well. 

CareSource, an Ohio-based managed care plan offering insurance coverage to vulnerable populations across five states, recognized a similar disparity in their diverse member population and sought a solution. Traditional methods of engaging members had failed to produce desired results, creating an opportunity to incorporate a new approach in their outreach efforts. The plan partnered with us to implement conversational outreach and streaming health education into their COVID-19 vaccine program strategy.  

Here’s some key takeaways from the program along with strategies that health plans can adopt to drive vaccine engagement.  

Strategies That Personalize Outreach

Delivering vital information about vaccines becomes more difficult when using a one-size-fits-all approach to communicating with vulnerable members. A successful COVID-19 outreach program requires personalized interactions with members to inspire healthier actions. CareSource identified a need to activate hard-to-reach consumers and sought a tool to tailor engagement based of range of factors including health beliefs. 

The plan leveraged our robust technology platform and Natural Language Understanding capabilities, which enabled tailored engagement through 25 SMS workflows, 1 Secure Survey, and 1 streaming video.  

We helped deploy SMS surveys to assess individual vaccine readiness levels, and members were assigned one of three personas based on their responses: Ready, Unsure, and Nonbeliever. Developing personas enables plans to tailor messaging according to personalized interactions with members to inspire healthier actions each member’s preferences and self-reported barriers. Messaging must be intentional and sensitive to inspire paradigm shifts for unvaccinated members or members who have no plans to get vaccinated.

Behavior science informs every communication we send, and this program was no different. An effective behavioral science strategy in the CareSource program was giving members Social Proof, which comes from the Social Determination Theory and suggests that people are motivated by feelings of competence and relatedness. Through the texting channel, members were sent a streaming video, “My Why,” which highlights a diverse range of people explaining their personal reasons for getting vaccinated. Plans can inspire confidence and healthier actions just by making members feel as though they are not alone.

Another behavior science strategy employed in the program was Authority, which is using trusted health experts to improve education, drive health literacy and reduce barriers like misinformation. Using sources like the CDC can ease doubt and motivate members to reconsider personal health beliefs that may contribute to vaccine hesitancy.   

CareSource provided zip code data, which we used to further tailor conversations based on socioeconomic factors. Providing members with personalized, familiar interactions gives the member a voice and drives self-efficacy. 

By incorporating behavioral science and SDOH into their COVID-19 engagement strategy, CareSource was able to tailor conversations and streaming educational content at scale. Social determinants of health (SDOH) can play an integral role in tailoring messaging to each individual inspiring vaccine readiness. 

Innovation That Drives Outcomes

We sent a total of 4 million SMS messages and delivered over 3 million automated dialogues to 664,000 members. The program yielded nearly a 15% engagement rate, an increase from traditional rates of 8-10%. Of the members who received a first dose, 81% reported they would follow through to get a second dose. By the end of the program, 57,000 of the 107,000 “Unsure” members moved into the “Ready” persona. 

Each member response led to additional tailoring, with automated responses covering topics like variants, availability, cost, fear/anxiety, effectiveness, and side effects. Upon conducting 30-day and 90-day reviews of the program, common themes were uncovered within each member persona. Gathering insights from member interactions can help influence future vaccine engagement programs and ensure that each conversation is tailored to drive the best results. 

As companies focus on highly tailored engagement, scalable intelligent capabilities are required.  CareSource has demonstrated the potential for Conversational AI outreach and streaming health education to drive healthier actions and meaningful outcomes.

What Type of Healthcare Chatbot Do You Need?

Posted on by mPulse Team

Chatbots play an increasingly important role in healthcare. In addition to improving member and patient satisfaction, many chatbots gather data through conversations, providing rich, new sources of health data that can inform care at the individual and population level.

This post walks through nine different types of healthcare chatbots, the role chatbots play in healthcare, and recommendations to consider when using a chatbot to help serve your patients or members.

Types of Healthcare Chatbots and Their Value

Appointments

Scheduling (and rescheduling) healthcare appointments is a relatively simple process that has historically required at least one staff member for each appointment and been very time consuming. This is where appointment scheduling chatbots come into play. These chatbots make It easy for a patient to schedule an appointment on a website, inside a portal, through an app, or even via text message while including valuable information like reason for appointment, symptoms, etc.

In many cases, appointment scheduling chatbots need to be integrated with an EHR system to be most effective, which allows for automatic scheduling and re-scheduling with little to no human intervention. And when PHI is properly managed, these chatbots may also be able to deliver valuable information like lab results directly to the right patients.

Symptom Checker

At their best, chatbots provide more valuable and relevant information than a web search. They are able to do this because they are siloed; if a user is within a healthcare chatbot’s ecosystem, it can be assumed their questions are all healthcare related. When a user searches on the web, results often need to be broader to address a variety of intent.

In addition to an improved experience, as chat often feels more personal than search, symptom checker chatbots rely on a blend of healthcare experts to provide reliable data and Natural Language Understanding to analyze patient and member symptoms, return helpful information, and recommend care.

At their best, symptom checker chatbots align with appointment chatbots to help patients and members get necessary care with limited barriers.

Health Tracking

Many patients and members have ongoing health needs such as care prior to, day of, and following a procedure. These chatbots typically feature timely check-ins, medication / care reminders, and the ability to understand if a patient or member is reporting an adverse condition. These chatbots need to be able to log a record over time to be most effective and relevant.

Chatbots that help users with fitness or diet goals often fall into this category as well.

Chronic Condition Self-Management

Properly managing chronic conditions is an ongoing challenge for healthcare organizations and their consumers as chronic conditions require a blend of ongoing tracking and specific care as challenges related to the condition shift. Whether coordinating care, reminding people to take medication, providing valuable information or many other uses, these chatbots need to be able to both provide tailored information and react to changing individual needs.

Similar to Health Tracking chatbots, Chronic Condition Self-Management chatbots help users track and manage their condition on an ongoing, long-term basis. They typically require a more specific medical knowledge base than Health Tracking chatbots.

Engagement

Everything people do impacts their health. One challenge healthcare organizations face is getting people to engage with their health and healthcare. Afterall, there are so many other things that fill time and mindshare. Patient and member engagement chatbots create meaningful experiences and find valuable ways to connect with people and engage them in their health, whether by providing an important health reminder, uncovering some new healthcare information / status, getting a mental health update in real-time, or many other uses.

Engagement chatbots typically focus on consistent touchpoints and a long-term relationship with patients and members.

Digital Front Door

Chatbots are a key component of many successful digital front door applications. Digital front doors provide a virtual experience similar to a really great waiting room where a nurse collects key information to help optimize your visit and route care accordingly. Chatbots play a vital role here as they act as a combination receptionist, nurse, and source of information.

Digital Front Door chatbots must be personable and useful to consumers while gathering key information that helps healthcare organizations optimize care resources.

 FAQs

While a symptom checker chatbot helps address patient and member questions about their health, FAQ chatbots help address questions about healthcare. The goal of FAQ chatbots is to provide a better experience and easier access to answers than scouring a healthcare organization’s website or portal in search of answers. Similarly, they reduce the burden on call centers by reducing inbound calls to find answers to common questions.

A smart FAQ chatbot is able to ask the user questions to refine and deliver the best answers.

 Inbound vs Outbound Chatbots

Like any conversation, an interaction with a chatbot can be started by a consumer (inbound) or by the chatbot (outbound). In most cases, chatbot conversations are inbound as they trigger when a consumer visits and app or website and begins a chat. The challenge with inbound chatbots is they require a consumer to take an action (sometimes a few actions) before the conversation can begin. Outbound chatbots are less common as they require an existing, open channel to work. The best example of outbound chatbots is those that communicate through SMS or RCS, reaching consumers directly in their text message inbox.

mPulse Mobile offers a variety of solutions that feature outbound chatbots.

How Chatbots Need to Work Together

The overall goals of healthcare chatbots are to improve patient and member experience, optimize healthcare staff, help people stay healthier, gather valuable data, and make organizations more efficient. While specific chatbots can help address specific needs, a holistic approach is needed to accomplish all of these goals.

Learn how mPulse Mobile is combining omnichannel patient and member engagement with streaming health education to help solve many of healthcare’s biggest engagement challenges.

3 Steps to Listen to your Members at Scale

Posted on by mPulse Team

Are you having meaningful conversations or talking at them?

There are certain human experiences everyone can relate to. One we have all felt is someone talking at you. It’s not a conversation. There are not two participants. You are just there to absorb whatever they say, and if you respond, they don’t listen. They just wait for their turn to speak again. We all know this feeling. It’s frustrating and leaves you looking for an exit.

Fortunately, people can become better communicators. They can learn to slow down, focus, and listen. They can learn to have a conversation instead of just dumping their message on an unwitting volunteer. And when they do, the rewards are clear. Two-way dialogues allow for feedback and new information that, when listened to, can drive the conversation deeper or take it in new directions that teach both parties something new.

The key difference between a one-way dump of information and a meaningful conversation is the ability to listen and have empathy. For healthcare organizations that aim to have these meaningful interactions with hundreds of thousands of people, the question is how to listen at scale.

Step 1:

Start Conversations at Scale

The easiest way to engage people in conversation is to find topics they care about then ask them about those topics. Most of us do this intuitively. Doing this at scale requires determining content / topics that are relevant to specific segments across large populations and leveraging technology that allows you to start and maintain thousands of conversations at once across communication channels. We call this member-centric outreach.

To properly conduct member-centric outreach and begin conversations, there are a few things you need to have in place.

  • Ability to deliver messages on high-reach conversational channels, such as SMS
  • Population segmentation to tailor content / topics
  • A way to track engagement and responses to verify and update population segmentation and tailoring

Using automated conversations with the ability to listen to member responses and handle those responses appropriately is crucial to making interaction between a plan and its members natural and easy

Step 2:

Orchestrate Engagement Across Channels

Imagine having a great conversation with someone at a party. You found a common interest and dove deep into it. Then days later you read an article your friend might find interesting, so you email it to them. A few days later, they text you a link to a related video. You are communicating across channels to maintain and deepen your relationship, all connected to that initial conversation.

Orchestrating engagement across channels is relatively simple to do at scale when your engagement channels are all hosted on a single platform. Think of your engagement platform as the person at the party – it’s easy to keep track of what content has been shared across channels when it’s all coming from and to the same place.

Digital communication occurs in real-time more often than traditional healthcare outreach. When you consider the outreach strategies of Pharmacy, Clinical, Quality, Care Management and Marketing, it’s vital to orchestrate engagement over mobile channels. And if a platform is not listening to data from member actions and adjusting appropriately, it is falling short of true omnichannel orchestration.

Step 3:

Use data to listen and empathize

During in-person conversations, people gather all sorts of valuable information in real time. We gauge sentiment based on vocal tone and body language that is not typically available with digital conversations at scale. To compensate for real time empathy, digital conversations rely on new types of data to listen and inform an appropriate, tailored response. To listen well, there are some important focus areas when it comes to data.

  • Focused Data: Determine what information you are trying to capture before launching a digital conversation program. Are you hoping to learn about channel preferences or something like barriers to care? Determine that and engage in line with that goal.
  • Sentiment: Leverage technology or a team to understand the sentiment of member responses.
  • Preferences: Analyze what channels, message frequency, language, topics, and content individuals and persona populations prefer.
  • Target Insights: If there are specific insights or answers you need, use your trusted relationship to have conversations about those topics.

Asking members questions on scalable conversational channels can create a wealth of new data that is almost impossible to gather otherwise. This data provides a fuller understanding of populations which allows for more informed decision- making.

Meaningful conversations and experiences are core to human relationships. The better you can create and maintain relationships with all of your consumers through conversations, the more aligned you will be about their care.

If you would like to have a conversation with us about how we can help you build more positive relationships with all your members, please contact us here.

Key Takeaways: RISE 10th Annual HEDIS and Quality Improvement Summit

Posted on by Nora Cristobal

mPulse Mobile’s Government Programs Strategic Market Executive, Reva Sheehan, sat down with John Hopkin’s Director of Medicare STARS at Advantage MD, Tejaswita Karve, and Molina’s Regional Manager of Risk Adjustment, Ryan Dodson, to discuss New HEDIS Patient Experience Measures and Weights at the RISE HEDIS and Quality Improvement Summit. While the summit focused primarily on HEDIS and Star Ratings changes affecting the 2021-23 years, there were a few key insights we thought stood out during the panel. Here are our Key Takeaways:

Get to Know Your Members and Their Experience with Their Plans

The Annual Open Enrollment period is an important time of the year for both health plan and members. Health plans have the opportunity to re-engage members with new and important information and hopefully retain membership while welcoming new acquisitions. Members also have the opportunity during this time to reevaluate their current plan and benefits and voice what is important to them and what they felt was lacking throughout their interactions with their plan. It is a crucial time for member outreach.

Because CMS requires some materials are delivered to members before the beginning of the Annual Enrollment Period (AEP), if plans experience returned mail or unopened digital messages it can be a good indicator of who is or is not  receiving the plan’s communications because the bulk of members will get some form of touchpoint from the plan during AEP. This presents an added opportunity to engage members the plan may not have known they were missing all while strengthening continued outreach to members who voiced their pain points with the plan.

Discover the Differences Between High Utilizers and the Mildly Engaged

Understanding engagement differences from in-between members, those who the plan does not hear from often enough, from high utilizers will help guide what touchpoints are most effective for that mildly engaged population. Perhaps one method of communication results in a high feedback but is less successful for an entire smaller core demographic. What does the plan do with that data? Using encounter data or claims compared to communications with the plan can uncover communication barriers that will help the plan hone in on the right outreach for each member. For example, when mPulse deployed our Fotonovela Solution with one of our managed care partners, our data reflected that our partnered plan had a 37% engagement rate from the Spanish speaking population vs. 17% from the English-speaking population. Fotonovelas proved to work more effectively with one population over the other. Without that response data with specific language points and outcomes, mPulse may have seen a successful use case but would not have had the valuable data that prompts the plan to segment their outreach appropriately. Being able to capture those data points and incorporate them into future outreach strategies alleviates some of the unknown factors that affect the overall member experience from outreach to appointment.

Measures with Increased Weights – Moving forward with CAHPS

CAHPS carries much more weight in the coming years and with that plans will need to rethink how they deploy off cycle surveys and related communications, while trying to sift through the stagnant data they have now. During the RISE panel, John Hopkins’, Tejaswita Karve, touched on the efficacy of NPS scores and how to collect that feedback and utilize those data sets. Plans can use that data to keep their members in the loop while waiting for the 2021 survey results. Educating members and empowering them with the knowledge that their feedback matters and why it matters and how the plan makes changes based on the data collected from these surveys will have a positive impact on member perception. Being proactive helps engage the member in future communications because the member is more aware of what to expect and how their input directly impacts their care management.

Combat Survey Fatigue

Deploying short surveys throughout the year to collect information on what resonates with the members shows that the health plan is listening to members’ feedback and are taking action. One of the panelists mentioned that her past organization deployed a “We Heard You” campaign that worked well by engaging members of new changes all throughout the year, keeping them informed of new programs and benefits that in some cases were a direct response from the members. Advisory boards and focus groups can be a good tactic when gathering data for outreach, but it also makes the member the centerpiece of the conversation. It is an opportunity to ask if they have everything they need, all while building a relationship and ambassadorship. The data collected right from the source is a valuable tool when engaging in future outreach.

Sometimes Perception is More Important than Experience. Go Above and Beyond Ahead of the Visit.

Taking action to inform and engage members on what to expect from their doctor visits, providing information that is important to them, like billing and what is covered and what is not, will help build a more trusting relationship between provider and member, but it will also eliminate any future mistrust due to lack of information. Utilizing automated touchpoints to prevent minor backend mistakes and miscommunication with the member can go beyond the annual survey. For example, the provider and plan have the opportunity to explain the terms of Annual Well Visits within the defined value sets ahead of the member booking their “free AWV” that could prevent any mistakes about co-payments and billing. Explaining the terms ahead of the visit and providing a list of what falls under annual well visits, not only informs the member and prevents coding errors on the provider side, but it creates a relationship and line of communicative trust.

Including members in the conversation ahead of outreach goes above and beyond the standard level of communication between plan and member. It is important to keep the data collected from past surveys and NPS scores close to engagement strategy, and above all, prioritize the ongoing relationship between member and provider and plan as member experience will make up over one-third of the overall Star Rating for 2023.

The Challenges and Opportunity for Technology and Health Equity

Posted on by Nora Cristobal

We know that COVID-19 has amplified many underlying issues in healthcare and beyond. Health equity was already an important topic in healthcare, but COVID-19 has brought it into sharp focus as cases, hospitalizations, and deaths from the virus disproportionately impact disadvantaged groups. Technology use in delivering healthcare is another long-time trend catalyzed by the pandemic, as millions were left with virtual care as their only option for the first time. It seems apparent that these advances in technology use create the capacity to meet people where they are with information and care that is quickly and easily accessible. But it will take careful effort and consideration to ensure that access is improved for those that most need it in an inequitable system. And with new technology, there will also come new challenges and barriers that may not have existed in the past. 

Understanding Technology Across Segments 

At mPulse, we naturally look closely at technology adoption rates in healthcare’s most important populations. When we look at the disparities in technology use and access, they tend to line up with the negative outcomes we see in healthcare. Black and Hispanic communities have faced a disproportionately higher fatality rate than other races due to COVID-19 and suffer from higher rates of chronic conditions. The Pew Internet Research Center’s statistics show black and Hispanic communities more than twice as likely to be dependent on smart phones for internet access than white Americans. This means that they are more likely to rely on smartphones as their sole access to the internet, as opposed to a tablet, laptop, or desktop computer. Telehealth platforms that are optimized for desktop/laptop use and not mobile phones could disadvantage these groups disproportionately. Furthermore, populations who may not have access to stable and high-speed broadband in their homes would only be able to interact with telehealth that is mobile-optimized and can be supported on a cellular data connection.  

Though smartphone dependency and internet access disproportionately impact minorities and low-income groups, mobile phone adoption presents an opportunity to connect hard-to-reach populations with tools and information to access and maintain their healthcare. Overall cellphone adoption rates in the US have converged across demographics, with Black, Hispanic, and white Americans equally likely to own a cellphone (over 96% of all adults do). So while internet and broadband-reliant technology may create new barriers hat must be overcome if telehealth is to become a long-term solution for improving access, engagement solutions that focus on cellphones have the potential to reach oft-neglected populations just as effectively as any other.  

The role technology can plan to help address health disparities will be a key area covered by our keynote speaker – Dr. Gail Christopher- at our Activate 2020 virtual conference. Dr Christopher is the Chair of the Trust for America’s Health. 

Language Barriers: A New Version of Old Challenges

Telehealth and virtual care in general must be able to support multicultural and multilingual populations effectively. According to a poll from the Associated Press-NORC Center for Public Affairs Research, “half of these Hispanic adults age 18 and older rely on family or another health care provider to help resolve language or cultural difficulties in the health care system, while more than a quarter have relied on a translator, public resources in their community, or online sources for assistance.” Understanding that language barriers in traditional care delivery may have been managed more than successfully bridged will be vital as systems and plans roll out new models. Beyond language, there can be significant cultural differences in attitudes and use of the healthcare system across populations.  mPulse has seen in cases with several multi-cultural populations that tailoring content to account for language as well as culture can be just as important as tailoring based off of health status or age. In cases like the COVID-19 pandemic, where organizations need their entire populations to understand important prevention and system navigation information, closing gaps between language and cultural groups becomes critical. Configurable and engaging content that can be fully adapted to different languages or populations, such as the fotonovelas we’ve used with some of our customers are just one example of the effort required to get key information to people in these diverse populations equitably.    

Preconceived Notions of Telehealth 

Studies have shown Black and Hispanic communities may feel more uncomfortable interacting with health professionals via camera and having facial pictures taken – practices that are common in telehealth appointments. This discomfort could be a factor for low engagement, or appointment no-shows. So while these two communities are likely to be among the most at risk for negative health outcomes, if they do not feel comfortable engaging with their plan in the new virtual or telehealth environment, they may be a lot less likely to move forward or seek out care. Building trust becomes crucial. One of the advantages to the kinds of asynchronous and automated conversations that the mPulse platform supports is that the patient or member can engage on their own time and terms. Whether through solutions like ours, or other types of outreach, organizations should find opportunities to create meaningful touchpoints with the people they care for that do not initially require new technology navigation, app downloads, or unfamiliar forms of interaction. In fact, some of our leading plan partners have used mPulse as the primary means of driving awareness and adoption of their telehealth platforms. The key has been that members who are used to getting important and relevant engagement from our solutions about their benefits, medications, and preventive care, are being directed to telehealth by an established and trusted line of communication with their plan. Helping to meet members at their comfort level and introduce new technology with compassion and understanding will be vital to ensuring the widest access.  

How can healthcare achieve the triple aim of managing cost, access and quality of care when it comes to virtual care and other new technologies? How can we embrace connected health and the power of the Internet of Things when smart device use is not embraced or even feasible across all populations? And how can technology create opportunities to solve disparities and inequities in healthcare? These questions will take a central role as we move toward an end of the pandemic and the healthcare system reckons with its long-term impact on how we deliver healthcare in the US. And while we can’t always expect definitive answers, being aware of challenges and watching for opportunities is the first step to making that impact as positive as humanly possible.

COVID-19 Member Engagement: Our Top 5 Best Practices

Posted on by Nora Cristobal

Health plans are confronting the COVID-19 outbreak on a wide range of fronts. Member engagement and outreach has become crucial as people want to hear accurate information and access helpful resources from the organizations that manage their care. The rapidly changing nature of the crisis and the massive amount of questions and concerns that members have about it makes this a uniquely difficult communication challenge. As a partner to some of the best and largest plans in the country, mPulse Mobile has been helping our clients face that challenge, sending over 10 million messages about COVID-19 to Americans in the first week after the WHO declared it a pandemic. Three weeks in that figure has grown to over 20 million. As plans and providers grapple with how best to keep members informed while maintaining focus on delivering care and support to the members who most need it, we identified 5 key best practices to help our clients navigate COVID-19 outreach:

Focus on Efficiency

Getting accurate and timely information to your population is a top priority. As the crisis progresses, it becomes difficult to focus on building and maintaining outreach efforts, and “build-your-own” vendor tools can take deceptively long to deploy. Now is not the time to task an IT team with implementing and managing self-service tools or develop content for new channels for the first time. Work with a healthcare-focused partner with existing and ready-to-launch content to help you keep your members aware of resources you have available (e.g. telehealth, mail-order pharmacy, etc) and updates to shelter-in-place and social distancing guidance.

To help organizations launch and optimize programs quickly and confidently, we developed our COVID-19 Strategic Communications toolkit, which has details on our ready-to-launch programs and essential platform capabilities. Click here to learn more.

…But also, Be Strategic

As Covid-19 continues to evolve, it’s critical to plan outreach strategically. The urgency of the situation makes it tempting to send mass communication through emails, mailing, or broadcast phone or text outreach whenever there is new information. We have seen organizations find the most success when they work with us to plan content, channel mix, frequency, readability, and language. You want to be a consistent, trusted, and an easily accessible resource for members – that means being careful to not over-message or use channels with limited reach and engagement, or use content that is not optimized for your audience or outreach method. Strategically thinking about the way you deliver those messages will not only drive critical resources to members efficiently, it will also build a stronger long-term line of communication as conditions shift.

Help Your Staff Through Automation

Call centers are heavily impacted during this time. We have heard from clients that members are calling into nurse lines and member services centers with COVID-19-related questions at an extremely high rate. Help throttle inbound calls by leveraging the automated outreach that gets general information and self-service resources into members’ hands before they call. Proactively sending members links to telehealth options, online resources, and symptom checkers, (the CDC has one if you don’t yet https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html) will help members with COVID-related questions without calling in for additional questions.

Be Ready for Members’ Responses

Because of its unmatched reach and read rates, using SMS is an obvious best practice in crisis situations. But the conversational nature of the text channel combined with the uncertainty and dynamism of this crisis means that you need to be prepared for members to reply back with questions or concerns. In the initial weeks of the pandemic, we have seen even 1-way text campaigns that do not solicit any response receiving high levels of replies from members. Generic autoresponders that ask members to call a number for help can cause member abrasion and more inbound calls at a time when you want to avoid them (see #3). At minimum, you should ensure that member responses to COVID-19 messaging receive relevant auto-responses.

mPulse has gone a step further and developed a Natural Language Understanding domain around COVID-19. This domain reads and automatically categorizes non-standard responses so that members get questions answered and concerns addressed. It dynamically updates as members reply to outreach, so programs will get better at understanding member replies over time.

Support your entire population

While broadcast messages out to your members are fast and easy, it’s crucial to ensure your strategy accounts for differences across your members to ensure ongoing outreach is relevant and effective going forward. Utilizing zip code segmentation allows for content to be tailored to members in specific areas, allowing for updates on specific facilities, services, or public health guidance. We have also seen plans using fotonovelas to reach multicultural segments of the population. They use comic-style graphics that help break down language barriers and can be utilized during COVID-19 to showcase best practices, resources, and updated information.

The COVID-19 crisis has placed tremendous pressure on the healthcare system, including how it communicates to the populations it cares for. With these practices, plans can get the right information out to the right people efficiently and effectively. For more help, email info@mpulse.com Review our COVID-19 Strategic Communications toolkit, where you can find details on multiple COVID-19 programs. Click here to access the toolkit.

mPulse Mobile Holds Its Third Annual Activate Conference

Posted on by mPulse Team

mPulse Mobile wrapped up its third annual Activate conference last month. Activate2019 was another resounding success at the Marina Del Rey Hotel on October 9th and 10th with over 100 leaders from across the healthcare engagement landscape.

mPulse’s CEO and Co-Founder Chris Nicholson kicked things off with his outlook on how the conversation about healthcare consumer engagement has changed dramatically in just the last few years. The role of Conversational AI in adding capacity and improving access to care took center stage early on, with an insightful keynote address by Kaveh Safavi MD, JD – Senior Managing Director and Head of Global Health Practice at Accenture – that focused on how AI can change the future of healthcare. His talk focused on the practical and actionable ways that automation and scale can (and must) be applied to healthcare to confront some of the major challenges of the present and future.

Attendees then heard from the first of three panels of mPulse Mobile clients driving improved outcomes through innovative mobile solutions. Susan Arcidiacono, Chief Marketing Officer at Inland Empire Health Plan discussed how text message programs extended and enhanced her team’s efforts to close gaps in care, improve member experience, and promote preventative service utilization for a large Medicaid population. Sagar Makanji, the VP of Clinical Programs at Magellan Rx Management, then outlined how the PBM has transformed member engagement to help client plans improve Medicare Part D Star Ratings.

The next panel featured three clinical leaders from Kaiser Permanente – Winston Lai, Innovation Lead, Amy Chateau, Manager of Ambulatory Care, and Kristi Tague, Support Services Supervisor. They discussed how tailored and Conversational AI-enabled messages drove improved screening completion rates for key populations. The team shared specific workflows and best practices they used to improve colorectal cancer screening and pulmonary function test completions in San Diego.

After a lunch on the Marina and a roadmap update from our CTO Ram Prayaga, attendees took part in interactive workshops to develop new applications for Conversational AI in healthcare and engaging with the data that these solutions generate. The final customer panel of the day featured Donna Stanislawski, Director, Quality and Population Outcome at IlliniCare Health, Jacqueline Thong, Senior Director of Product Performance at Docent Health, Erwin Jeong, Pharmacy Clinical Operations Manager at Kaiser Permanente, and Rachel Fournier, Director, Product Management OnTrak Digital at Catasys. The group heard from Donna how IlliniCare manages a wide range of key engagement initiatives with a difficult-to-reach population. Jacqueline explained how Docent Health has embraced the text channel and mPulse’s Engagement Console to provide impactful support to patients during the care journey. Erwin detailed how Kaiser Permanente leverages mPulse’s Social Determinants of Health Index to predict Medicare members’ Medication Adherence rates. And Rachel shared learnings and best practices for deploying innovative solutions to engage large populations about behavioral health.

After Chris Nicholson shared his key takeaways and and announced the winners of our Activate Awards, everyone boarded the historic yacht Zumbrota to cruise Marina Del Rey, celebrating the collaboration and shared insights of the day.

Be sure to look out for information on Activate 2020 in the new year!

Improving Patient Engagement in Pharmacy Operations Using Conversational AI

Posted on by Brendan McClure

Leading healthcare organizations from payers to IDNs, PBMs, specialty pharmacies, and hubs have recognized traditional programs for patient engagement are proving ineffective. Mail, telephonic and even app-based tools are not how the modern consumer prefers to communicate. Many consumers have experience engaging with ChatBots and Conversational Agents through automated conversations, and they are demonstrating a preference for this dialogue-based approach. Engaging with companies through messaging conversations is convenient, self-service tools delivered this way are more efficient and communications are tailored and relevant. A recent large cross-industry study found that 69% of consumers consider chatbots the preferred way to engage with businesses for quick answers to simple questions. The shift to conversational approaches for engaging consumers is also aligned to the widespread adoption of mobile phones. Mobile phone ownership is at 90% or above across all key population segments, including lower-income adults and seniors over the age 65.

What does this shift in how consumers prefer to engage mean for pharmacies?

The pharmacy industry is adapting to the rapid increase in specialty medications. These therapies have more complex dosing regimens, a higher potential for side-effects and require closer patient monitoring as a result. The generally higher costs of these medications also make demonstrating improved health outcomes and value critical. To ensure patients are successful, pharmacies must provide high-touch clinical support and they have large teams of support staff based in call centers to check-in, follow-up and assist with patients. But this becomes challenging when consumers are much more reluctant to answer telephone calls. Which is why conversational texting represents a huge opportunity for specialty pharmacies who want to maintain their high-touch approach, deliver it efficiently at scale, and leverage a consumer-preferred channel.

Leading pharmacy organizations have identified this opportunity and are leveraging conversational text messaging approaches to:

  • Improve chronic condition medication refill rates by 14PPs
  • Increase the number of touchpoints during therapy dosing period by over 3x
  • Reduce the average call wait time from 8 minutes to 90 seconds by diverting calls to the text channel

Click here to learn more about these outcomes and how Conversational AI programs improve patient outcomes in the pharmacy space.

Insights from Activate2018: How Data and Conversational AI Drive Behavior Change

Posted on by Brendan McClure

Activate2018 was mPulse Mobile’s second industry event focused on leading strategies and mobile programs to drive healthy behavior change. Over 100 attendees from 44 companies attended the event to engage with industry thought leaders and innovative healthcare executives that are leveraging Conversational AI capabilities to drive behavior change across their populations. 

Using Technology to Promote Healthcare Data Accessibility

Aneesh Chopra, former Chief Technology Officer of the United States and President of Care Journey, gave a powerful keynote address focused on how to achieve a lower cost, higher quality healthcare system through technology innovation, open data and consumer activation. He highlighted that success in improving healthcare can only be achieved through consumers taking a more active role in navigating the health delivery system. But to do this they need to be empowered with greater access to their own data to help them make better decisions at each stage of their health journey.

Chopra stressed the importance of developing API-based interop standards similar to those that have proven effective in other industries (such as the banking industry) as a way to drive innovation and more consumer-centric solutions. He used the CMS Blue Button 2.0 initiative as an example, highlighting CMS’s widely expected requirement for Medicare Advantage plans to adopt data release platforms “meet or exceed” the capabilities of Blue Button 2.0 FHIR API by 2020. He also discussed the importance of cultural shifts in addition to technology advancements. Weaving together technical expertise with rich anecdotes, Chopra painted an inspirational view for healthcare’s path forward.

Activation in Action

In a panel of mPulse customers sharing their stories of successful behavior change, Kaiser Permanente and Home State Health presented the results of their Conversational AI programs. They were joined by Rena Brar Prayaga, mPulse’s lead Behavioral Data Scientist, who provided further detail on how the programs were optimized to impact behavior change.

Dr. William Woo, Assistant Chief Family Medicine at Kaiser Permanente, shared how he is using mPulse’s Conversational AI capabilities for his Diabetes Self-Management program to drive healthy behavior change and improve maintenance of A1c control in his diabetic population. Dr. Woo demonstrated the importance of understanding the specific challenges and health needs faced by individuals, and using these insights to tailor the most appropriate dialogues to educate, motivate and drive change. During the Kaiser Permanente program, more than 276,000 dialogues were sent to 11,238 members over a six-month period. Leveraging a broad range of data inputs from Kaiser Permanente’s system information and patient-generated data, these dialogues were dynamically tailored to advance the consumer’s health activation levels. The program achieved a significant improvement in A1c control. Commenting on the results, Dr. Woo spoke to the efficiency of the program and how it freed up his care team’s resources to focus on higher risk segments of his patient population.

Andrew Dietrich, Director of Telehealth Services at Home State Health, walked through the sophisticated health engagement program that he deployed to engage his diverse Medicaid population. Home State Health covers over 250,000 lives, of which 85% are <18 years old, and over 95% are in the Temporary Assistance for Needy Families (TANF) program. Dietrich discussed the need to engage members across a broad range of health topics including care gaps, healthy living, pregnancy, plan services, finding a PCP, redetermination and ED avoidance among many others. Historically, the plan had used mailers and phone outreach to address only the most pressing of these topics. Home State Health partnered with mPulse to develop a library of content dialogues covering all potential health topics and use mPulse’s Conversational AI solution to assign those dialogues to each member based on a dynamic profile of their preferences, health status, previous engagement and Home State Health’s priorities. In addition to delivering over 240,000 dialogues to 17,208 members over a 12-month period, Dietrich highlighted the program’s impact on key quality measures—members that participated in the health engagement program had significantly higher Well-Child and Adolescent Well-Care visit rates.

A recording of the complete panel can be viewed here. 

Technology Overview

Ram Prayaga, mPulse Mobile’s Chief Technology Officer, presented on the direction of mPulse Mobile’s Conversational AI capabilities. He spoke to three key themes: Data, Growth and Empathy.

The importance of data was a consistent theme throughout the event. Driving behavior change requires a deep understanding of individuals’ socioeconomic environment and the psychographic factors that influence their behaviors. Some of these insights are sourced from customer information systems. For example, a zip code yields rich data about Community Need and key Social Determinants of Health factors. However, almost all psychographic factors have to come directly from the consumer. Prayaga spoke to how these complex data points can be sourced directly through conversational interactions.

The second theme, Growth, covered the necessary capabilities to deliver Conversational AI solutions at scale. Obviously, a basic requirement is the ability to handle large volumes of concurrent dialogues. However, Growth also describes mPulse’s expanded solution offering to address additional health challenges, new segments of the population and international languages. As many of mPulse’s solutions leverage Natural Language Understanding (NLU), Growth requires building out new language domains to support new engagement areas and deepening conversational capabilities to have more meaningful dialogues. These capabilities support Prayaga’s third area of focus, Empathy.

Empathy, describes the ability to understand consumers, their health situations and engage with them in a way that provides the support they need. Prayaga highlighted the importance of empathetic solutions, particularly when engaging diverse populations segments. He used the examples of senior populations and how they like to engage, which is very different from millennials. Empathy enables mPulse to engage with these members as individuals in a way that minimizes abrasion and contributes significantly to the consumer experience.

Customer Perspectives on Implementation

In the second customer panel, The Milestones of Implementing Mobile Health Engagement Solutions, leaders from Cambia Health Solutions, Trusted Health Plan, Healogics and Healthx presented on their mobile health engagement programs and the milestones they each experienced over the first 12-18 month period to demonstrate key learnings for the audience. Each speaker walked through how their program was developed to address key engagement challenges, and their unique approach to drive success.

Michael Novotny, Technical Product Manager at Healogics, provided an excellent example of rolling out a major health engagement initiative across multiple sites and how they focused on success to identify best practices, as well as identify program champions. It was key to the success of their implementation, as their operation includes over 800 clinics.

In contrast, Jason Thomas, Director of Corporate Facilities and Special Projects at Trusted Health Plan, focused on identifying their biggest engagement pain points. In their case, a significant proportion of members lost coverage as a result of not completing the necessary redetermination process. Lost coverage impacted members’ ability to get care, and also added significant administrative costs to get the member re-enrolled. The text program drove a significant improvement in redetermination rates. This validated the effectiveness of the text channel, which helped expand programs into other engagement areas.

As a leader in a large complex healthcare organization, Lynn Dusek, Director of Consumer Relationship Marketing at Cambia Health Solutions, talked about the importance of internal alignment. In her role it is critical to coordinate the mobile health engagement strategies across multiple departmental stakeholders. A key milestone for her program was establishing the necessary program governance processes to enable coordination of consumer engagement initiatives from multiple departments.

The final presentation was by Mike Rowe, CTO of Healthx. Their partnership with mPulse focuses on providing mobile solutions that fully integrate with their core portal capabilities to drive true consumer engagement. In his presentation, he stressed the importance of data; both understanding in detail what data is available and leveraging the data in a way that allows micro-segmentation and orchestration best practices for member engagement.

A recording of the complete panel can be viewed here.

Activate Awards

In closing Activate2018, mPulse’s CEO Chris Nicholson announced the winners of the inaugural Activate Awards. Designed to recognize key areas of program impact and innovation, the awards recognized 4 categories to which companies had submitted applications prior to the event.

The winners were:

  • Home State Health: Most Innovative Program
  • Docent Health: Most Improved Consumer Experience
  • Kaiser Permanente: Best Use of Conversational AI
  • Healogics and Ieso Health (joint winners): Most Significant Outcome

The awards demonstrated the impact health activation can have on key health outcomes and how successful programs enable healthcare organizations to achieve key business outcomes. As well as demonstrating leadership in the space, these organizations set the benchmark for some healthy competition at Activate2019.

For details, read the press release.

Conclusions

A key theme of Activate2018 was the importance of data for successful behavior change programs. By using real-life examples of Conversational AI behavior change programs, the event highlighted how both source system data and patient-generated data are integral to the success of solutions. Discussions around these themes clearly established that open data sharing between healthcare organizations and technology companies such as mPulse and engaging consumers in a way that empowers them to share their health needs are fundamental requirements for successful health activation at scale.

Patient activation is critical to improve health outcomes and take costs out of the system. mPulse’s Activate series of events (look out for ActivateX and Activate2019 later this year) is unique in bringing together thought leadership in behavior change approaches and innovative mobile technologies to illustrate how organizations can achieve health activation at scale.

Stay informed about future Activate events.