Request a Demo

3 Ways Health Information Technology Improves Health Outcomes

It’s no secret that better provider-member relations can often lead to better health outcomes for the member and improved financial performance for the health plan.

Building trust, enhancing communication, and personalizing care through health information technology not only fosters better provider-member relationships but also improves health outcomes and the financial performance of health plans.

When trust is built, communication flows, and care is personalized, patients are willing to follow the care plans put in place more closely. With providers having shorter appointment times to spend with patients inside the exam room, most of this relationship-building needs to be focused outside of that small window of time. 

Health Technology Connects Providers and Patients

Providers can tap into digital health technology at their fingertips!

We are walking (okay, maybe running) into a time when healthcare will be no stranger to digital transformation nationwide.

The latest HIMSS State of Healthcare Report says, “Digital transformation is a top-level priority for health systems, with 99% of U.S.-based health system leaders agreeing that it’s important for their organizations to invest in digital transformation.”

Payers are also in alignment, with 74% of U.S.-based payers reporting that their organizations have a dedicated core team focused on digital transformation.

With so many invested in bringing health technology to the forefront of their patient care, the question is how? 

3 Ways Technology Improves Health Outcomes

1. Leverage Patient Data to Offer Personalized Care

In a time where personalization is becoming the norm in so many areas of our lives, it’s about time that healthcare gets into the game. The 2022 State of Healthcare Report found that “roughly 25% of patients or less completely agree that their provider personalizes care based on their current health, lifestyle and unique health goals.”

With so much room to grow, it’s time to tap into the data available on each patient to create a truly tailored healthcare experience. As a health plan, offer a single location where physicians, members, and the plan can see a comprehensive, action-oriented view of their patients/members.

The EHRs today are not integrated with the health plan, and to improve care, we need to ensure that all three are in the know. Knowing everything they can about a member, such as diagnosed conditions, known allergies, immunization records, and medication history, will help them develop a plan that makes the most sense for each person.

A disease or condition could affect one patient very differently from how it affects another. Because of this, treatment options and care plans cannot be treated as a one-size-fits-all approach if we want to see the healthiest outcomes for each patient. They need to consider a person’s unique health history, behaviors, and preferences.

When personalized care becomes the norm, everyone wins. Patient satisfaction increases, and the potential to improve health outcomes grows exponentially.

2. Provide the Right Tools to Help Members Manage Their Health

Patients often need ongoing support with health management between office appointments. As a health plan, your members will turn to you, and it is important to ensure that both providers and members have access to the resources they need to make this support a reality.

Using digital health technology, patients can improve their health in the comfort of their homes, leading to better clinical outcomes. Giving them access to tailored self-management tools and providing personalized health education materials are two great ways to help members stay the course.

When health plans, healthcare organizations, and providers can come together to implement patient-centric education strategies, members may become more inspired to make changes that better their overall health. A 2018 study published in the Journal of the American Osteopathic Association showed that just 45 minutes of patient education can improve chronic disease management

3. Strengthen Communication Through Secure Channels

Regular check-ins with physicians can keep members on track once they leave their appointments. With connected and HIPAA-compliant patient and provider portals, physicians can send secure messages to members about their progress regarding any current care plans or wellness programs. Sending these timely and encouraging messages demonstrates to members that providers are still within reach outside of the office and are dedicated to helping them along their health and wellness journey.

Are you ready to elevate provider-member relations and enhance health outcomes with digital health technology? Discover how mPulse’s provider and member portals can transform your health plan today!

 

This article was originally published on healthtrio.com.

How to Use SMS to Transform Healthcare Communication

In an era where communication is king and technology reigns supreme, SMS (Short Message Service) has emerged as a pivotal tool in healthcare outreach. With nearly 6 billion text messages exchanged daily in the United States alone, the potential of SMS in healthcare consumer engagement is unparalleled.

However, harnessing the full power of healthcare SMS for outreach requires more than just sending generic messages. It demands a nuanced understanding of best practices to truly connect with members and drive positive health outcomes. From personalized messaging to maximizing call-to-action completion rates, mastering SMS best practices is essential for any health plan striving to optimize member engagement and deliver impactful healthcare outcomes.

Join us as we explore the intricacies of SMS best practices in healthcare outreach and delve into five key healthcare SMS strategies proven to

  • enhance SMS engagement,
  • optimize member interactions, and ultimately
  • drive better healthcare outcomes.

Understanding the growing potential of SMS

From its humble origins in 1992, SMS has evolved into a cornerstone of connectivity, facilitating billions of daily interactions across the country. In fact, SMS is today the most common and widely used form of communication in the United States, and it has been since 2007 when the number of text messages surpassed those of phone calls.

Within healthcare, SMS has reshaped how healthcare organizations engage with patients. With the advent of multimedia messaging services (MMS) and rich communication services (RCS) functionality, the capabilities of SMS have expanded exponentially, offering personalized and interactive touchpoints for patients.

One significant advancement in recent years has been the integration of artificial intelligence (AI), which marked a new era in healthcare communication. Healthcare organizations can now deliver tailored support and guidance to patients by leveraging AI-driven conversational interfaces. This has revolutionized the member and patient engagement landscape and realized remarkable outcomes for engaging hard-to-reach and diverse populations.

Navigating Engagement and Outcomes

Despite so many technological advancements, the essence of effective SMS communication for healthcare remains the same – its ability to engage members and patients meaningfully. Generic messages often fail to capture recipients’ attention, resulting in low engagement rates, and it’s clear that personalization is key to driving meaningful interactions.

On average, text messages have a 99% delivery rate, with 95% being opened within 5 minutes. However, receiving a text from your health plan isn’t quite as exciting as receiving a text from your best friend or significant other. This is why it’s imperative health organizations schedule health SMSs that are personalization and meaningful dialogue to maximize engagement.

An example of a tailored SMS conversion between a healthcare provider and a patient to remind them of their mammogram screening.
An example of a tailored SMS conversion between a healthcare provider and a patient to remind them of their mammogram screening.

Imagine receiving a text message from your healthcare provider addressed to you by name, offering tailored guidance based on your specific needs and preferences. Going even further, picture being able to respond and converse through text messages with your health plan or provider and being sent helpful videos and lessons in response to your concerns. This personalized approach enhances engagement and fosters a sense of trust and connection between patients and the healthcare organizations serving them.

Furthermore, the impact of personalized healthcare SMS content extends beyond mere engagement metrics. Healthcare organizations have witnessed tangible improvements in health outcomes by delivering targeted messaging. From a 10pp improvement in colorectal cancer screenings to enhanced access to care measures, the power of tailored SMS content is undeniable.

Embarking on a journey of best practices

As healthcare organizations navigate the realm of SMS communication, embracing best practices becomes essential. It’s not just about SMS templates for health insurance or other medical solutions but crafting meaningful interactions that resonate with patients.

Five key practices to optimize healthcare SMS outreach efforts

 
  1. Establish trust for effective communication

Trust is the cornerstone of effective SMS communication for healthcare. By introducing yourself and explaining the purpose of the message, you lay the foundation for a meaningful dialogue with patients.

To do so, begin by addressing recipients by name and introducing yourself, then explain the purpose of the message clearly. Not only does this approach confirm the message is intended for the recipient, but by letting the consumer know you care about them and their health, you begin to lay the foundations for a meaningful relationship that will improve the likelihood of health action and, thus, member retention.

Another important consideration, although somewhat more technical in nature, is your “sender number”. Be consistent with this. Using a standard shortcode will establish trust with the service provider, preventing your messages from being blocked as spam. You can also send your members a virtual contact file (VCF) card, a great way to get all your information into your members’ phones and ensure your messages are automatically directed into their “known inbox”.

  1. Empower members to take action

Healthcare messages should be structured to enable members to take immediate action. Provide clear instructions and mechanisms for them to follow through on desired actions, such as scheduling appointments or accessing resources.

SMS allows you to use clickable links, making it easy to direct members to relevant materials or services. These branded links enhance trust, as members can see where they’ll be going before they tap on a link, but they also mean you’ll be able to track interactions at the member level for valuable, near-real-time insights.

Beyond that, you must enable your members to continue interactions. This will allow you to address any barriers preventing them from taking action and empower patients to navigate their healthcare journey seamlessly.

Conversational AI and Natural Language Understanding (NLU) enable members to reply with questions and for the technology to read a message and provide a relevant response that addresses their concern and motivates them to engage in the health action you’re driving by providing the tools they need.

By responding in a natural conversational way, you can continue the conversation, uncover barriers, and get the member or patient one step further toward taking the desired action. In turn, your members will feel seen, heard and valued, resulting in a far more pleasant consumer experience overall.

  1. Give your content a boost

Personalizing your content not only builds trust but also allows you to tailor messages to the specific needs and preferences of each recipient. By tailoring content to address demographic information and social determinants of health, you can enhance engagement and drive positive health outcomes.

Incorporating multimedia elements into SMS, such as streaming health content, further boosts member engagement. Visual and narrative communication, particularly through video, captivates recipients, fostering a deeper connection and understanding of healthcare information.

A recent A/B test including embedded streaming health content in SMS resulted in a 270% increase in click-through rates and engagement. At the same time, the neuroscience around narratives shows that people retain about 7-12 times more information when it’s told as a story.

A patient accessing streaming health content on her mobile phone in the convenience of her home
Using streaming health content is a convenient way to reach people with relevant health education content.
  1. Speak the same language as your members

Health plans often cater to diverse populations with varying language preferences, which can present a challenge. However, there’s no denying that effective communication involves speaking to your members in their preferred language.

Example of using SMS in healthcare communication and adjusting to a member’s preferred language
Adjusting to a patient’s language encourages positive engagement and valuable relationship creation.

Communicating with members in their native language is one of the most high-value things you can do for positive engagement. Fortunately, with NLU, it’s possible to identify and respond to your members’ language choices.

Adjusting to a patient’s language encourages positive engagement and valuable relationship creation

For example, if someone responds to you in Spanish, respond to them in Spanish to let them know they can change their language from English simply by replying with the word “español”. Once you’ve confirmed their language, you can update their language preferences automatically to ensure that all future communications with them will also be in Spanish.

  1. Check the compliance box

Managing opt-ins and opt-outs is not just a best practice; it’s a legal requirement under the Telephone Consumer Protection Act (TCPA).

Ensure compliance with regulations by promptly honoring requests to opt-out. We all know what it’s like when you’re inundated with messages – sometimes people may reply “stop” simply because they’ve received one text message too many that day or because they don’t understand who the sender is. To overcome that particular challenge, make sure you always provide a way for members to opt back into the communication channel if they change their minds.

Understandably, healthcare organizations may have concerns about TCPA compliance, but if you’re looking to use messaging for the first time, rest assured that text messaging programs offer some definite advantages over other forms of communication.

Elevate your SMS strategy for better healthcare outcomes

In the evolving landscape of healthcare communication, healthcare SMS stands out as a versatile and effective tool for health plan outreach. Adopting SMS best practices is essential for any health plan aiming to unlock the full potential of this powerful communication tool, transform member engagement and drive positive health outcomes.

Our recent webinar on “Leveraging SMS for Health Plan Outreach provides even more in-depth insights and practical strategies.

To delve deeper into the world of SMS best practices and get to the bottom of some common myths about the TCPA, download the full webinar, where industry experts discuss real-world outcomes and practical tips for success.

To learn more about mPulse’s digital health solutions and outcomes, contact us at info@mpulsemobile.com.

 

mPulse Recognizes Innovative Healthcare Organizations in the Sixth Annual Activate 2023 Awards

mPulse Mobile recently wrapped up its fifth annual Activate conference with the Activate Awards, which provided yet another celebration of healthcare leadership, innovative program design, and improved health outcomes amidst various health engagement challenges.

The theme of Activate2022, The Power of Behavioral Science to Drive Health Action, was reflected throughout the conference with captivating speaker sessions and expert panel discussions. Networking inspired exciting conversation around innovative technology, behavior change design, and consumer experience, and the Activate Awards surely brought those conversations full circle.

The awards help illuminate health plans, health systems, health service providers, PBMs and other types of healthcare organizations that utilized new strategies or unique tools to activate their consumer populations. The companies highlighted each year typically face barriers with engaging a certain population or driving specific health actions, so they search for innovative solutions to tackle those challenges. 

For example, in 2019, CountyCare saw drastic rates of members losing Medicaid coverage, so the managed care organization (MCO) implemented automated text dialogues and saw their Redetermination rates improve by 3.3 percentage points in just one month, subsequently running away with the Most Improved Consumer Experience award. Last year, CareSource incorporated secure surveys, SMS, and streaming video to significantly impact their hard-to-reach members – they won 2021’s Best Use of Conversational A.I.  

The same story is true for this year’s winners.   

The remaining 3 award categories are Achieving Health Equity, Most Innovative Solution and Most Significant Outcome. Like the teamwork and critical thinking generated from breakout workshops and Q&A during the conference, the awards are a celebration of two companies that partnered together to overcome consumer barriers or gaps in care by building uniquely tailored engagement programs. 

Here are the winners of the 2022 Activate Awards: 

Achieving Health Equity

 
Program Goal
Increase Colorectal Cancer Screenings

AltaMed Health Services is one of the largest Federally Qualified Health Centers (FQHC) in the United States and provides a range of health services to Latino, multi-ethnic and underserved communities in Southern California. After seeing a steep drop in colorectal cancer screenings during the COVID-19 pandemic, the health center sought a solution that could help patients overcome barriers like language and lack of awareness of services. 

AltaMed partnered with mPulse to deliver multi-lingual, educational health content to patients using mobile fotonovelas tailored to both males and females who had not completed a screening. Patients received and digested vital communication about getting screened, where to find the nearest screening site, and more through culturally sensitive stories delivered in a familiar format.  

A randomized control study found that 63% of patients who responded to the fotonovelas either liked or loved it, and 39% reported it positively impacted their willingness to act. By educating patients with curated content, AltaMed closed a key screening gap, lifted health literacy and perhaps most importantly – made significant progress toward health equity.

Notable Outcome
Patients that viewed the fotonovelas (19%) were more likely to submit a sample for cancer screening than patients in a control group (11%)

Best Use of Conversational A.I.

 
A Technology-Enabled Health Services Company
 
 
Program Goal 
Promote smoking cessation among teen vapers 

This leading health services organization employs over 210,000 employees globally and utilizes technology-enabled solutions to promote consumer wellness and population health. A major public health problem facing young adults, particularly teens, across the U.S. is the use of e-cigarettes, or vaping. The company sought to promote smoking cessation among teen vapers, a cohort still widely understudied, by implementing intelligent conversational solutions and educational content.

They collaborated with mPulse to build a personalized SMS program, lasting 4-6 months, that leveraged Natural Language Understanding (NLU) to deliver automated, interactive text dialogues to a targeted teen population. Individuals were also provided custom-built streaming health videos that offered tips on quitting and even an option to connect with an SMS coach. 

The use of NLU enabled the delivery of automated messaging based on text responses, which helped the organization direct each individual to the appropriate resource. The program yielded an 85% engagement rate, and ultimately 69% of participating teens completed the program. The key result, that 73% of teens in the program set a date to quit vaping, demonstrates the value in utilizing automated text conversations and on-demand content to promote smoking cessation in vulnerable teens.

Notable Outcome 
73% of participating teens set a quit date
 
 

Check out a new streaming health course for smoking cessation. »

 

Most Improved Consumer Experience

 
CalOptima Health
 
 
Program Goal 
Increase Awareness of SNAP benefits (CalFresh)

CalOptima Health is a County Organized Health System that provides health insurance coverage for low-income children, adults, seniors and people with disabilities. As Orange County’s largest health plan, the organization includes a network of over 10,000 primary care doctors and serves over 900,000 Medi-Cal beneficiaries. The health system looked to address a gap they had identified with low-income families enrolling in the state’s food assistance program, CalFresh, federally known as SNAP.

CalOptima and mPulse partnered to launch a two-way texting campaign, which utilized interactive SMS powered by NLU and tailored to 7 different languages. The health plan addressed language barriers by delivering vital information about CalFresh’s food security benefits to underserved families and Medi-Cal members in their preferred language.  

Through automated text workflows, members could respond in their native language with answers like: “I already have CalFresh” or “I want to apply.” The program has continued to expand, having delivered over 5 million messages in 2022 already. Communicating with members according to their preferences about important CalFresh benefits helped CalOptima both improve consumer experience and reduce food insecurity for an at-risk population.  

 
Notable Outcome 
Over 5 million messages delivered to members in 2022 about CalFresh benefits

Like what you’re reading? Join us next year for Activate2023! Secure your spot now. »

Most Innovative Solution

 
 
Program Goal 
Drive members to schedule a diabetic eye exam

Humana is one of the five largest health plans in the country according to member enrollment and has been partnered with mPulse for over 10 years. With more than 20 million members, including over 5 million Medicare members, the plan looked to close a gap with their members scheduling the annual diabetic eye exam.

The plan worked with mPulse to launch an SMS texting campaign to increase awareness around the importance of the eye exam and to drive members to schedule an exam. The program featured A/B testing, in which one half of members was provided a 30-second streaming health video in the initial message while the other half received only text.  

The educational video enabled a learning experience that was easily accessible and familiar, concluding with a URL for members to learn more about scheduling the eye exam. Humana saw a remarkable 270% increase in clicks to schedule an exam when outreach included the streaming video. The test demonstrates that using streaming health content alongside two-way conversational solutions can significantly help activate hard-to-reach members with diabetes.

Notable Outcome 
270% increase in clicks to schedule a diabetic eye exam when outreach included 30-second streaming video

Most Significant Outcome (tie)

 
A Technology-Enabled Pharmacy Services Company
 
 
Program Goal 
Improve member experience and pharmacy engagement

The leading PBM and pharmacy services company is nationally recognized and fills over 1 billion prescriptions annually for millions of healthcare consumers across the country. With a rapidly growing population, the healthcare leader sought a solution to improve pharmacy patient engagement by utilizing a new communication channel for its home delivery pharmacy and prior authorization programs. 

The pharmacy leader partnered with mPulse to roll out more than 50 outbound-dialer Interactive Voice Response (IVR) campaigns. The IVR messages notified members about prior authorization approvals/denials, refill reminders, shipping details and doctor responses.  

Ultimately, over 5.8 million IVR records were exchanged and the outbound dialer launched over 5.1 million total calls. By offering a new avenue for members to complete a healthy action like ordering medications, the pharmacy enterprise initiated meaningful conversations to help enhance member experience, improve self-service capabilities, and close pharmacy engagement gaps.

Notable Outcome 
Reached over 2.2 million members with 55,000+ members giving SMS consent

Most Significant Outcome (tie)

 
 
Program Goal 
Improve refill adherence for HIV patients 

MetroPlus Health Plan is a subsidiary of NYC Health & Hospitals, the largest municipal health system in the country. The insurance organization serves a diverse group of over 600,000 New York residents across Medicaid Managed Care, Medicare, D-SNP, MLTC and more plan types. A big challenge for the plan was getting HIV patients to refill medications that are pivotal to managing their condition and avoiding complications.

MetroPlus partnered with mPulse to educate the vulnerable population through interactive text messaging about the importance of medication adherence and reducing their  unmedicated days. Texts were delivered one week apart and provided members with vital resources like phone numbers of a pharmacy or a member of the HIV care team.

The plan measured results based on whether or not a patient completed a refill within 7 days of initial outreach. The program yielded a 69% improvement in medication refills when SMS text reminders were deployed, indicating that text nudges inspire self-efficacy and action within this vulnerable population. Through targeted, mobile intervention, MetroPlus helped positively impact medication adherence for over 1,000 patients living with HIV.

Notable Outcome 
69% improvement in medication refills with mPulse text reminders

Health Challenges in 2023

The 6 winners of this year’s Activate Awards showed that even when a new barrier is identified with engaging a population, healthcare organizations must adapt to adhere to their consumers’ needs. Whether utilizing a new communication channel, adding streaming video or incorporating multiple languages, the awards demonstrate that providing healthcare consumers with tailored, learning experiences can significantly impact how they engage with a program. 

As the needs and preferences of healthcare consumers continue to evolve, so too should the capabilities of the healthcare organizations that serve them. Next year’s awards ceremony will surely exhibit a new string of engagement challenges with complex populations and niche use cases – let’s see what type of healthcare innovation surfaces in 2023! 

Medicaid Redetermination: 180 Days After the Return to Regular Operations

Three years after the start of the COVID-19 pandemic and after over two years of continuous Medicaid enrollment, we finally saw the return to normal operations in April 2023 as the national public health emergency (PHE) was officially decoupled from Redetermination.

Now, almost 180 days out from the start of the unwinding process, it’s time to look back at how states have handled this massive undertaking, how Medicaid beneficiaries have fared, and the strategies of those plans who have been successful with the redetermination process these last six months.

The 2023 Medicaid Redetermination Process So Far

Having been in Phase 1 of the unwinding process (outreaching to members for updated contact information) for the majority of 2022 and into 2023, the market finally saw a shift into phase 2 in April 2023 when states officially began the process of redetermining eligibility for millions of members

Sourced from KFF.org. Of all people who were disenrolled, 73% were terminated for procedural reasons, as of October 2, 2023.

While it’s true that it was expected many people would lose their coverage, we are unfortunately seeing large numbers of people losing coverage for procedural reasons rather than due to a lack of eligibility. Recent data from the KFF Medicaid Enrollment and Unwinding Tracker shows that of the over 7 million people who have lost their Medicaid coverage since the start of the unwinding, 73% of those fall into this bucket of people losing coverage not as a result of merit or financial requirements but rather on a lack of replies, incomplete information, and the like. 

In light of this, Congress has paused the redetermination efforts of 30 states due to their exceedingly high numbers of procedural disenrollments. Nearly half a million individuals will be reinstated after CMS found some states processing eligibility checks at the family level thus leaving out children who have lower or fewer requirements for coverage.

These 30 states have had to return to Phase 1 and 2 efforts to reach out to individuals to update their contact information and process their eligibility. Some are taking action to re-enroll everyone they presume might no longer be eligible, while others are asking their members to re-enroll based on their initial enrollment month. 

An All Hands On Deck Approach 

There’s been no shortage of assistance from state and federal organizations providing guidance and resources on approaches to drive the redetermination process and encourage people to re-enroll and maintain as much coverage as possible.

Furthermore, to reduce some of those procedural issues, health plans are now also allowed to help individuals fill out enrollment forms, which we hope will drastically reduce the amount of procedural disenrollments.

Another game-changing move was a declaratory ruling by the FCC earlier this year that health plans can now leverage SMS texting and IVR calls to conduct outreach and support continuation of coverage efforts.

This brings us to a discussion around digital strategies and asking the question, will doing the same thing deliver different results? If states are encountering issues around procedural disenrollment, what other approaches can they adopt? 

Digital Strategies to Tackle Medicaid Redetermination 

If traditional outreach methods haven’t been as effective as we hope in some states, it only makes sense to consider alternate strategies when it comes to member outreach. One channel we have seen work very successfully in redetermination efforts is SMS texting. A widely adopted channel, it can produce engagement rates of up to 60% for the most valuable and tailored programs sent to engaged populations.

To employ the SMS channel in your redetermination efforts, there are four best practices to consider.

Deliver Outreach Aligned to Language Preferences

Be sure the messages you are sending are personalized and relevant to the member. Reaching your Limited English Proficient (LEP) members can be difficult, especially when you don’t know who they are or what their preferred language is. Even if you are using pre-approved language for your redetermination outreach, an easy action to implement when leveraging a text channel is to ensure you align your messaging to the language preferences of your members. For example, mPulse technology allows for you to go beyond typical language challenges or compliance required taglines by automatically transitioning between English and Spanish in our two-way SMS conversations.

Include Educational Content to Address Health Literacy Gaps

Streaming health empowers behavior change and overcomes member barriers in 60 seconds or less.

Use captivating and engaging content in these outreach programs that educate individuals on why they should reapply. While creating awareness is the first step, educating members on why it’s important to reapply in an effort to maintain their coverage is vital. Think about it: if you don’t understand the benefits of Medicaid and how it contributes to your long-term health, why would you spend the time and energy filling in forms to prove your eligibility? Providing members with educational tools designed to build knowledge and confidence will increase the likelihood that they’ll take action.

Incorporate Behavioral Science Strategies into Messaging

Behavioral science has become a crucial component of health engagement programs and has been proven to directly impact health outcomes. Loss aversion, a cognitive bias that describes why the pain of losing is psychologically twice as powerful as the pleasure of gaining, or social proof, the phenomenon where we look around us for clues on how to behave, are examples of behavioral science strategies you can incorporate into messaging to foster greater trust, dispel concerns and increase the likelihood that your hard-to-reach members will engage and respond to outreach materials. This will help create a need for members to act.

Use Conversation AI Outreach to Identify Barriers

Leverage conversational AI and two-way texting to uncover barriers and encourage action. These AI powered, bidirectional texts allow automated, tailored responses to address individual barriers. If members reply to the texts, conversational AI uses natural language understanding (NLU) to “listen” for known barriers and other expected replies and provide relevant, automated responses to create logical conversation flows to address these barriers. This is also an opportunity to build health literacy and raise awareness about the need to maintain coverage. You can imagine how helpful these kind of capabilitiies are when trying to determine barriers to reapplying for coverage and encouraging action among your members. 

An Activation Solution 

While organizations may feel hampered by the requirement to use pre-approved state language, there’s no reason you can’t use it as an interim solution or in tandem with additional, tailored outreach. 

This is exactly the approach that one health plan adopted in preparation for the unwinding. Their goal was to activate Medicaid members with high-impact messaging and content to educate, set intent, and reduce the perceived effort of completing the redetermination process.

They achieved this by utilizing automated two-way programming to uncover and address member barriers, integrating fotonovelas, in multiple languages, into the outreach messaging. They delivered relatable stories to members that leveraged the endowment effect and loss aversion to build intent to keep coverage, and they used natural language understanding (NLU) to uncover and address common barriers and address members’ issues at scale. 

As a result, 33% of targeted members engaged with the program and by leveraging NLU, 18% of targeted members responded to the program which uncovered and addressed common barriers.

So, what does this prove? SMS is an effective channel for member outreach. It allows for delivering messages via a high-reach, high-touch channel and gives people something they can either act on in the moment or return to after the fact.

In the example above, the outreach was delivered in both English and Spanish, and made all the difference in overcoming barriers to action. Considering the best practices for member outreach that we mentioned earlier, it’s clear that addressing people in their own language, at the right time, on the right channel is key. 

Looking Ahead to Better Health Coverage 

While procedural disenrollment is a concern, several systemic issues have been identified, and the administration is taking steps to address them to keep people connected to care. Better processes and partnerships are expected to come into play, enabling easier approvals and ways to share data between states and health plans.

This includes partnering with managed care organizations, community health workers, walk-in centers, and more to raise awareness and assist enrollees in completing and submitting their renewal forms, even over the phone.

And while state-based content and language is a great starting point for communication, if you’re looking for ways to enhance your outreach efforts, start by considering what’s worked, what hasn’t worked, and where you can integrate these best practices to produce better outcomes.

How can you improve the content, add more languages, or add additional outreach modalities such as phone, email or SMS? Most importantly, how can you include streaming content and facilitate two-way conversations to overcome barriers and inspire your member populations to take action?

Not sure where to start? Reach out to learn more about the power of SMS and how you can establish a robust redetermination solution to reduce coverage loss and create high-value member touchpoints. 

Avoidable & Unnecessary ER Visits: Emergency Room Diversion Strategies

Using the Emergency Department excessively is the fourth largest financial waste in US healthcare – it costs over $38 billion annually. Emergency departments are overwhelmed, and emergency physicians experience almost three times more burnout than other departments.

Health organizations are under increased scrutiny to lower non-emergent ER visits and implement solutions to encourage health consumers to seek the right level of care. Despite ongoing efforts and initiatives, emergency department overutilization continues to rise yearly.

Understanding and analyzing commonalities in ER utilization will enable deeper insight into how we can begin tackling this issue head-on.

Why do consumers go to the ER when it’s not an emergency?

There are many reasons why health consumers visit the ER. In more ways than not, the emergency department checks several boxes when it comes to convenience:

  • It’s open 24 hours, 7 days a week.
  • It offers patients immediate reassurance regarding their condition or ailment.
  • Patients receive a full range of services regardless of the severity of their condition or whether or not they can afford it.
  • Hospitals have financial and legal obligations to treat patients.

To deter consumers from visiting the ER, alternative care options need to become more accessible and outweigh the convenience of a visit to the ER. Shifting consumer paradigms is easier said than done, and health organizations need to adopt innovative solutions to educate and encourage patients to seek alternative care models.

Further consideration of commonalities in emergency room overutilization offers clues to designing solutions that address the why and offer insight into the how.

Commonalties in Avoidable or Unnecessary ER Visits

ER overuse is a nationwide issue with the highest prevalence among those who are uninsured or enrolled in government health programs, particularly Medicaid.

Nearly 53% of Medicaid members will have an avoidable or unnecessary ER visit this year. Those with health disparities are most likely to have an avoidable ER visit.

Risk factors include

  • being in a lower-income decile,
  • unemployed,
  • living in a single household,
  • less than high school educational attainment,
  • English speaking,
  • aged 27-54 or 65+,
  • limited internet access,
  • divorced or widowed,
  • female,
  • having a disability,
  • having one or more chronic conditions,
  • uninsured or having public health insurance, and
  • having limited or no transportation.

It is important to note that institutionalized and structural inequities cause these commonalities. Collecting data points and creating false attributions is easy; systemic racism and long-standing inequitable distribution of wealth and resources are to blame in this instance. Health organizations are taking responsibility for recreating a system in which diverse populations have greater access to the care and resources they need.

At the end of the day, health equity benefits all of us. Providing equitable opportunities for care availability and resources is foundational in lowering avoidable ER use, and understanding commonalities help address and overcome existing barriers.

The Difference Between Avoidable & Unnecessary ER Visits

There is an important distinction between the terms ‘avoidable’ and ‘unnecessary’ when it comes to the course of action and corresponding interventions needed for ED diversion.

For the purposes of this blog, avoidable ER visits are visits related to unmanaged conditions, such as diabetes or mental health/substance use disorders (MH-SUD). In fact, nearly 60% of all ER visits are from people with one or more unmanaged chronic conditions, with these individuals also having higher rates of ED recidivism.

Unnecessary ED visits are often due to a lack of accessibility and educational resources and typically account for visits that are urgent care or primary care treatable.

The top four ER diagnoses, in order, are as follows:

  1. Abdominal pain and digestive issues,
  2. Upper respiratory infections,
  3. Minor injuries, and
  4. Sprains.

Both avoidable and unnecessary ED visits require intervention; however, the methodologies and approaches vary. Healthcare isn’t one-size-fits-all, and meaningful behavior change requires personalization dependent on each consumer’s unique needs, preferences, and health status.

ER Diversion Strategies

Understanding why consumers seek care at emergency departments, coupled with commonalities in ER utilization, provides a deeper understanding of what’s needed to help support and educate consumers in seeking the right care for their health needs. The right education and support also depend on whether the ER visit is avoidable or unnecessary.

Education

Meaningful education incorporates behavioral science principles to motivate and empower behavior change. Simply telling a consumer they shouldn’t go to the ER unless they have to won’t work. Engaging with consumers in frictionless and meaningful ways requires expertise.

mPulse Mobile’s in-house instructional strategists, behavioral scientists, and health equity researchers develop cinematic streaming content experiences designed for optimal behavior change. Short-form content is designed to be relatable and educational, enabling consumers to realize the benefits of seeking alternative care.

See an example animation below.

Want to learn more about how streaming health content can drive behavior change? Download the complete guide »

Accessibility & Convenience

Providing personalized resources and support through frictionless calls to action will promote the utilization of better care options. Many health plans have resources available such as ride-share services and telehealth or nurse line providers for non-emergent cases. Despite these resources, utilization remains low, primarily due to a lack of awareness that they exist.

Engaging with members through an omnichannel approach, such as SMS, Email, and/or IVR, enables health organizations to meet their consumers where they’re at frictionlessly while providing accessible links to resources and support at their fingertips. When health organizations leverage innovative technology as a vehicle of communication with their consumers, engagement rates rise along with better health outcomes.

Avoidable ER Visits: Condition Management Solutions

Reducing avoidable ER visits begins with creating and maintaining meaningful relationships with health consumers. Because one size doesn’t fit all, understanding each consumer’s needs and preferences and their conditions and health status are crucial. mPulse Mobile creates individual member profiles in which each consumer’s protected data is leveraged to send tailored and relevant cadenced touchpoints. This becomes increasingly important for better condition management and medication nonadherence, accounting for billions in avoidable ER spending.

mPulse Mobile provides integrated and meaningful solutions for condition management, such as hypertension and diabetes, as well as MH-SUD and routine appointment reminders and scheduling.

Our solutions leverage an omnichannel engagement approach incorporating conversational AI and streaming content to educate and empower members to own their health while adopting healthier behaviors, including:

  • eating better and exercising,
  • regularly communicating with their care team, and
  • taking their medications as prescribed.

Educating consumers on where to seek the right level of care and providing resources and support are critical components of ED Diversion, but understanding individual consumer health needs and support will help health organizations reduce avoidable and unnecessary ER visits.

Visit mPulse’s condition management solutions to learn more »

mPulse Case Study

One of the nation’s leading health plans partnered with mPulse Mobile to lower unnecessary ER visits and redirect members to better, more affordable care options.

Goals & Execution: Automate and optimize digital communications to members using SMS text messages to redirect members identified as high-utilizers of the ER and provide meaningful messages and streaming content to redirect them to more appropriate levels of care.

A population analysis was performed to assess the intervention impact for members outreached. SMS messaging was deployed to engage and educate members to seek the right level of care for their health needs. A group of approximately 12,000 high-utilizers were enrolled in the program.

Results: 69.7% reduction in ER visits. Before outreach, there were nearly 19,000 total ER visits. Post outreach, that number decreased to under 5,700 visits. Assuming the average ER visit cost is $1,082, the program saved over $14 million in health plan and consumer savings during the program’s duration.

In Conclusion

Health organizations are uniquely positioned to engage meaningfully with their members and patients and have invested time, money, and resources into providing services conducive to bettering health outcomes.

mPulse Mobile is the leader in innovative digital engagement solutions and partners with 200+ leading health organizations to deploy over 1 billion conversations annually to inform, educate and tailor conversational engagement designed for health action across diverse populations.

 

To learn more about how mPulse Mobile can lower avoidable and unnecessary ER visits, lower costs, and improve health outcomes for your consumers, contact us to schedule a consultation.

mPulse Mobile Achieves Strong YoY Revenue Growth in Q2 2023 Driven by Outcomes-Driven Engagement Solutions

LOS ANGELES–(BUSINESS WIRE)–mPulse Mobile, a leader in conversational AI and digital engagement solutions for the healthcare industry, today announced strong momentum in Q2 2023, with 159% new revenue growth over the prior year (Q2 2022) and over 80 million unique health consumers engaged through its SMS programs in Q2 2023. The company also announced the launch of its Emergency Department Diversion solution aimed at addressing overuse of the ED to reduce costs and help members access appropriate channels of care.

Value Based Care and Emergency Department Use

Value based care (VBC) strategies require a high level of member engagement, proactive outreach, and seamless coordination of care to scale across diverse populations and drive a successful business model. mPulse is supporting the needs of VBC organizations such as Accountable Care Organizations (ACOs) and managed services providers by deploying Conversational AI solutions that integrate streaming content to educate members and drive better health behaviors.

Reducing inappropriate or overuse of the Emergency Department (ED) offers a key opportunity to improve the performance of value based care plans. Today, mPulse announced the launch of its Emergency Department Diversion solution, which targets large populations and “high utilizers” to adopt more efficient and appropriate care channels. The solution is an optimized version of in-market programs, which have already reduced improper Emergency Department use by almost 70% and directed 60% of patients to visit their primary care provider (PCP) instead of the ED.

Medicaid Continuous Enrollment

As individual states manage the resumption of Medicaid re-enrollment, mPulse is supporting 24 health plans with omnichannel digital engagement that activates members to complete the redetermination process. Recently reported data shows procedural disenrollments account for 75% of beneficiaries losing coverage. This highlights the importance of providing support to individuals to help overcome barriers and connect them to appropriate resources. mPulse has leveraged its Redetermination Solution across SMS, IVR and email channels and launched over 110 tailored Redetermination engagement programs to over 7 million Medicaid beneficiaries at risk of losing coverage. mPulse’s solution uses conversational AI to generate engagement rates in excess of 30% by automatically interpreting member’s responses, aligning with language preferences and integrating high-impact streaming content into the outreach. Historically, mPulse’s redetermination outreach solutions have driven 42% increases in redetermination rates and a 93% completion rate after engaging with the program.

mPulse Recognized by Gartner® in Multiple Categories

mPulse was recognized by Gartner in its July 2023 report, “Hype Cycle™ for U.S. Healthcare Payers, 2023” as a Sample Vendor in two categories identified as having transformational benefit rating: Consumer-Centric Health Products and Community Resource Network Management (CRNM). Both categories are forecast to have a transformational impact and mainstream market adoption within a two- to five-year time horizon.

In addition, mPulse was mentioned in a new July 2023 Hype Cycle report, “Hype Cycle for Consumer Engagement and Experience in Healthcare and Life Sciences, 2023.” We believe its mention in this report demonstrates mPulse’s growing presence in the life sciences market segment, as its engagement solution increases in adoption to help support clinical trial engagement and participant retention over time.

“Through our extensive partnerships across the healthcare ecosystem, we are closely attuned to the needs of leading healthcare organizations, which continue to seek innovative technologies to support core business strategies,” said Bob Farrell, CEO of mPulse Mobile. “The innovative health plans we work with recognize the need for technology-driven member engagement that go beyond what traditional outreach can offer, and our flexible conversational AI and digital engagement solutions move the needle for their value based care goals, even among the hardest to reach populations. We feel both our customers’ results and our recognition by Gartner in key technology categories illustrate mPulse’s ability to deliver lasting improvements in the consumer health experience and member outcomes.”

To provide a forum to discuss trends in digital engagement across the healthcare industry, mPulse Mobile is hosting the Activate2023 conference September 27-28, 2023 and today announces new speakers, including Dr. Reed Tuckson, a physician and public health research advocate, and Craig Kennedy, President & CEO of Medicaid Health Plans of America (MHPA). The full agenda and registration page can be found at https://go.mpulse.com/activate2023.

Improving Maternal Health Outcomes with Digital Trends

Despite having a highly advanced healthcare system, the U.S. faces a concerning reality as it records the highest rate of pregnancy-related deaths among developed countries. Alarmingly, the maternal mortality rate surged by 40% in 2021 compared to the previous year. While part of this increase can be linked to the COVID-19 pandemic, it’s important to note that maternal mortality rates were already on an upward trend even before the pandemic struck.

Up to 60% of pregnancy-related deaths and adverse maternal health disparities in the U.S. can be prevented by

Proper preventive and continuity of both prenatal and postpartum care are imperative, and health organizations play a foundational role in improving maternal health disparities for our nation.

In an era where technology is pivotal in improving maternal healthcare outcomes, conversational AI in healthcare emerges as a key player. As the U.S. grapples with rising maternal mortality rates, integrating advanced conversational AI into healthcare strategies offers hope. This innovative technology can significantly improve maternal health outcomes by providing timely, personalized, accessible support to expectant and new mothers.

Our conversational AI solutions are designed to bridge the gaps in maternal healthcare inequalities, offering tailored guidance and vital information that can make a real difference in the lives of women during their pregnancy and postpartum journey.

In this article, we explore the transformative potential of conversational AI in improving maternal health disparities and reducing the alarming rates of pregnancy-related complications in the U.S.

The role of healthcare communication technology

Organizations continually lean on digital trends in an increasingly technology-driven world to drive growth and business efficiencies. 97% of U.S. adults own a mobile phone, and with generative AI platforms such as ChatGTP and social media AI photo filters becoming mainstream, we’re beginning to see the power and potential of healthcare communication technology.

But how does this tie into health organizations and maternal health? 

A lot more than you may think. mPulse Mobile has harnessed innovative technology and digital trends and applied them to the healthcare landscape to educate and empower health consumers to take action. We continually deliver best-in-class health outcomes by borrowing inspiration from the world’s most innovative digital trends. We create highly relevant and engaging digital health solutions experiences through:

  • Technology’s leading trends,
  • in-house learning and design experts, and
  • access to rich data and population insights

Our solution to prenatal and postpartum care leverages this expertise. It tackles the challenges associated with our nation’s poor maternal health outcomes, opening doors to accessibility, catering to care preferences, and building knowledge.

Maximizing mobile outreach with conversational AI to enhance maternal healthcare accessibility

conversational ai example for maternal health resourcesWe know 97% of American adults own a mobile phone, so leveraging this communication channel to reach more consumers is a great place to start. Scaling this resource requires automation, and to avoid abrasion, we lean on conversational AI and Natural Language Understanding (NLU) to direct consumers to the right tools and resources.

Step-by-Step Process to Enhance Maternal Healthcare Accessibility:

  1. Identify Nearby ObGyns and Clinics: Automatically send pregnant members a list of the closest ObGyns and clinics based on their residential location.
  2. Provide Easy Scheduling Options: Include a phone number for members to call and schedule their appointments easily.
  3. Recognize and Respond to Barriers: Utilize Natural Language Understanding (NLU) to detect if a member mentions a lack of access to reliable transportation.
  4. Offer Solutions for Transportation Barriers: In cases where transportation issues are identified, automatically respond with information about available resources that offer low or no-cost transportation options.
  5. Simplify Appointment Setting: Ensure the entire process, from providing information to addressing barriers, is streamlined to facilitate quick and easy appointment scheduling for members.

Addressing maternal health disparities with culturally competent and personalized solutions

conversational ai example relevant and relatable

The disparities in maternal health outcomes and the lack of representation and consideration for consumers who are disadvantaged by our health system are undoubtable and require prioritization. mPulse Mobile is committed to helping reduce maternal health disparities and inequalities by designing our programs to be relevant, relatable and address the needs and preferences of diverse communities.

Our pregnancy solution is culturally competent, with multilingual messaging, NLU tailoring, and inclusive replies and opt-outs (miscarriage opt-out, not saying “pregnant women”). For SDoH-level data, we factor in zip codes to deliver relevant resource links and inclusive visual and streaming content representation. To create a personalized and relevant experience throughout, the member’s due date is used to provide timely information, and custom keys (name, provider name, etc.) further enhance personalization.

How we leverage digital trends for enhanced maternal health education

Information sharing and access to the news today are more broadly available thanks to smart devices and the internet. With Americans spending an average of 1,300 hours each year on social networking platforms such as Facebook, Instagram, and TikTok, it’s critical to derive inspiration from these platforms to maximize engagement and remove friction.

More than 50% of expectant Americans download and use pregnancy-related apps for educational resources and pregnancy-related updates. Health organizations are perfectly positioned to harness these trends and provide a frictionless experience to expectant consumers to engage and deliver the right education and resources, close care gaps, and gather rich population insights.

mPulse Mobile’s prenatal and postpartum solution uses a combination of expert-led videos from Dr. Christine Noa Sterling, board-certified ObGyn, interactive modules, and short stories and animations to educate and empower members around key milestones related to their and their baby’s health.

Content is sent via SMS at key moments based on each consumer’s due date, encouraging them to schedule routine appointments and make healthier choices.

Our in-house behavioral scientists and instructional strategists leverage learning theory and high-quality cinematography and animation to produce content designed to drive action. See for yourself.

Overview of mPulse Mobile’s prenatal and postpartum solution

mPulse’s prenatal and postpartum solution

mPulse Mobile’s pregnancy solution is a 12+ month interactive SMS program designed to improve quality performance and deliver better health outcomes.

The solution specifically targets multiple HEDIS® measures and is proven to engage and deliver outcomes such as a 2X engagement rate with maternity care management services, a 7.1pp increase in the prenatal and postpartum care measure (PPC) owned by NCQA, and 61% engagement across 400,000 Medicaid members. By incorporating our behavior change methodology throughout all conversations and streaming content, our comprehensive approach broadens access, caters to individual preferences, and educates to improve health outcomes at scale.

How to Overcome Flu Vaccination Inequities This Flu Season

The stark reality of flu vaccines is that they save millions from illness and death, yet there remains a significant inequality in vaccine distribution, particularly affecting certain demographics. During the 2022-23 flu season, while 173.37 million Americans were vaccinated, saving nearly $2.4 billion in healthcare costs, a concerning 46% of eligible Americans remained unvaccinated. 

Solving vaccine inequity requires a deeper understanding of the social determinants of health (SDoH), such as age, race, and income, which play a pivotal role in these disparities. Notably, vaccination rates are considerably lower among Black, Hispanic, and American Indian/Alaskan Native adults, with hospitalization rates significantly higher among Black adults. Furthermore, adults with lower incomes and those in the 18-49 age group are less likely to receive the flu vaccine.

Identifying and addressing the root causes of these inequities is crucial for improving vaccination rates and ensuring equitable health outcomes for all in the upcoming 2023-24 flu season.

Understanding why these inequities exist is essential when designing programs to help overcome them.

Overcoming inequality in vaccine distribution through inclusive flu outreach

Addressing vaccine inequity requires tailored strategies that specifically target the underlying causes of these disparities. The CDC highlights a lack of accessibility, misinformation, and widespread distrust in the medical system as primary reasons for flu vaccine inequities. Crafting programs that focus on overcoming these barriers is crucial to enhancing flu vaccination rates and bridging the gap in inequality in vaccine distribution.

By implementing such targeted approaches, we can work towards ensuring equitable healthcare access for all member populations.

How to address and solve vaccine inequity through enhanced accessibility

Overcoming vaccine inequity necessitates addressing accessibility challenges that disproportionately affect disadvantaged groups. Many individuals face barriers such as unreliable transportation, disabilities, limited internet access, inflexible work schedules, and language or translation issues, making vaccination access difficult. These systemic issues often fail to accommodate all members’ diverse needs and preferences, creating an unequal landscape in vaccine distribution.

Fortunately, health plans have a significant opportunity to address these challenges. By implementing programs focusing on accessibility, they can identify individual barriers and provide customized resources to facilitate access. This requires an in-depth understanding of the target audience’s specific needs.

At mPulse, we utilize internal and external data to gain comprehensive insights into member needs, allowing health plans to create highly relevant digital touchpoints. Health plans can effectively identify and address individual barriers by engaging with members through their preferred communication channels, such as SMS, email, or IVR. The right message, delivered through the right channel, in the appropriate language, and accompanied by suitable resources, is key to meeting members where they are and improving flu vaccination rates.

Learn more about how to solve vaccine inequity and enhance vaccination rates by watching our on-demand webinar, “Double Flu Vaccination Rates for Your Health Population.”

Combating vaccine inequity with effective communication strategies

In the digital age, where misinformation and knowledge gaps about vaccines are prevalent, especially post-pandemic, it’s crucial to tackle vaccine inequity by providing trustworthy and pertinent vaccine information. Misconceptions about vaccinations, particularly the flu vaccine, have increased, underscoring the need for reliable information sources.

At mPulse, we aim to solve vaccine inequity by adapting the engaging formats of popular social media platforms. Our approach involves creating short-form content that is informative, educational, entertaining, and easy to consume. We focus on making content frictionless and engaging while ensuring it’s accessible to a broader audience. This includes featuring relatable characters representing diverse populations and offering multilingual options, which are vital to resonating with broader member groups and building credibility.

By sharing health content through each member’s preferred communication channels, we ensure they efficiently receive vital vaccine information. This method is particularly effective in addressing misinformation and bridging knowledge gaps, thereby playing a significant role in how to solve vaccine inequity. To see an example of how we bring this to life, view another fotonovela included in the mPulse Mobile Flu Vaccination Solution.

Building Trust to Address Vaccine Inequity

Addressing distrust in the medical system, often rooted in a history of structural racism and discrimination, is crucial in solving vaccine inequity. While health plans represent only one component of this complex issue, establishing trust with their members is vital. Utilizing digital trends for inspiration can significantly aid health plans in scaling their efforts effectively.

Creating multiple positive and meaningful touchpoints over time is key to developing and maintaining strong member relationships. At mPulse, we collaborate with health plans to provide empathetic messaging that conveys relevant and accessible information in each member’s preferred language and through the most appropriate channel. This approach helps ensure members feel supported and can rely on their health plan for essential care and resources, fostering greater trust and empowerment.

Simply notifying members about their due flu vaccines can be perceived as intrusive. Instead, our approach incorporates sensitive, culturally relevant messaging that leverages behavioral science techniques, cinematic educational content, and tailored resources. This strategy demonstrates an understanding of the member’s unique needs and genuine concern for their health.

When members feel that their health plan values and understands them, they are more likely to trust the plan and engage in healthier behaviors, thereby contributing to solving vaccine inequity.

Leveraging technology to overcome health disparities and boost flu vaccination rates

Technology is imperative in helping overcome health disparities and barriers to flu vaccinations. By leveraging innovative digital trends designed to serve vulnerable populations, health plans can begin broadening accessibility, educating and empowering members, and building trust at scale to improve vaccination rates and inspire healthier outcomes for the people they serve.

mPulse Mobile designs solutions that identify and overcome barriers to action. Our behavior change model incorporates health equity, behavioral science, and instructional strategy to deliver best-in-class outcomes.

Contact us to learn more about how our flu vaccination solution can help overcome vaccine hesitancy for your members.

How Combining Conversational AI and Visual Stories Can Increase Colorectal Cancer Screenings

In today’s world of information overload, capturing health plan members’ attention and encouraging them to take preventive health measures isn’t easy. It’s even more challenging when members are experiencing health disparities due to race, ethnicity, socioeconomic factors, and other social determinants of health. To address this challenge, mPulse Mobile created an innovative way to encourage members to get screened for colorectal cancer.

Specifically, mPulse’s approach combines text messages powered by conversational AI with visual storytelling to address misconceptions, raise awareness, model healthy behaviors, add an element of humor, and build overall health literacy.

To evaluate the clinical value of this approach, mPulse and The AltaMed Institute for Health Equity partnered to research the impact of text messages and fotonovelas on encouraging colorectal cancer screenings with socially vulnerable groups. They conducted a study to determine whether members were more likely to get screened after receiving

  • A series of bidirectional texts that tailor responses to address individual screening barriers, and
  • Fotonovelas or illustrated comic strips that tell a story explaining the importance of early detection and encouraging screenings.

An important motivation was to use culturally relevant messaging to engage these groups and to measure whether it could yield improvements in outcomes equitably across populations.

Evaluators at the Center for Community Health and Evaluation (CCHE), part of the Kaiser Permanente Washington Health Research Institute, independently evaluated the intervention. The results, recently published in JMIR Cancer, a peer-reviewed journal focusing on innovation and technology in cancer care and research, were very positive: nearly 40 percent of patients who received texts and fotonovelas responded, and they had significantly higher screening rates than those who did not receive the texts and fotonovelas.

The program was developed by mPulse and combined interactive text messages and fotonovelas to educate and activate patients throughout the four-week outreach. When patients shared their reasons for not completing the screening, the conversational AI platform provided relevant automated responses to address these barriers and to influence their health beliefs and behavior.

A Closer Look at Colorectal Cancer

Colorectal cancer is the second-leading cause of cancer death in the US, accounting for an estimated 151,030 new cases and 52,580 deaths in 2022. With appropriate screening, however, it is mostly preventable and can be treated successfully when localized and diagnosed early. Indeed, the five-year relative survival rate for localized colorectal cancer is more than 90%.  

Several screening tests can be used to find polyps or colorectal cancer, including an at-home stool test known as the fecal immunochemical test (FIT) which uses antibodies to detect blood in the stool. Upon completing the test, the patient mails it back to the health plan.

Barriers to Screening

A key step in improving screening rates is understanding why patients don’t get screened.

Studies have identified several potential barriers, including feeling fine and not understanding the need for the test, being busy or forgetful, expressing fear about what the test may indicate, the potential risk of perforation, embarrassment about a fecal collection procedure, concerns about mailing fecal matter, mistrust of the healthcare system, and the cost of follow‐up colonoscopy. Limited health literacy is another stumbling block, particularly when combined with cultural health beliefs and linguistic barriers.

The barriers impacting different populations vary which contributes to differences in screening rates and cancer diagnoses. For example, researchers report that Hispanics have significantly lower rates of screening for colorectal cancer than non-Hispanic Whites, and are more likely to be diagnosed with advanced disease.

The Study

AltaMed, the largest federally qualified community health center (FQHC) in California, and one of the largest nonprofit FQHCs in the nation, serves approximately 300,000 patients across Southern California and routinely mails out FIT kits to patients due for colorectal screening.

As part of usual care, about 11,000 patients who were due for a screening received a text message with a link to an instructional video, a follow-up text reminder, and a call from a patient navigator within a month if they still hadn’t returned the FIT kit.

Three months after the kits were mailed, 5,241 patients, age 50-75 years, had not returned the FIT kit and they were randomized into two groups for the study: the intervention group which received additional outreach (texts and fotonovela over four weeks), and the control group (no additional outreach).

A majority of patients in the intervention group were Hispanic or Latin American. mPulse has developed an index to map social determinants of health (SDOH) impact levels (using several census variables) and over 75% of patients in the study were living in neighborhoods where SDOH might negatively impact health access and health equity, resulting in health disparities.

The texts and fotonovelas were designed and implemented by mPulse to educate, remind, and encourage patients to return their FIT kit. All text messages were in patients’ preferred language, either English or Spanish, and written at a sixth-grade reading level or lower. 

In the first week, the texts focused on building health literacy about colon cancer and screenings, and the purpose of the FIT kit. Week two texts sought to uncover barriers by asking why the patient hadn’t yet taken the test. The next week gathered feedback on the fotonovela and its impact on health beliefs and behaviors; and the last week was a final reminder to mail back the kit.

If patients replied to the texts, the conversational AI used natural language understanding (NLU) to “listen” for known barriers and other expected replies and provided automated responses to create logical conversation flows.

Conversational AI

Patients could text back in their own words, and their responses were handled using rules and conversational AI. This was also an opportunity to build health literacy and raise awareness about the need to get screened regularly. Here is a sample conversation:

Patient’s reply:

“I don’t know why I need the test; I feel fine and have no symptoms.”

Automated response:

“It turns out most people with colon cancer feel healthy and have no symptoms. And most people with colon cancer also have no family history of the disease. This is a quick and easy way to find out if there are any problems.”

Similarly, if a patient replied, “I’m worried about getting COVID-19 if I come into the clinic”, the system was listening for COVID anxiety and would respond immediately by reassuring the patient using conversational AI.

The automated response was: “You don’t need to come into the clinic right now. Just mail back the FIT colon health test kit that we sent you in the mail. If the results are abnormal, somebody from AltaMed will contact you. Don’t let your worries about coronavirus get in the way of completing the test. It’s quick and easy!”

Thus, patients received timely and relevant information as part of a meaningful back-and-forth dialogue in real time.

Fotonovelas

The fotonovelas were created to address barriers such as procrastination, lack of self-care, lack of time, embarrassment about the process, and fear of results. They were developed in Spanish and English, in collaboration with the AltaMed Institute for Health Equity, and there were separate versions for men and women.

To ensure that the fotonovelas were compelling, the storyline used characters who were 50–75-year-old Hispanic or Latino patients and who looked and talked like they could be the patient’s best friend or neighbor. And the fotonovelas reflected the central role of family in the Latino community by emphasizing that the characters were getting screened not just for their own health, but for the sake of their loved ones as well. All fotonovelas also contained a call to action for patients to use and return the kit. Sample frames are shown below for the English versions (there were 9 frames in each fotonovela). The second fotonovela can be viewed in full in the JMIR Cancer publication.

Want to learn more about how stories can change behavior? Watch the on-demand webinar, Stories That Move »

Results

Approximately 40% of the patients engaged with the text messages (1,026 patients responded to at least one text out of the 2,597 patients in the intervention group). This is considerably higher than the typical engagement rate with screening reminders. Interestingly, patients who did engage were quick to respond and 86.1% of those who engaged did so within an hour of receiving a text. Of the patients who engaged, 31% clicked on the link to view the fotonovela.

Most importantly, there was a statistically significant 7 percentage point difference in screening: 18.8% of patients in the intervention group were screened, compared with 11.6% of those in the control group.

Social Determinants of Health and Health Equity

A central consideration in the study was to understand whether culturally tailored text messages and fotonovelas could drive behavior change in patients experiencing disparities due to sociodemographic and social determinants of health factors such as race, ethnicity, income, cultural linguistic barriers, and geography.  The results suggest that layering text and visual modalities was particularly effective, with these subgroups showing higher screening rates than the group average. Spanish speakers in the intervention group had an 8.2 percentage point improvement in screening rates (compared to a 5.7 percentage point improvement among English speakers). Similarly, patients in very high need areas and high need areas based on SDOH had an 8.5 percentage point improvement and 7.2 improvement in screening rates respectively (compared to a 2 percentage point improvement in very low need areas). Finally, among those who had never been screened for colon cancer, there was a 6 percentage point improvement in screening rates.

Bringing it All Together: The Impact of Conversational AI and Fotonovelas

Most patients who engaged with the text messages, fotonovelas, and conversational AI had positive or neutral responses and there were very few negative responses. This study underscores how the combination of text, images and tailored responses can help health plans build health literacy and influence health beliefs and behavior in an innovative and culturally relevant way, while achieving positive clinical results. Looking ahead, the mobile health solution in this study provides a robust and replicable model to uncover and address barriers to screening and to improve colorectal screening rates, particularly for disparate and socially vulnerable populations. Increasing the number of screened patients typically leads to more early detection of colorectal cancer, which in turn, can save lives.

The author, Rena Brar Prayaga, is an Impact Tech Advocate and a Behavioral Data Scientist. She is also an Advisor at mPulse Mobile, and a co-author of the study published in JMIR Cancer.

mPulse Mobile and AltaMed Research Innovative Approach to Increasing Colorectal Cancer Screenings

LOS ANGELES–(BUSINESS WIRE)–mPulse Mobile, a leader in conversational AI and digital engagement solutions, partnered with AltaMed Health Services, one of the largest nonprofit federally qualified health centers (FQHC) in the U.S., to publish a research study in JMIR Cancer. The study found that automated, bidirectional texting using Natural Language Understanding (NLU) and fotonovelas can increase screenings for colorectal cancer, particularly among populations facing Social Determinants of Health (SDoH) barriers.

While colorectal cancer is the second most deadly type of cancer in the United States, it is also highly preventable with regular screening, as rates of survival are high when caught early. The California member population served by AltaMed, which is majority Hispanic or Latin American, is less likely to be screened for colorectal cancer and more likely to be diagnosed with advanced disease than non-Hispanic white patients due to a variety of SDoH barriers to care. AltaMed partnered with mPulse Mobile to research ways to address these barriers by delivering culturally-tailored mobile content, in the familiar fotonovela format, aimed at overcoming lack of awareness around CRC screenings and other cultural and behavioral barriers.

Along with mailing at-home fecal immunochemical tests, or FIT kits, to members due for screenings, the randomized controlled trial used an automated texting program for two-way communication to identify barriers to getting screened and to educate members around the importance of screening. Among 5,241 members who had not completed their FIT kit after 12 weeks, an intervention group received an additional 4-week series of automated text messages monitored using a program developed by mPulse Mobile. In combination with the text messages, participants were sent a link to a fotonovela in either English or Spanish, containing a comic about someone encouraging a friend to complete their FIT kit and explaining why the screening is important.

The intervention resulted in a significant quality improvement among participating members:

  • 40% of members in the intervention group engaged with the text messages. Of those, 31% clicked on the link to view the fotonovela.
  • The intervention group had a screening rate of 18.8%, while the group that did not receive the texts and fotonovela had a screening rate of 11.7%.
  • Screening rates were higher among members who engaged with the text messages than among those who did not.

“Addressing Social Determinants of Health barriers among hard-to-reach populations is a core facet of mPulse Mobile’s mission,” said Bob Farrell, CEO of mPulse Mobile. “We’re thrilled to have partnered with an organization like AltaMed to demonstrate how innovative digital engagement approaches can address the challenges people face completing important health actions. Understanding the needs of individuals at scale and then tailoring touchpoints to address these needs is a crucial part of improving health outcomes across diverse populations.”

mPulse Mobile, the leader in Conversational AI solutions for the healthcare industry, drives improved health outcomes and business efficiencies by engaging individuals with tailored and meaningful dialogue. mPulse Mobile combines behavioral science, analytics, and industry expertise to help healthcare organizations move their consumers to adopt healthy behaviors.

“Our program used tailored conversations and personalized stories to engage different segments and drive behavior change. Conversational AI helped us to uncover the reasons why people weren’t completing their screenings and to address these barriers in real time. The results show that we were able to reach and influence some of the most vulnerable populations and this is very encouraging,” said Rena Brar Prayaga, Behavioral Data Scientist and co-author of the study.

AltaMed Health Services, serving primarily Latinx patients in Southern California, has a history of leading innovative, culturally-tailored member engagement programs that improve care outcomes and overcome social determinant barriers among their member population.

Evaluators at the Center for Community Health and Evaluation (CCHE), part of the Kaiser Permanente Washington Health Research Institute, independently evaluated the intervention. The full study, “Using Text Messages and Fotonovelas to Increase Return of Home-Mailed Colorectal Cancer Screening Tests: Mixed Methods Evaluation” was a collaboration between AltaMed, mPulse Mobile and CCHE and published in JMIR Cancer. Authors of the study are Carly E Levitz and Elena Kuo from the Center for Community Health and Evaluation, Monica Guo, Esmeralda Ruiz, Evelyn Torres-Ozadali and Anne Escaron from AltaMed, and Rena Brar Prayaga from mPulse Mobile.

About mPulse Mobile:

mPulse is transforming digital engagement for healthcare’s leading organizations through proven solutions that combine conversational AI with integrated streaming content. mPulse Mobile’s innovative technology and engagement strategy deliver business efficiencies, improve health outcomes, and inspire a more equitable, healthier world, one person at a time. mPulse Mobile has over 12 years of digital health engagement experience and partners with over 200 leading healthcare organizations to deliver over 1 billion tailored digital touch points with health consumers annually. To learn more visit mpulse.com.

About AltaMed Health Services:

AltaMed understands that when people receive care that considers their individual health needs and respects their cultural preferences; they grow healthy—and help their families do the same. Since 1969, we have delivered complete medical services to communities across Southern California. Our team of qualified multicultural and bilingual professionals—from these same communities— is focused on eliminating barriers to primary care services, senior care programs, and essential community services. With nearly 50 accredited health centers and service facilities, we remain committed and ready to help you grow healthy at any age.

View the press release on Business Wire.