Improving adherence by listening and learning

Lucas Merrow, CEO of Eliza Corporation, details the effect of multi-touch communication strategies on patient compliance.



Lucas Merrow, CEO of Eliza Corporation, details the effect of multi-touch communication strategies on patient compliance.



As much as we like to believe we can change, the fact is that transforming our wayswhether it involves eating patterns, spending habits, or exercise goalsis extremely difficult. Making a New Years resolution is different from following through in a sustainable manner over the course of the coming year.


Thats especially true in a world saturated by powerful messaging that, more often than not, returns us to the ways were trying to move beyond.


Since the beginning of time, it feels like healthcare organizations have been trying to get the right message to the right person in the right time in the right channel, says Lucas Merrow, CEO of Eliza Corporation. But this is what were competing against, pointing to a Hardees food ad featuring Padma Lakshmi, the fetching host of the hit show Top Chef, licking the ketchup of a Western Bacon Thickburger off her wrist.


Typically the food and tobacco industries spend something on the order of $70 to $100 per [US] citizen per year on selling their products, Merrow continues. I dont know what the comparable figure is in healthcare, but my guess is its quite a bit lower.


The personal touch


To compete with such powerful messaging, Merrow says its essential to reach out to people in a personalized manner. After all, what motivates one person might deter the next.


Some people use family as an incentive to change; others use longevity, money, competition, or pain avoidance. Taking these differences into account and melding them into a far-reaching but personalized method of communication is Elizas speciality.


The company uses a range of approaches, from the basics of listening and learning to more complex solutions, like multi-modal approaches, profiling technology, and engagement indexes.


Because we all work in healthcare with these issues, and adherence and wellness are so important to us, we feel like everyones at home just waiting to talk about taking their medicine, Merrow says. But theyre not. Touching people in an authentic, engaging, and relevant manner can have a beneficial effect.


Words matter


One of the most significant lessons Eliza has learned during the past decade is that words matter. Not just the content and the phrasing, but the tone and the pace and things of that nature, Merrow says.


He points to hot beverages as an example. Most companies that sell hot beverages these days place a safety message somewhere on the cup. Dunkin Donuts warns, Caution. This beverage is extremely hot. Starbucks takes a warmer approachCareful, the beverage youre about to enjoy is extremely hotwhile Caribou Coffee assures, Our quality coffee is always served piping hot.


In the same way that the Starbucks and Caribou messages come across as more inviting than the Dunkin Donuts cold-hearted warning, Merrow says, communicating effectively with healthcare patients and members is equally dependent on word choice.


He points to the run-of-the-mill hypertension line: As you may know, an LDL cholesterol test, which measures the level of bad cholesterol in your blood, tells you your risk of developing heart disease and other complications.


No offense to people who use that content, but people have heard it before, in some cases over and over again, Merrow says. So talk about that; youll gain their trust. We added, We know youve probably heard the same things over and over and then led into the same content, and the completion rates jumped 10 percent.


Multi-touch communication


Multi-touch communication is highly effective. For instance, reaching out to a patient four times over the course of a programwhen patients are brand new to the program, when theyre starting to get engaged, when theyre a few months in, and when they need encouragementis far more effective than calling them only when theyre late to refill a prescription.


Similarly, integrating phone calls with follow-up mailings, emails, or text messages is effective, as is establishing contact with a patient or member without asking them for anything. Eliza calls these courtesy calls primer calls and uses them to establish a relationship with the person.


Not only does this create a comfort level but also a medium through which Eliza can learn information about a patient that then can be fed into its profiling technology.   


Building trust


The termination rate for the people who got that primer call was about the third of the people who didnt get it, Merrow says. The whole notion is of trust building, interaction-history building, not making things a one-off, one-hit wonder type of interaction.        


A third piece of advice, and perhaps the most important, is that the myth of one-size-fits-all needs to be debunked. A single approach will never work if you want to effectively communicate with a spectrum of complicated and variously motivated patients and members.


If we can understand whats motivating people, what their attitudes are, what their preferences are, whats driving their behavior, and then plan ahead, we can be less reactive in how we communicate with them, Merrow says. You want to come up with a program that touches people at the right time with content that matters to them.


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