We’re recently back from the World Healthcare Congress, where health plans, providers, employers, and more debated the hottest topics facing the industry – and how to address them in sustainable, measurable ways. Here are a few concepts that seemed to get the most attention…

Engage members as individuals.

This was the theme of our presentation, and throughout the conference – how health plans and others can better understand what’s really driving health-related behaviors, build out meaningful member profiles, and develop impactful programs based on this Behavioral Intelligence.

We shared one example of how this consumer-focused approach doubled engagement levels and participation in one client’s health and wellness initiatives. Meanwhile, strategy executives at Humana and AARP brought their own perspective and initiatives to the panel, underscoring the theme that a one-size-fits-all approach is no longer an option.

Stay tuned for more details from us (we are super excited about this stuff) on the consumer segmentation work we’re doing to complement our clients’ engagement strategies.

Which brings us to our next point…

Big data must play a role… but what should it be?

While there was plenty of talk about and praise for ‘big data,’ there was little acknowledgement of how it could be used to engage individuals upstream, where those kinds of insights could be used to avoid costs and prevent disease from occurring in the first place.

From our perspective, you can have all the data in the world – the value is in translating it into action and impact. That’s why we are so intent on using Behavioral Intelligence insights to predict how likely someone is to act in a desired way, as well as the capacity they have to act at all given their full life context, and leveraging that knowledge to drive targeting and messaging strategies that impact health and financial outcomes.

For example, we shared data suggesting that people who are dealing with 4 to 5 life context issues – such as financial stress or caregiving –are over 5x more likely to report bad health. Understand those drivers early and you can take advantage of more than just big data – better data.

Ok, what out there in the market is actually working — beyond a pilot program?

Of course, models of success were on everyone’s mind. Here’s one example from our own work – the below chart shows the results of several controlled studies of Eliza gap-in-care programs that have increased compliance rates by as much as 71% for important chronic and preventive measures.

These automated, interactive programs are proven to work over time, across different populations, and to impact a range of health outcomes. It’s an almost perfect illustration of health reform’s triple aim that everyone is chasing these days: better health and better healthcare at a lower cost.

Are there other topics that you think got well-deserved air time at the event, or that we didn’t hear enough about? Let us know.

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Great perspective on behavior change from Eliza Interaction Designer Paula Renzi Gibbs – big inspiration can come in some of the smallest (and cutest!) packages.

With school vacation coming up and summer around the corner, many of us with school age children have two things we’re thinking about – how to get the kids out of the house now that the weather isn’t -10 degrees and how can we ourselves get active and back in shape after hibernating and eating through the winter from hell.

The CDC recommends children and adolescents get an hour of exercise a day. In fact, it’s recommended for all of us. And walking up and down the stairs of Eliza running to meetings doesn’t REALLY count…

So, in an attempt to try and do some semblance of exercise while realizing bikini season is just around the corner… I’ve started running again. After watching me go out a few times, my daughter Lana, age 7, asked me if she could start running with me. I figured she’d run a block, wipe out and that would be the end of it.

So the first day, I went for my regular run, came home and then grabbed her and we did .71 miles. I know the exact distance because she made me wear my training watch and the next day came home from school with a drawing of us running (I’m much faster and thinner in stick form) with the proud caption “My mom and I ran .71 miles yesterday!”. Not exactly the 26.2 I ran a year ago Monday but…it’s a start.

The next night, I came home from work, exhausted, at 7:00pm. It was about 20 degrees with wind chill. All I wanted was to crawl into my flannel pj’s and cuddle with my kids on the couch watching bad tv. However, Lana – the apparent reincarnation of Jillian Michaels – had other ideas and met me at the door like this:

And god help me, I changed and we went out and did 2 miles. Now our nightly runs are our thing. We go a little further each time, talk about the day, and are planning on doing a couple of 5K races together this summer. And running is no longer about getting in shape or having “me” time anymore – it’s about accidentally creating a really special time with my daughter each day. And I know in my heart we’ll be doing this for a long time to come.

So as you try to start working on your fitness for the warm weather – it’s coming, I know it… think about including your children. Not only will it bring both of you health benefits, but it’s the extra love from doing something together on a regular basis – whether it be running, biking, hiking or even a long walk -that’s where the magic happens. And your kids just might inspire you to get off the couch. My Lana did.

Happy Spring!

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A few days ago we posted a piece on the value of engaging with people based on how they define themselves (as people who brake for squirrels, for example, or as people who always floss), and rewarding them for having such a profile.

With the health Exchanges on the horizon and the very consumer-directed approach they’re demanding from everyone competing in them, we wanted to better understand the public’s attitude and appetite for this new marketplace – and how we can use those insights to create messaging that resonates.

For starters, our consumer survey found that 67% of people (!) are not familiar with the term “health insurance exchange.”  We went on to explain the concept in plain language, and asked how they might think about approaching this health plan marketplace.

Of course, the idea of purchasing insurance isn’t new to most Americans – for years, auto insurance has been mandatory for anyone with a driver’s license. So we also used this survey to get a better handle on people’s buying habits on this kind of mandated insurance, and what we might be able to learn from an industry that’s been making a consumer play for years.

Turns out that our survey respondents tell us that while cost matters, brand recognition is right behind (and recommendations from friends are a close third) when it comes to driving purchasing decisions. Not too surprising. After all, people always say cost is a key driver, but we all know brand matters – those generic grocery brands have yet to dominate the supermarket shelves.

With that in mind, let’s cue that Nationwide Insurance ad again – and note how the driving message is cost, delivered in a way that helps people recognize themselves. Plus it’s witty and memorable (and narrated by America’s Sweetheart Julia Roberts, so what’s not to love).

Bottom line? There’s a huge opportunity to help the public better understand and navigate this new Exchange environment.  And for health plans to better understand who the people are that will become their best customers, and how to best attract them using messages that resonate.  And let’s not underestimate the opportunity for those plans, in their pursuit of promoting lower cost and better quality of their offerings, to add a dose of the cool factor.

Stay tuned for more details on our solutions and recommendations for getting tactical on this opportunity  – and using messaging and design strategies that turn this current confusion into long-term value.

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This is what happens in our Eliza offices when someone finds out it’s your birthday, and you happen to be the Design Director with lots of wall art to exploit.

The tricycle-riding clown is just out of the frame, and the cake, well, all things are good in moderation.

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A recent article in Forbes outlines some key things to consider if you’re one of the millions of people who will be selecting and buying health insurance for the first time later this year.

There’s a legitimate reason for an Obamacare primer like this. After all, a large portion of the new consumers entering the market are non-traditional health care consumers, many with little or no experience navigating the managed care delivery system. Or perhaps worse – they’re people who don’t understand the value that having health insurance offers.

In many ways, we deal with these kinds of challenges every day – reaching out to people and engaging them on topics that they may not think they care about or need to worry about. One of our guiding principles of interaction design (underscored at this year’s Healthcare Experience Design conference) is the idea that if you make information relevant and understandable – even if it is typically more comfortable coated in industry jargon – people will engage.

A great example of speaking to people in ways that influence behavior (courtesy of the very consumer-facing car insurance industry) is this ad from Nationwide Insurance. They’re targeting –with panache — drivers who choose smart behaviors, and offering them better value in return.

It’s good food for thought – how is your marketing attracting the folks who will turn into your best customers?

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The mhealth and digital health movements offer many compelling ways to better engage people in their health during all that time that they’re not getting face-to-face time with their healthcare team. Which, let’s face it, is pretty much 99% of the time for most healthy folks.

Understandably, we’re big fans of this approach, and we have loads of examples of how relevant outreach – whether it’s an automated phone call, or a cheeky email, or a quick SMS message – drives health behaviors.

That said, a recent viral phenomenon has us acknowledging the incredible impact the human touch has on health and wellbeing. It’s the handwritten (!) note an ER doctor sent to the husband of his late cancer patient, and it has hit a nerve in people around the country.

Meanwhile, a great piece in The Health Care Blog  underscores the power of empathy, holding up Apple as an example of how empathic product design creates loyal customers. According to studies cited by the author, the same applies to healthcare – physician empathy has been shown to drive better clinical outcomes, higher patient satisfaction rates, and reduced burnout for doctors.

These examples remind us of the power of a heartfelt touch, how rare those moments are, and how hungry people are for that kind of connection, especially in healthcare. We’re making it a point to be true to these principles in our own work – to make people feel heard, to support them in reaching their goals, to acknowledge their attitudes and beliefs, and avoid seeming paternalistic or patronizing.

For the sake of every person you touch, we challenge you to do the same.

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You know how as soon as you buy a Honda, all you see are Hondas on the road? Well it’s a real phenomenon, and there’s an entire field dedicated to this concept of “attention research.”

A recent article on the topic got us thinking about our own perspectives on the powers and pitfalls of observation. The article describes a study in which a majority of radiologists – who are obviously trained to look for very specific things in a given environment – missed a tiny illustration of a gorilla that had been added to a view of cancerous nodules.

We have the luxury of engaging millions of people in conversation about their health – the barriers and motivations and all the rest. But there are times, as this article suggests, when we’re so trained to be find what we are looking for, we often miss the revelations that are right in front of our eyes.

Let me say that one time – THEY MISSED A GORILLA IN THE CORNER!!! Here’s the visual:

Sort of begs the question – how many gorillas are we all missing on a daily basis?

To that end, when we analyze our clients’ programs, we listen hard to the data, and let its story come through – even if it might not be the story we were expecting.

That might mean discovering that the reason one in ten people are denying having diabetes despite their claims data is because they refer to their condition as “a touch of sugar.” Or it may be learning that 30% of women who are eligible for a colorectal cancer screening aren’t getting one because (in their own words) “women don’t get colon cancer.”

These are the kinds of insights that – when addressed and applied – can actually help people take better control of their health. Plus, we get smarter about our own engagement strategies – what works, what falls flat, where to go from here.

Our recommendation? Listen hard to what the data is actually telling you – as opposed to what you are expecting to hear. Be open to what you might find.

After all, you might just be staring at a gorilla-sized opportunity.

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The Pew Internet Project just released another fascinating report called Health Online 2013. There’s so much to pore through, but a couple headlines immediately caught our attention:

“Eight in 10 online health inquiries start at a search engine.”  We see this finding as a huge potential opportunity for healthcare organizations to proactively reach out to the people they serve and help guide their online activities – such as pointing them to the resources that already exist but that are often overlooked. And if these resources are free, even better! After all, the report also points out that “one in four people seeking health information online have hit a pay wall.”

“Half of health information searches are on behalf of someone else.”  Yet another example of how caregiving influences how people engage with their health. Connect the dots between this online search for health information and the impact the role of caregiving itself has on health (our own data suggests that caregivers are 15% less likely to have their recommended diabetes tests and 20% less likely to have preventive screenings compared to people who aren’t immersed in the task of taking care of aging parents) and there’s a clear opportunity to assess and address caregiving as a standard part of the healthcare experience.

“Clinicians are a central resource for information or support during serious health episodes – and the care and conversation take place mostly offline.” That means that the health-related interactions that people are having outside of the traditional healthcare environment can be hugely valuable when it comes to bridging the gap between the online and offline healthcare worlds. In addition to looking at things like Google logs, we can also learn a lot about people’s barriers, fears, and motivations around their health by proactively engaging them in conversation and funneling the insights we learn back into the larger healthcare ecosystem. For example – we might learn that women in a certain area code aren’t getting their mammograms because they don’t know where to get one… and then loop that information back to the healthcare system that’s responsible for connecting people with nearby clinics or vans.

At its core, this report reminds us that people are hungry for health information. The over 800 million interactions we’ve had with people on their attitudes, motivations, and behaviors related to their health underscore that point – most people (especially those with chronic or multiple conditions) appreciate an ongoing connection to their healthcare providers, and this connection drives better outcomes.

Let’s commit to using all this data to better engage with – and support – this path to better health.

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For the past couple years, we’ve been honored to bring our engagement experience and passion to a topic that not only has huge implications for the health care system, but also affects each of us personally.

The group we’re part of is called the Coalition to Transform Advanced Care (C-TAC for short) and its vision is that all Americans with advanced illness, especially the sickest and most vulnerable, will receive comprehensive, high-quality, patient-centered care that is consistent with their goals and values and honors their dignity.

C-TAC calls it a vision because so many of us have personal stories of how the care that they or someone they love received upon facing serious illness could’ve been better. Stories like that are at the heart of our own non-profit movement, Engage With Grace.

At the end of the month, we’ll be heading down to Washington, D.C. to attend C-TAC’s national summit on advanced illness – bringing together influential people (including Judy Salerno from the IOM, Nancy Brown from the American Heart Association, Terry Clark from UnitedHealth, Jennie Chin Hansen of the American Geriatrics Society, Randy Krakauer from Aetna, and so many more) to discuss the issues and potential solutions around advanced care and to create a roadmap that lays out what each of us can do to bring positive, lasting change.

If you have a personal or professional interest in joining the summit, there are still a few spaces left. Learn more and register here.

Stay tuned for updates (follow @CTACorg if you’re on Twitter) on what we believe is some incredibly important work that will impact us all.

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Every fall we reach out to people about the importance of having a flu shot, but we couldn’t have overestimated its importance this year. Brace yourself – the Centers for Disease Control and Prevention has labeled the 2013 flu season as one of the worst in the last 10 years — and it hasn’t even peaked yet.

Just take a peek at the Google flu trends map and the deep red that covers the US, indicating “intense” flu activity. That’s also the look of a couple million US workers calling in sick, according to the U.S. Bureau of Labor Statistics.

It’s still not too late to get a flu shot, and it’s not too late to remind the people you serve to do the same. In fact, according to a survey we ran last October, 64% of Americans we talked to said they’d like to be reminded to get a flu shot this season and 57% say they would be more satisfied with their health plan if they got such a reminder.

We’d venture to say that, in retrospect, those figures are actually a bit low, given the ferocity of the season.

Let us help you fight the flu in your own backyard.

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As we settle into this new year, we thought we’d get some perspective on what lies ahead for the healthcare industry from some well-respected folks who have been there, done that, and have a good hunch on what it takes to succeed.

Listen in here to a spirited conversation between Charlie Baker, Entrepreneur in Residence at General Catalyst Partners and former CEO of Harvard Pilgrim Health Care, Jeff Goldsmith, one of the nation’s foremost health industry analysts, and our own Alexandra Drane.

So what will 2013 bring according to this crowd? Among other things, it will be the year that healthcare can no longer ignore Exchanges, when employers step up to fill in some of the gaps, and the provider community finds ways to keep and stay relevant given seismic demographic and financial change.

The good news is that many of these trends can be addressed through strategies like a stronger consumer-focused angle; higher-touch yet lower-cost communication between healthcare organizations and the people they serve; and a deeper understanding of how to proactively encourage health in both traditional (preventive health) and not-so-traditional (patient advocacy) ways.

Listen, learn, and enjoy…and most importantly, stay ferociously committed to a healthier 2013 for all of us.

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Our thoughts go out to those affected by the tragedy in Sandy Hook.

Meanwhile, back at home, many of us are looking for ways to help comfort, reassure, and support the children in our lives in the aftermath.

Our friends at the Foundation for Art and Healing offer some suggestions here – simple exercises and guidance that can help kids express some of the feelings of fear and vulnerability they no doubt have about what happened last Friday, and whether or not it could happen in their neighborhood. You can find other talking point tips here, courtesy of National Association of School Psychologists (NASP).

It’s a hard conversation to broach, but obviously important. We hope that these suggestions will help you engage with the children in your lives, and that you will consider sharing these tips and ideas with anyone who might need them – friends, neighbors, customers, patients, members.

In other words, everyone you care about.

Pass it on, and may we strengthen and support each other all during these difficult times.

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Talk to a few million people about the things that keep them from being their healthiest and they’ll tell you. The comment below is just one example – and part of the impetus behind our research project on The Unmentionables that helped quantify the impact of caregiving and other life context issues on health and productivity:

“This is a beautiful reminder. Uh when one gets tied up with taking care of another family member 94 years of age; uh energy goes there and I’m going to have to balance this out because I will lose too…. I’m so glad I followed up on the call. I will do both of these. I will talk to my doctor and I will follow through and yes I know I need some help in the diabetes area. Um… I- I really have to pay attention to this- this is ridiculous. I don’t- I don’t wanna go down any further. And I really thank you professionally and kindly and thank you so much.”

In the years that we’ve been assessing for and addressing caregiving responsibilities in our clients’ populations, we’ve seen in black and white how that role impacts health behavior –  such as caregivers being 15% less likely to have their recommended diabetes tests and 20% less likely to have preventive screenings, compared to people who aren’t immersed in the task of taking care of aging parents.

We also know from experience that when you’ve got someone who is actively engaged in a conversation about their health, there’s no better time to connect them with resources that might help. And as recent Pew Internet and American Life Project report  suggests, caregivers are particularly hungry for online information and resources.

Maybe you’ve already developed caregiving resources – let’s help drive folks to them and have them engage. Or maybe you’re trying to identify caregivers in your population – we can elegantly help with that too.

After all, if they’re this overwhelmed by taking care of their loved ones, how can they be expected to take care of themselves?

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We are thrilled to be joining smart people using smart phones to support better health at this year’s mHealth Summit in Washington, D.C. In addition to hearing about what’s working and what’s next in mHealth, we’re announcing our plan to offer Voxiva’s text-messaging based Care4Life service as part of our comprehensive diabetes management support programs. Stop by and see us at booth #628 to learn more.

Whether or not you’ve personally embraced the mHealth movement in your own life (how many health-related apps are gathering dust in your phone right now?) the latest report from the Pew Internet Project suggests that there’s no putting the toothpaste back in the tube at this point. Key findings from the report include:

• One in three cell phone owners (31%) have used their phone to look for health information – up from 17% just two years ago

• Not surprisingly, caregivers, those who recently faced a medical crisis, and those who experienced a recent, significant change in their physical health are more likely to use their phones to look for health information

• About 19% of smartphone owners have at least one health app on their phone; exercise, diet, and weight apps are the most popular types

So while self-tracking (and its cousin, well-deserved back-patting) are leading the way for the more highly engaged among us, we believe there is also great opportunity to use mhealth for the kinds of proactive “push” outreach we’ve been doing for years. The mediums may change, but the goal remains the same — personalized, relevant content that’s engaging enough to actually change behavior.

Watch this space for more on the trends shaping our space, and ideas for elegantly incorporating them into your own engagement strategies.

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Once again, the Engage With Grace team welcomes the Thanksgiving weekend with a blog rally to encourage everyone we know — and those we don’t — to have those tough end-of-life conversations with their loved ones. We invite you to share this post (or some version of it that speaks to you) with your own friends and family, and above all to consider these key questions for yourself. Happy Thanksgiving from your friends at Eliza.

One of our favorite things we ever heard Steve Jobs say is… ‘If you live each day as if it was your last, someday you’ll most certainly be right.’

We love it for three reasons:

1)      It reminds all of us that living with intention is one of the most important things we can do.

2)      It reminds all of us that one day will be our last.

3)      It’s a great example of how Steve Jobs just made most things (even things about death – even things he was quoting) sound better.

Most of us do pretty well with the living with intention part – but the dying thing? Not so much.

And maybe that doesn’t bother us so much as individuals because heck, we’re not going to die anyway!! That’s one of those things that happens to other people….

Then one day it does – happen to someone else.  But it’s someone that we love.  And everything about our perspective on end of life changes.

If you haven’t personally had the experience of seeing or helping a loved one navigate the incredible complexities of terminal illness, then just ask someone who has.  Chances are nearly 3 out of 4 of those stories will be bad ones – involving actions and decisions that were at odds with that person’s values.  And the worst part about it? Most of this mess is unintentional – no one is deliberately trying to make anyone else suffer – it’s just that few of us are taking the time to figure out our own preferences for what we’d like when our time is near, making sure those preferences are known, and appointing someone to advocate on our behalf.

Goodness, you might be wondering, just what are we getting at and why are we keeping you from stretching out on the couch preparing your belly for onslaught?

Thanksgiving is a time for gathering, for communing, and for thinking hard together with friends and family about the things that matter.  Here’s the crazy thing – in the wake of one of the most intense political seasons in recent history, one of the safest topics to debate around the table this year might just be that one last taboo: end of life planning. And you know what? It’s also one of the most important.

Here’s one debate nobody wants to have – deciding on behalf of a loved one how to handle tough decisions at the end of their life. And there is no greater gift you can give your loved ones than saving them from that agony.  So let’s take that off the table right now, this weekend.  Know what you want at the end of your life; know the preferences of your loved ones.

Print out this one slide with just these five questions on it.

Have the conversation with your family.  Now.  Not a year from now, not when you or a loved one are diagnosed with something, not at the bedside of a mother or a father or a sibling or a life-long partner…but NOW.  Have it this Thanksgiving when you are gathered together as a family, with your loved ones.  Why? Because now is when it matters. This is the conversation to have when you don’t need to have it.  And, believe it or not, when it’s a hypothetical conversation – you might even find it fascinating.   We find sharing almost everything else about ourselves fascinating – why not this, too?   And then, one day, when the real stuff happens?  You’ll be ready.

Doing end of life better is important for all of us.  And the good news is that for all the squeamishness we think people have around this issue, the tide is changing, and more and more people are realizing that as a country dedicated to living with great intention – we need to apply that same sense of purpose and honor to how we die.

One day, Rosa Parks refused to move her seat on a bus in Montgomery County, Alabama.  Others had before. Why was this day different?  Because her story tapped into a million other stories that together sparked a revolution that changed the course of history.

Each of us has a story – it has a beginning, a middle, and an end.  We work so hard to design a beautiful life – spend the time to design a beautiful end, too.  Know the answers to just these five questions for yourself, and for your loved ones.  Commit to advocating for each other.  Then pass it on.  Let’s start a revolution.

Engage with Grace.

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