HealthEd Blog

HealthEd Named Finalist for 2012 MM&M Awards

This past week we received word that HealthEd has been named a finalist for the 2012 MM&M Awards in the category of Best Multichannel Campaign, Large Client Organizations for the Xeloda Multichannel Patient Adherence Campaign. We’re excited!

The MM&M Awards recognizes the most creative communications in the pharmaceutical industry. Hundreds of entries in over 24 categories were judged by a panel of 100 industry thought leaders, which makes being a finalist that much more fulfilling. The multichannel marketing categories are highly competitive and HealthEd will be in the running with much larger integrated agencies including Edelman and DraftFCB. Gold and silver winners will be announced at an awards gala in October. (The list of all finalists is online.)

So far this year, HealthEd has won 3 Web Health Awards and our people and work have been nominated for several others. It’s a testament to our point of view, that a collaborative team and the knowledge of how to apply health education principles can create breakthrough ideas which help both patients and clients.

 

Mary Lou Szekeres
Client Development Manager
HealthEd

 

The Importance of Care Partner Support

Recently a colleague of mine passed on after a six-year-long battle with brain cancer. He was in his thirties and left behind two young sons and his wife who is a living angel.  Personally, there are many important things I will take away from this. He never lost faith. He lived his life with passion and fought to the end. He was always happy and thankful for all that he had in his life.

Professionally, I had some takeaways as well. My colleague worked in pharmaceutical marketing and certainly was an educated patient. However, his wife was the pillar who held everything together. Caring for him, understanding and researching treatments, getting him into clinical trials, fundraising…whatever it was, she was essential to it all.

Sometimes illness can be as challenging for the care partner as for the patient. While it certainly is important for the patient to understand their treatment and side effects, it is also critical for the care partner to equally understand. Additionally, they need support to help their loved one handle treatment, as many times, especially with cancer, it can be a difficult process.

When you consider that 29% of the US population (over 65 million people) provides care for a chronically ill family member or friend, this is a large audience with a tremendous need for resources. These people spend an average of 20 hours per week caring for their loved one, all while potentially balancing a job, care of their children, and the stress of everyday life.

So how can we help care partners? When we develop resources for patients, we should address the needs of the care partner as well. Care partners need the same information that patients do, such as disease understanding, treatment expectations, and side effects. As for patients, all care partner materials should be presented in a health literate way while utilizing adult learning principles such as analogies or storytelling to aid understanding.

Additionally, care partners can benefit from help with the following:

Practical tips on:

• How to give care
• Managing appointment schedules
• Navigating insurance claims
• Accessing treatment

Emotional help with:

• Providing emotional support to the patient
• Recognizing the signs of depression in the patient
• Coming to terms with the diagnosis and being realistic about it
• Enlisting the support of others for driving, cleaning, meals etc
• Utilizing social media to garner support from friends and family
• Finding support groups

Personal needs such as:

• Taking care of themselves and their health
• Staying positive
• Keeping up with their own interests and activities

While nothing can ease the pain of having a loved one who is ill, certainly the right resources can help care partners cope. In turn, the care partner will be better enabled provide emotional and physical care and help the patient with their treatment.

Mary Lou Szekeres
Client Development Manager
HealthEd

 

 

Top 5 Reasons to Include Patient Education in the Pharma Marketing Mix

With tight budgets and aggressive brand goals, marketers needs to take a close look at what drives sales for a pharma brand. Why should patient education be a critical part of the marketing mix? Here are 5 key reasons.

1. It is valuable to healthcare professionals (HCPs)-Aside from samples, patient education is one of the resources most requested by HCPs from pharma sales representatives.  The fact that the American Academy of Family Practioners (AAFP) has an entire section on their Web site featuring patient handouts, counseling tools, and other resources, illustrates there is a need.  Also according to research conducted in late 2011 by HealthEd OnDemand, HCPs -- specifically 99% of dietitians -- consider educational materials to be important or essential. In short, having patient materials provides sales representative access to HCPs.
2. It drives adherence -When patients’ expectations for treatment are set up front, they are more likely to remain committed. Patients need to understand the importance of taking their medications, what the benefits will be and how quickly the benefits will come. Sometimes they can’t tell if a treatment is working. Or their treatment may not work right away. They need to know what to expect.
3. It helps patients effectively manage side effects– This is tied to adherence but I feel the need to call it out separately. Setting patients understanding of side effects is much more than placing safety information on materials. Side effects are one of the top reasons for patient drop off for most medications; however, if patients truly understand what to expect upfront and are prepared with how to manage, then the likelihood of drop off decreases. The phone calls to their HCP’s office also decrease which I’m sure physicians and healthcare extenders appreciate.  Patient complaints about side effects can be a huge barrier to physician prescribing so focusing on the patient can have a halo effect on prescribing.
4. It provides accurate and understandable information-My parents’ generation still takes a physician’s recommendation at face value, doesn’t question things and doesn’t really understand their disease state or their treatments. This is no longer the case with younger generations. The baby boomers spend a lot of time online.  In fact, 79% Americans age 50-64 are online. And 80% of adults who are online are looking for health information. So patients are getting information about their health and treatments but it may not be the correct information. Or it may be confusing and not health literate. Developing good patient materials ensures that patients are getting the right message about your brand.
5. It improves patient outcomes – This last one may sound altruistic when you’re used to thinking about brand sales; however, with healthcare reform a physician’s compensation will be increasingly based on patient outcomes.  There is a link between a well-educated patient and improved health outcomes and helping physicians improve outcomes for their patients will provide the best value pharma can bring to the table. Plus, helping patients is the right thing to do for both personal and professional reasons.

 

Mary Lou Szekeres
Client Development Manager
HealthEd

 

 

 

How to Build Patients' Skills Using Adult Learning Principles

Going Beyond Informing

So much of patient education is about sharing information – about risks, symptoms, treatment options, lifestyle changes and so much more.  However, it is critical to go deeper than merely informing patients if we expect substantive changes in their thinking and behavior. We must acknowledge what patients bring to a learning situation: their hopes and fears, their motivations, and the questions that indicate their priorities and problems. By using adult learning principles to underpin our skill-building efforts, we can more successfully help patients identify and address their needs – and be successful in managing their health.

Let’s imagine a typical scenario: Ellen has had diabetes for several years. She has been doing her best to manage her diet and exercise plan, and always takes her oral medications. However, at her most recent visit to her doctor, she learned that she now needs to add insulin to her routine.  How can we address this situation using an approach that combines adult learning with skill building?

What is Adult Learning?

Adult learning theory, sometimes called andragogy, includes a number of principles. Three of these are clearly related to helping patients build skills to manage their health.

• Readiness to learn: Adults become ready to learn when they need information to effectively cope with real challenges they are having.
• Motivation:  For adults, there is no “test” that will reflect a certain grade, but there are real life outcomes which may result from this learning. This means that adults are driven by internal motivation, such as the desire for maintaining or improving their health or quality of life, or avoiding worse health.
• Task-centered learning: For everyday learning, adults want to figure out how to acquire a skill or solve the problem at hand, rather than needing to learn everything about a topic.

Back to our scenario: At a quick glance, it would seem that the next step for Ellen is to have a healthcare professional demonstrate how Ellen can give herself insulin injections. We can imagine a caring educator seated with Ellen in the provider’s office. They probably have a somewhat limited time in which to meet and review the device use. How can the educator build Ellen’s confidence and skills in that initial demonstration? How will the educator know that Ellen will be able to do the injections on her own?

• Assess Ellen’s readiness to learn by talking about what she thinks and feels about starting insulin and, perhaps for the first time, must inject herself. While this might seem like a time-consuming discussion that could take away from “training” time, it is critical to Ellen’s success that she identify and share her concerns and hopes so that the educator can dispel misconceptions and support her emotionally. This can clear the way for Ellen to be open to learning about the device and her new phase of treatment. And, it’s not a conversation that can be had until this time in her treatment, so having it earlier will not benefit her learning.
• Understand Ellen’s health goals related to using the device. How does Ellen see the use of insulin and this particular device as supporting her diabetes management?  Will it help her control symptoms? Will it enable her to do more of what she wants to do? Tying the use of the device to this internal motivation is another layer of preparation for active learning.
• Now, demonstrate the tasks and involve her in each step. This is where the step-by-step instructions come in handy, and offer the educator tools to demonstrate each step of the process, such as how to safely and effectively choose her dose and deliver her medication.  As part of this process, the educator will ask Ellen to verbalize and demonstrate the key steps required to show that she has learned each skill. And, to continue with the support for task-based learning, a final step is to show the trouble-shooting guide or tips to empower Ellen in her continued use of the device at home.

This skill-building approach allows for the acknowledgement of the patient’s emotions and desires as part of the practical adoption of skills. This recognition and balanced approach not only enhances the physical skills, but builds confidence as well. This combination, called self-efficacy, is the true end goal of patient education.

Laura Wilson, MEd
SVP, Health Education
HealthEd

 

 

Adherence Begins Before Treatment: 5 Strategies You Must Consider to Drive Effective Patient Interactions

At a recent presentation of the ExL Patient Adherence Summit, I had the privilege of presenting HealthEd’s unique strategic approach to promoting adherence. Focusing on the top 5 strategies to drive effective patient interactions, we covered recommendations and rationale for including deeply patient-centric strategy to drive adherence through:

1.      Mapping the patient journey

The patient journey helps form and secure brand strategy by providing a predictive snapshot in time of the aggregate patient experience. Through it, we distill insights and translate emotional and environmental barriers to wellness into visual, actionable frameworks. It is informed by a multitude of inputs, including qualitative and quantitative research, ethnographies, brand research, social media, literature reviews, and focus groups and in-depth interviews. Because we view adherence as a cumulative experience, patient journeys take into account every stage of the patient experience—including initial awareness of the disease or product, taking the first dose, and continuing with treatments through maintenance.

2.      Identifying a behavior change model

Utilizing a behavior change model helps us to explain people’s behaviors, as well as how people can be influenced to change. As with the patient journey, a behavior change model is predictive in nature and can help identify issues that a patient may have with the disease or therapy. Behavior change models evolve beyond the typical pharmaceutical model of awareness, conversion, initiation, and adherence to look at the individual motivating or inhibitory factors that influence behavior change. These factors can then be leveraged or manipulated to drive desired behaviors, such as successful adherence.

3.      Understanding the clinical encounter

The clinical encounter is an important key strategy to drive patient interactions because it embodies the complex dynamic not only between doctor and patient but also between other important (and sometimes not top-of-mind) stakeholders. These can include nurses, allied health professionals, caregivers, support groups, pharmacists, and the brand sales force. It can also illustrate the dynamics between those individuals and groups. Identifying these complex relationships and interactions can help brands to leverage each tactic appropriately and at the correct key moment.

4.      Measuring patient behavior

Measuring patient behavior goes beyond typical pharma measurement variables such as script refills. Rather, measuring patient behavior focuses on measuring change in patients’ skills, knowledge, attitudes, behavioral intention, and unique behavior change model metrics. In doing so, we can determine baseline levels and demonstrate the power of tactical interventions to influence behavior change—which can ultimately lead to successful adherence.

5.      Using health literacy principles

Last, incorporating health literacy principles into patient communications can help to aid adherence by assisting the roughly 90% of the population that has less-than-proficient health literacy. Using health literacy guidelines can lead to greater comprehension, which ultimately relates to greater adherence. It also leads to a greater financial impact for brands. The importance of meeting health literacy guidelines is being recognized by government entities such as the FDA’s Office of Prescription Drug Promotion.

These 5 strategic areas aim to place the patient at the center of the brand experience to drive effective patient interactions. The dynamic relationship of all 5 considerations helps create a strong, targeted, and effective brand experience that fosters adherence.

Adherence Begins Before Treatment: EXL Adherence Summit Presentation

View more PowerPoint from HealthEd

 

Liz Carden, MPH, CHES
Manager, Health Education
HealthEd 

 

 

The Health Education Difference

 Proven success is an eye-catching brand claim. This simple statement can instantly add credibility for a brand and build trust with patients and healthcare providers with a mere 2 words. This claim is always substantiated by the brand’s clinical research; however, as a health educator, I often question whether or not the results are sustainable long-term behavior. 

I would argue that partnering claims with the support of health education can lead to sustained health behavior changes. Here's why.

I discovered health education while I was coaching consumers of a well-known weight-loss brand on the basics of nutrition and the brand-focused weight-loss products. I felt that despite all my efforts, the end result for consumers was not life changing. Consumers could use the brand’s products and achieve success, but market research showed that few consumers could sustain the weight loss over the long term. 

Proven success was the brand claim. I felt challenged with this because I believed that the slogan overpromised. In my experience, the claim was based on short-term results, and using the products did not result in the behavior changes necessary to lead to sustainable weight loss for the consumers. At this moment, I recognized the need for health education—and with that, my educational approach was transformed. I started to recognize that arming consumers with nutrition knowledge was not nearly enough. Consumers simply needed more in order to understand the information and then be able to act upon it to achieve long-term success.

Applying the health education learnings and a theoretical behavior change framework helped me overcome these challenges and changed the outcomes. This change not only affected the consumers in supporting their behavior changes but also helped to grow the brand. Consumers gained the ability to self-recognize and to strategize a personalized approach to dealing with nutrition and weight issues that was sustainable over time. The brand gained heightened perceptions of results that could potentially lead to a larger market share. 

Health education made the difference. There are many opportunities to apply this to healthcare products and related consumer goods. To take advantage of these opportunities and make a difference for the consumers of your brand, a health education approach may be key to proven longer-term success.   

 

Laura Catalusci
Specialist, Health Education

The Rise of the Nanoeducators: Why Behavior-Change Programs Will Never Be the Same

Have you seen the science fiction movie in which the mad scientist invents a chip to implant in patients’ bodies and then controls it with a wireless device?

Wait a minute. That’s not a movie. It’s real.

Massachusetts Institute of Technology professors Robert Langer and Michael Cima just published the results of their chip-implantation trial conducted with 7 Danish women who have osteoporosis. Patients did not receive the medication—teriparatide, a growth hormone—by injection; rather, each dose was sealed inside a chip. Doctors implanted the chips in each woman’s abdomen. When a remote control was triggered, a tiny foil seal on the chip would melt, releasing a dose of hormone into the patient's bloodstream.

And we all thought FDA social media guidance was a big deal.

In truth, remote-control medicine and the use of so-called smart objects raise questions that may not have answers for a long time. Some are technical: Could the wireless chip controls be hacked? Some are privacy related: What if the government tries to mandate implants for certain diseases or populations?

Meantime, healthcare innovators have been making much progress with a different kind of chip implantation: not in people but in things. All of these smart objects share a goal: helping patients change behaviors in support of better health outcomes.

The smart objects are like health educators. Only smaller.

Some background: Behavior models have long informed health educators about the power of feedback to drive behavior change. The Health Belief Model, for example, suggests that for change to last, patients must know the consequences of their actions (that is, have feedback). The importance of feedback is why HealthEd recommends that clients provide medication tracking tools to patients. You can’t control what you don’t know.

So, why do people keep missing doses of medicine? For one thing, it takes work to track your behavior. Often, the patients and care partners we talk with ask for tools to help manage their conditions, but they don’t always use the tools. For another, it turns out there is value in having someone else—or something else—there for motivation. 

Enter smart objects. Thomas Goetz, author of The Decision Tree, wrote a great summary in “The Feedback Loop,” an article in Wired. Goetz explained that as the price of simple sensors drops—a motion-sensing accelerometer costs under $1, he wrote—the door opens to embed these tiny feedback generators into everyday objects.  

One example you may already know about: GlowCaps, those plastic tops for medicine bottles that light up when it’s time for a dose. A tiny chip in the plastic “knows” when you haven’t taken your medicine and, like a personal nurse, gently reminds you to follow your doctor’s orders. This virtual nurse can get progressively more assertive: GlowCaps play a reminder tune until a dose is taken. Then, if you’re still not compliant, GlowCaps can call you and send e-mail progress reports to your physician.

(Kind of makes an abdominal implant sound less invasive, doesn’t it?)

The manufacturer, Vitality Inc., raised eyebrows when a GlowCaps study resulted in a 98 percent adherence rate. But, as Goetz pointed out, here the technology plays second fiddle to the patient experience. A GlowCap is a humble piece of plastic fitted with the heart of a health educator. Get the user experience right, says Vitality CEO David Rose, and smart objects begin to feel “enchanted.”

There are many other examples of smart objects in healthcare, particularly in prevention and monitoring:

• The Humana Horsepower Challenge lets kids advance in a video game by using sensors attached to their sneakers. The game is meant to encourage physical play and exercise
• French-based Withings has won design awards for its connected products, including a blood pressure cuff that plugs into an iPhone, as well as a scale that can tweet your weight for motivation
• A stateside competitor, Fitbit, closed on a $12 million round of private equity funding in January. Its Fitbit Ultra, a clip-on health-tracking device, contains chips and sensors that analyze its wearer’s sleep patterns and exercise habits, which it reports back over the Web

All to say, while social media innovation gets most of the press, I think pharma and healthcare organizations should spend more time exploring behavior innovation. Learn about behavior models and how they can predict personal health decisions. Ensure that flesh-and-blood health educators are integrated with marketing teams. And explore the many ways that “nanoeducators”—tiny chips programmed with the brain of a behaviorist—can help you improve patient outcomes.

 

Jeff Greene
Director, Digital Strategy
HealthEd

 

 

Review Panels: A Key Driver for Innovation and Positive Outcomes

The Centers for Disease Control and Prevention (CDC) recently highlighted the foundational benefit of knowing and involving your audience when developing clear, innovative health communications. Here are 2 excerpts from recent CDC publications that capture these benefits:

Know your target audience: “The more you know about your primary segment, the better you can reach them with messages. Your up-front research should include understanding the needs and wants of the target audience on a more personal level, and their motivations and lifestyles so you can truly engage with them.”

Involve your target audience: “When members of the target audience participate in designing and testing communications, outcomes are more successful, including those for people with limited health literacy.”

This is not news to us. We have used review panels in all aspects of educational design and program development for the past 20 years.

Our panels include representatives of all people who influence health and business outcomes—such as patients, caregivers, healthcare providers, and knowledge leaders who have firsthand experience with a particular condition or treatment. 

As a health educator, I can honestly say that I learn something new from every review panelist interaction. Patients and caregivers who are living with health conditions offer a unique perspective. This can also be said for professionals who provide care and education on a daily basis.

A recent story will bring this to life. I was interviewing a patient and nurse separately to better understand why patients were struggling with appropriate use of a medicine when starting a new treatment. The exchange below captures the magic that happens when you involve your audience.

My question to a patient: “So, when did you first hear about your diagnosis?”

Patient: “They told me about the diagnosis, and I didn’t hear anything after that.  The doctor and nurse walked me through a pamphlet, but when I got home, I didn’t remember anything they said. To complicate matters, I didn’t actually receive the treatment in the mail for 2 to 3 weeks, so by the time I needed to start treatment, I was anxious and had so many questions.”

My follow-up questions to a nurse: “In talking with patients, we have learned that they feel overwhelmed after hearing their diagnosis and have difficulty in processing the education they receive about their treatment.  We also heard that there is a time delay in receiving their treatment, so by the time they start treatment, they are anxious and don’t recall what to expect and what to do. Is that common, and how do you combat this challenge?

Nurse: “Wow—what a great insight! This is so true, but until now I didn’t really give it a thought. I have heard of some offices scheduling a follow-up education session about new treatments when counseling occurs on the same day as hearing difficult news. In terms of the time delay, I wonder if there is a way to call or send e-mails during the delay period to reinforce key things patients need to know and do before starting treatment. It might also help to acknowledge this barrier before educating about a new treatment. I would be happy to review anything you guys develop.”

These vignettes capture the amazing interactions we have with review panelists as we develop our materials and campaigns. They also show the huge void that exists when we do not take the time to know and involve our audience.

Christopher G. Kelly, MEd
Director, Health Education
HealthEd

 

Return on Education – It’s ROI, With The “WHY”

 

Multichannel measurement is not all about ROI, according to an article in PharmaVoice’s January 2012 edition. We couldn’t agree more. Understanding the softer, qualitative metrics, such as patient engagement, brand awareness, and intent to ask, can yield valuable information about how to optimize campaigns.

So, we asked ourselves, how can we measure the why? The answer was to develop a unique measurement approach, called ROE^TM (Return on Education), to help us understand how education and brand promotion drive business and health outcomes. In essence, how do these programs effectively change patient behaviors?

The ROE framework starts with an assessment of educational impact opportunities—a baseline of patients’ attitudes, behaviors, knowledge, and skills related to their condition and its treatment—that reveals diverse patient segments at various points along their disease and treatment journeys.

We then evaluate how shifts in patients’ knowledge, attitudes, behaviors, and skills achieve the desired actions. Do patients intend to speak with their healthcare providers about the brand? Are they actively requesting it? Are they given prescriptions, and if so, do they fill them and adhere to treatment over time?

But recording desired actions alone is not enough—you need to understand the “WHY behind ROI.” Only when we connect patients’ attitudinal drivers and barriers to a desired action can we truly know what motivated patients to act in the first place. This is the key to maximizing business and health outcomes through all phases of the patient journey—from awareness to consideration, to initiation, to adherence/attrition, and, finally, to advocacy or reinitiation.

How can you measure health outcomes, you ask? ROE incorporates outcome surveys (eg, those of HEDIS and the National Committee for Quality Assurance [NCQA]) to determine if an educational effort directly resulted in positive health outcomes.

The ROE framework now serves as the basis of all our measurement planning and informs optimization of relationship marketing and digital initiatives so maximal success is achieved for both patient and brand.

 

Barbara Haimowitz, PhD
HealthEd

The Search for Quality Health Information

We’ve all been there. Concerned about a rash. Starting a new medication. Or, possibly, just diagnosed with an unfamiliar disease.

What is one of the first things you do when you go home? Chances are your response is that you open your Internet browser and use Google to find out as much health information as possible. But how do you know if the information you discover is accurate, credible, relevant, and trustworthy? In many cases you (and many others like you) cannot tell for sure, so you continue to search. Before you know it, hours have gone by, and you still haven’t found good answers. Worse, you may have found information that’s inaccurate, outdated, or otherwise causes you unnecessary alarm.

In the quest for quality health information, healthcare professionals often face this same struggle. According to new research conducted in late 2011 by HealthEd On Demand, a part of the HealthEd Group, healthcare professionals -- specifically 99% of dietitians -- consider educational materials to be important or essential.

The survey highlighted that the Internet is a common source for educational materials and health information. Handouts, websites, books, pamphlets, and videos are now all available at the click of the mouse. However, evaluating quality as well as relevance (for instance, culturally appropriate, health literacy) for their patients can be tricky. To overcome this challenge, healthcare professionals often look to specific sources they can trust -- but even that involves combing through a lot of different resources, as illustrated in the survey results infographic snapshot below:

 

Further, the amount of time it takes healthcare professionals to find and organize materials is a clear frustration. This frustration is illustrated in the infographic snapshot below:

After all the time and effort searching for and evaluating quality education materials, it must be common to wonder, “Isn’t there a tool that can do all this work for us?” Healthcare professionals may even wish they had a tool that would help them know whether their patients are actually using those resources -- a tool that provides them a feedback loop so they know whether their time and effort educating patients is working.

Here at HealthEd, we also asked ourselves this question and immediately started brainstorming a solution. That’s why we’ve been developing a free tool to make it easy for healthcare providers to find, save and share quality health information with their patients and track their progress. 

It’s called HealthEd On Demand: http://www.healthedondemand.com.

To learn more about the challenges we’re trying to address, you can check out the full infographic of the survey results at:

https://healthedondemand.com/HeodPages/Pages/Dietitians_Survey.htm.

We hope our new tool will save us all the time and frustration in searching for quality health information -- because we’ve all “been there.”

 

Laura Catalusci
Specialist, Health Education