Patient Engagement, Events

How do we help patients actually modify behavior?

At MedCity’s patient engagement conference, a speaker said understanding patients’ psychological motivations and tailoring messages to those can be more effective in prompting a change in behavior.

Brent Walker, EVP and Chief Marketing Officer, c2b solutions

Brent Walker, EVP and chief marketing officer, c2b solutions

At this week’s MedCity News ENGAGE conference in San Diego, Brent Walker, chief marketing officer at c2b solutions, laid out the shortcomings of current patient engagement strategies and offered a potential solution to patient behavior change based on consumer psychology.

Turns out, educating patients just isn’t enough to cause behavior change.

“If education was the answer, why did Johns Hopkins find that 52 percent of physicians are either overweight or obese?” asked Walker during his ENGAGE presentation. “Why would UCLA find that a quarter of LPNs [licensed practical nurse] smoke? These are the most health-educated people in the world.”

Four former Procter & Gamble executives, who spent decades learning how to better segment consumer psychology to sell more Tide and Pampers, founded c2b solutions in 2012. Now they want to use those same psychographic resources to boost patient compliance — or as patients prefer to call it, patient achievement in sticking to their care regimen — to lower hospital readmissions and reduce costs.

The problem, as Walker and colleagues see it, is that healthcare organizations look at patients by demographics or condition and think they all think alike.

“They act like they’re walking disease states,” Walker said. “But patients don’t define themselves by their condition.”

For instance, understanding that consumer choices are not homogeneous, P&G makes many different types of Tide. Executives at c2b solutions have applied this consumer segmentation approach to healthcare, creating a simple 12-question survey that segments patients by their preferences:

  • Self achievers are proactive, listen to medical professionals and stay on top of appointments, screenings and other things that need to get done.
  • Balance seekers are also proactive, but they don’t necessarily take a physician’s word as gospel. A clinician’s insights are part of the larger tapestry of medical information.
  • Direction takers listen to doctors but may not actually heed their advice. They need to figure out how to work it into their routine.
  • Priority jugglers are reactive with their own health issues but proactive with their family’s needs. “If you go to the office and see someone who’s hacking and coughing and really sick, chances are they’re a priority juggler,” Walker said.
  • Willful endurers aren’t planning for the long haul. They need to know how a specific behavior is going to help them in the here and now.

This segmentation could potentially help clinicians code their health messages for each audience, building trust and potentially enhancing compliance. Walker cited a couple of case studies to prove the point.

“We did a pilot where we trained four health coaches on how to talk to the different psychographic segments,” Walker explained. “Words to use, words to lose, psycho- specific keywords and messages to help patients reach their health goals.”

The coaches found the approach accelerated their ability to build trust with patients – in just in one or two sessions instead of five or six. In addition, patients increased the number of health goals they achieved by 90 percent.

In another case, c2b worked with a Massachusetts hospital to reduce readmissions after posterior lumbar spinal fusion surgery. The hospital had three full-time nurses coaching the patients, but the readmission rate was hovering at 6 percent. At around $35,000 per readmission, this was adding up.

The c2b team implemented a nine-wave communication campaign and created an online dashboard to monitor responses. Compliance increased dramatically and the hospital had one readmission in eight months and went from three nurse coaches to one, working an hour a day.

These results look good, but will it help spur behavior change for millions of patients?

The company is acutely aware of the problem and is working with PatientBond to scale up psychographic segmentation. Walker notes there is an urgent need for this type of solution.

“The [Affordable Care Act] has been seismic – value-based reimbursement tied to patient satisfaction and the need for patients to do those behaviors that are in their best interest. We need to influence behavior after they leave the doctor’s office.”

Photo: Ivan Hundric