Medsider: Learn from Medtech and Healthtech Founders and CEOs - Patient Engagement for Medtech Companies is Hard – Here’s Some Advice on How to Do it Right

Episode Date: August 11, 2016

Engaging with patients in a genuine and transparent way is tough.  Really tough.  It’s challenging for all healthcare stakeholders – payers, providers, and industry. From a medtech perspective, we often times get stuck in a certain mindset when trying to engage with patients. Whether it’s a continuous glucose monitor for diabetic patients or a new...[read more]Related StoriesSubstantial and Sustainable – 2 Words That Medtech Companies Should Get Used ToSocial Media Best Practices for Marketing Medical DevicesAre Medical Device Models the Key to Building a Lean Medtech Startup? 

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That's all we do. Second, our wheelhouse is analytics, which drives all of our marketing recommendations. And third, we're fully integrated, which means you don't have to source capabilities from another shop. So if you have a project in mind that you'd like to discuss, hit me up at Scott atmedsider.com. That's Scott at Medsider.com, S-C-O-T-T-T-T-T-E-S-I-D-R.com. Okay, on to today's episode. Engaging with patients in a genuine and transparent way is tough.

Really tough. It's challenging for all health care stakeholders, payers, providers, industry, etc. Now, from a med-tech perspective, we oftentimes get stuck in a certain mindset, whether it's a continuous glucose monitor for diabetic patients or a new hip implant for orthopedic patients, we gravitate towards communicating the features and benefits of our particular product. For example, this may sound kind of familiar. Joe Patient, you should consider our knee implant because it has a greater arc than competitor X. But is this really the right approach?

If our end goal is for a patient to take action, is this the best way to engage with them? To answer that question, I invited Neil Sophean to the program. He's currently the VP of Engagement and Innovation at Vivacity, a subsidiary of Pramara Blue Cross. Neil is recognized internationally for his work in population health management and behavioral change. Here are some of the topics we're going to cover in this interview. What does patient personalization really mean and why messaging around life and context is so important? Why do so many life science companies fail to effectively personalize their messages to patients? What technologies can actually support effective patient engagement?

examples of companies that have been successful at patient personalization, how to overcome some of the legal challenges associated with patient engagement, and the top two things that med tech or biotech companies should do right now to improve their patient engagement initiatives. Of course, there's a lot more that we cover in this interview, but without further ado, let's jump right in. Neil, welcome to the program. Well, glad to be here.

Yeah, thanks for taking time for the Medsider audience. So we're going to talk all things patient engagement here today, especially as it relates to how medical device companies, pharmaceutical companies, biotech companies, et cetera, how they should really think about engaging with patients in a meaningful and transparent way. So let's start with that in mind. And the first maybe question I'd like to, or topic I'd like to discuss,

is the fact that patient engagement is so challenging. right? Certainly pharmaceutical companies that's where we see their ads most most often, but even medical device companies now are most are starting to think about or trying to incorporate patient engagement in a larger way. But it's challenging for everyone, right? It's not just on the industry side, it's payers, its providers, et cetera. So when we think about that, let's start with personalization and personalization to the to the, to the, to the, to the, the and patient. So what does that really mean, in your opinion, Neil? It means a couple of things. One is we are actually people. We're not patients. We spend a lot of

time, even though I know in your field, a great deal of the work is focusing on the patient. I think too much of what's happened in health care in general is that when we've looked at people, we've tended to look at their risk, their disease, their condition, their current costs, circumstance, I'm impatient or I'm on this drug. And we forget that for the most part, we spend most of our lives not being patients but being people and that we're motivated by all sorts of things and that health, other than when you don't have your health, is not particularly motivational. Most people don't get up in the morning and say, what can I do to be healthy today? They do all sorts of things around what can I do to make my life better? How can I do well at work?

what can I do for my family? You know, what can I do for, I'm going to get together with a friend, those sorts of things. We have purpose, but rarely is health at the top of that list. And yet, most of what we're doing is we spend our time personalizing by telling people we're being personal by talking about your risk, as opposed to, instead of giving you general information, we at least acknowledge you have diabetes,

or you're in for a specific surgical procedure, and we call that personalization. And I would say that that is better than a stick in the eye, but it's not exactly what I would consider personal because it's really just conditional, as in focused on the condition. Got it. I love your comparison of better than a stick in the eye.

I'm not sure if that's the bar we want to measure ourselves upon, but I couldn't agree with you. No, I think a low bar, but then again, I think in our field, our bar is sadly extremely low. We do not use technologies at almost every other. industry, every other industry vertical in the economy uses to personalize, and we use almost none of that.

We're still, to the most part, in the healthcare industry, using 1995 technology in a 2016-2017 world. I couldn't agree with you more on that comment. I still find it amazing. I like to somewhat pride myself on trying to be on the leading edge of how, you know, especially SaaS companies that really do it well and how they market and message to their to consumers, right, their consumer audience. And it's amazing how far health care is behind. It's, you know, quite laughable. But a comment you made about personalization with your protection to patients,

and I guess the end message would be we need to put ourselves in the shoes of the average patient and treat them as a human versus a patient. But on that note, why do you think so many not just companies, but other organizations as well, you know, payers, providers, et cetera, but more specifically, why do you think most companies fail to do that? I think there's a paradigm problem and a laziness problem and a legal problem. We are more focused on trying to change people's behavior by simply telling them what they should do

with kind of the presumption that if I provide you enough information, you'll do the right thing. and that's simply not true. Information can be an important motivator. It can be an important precursor to behavior change, but rarely is information sufficient. And yet if you think about it from our world with legal issues, with HIPAA issues, with things like that,

we're more focused from a payer perspective or an employer perspective with let's just make sure whatever we tell you is accurate. And if it's accurate, you can't assume. me. And if you can't sue me, then at least I've checked off that bar, or if I'm a health plan, I can say, gee, I sent out materials and that meets a requirement around HEDIS or star ratings, so I can say I accomplished that goal. What my goal in those cases are, are organizational or institutional goals. They're really not about changing people's behavior. More than that, they're not focused on, from what I would view as a public health perspective, which is

my goal is not simply to change a person. My goal is to change the prevalence so that if I have a population of a million people who have diabetes, you know, it's not just enough that I want to help one person. I need to say, how do I change the prevalence of that million people? How do I get it down to where all million of these people are being treated? Now, the paradox of that is, of course, I have to do it one person at a time, which means I need to understand them. So I need almost a public health prevalence view and then a highly personal strategy at a tactical view to make it happen.

Got it. And certainly it's somewhat easy to grasp, I think, you know, from an intellectual standpoint. But I think much, much easier or much more difficult or challenging to execute on that, kind of combining of those two different paradigms, that sort of that macro strategy or population health mindset versus, you know, drilling all the way down to the individual person and messaging a, accordingly. So let's let's talk a little bit more about that. So, so in essence, I guess, just to kind of, you know, put a, put a big into that topic, the goal, you know, again, viewing things from the lenses of industry or a company, we shouldn't really need to be,

we shouldn't be communicating, you know, XYZ health problem, or to use your example, you know, the problem of type two or type one diabetes. We really need to be talking about, you know, context and life of that particular patient. Correct? Yep. Got it. Absolutely. I'll give you an example.

It's not about a disease, but it's about weight. So when is one of the highest times of the year people lose weight? Well, one is New Year's. We always say that. Another is when people are going to have a wedding. So those are very specific times. But what's interesting is one of the other most fascinating times is people lose weight before their 10th and 20th high school reunions.

Now, why? And let me assure you, it's got nothing to do with health. You know, there's no, this is a group of people that you haven't seen in 10 or 20 years in many cases. So what's really going on is you're wanting to let people see you who you haven't seen in a long time. Maybe show them what they missed or show them how you've changed. Or maybe there's somebody there that you're wondering if, hey, I wonder if they're available. In other words, this is all about relationships and sex. It's got nothing to do with health.

And yet it's a huge motivator to get people to take action. So that's an example of context where something that seems totally unrelated can make a massive difference in getting people to do something because you're keying into something that's meaningful to that person at that moment in their life. Got it. That makes a ton of sense to, you know, that example that you shared. Do you have one that's maybe a little bit more specific to how an organization would be could do better in terms of communicating this to the end to the inpatient?

Sure. So let's start by what information do we need on you to make this happen? You know, because, you know, so I'll kind of start at the basement, the foundation. The first thing I need to know is how to contact you. Amazingly, of all the major industry verticals, we know less ways to get a hold of you than anybody else. It's been a bugaboo in the whole industry, whether you're at the provider level, whether you're at the payer level, not as much at the employer level, but that we don't even know how to, we don't even have your phone number. We can't text you. We don't even know your email. So it's hard to be consumer-centric if you don't actually have some basic information.

I can't call you if I don't know where to find you. So that's first. The second is we need to start thinking about a different kind of data. Right now, the data we tend to collect on people is claims. we might have biometrics, we might have risk data if it's an employer population, we will have cost data, we'll have claims data, we will have risk data, you know, because we can risk rate you based upon your pharmacy utilization, your diagnostic codes, and your costs. I'd like to suggest that you are more than your costs and your diagnoses,

but that you actually have values, that you have purpose, that you have purpose, that you have, have other things going on in your life that are important. For example, are you a caregiver? How are your relationships? How are your finances? Those sorts of things. And if I understand that, which means I have to have a tool that begins to acquire that data. And I can do that in two ways. First, a lot of this data is purchasable. You want to buy a psychodemographic profile on a population of people? You can do it. There are any number of companies out in the marketplace, whether it's the futures company or others that will sell you that data on hundreds of millions of people and for pennies per person if you're buying a large population of people. So I can actually find

demographic profiles on people. I can find purchasing profiles on people. Are these people folks who buy sporting goods or they have pets or they're value shoppers at the grocery store or they tend to be shopping high end? And based upon all that, I can either use that to assume a psychodemographic profile or I might even be able to predict what their hobbies are, which are the things that motivate them to do things. So I can get that kind of data. And then lastly, besides what I can purchase, I can do an old-fashioned thing assuming I can connect with people, is I can ask them what they care about. Surprisingly, we don't do that. We might ask them in a health assessment, you know, about their health behaviors. You know, do you smoke? Do you drink? Do you wear a

seatbelt, did your mother have breast cancer, things like that, and then give you a score, as though a score is somehow useful. But we don't ask some things like, how'd you sleep? How's your energy level today? How do you feel about what you ate? Did you move? And what's your stress level today? And then accompany that with some simpler questions that says, what do you value in life?

Is career more important than relationships or family or health or finances? Let's force rank those. Let's get that information about you and then find out how you're spending your time in relation to that. Let's ask you simple questions. How do you feel about your relationships? How do you feel about your finances? Are you a caregiver?

And if so, who are you a caregiver for and how are you feeling about that? And maybe even things like introversion, extroversion scales. And if I put that together, I now have that between the person, if I can take the data I tend to accumulate from being a provider or a payer. if I can take the context of information I gather from third parties, and then the questions I ask, I can build a composite profile on a person that's surprisingly robust and meaningful. And based on that, I can make some assumptions of who you are

so that when I begin to reach out and build content for you, I can build it based on who I think you are, and then actually tailor that content very precisely. And I don't mean like you'll get the diabetes brochure versus the asthma brochure, but I mean tailor down to words within sentences that speak to your values, to your circumstances, and to what sort of things that you might want to do to address your issues. And if I do that by through high personalization of both the words, the images, and the offers, I can really significantly change the level of behavior change that I may get out of that one individual diabetic

who currently is impatient for someone. some sort of maybe retinopathy or some other issue or neuropathy. And then how we then continue to have a conversation with that person ongoingly. Got it. That makes sense. So just to kind of summarize, because that was a lot of really good information. But to summarize, and again, I'm going to put back on my med tech hat, viewing things kind of from the industry perspective, presuming I've got a valuable solution that I want to promote to a source. certain subset of patients. First and foremost, I've got to figure out how to best communicate to them,

communicate to them, I should say. And granted, most medical device companies or biotech companies aren't probably going to have, you know, cell phone numbers and email addresses. But the concept still applies is that what is the best channel to communicate our message to this, you know, this particular subset or cohort of patients? And the second item was really in regards to creating a persona about the inpatient, right? And, you know, a patient avatar, so to speak. And what you're saying, Neil, if I understand you correctly, is that avatar's got to be more robust than claims data and risk data, risk matrix data, et cetera.

It's got to be a lot more, it's got to involve a lot more than just health issues, I guess, to put it plainly. You know, you're talking about, you know, involving psychodemic or psycho analysis or demographic analysis and utilizing other, I guess, other data sets to build out a really robust, you know, patient profile that's not just about health. Did I kind of summarize that? Yeah, absolutely. And then what that allows for is instead of doing segmentation, which is what we do today, that's considered the kind of the gold standards of segment your population and you'll make a different. Well, segmentation is better than general. Just

unsegmented population conversations. But instead of thinking of segments like you're a diabetic or you're a depressed diabetic, which is a more refined segment, and I build messages around that specific, each of those things, whether it's your psychodemographic profile, your medical condition, your need for a medical device, any of these become attributes of a profile of who you are, and then those attributes come gathered together and then on the fly you can build messages that acknowledge those different attributes that make a difference for you. So I'm trying to think of an example we might pull together,

so you need a knee replacement or a hip replacement, but I also realize that you're caring for both children and you have an elderly parent staying in your home and your finances are strapped. That changes the conversation about what you think you can afford or not afford to do in terms of a surgical procedure, and it's not the money necessarily. Sorry, you may be insurance covered, but you've also got a 92-year-old mother upstairs in your house, and if I don't help you manage her, you're going to not do that surgery,

however much pain you're in because you can't afford the time to rehab yourself. And so I need to understand the context of your life if I expect you to, one, have that procedure done, and, two, help you be successful in your outcome because I have to understand your whole life circumstance, because that's important. Obviously, you're letting a parent live with you. That's an incredibly important thing. And then I would actually, if you're deciding on that, what should I have the procedure done,

one, the message should be focused on, how can I better take care of my mom? Because you're going to be more mobile after this surgery. And two, we're going to help you be able to get through the transition. That becomes a very different conversation than saying, clinically, your hip joint is had it, and you're going to need a hip replacement. Got it.

That makes a ton of sense because if you, I mean, I think that's that example that you just shared is really easy for everyone to understand regardless if they've ever had, you know, you know, knee pain issues or hip pain issues and they're considering a, you know, a joint replacement. But to your, to your point, the overarching issue in that person's life is going to be taking care of their 92-year-old, you know, mother or father, right? It's not going to be, for all they know, they just, their hip hurts, right? Or the knee hurts.

And, you know, their doctor and their friends and family have said that probably needs to be replaced. But that person's thinking, well, how, how is this even going to be possible to have my knee replaced or my hip replaced and then still take care of my, you know, my mother or father and whatnot? So that makes a lot of sense where, you know, from a device company perspective, if you're an orthopedic company. and that persona makes up a significant percentage of the patients that you want to message to that you should begin to incorporate maybe content that aligns with that a little bit better. Is that both content and who knows, you might even rethink your product saying that, and whether that's the device level or the care level, that part of your care, you know, see if you're thinking of a bundled care product,

that maybe that comes with three forms of additional help. And you might say, I don't need help for me. I need help for because I'm a caregiver. And I need to get three days or a week's worth of support for a parent. And maybe that gets bundled into the product, which is I realize a bit off the reservation from how we think about these things today. But that's just kind of an out-of-the-box example of that might really make a difference to somebody who's, you know, all of a sudden, who's the generation who's getting all these replacements

is actually my generation, the boomers, who are sandwiched. We have both kids and we have parents in many cases still alive. And our considerations around care go beyond the care itself. It goes around the kind of the swirl of life that's going on around us. And don't just support me with the device, support me with some multiple choices on how I can manage around that device and that incident so I can manage my life better. Yeah, that makes a ton of sense. Now, Neil, when you think about, you know, collecting a lot of these, you know, these different data points in order to help build out that maybe that more robust, you know, patient persona, so to speak, are there technologies that you utilize or that you are aware of that that help in that endeavor?

Sure. Now, I think the bigger, you know, there are a number of, well, for purchasing data, There's all kinds of sources for purchasing the data. Payers also clearly have the claims in pharmacy data, the ESIs, or the other PBMs have that sort of data. So you can get that. In terms of building out those kind of questions, that's actually some work we're doing, is looking at how do we build out that kind of different form of health assessment and integrating it into a learning system for messaging and on the back.

And so that's something we're actually doing at Premier. But there have been some other folks who are doing similar sorts of work. There's a little company called J-O-O-L, it's kind of an outgrowth at the University of Michigan that's looking at how can we gather data around life, purpose, and energy, developed by a gentleman named Dr. Vic Strecker, which is pretty cool technology. He was the founder of health media in the past, and he's a full professor at the University of Michigan School of Medicine. So I think that's an interesting capability.

There's a company called T-Zag. He used Z-A-G, like to Zieg and to Zag, that's really looking at building out the tailoring capabilities to take all that data and then create highly tailored messages, offers, and images to people on the fly. They're even getting down to can they push tailored video so that on the fly, it can compile, different little snippets of video together into a complete video for a person that is relevant

to their circumstance, which could be very interesting if we're having to build, if we know five or six key items about you, and let's say you need a hip replacement. Wouldn't it be great if you could get a three-minute video that was totally customized to your needs and your circumstances that would speak to your issues? And we might even speak to them in a style and language pertinent to your circumstance. That kind of technology has worked that people like Tuzag are doing. And then I think companies like Eliza, which is a company out of Boston, is looking at the kind of research it takes to look at those underlying issues around what are enablers and

inhibitors of health around caregiving and relationships and depression and finances that do and don't drive health and that they've built assessments that can help with that sort of thing. So there's a lot going on in the space. But for the most part, they're pretty new companies because the major shift is a paradigm shift, moving away from thinking medically and thinking more life-oriented and finding, are there, what are the kind of, what's the why behind all the what's in people's lives? Sure. That makes a lot of sense. And I can appreciate, well, I should say the technologies that you just mentioned are very cool, but, But to your point, you know, this is a complete paradigm shift.

So I would think that as more as more organizations, whether you're a payer, provider, you know, industry, et cetera, you know, kind of shift that paradigm. There's probably going to be even more, more activity around best ways to sort of not only collect data, but, you know, message, message accordingly to the right patient at the right time. So on that note, in your experience, you know, I mean, you're sort of, I mean, I would consider you all kind of on the leading. edge of this paradigm shift. Are there any, we've talked a lot about examples, and are there any, you know, real use cases that you can share that would give us a better idea for who's doing, who's doing this right? Or maybe on the flip side, if it's easier, maybe who's doing this wrong or examples

that you've seen where, you know, organizations aren't doing, doing this the right way? I think that who's doing it wrong is most everybody, so that's a long list. And I was once taught that the way you tell, that, and this may be an apocryphal story. So I can't swear it's the truth, but I kind of like the story, so I'll assume it's true. Is that when Treasury agents are taught how to tell what is counterfeit money from what is forgeries, they don't spend most of their time looking at forgeries. They actually look at mostly what they do is look at real money. And what they try and do is really, really, really become familiar with what real money should look like.

and if you really know what true north looks like, it's easy to tell when it's not. And I like that notion of saying let's focus on where we want to go and what looks right, because we have tons of examples of what's wrong, because the whole industry has just been very slow at this. Sure. So if you look at an example outside the industry, pretty good vendor for this is called Amazon, I mean, the ability to personalize.

And they don't even tailor down at the word level, but they certainly tailor at the offer level in terms of offering you highly resonant and relevant choice. I think that the work that we're doing with an assessment called track is an example of how we can do that and then use that data, either push messages to you that can be then tied to whatever your need is, or it could become a dashboard of information that a care coordinator could use because that way they understand. You know, just having all that kind of information we're talking about when a care coordinator is talking about your rehab and your choices around care, if they understand those are issues for you, that just becomes data for them to use when talking to you. So it becomes a back office capability. I think, like I mentioned, I think Jule is doing some very interesting things around that.

Some of the bigger companies who are trying to do that sort of thing are, I've seen companies like JIF, J-I-A-F and WellTalk are trying to do that sort of work. A company called Every Move is trying to do a little bit of that work. So I think there are now beginning to be examples of all that. And then I think the other thing which they're all doing, besides the data I'm talking about collecting it, and then they're also building data relationships with the places where they send you. So that way they can see if you actually went or not. And because those become new data points in to see, you know, if I sent you out to get some sort of a rehab after a joint replacement,

and I have a link and I send you someplace, I need to see if you went. And then if you went, did you take use of maybe that there's video support that can be done there? Did you go sign up for it? Did you use it? Because based on whether you used it or not, that's a data point that I can use to continue to refine my messaging to you. Something's like WEL Talk are doing those sorts of things now. I think those are the kind of things we're exploring right now with track. So there's a lot of that is emerging.

I wouldn't say any of that is totally mainstream yet, but I think it's going to be adopted quicker than we might think. Got it. I think it is resonant. People kind of cool, and health care is becoming more consumer-oriented. Right. Yeah, there's no doubt, especially as wearables continue to, sort of the wearable trend, you know, becomes less of a trend and more of a mainstay, so to speak. But on that note, you mentioned, you know, Amazon, right?

And I think most people that would listen to this interview or maybe listen to you present on this topic, your message probably resonates, right? Just like, you know, similar to what, you know, when I first, you know, came across your, you know, your work, everything resonated. I can, you know, I use Amazon on a frequent basis. I can, you know, sort of, you know, see how they, how, you know, the sort of, you know, tactics or, or, you know, things that they do in order to message appropriately to me. Everything makes sense. But to play devil's advocate, you know, some, you know, especially, you know, on the industry side, you know, I guess not necessarily just on the industry side, but, you know, pretty much anywhere, you're dealing with large organizations that, you know, feel that they have a target on their back from a legal. standpoint are going to say, well, Neil, some of these things that you're mentioning are going to be too hard to overcome from a legal standpoint, right? So how do you answer that question or that point? Well, I think, actually, I don't, I think we think it's a legal issue more than it is. Do we have to be careful? Sure. Do we need people's permission as we start getting more personal with them?

Absolutely. But people will provide permission if you offer them value. I think privacy is a huge issue, but we've made it more insurmountable than it needs to be. People don't tend to get as distressed by their privacy being invaded if they think they're getting something of value in return. Now, some people clearly don't want this kind of process happening with them, and we have to absolutely respect that. At the same time, if we were more valuable to people, they wouldn't view us as a nuisance, and the more valuable we become, the more trusted we'd become. The more trust that we become, the more value they're going to be willing to let us share with them, and the more personal they'll let us become with them.

So I think it's kind of how do we move from a doom loop to a virtuous circle. And it doesn't happen all at once, but I think it's just us starting inch by inch to do those things. And so you have to be careful in how personal you get how quickly. But I think it's going to be surprising. People are just hungry for something that's meaningful to them. as opposed to too often our industry just sends them stuff that meets our requirement, but it doesn't meet their need. Sure.

Maybe that's the... Here's the other way. Here's the other way. Before I forget, it just popped in my head. Sure. Another way to share data is to let consumers share data with each other. So, especially as you get into, like, you know, recovering from any kind of a percentage. seizure, you know, or even a broken bone.

I've had, you know, no one wants to have a, you know, is going to go to many websites to share information with each other about recovering from an ankle fracture. However, if you say, I'm an avid tennis player, I'd love to know other tennis players who have had a hip replacement. And I'd like to know what they did to recover more effectively so they could get back to tennis. Well, now you've just got a whole community of people who are probably willing to share,

it's not objective data, but it's that subjective knowledge that they've gathered in terms of what they've done and how they've learned. You know, and that tangential data is huge, and that can come in a peer model. And so, and that's a place where everyone there is choosing to give up their personal data to each other because they found a community of trust. We used to refer to it as a microculture of meaning or a mom, an MOM, and that people will listen to their mom because they learn through the experience of other people they identify with. The old days, that was called AA.

You know, I'm an alcoholic, you're an alcoholic. But now we can do that in ever-increasing detail around a lot of these sorts of things. So another real place to start is by not asking people to share with you, but to share with other people they care about or they identify with. Sure. Yeah, that makes sense. And just to circle back around regarding the legal, sort of the topic of legal ramifications or the fear around legal implications with, you know, legal implications with, you know, moving towards this sort of this paradigm change is I think oftentimes, and maybe you'd agree with this is that legal, is a cop-out, right? You kind of mentioned at the beginning of this conversation how you mentioned laziness and legal and kind of in the same sentence, and I'm not sure if you meant to do it that way,

but I think the legal folks are very vigilant, and I think their job is to prevent, is to reduce risk, and that's highly appropriate. But at the same time, I think it's our job if we want to change behavior to push against, push back and say, look, We absolutely have to stay on the right side of anything that's legal, but how close can we come up to that edge to be appropriate with all the right safeguards? And at the same time, don't presume just because we haven't done it before. We can't do it now. And I think a lot of that is like with anything in the consumer space, the critical issue is being transparent and asking permission. And if you get the right permissions from people, you can do a lot, and you're more likely to get the right.

permissions from people if you offer things of value. And I think too often we've assumed that people don't give us permission and they just don't like us or trust us, but that's partly because we haven't been offering anything that's worth their while. So we just have to get better. And then we're going to have to do it inch by inch so that we do need to get their permissions. Once you have people's permission, you can do a lot.

And, of course, they also have the right to revoke that permission at any time. So you better keep being right on because they can. can always say, don't send this to me anymore. Let me, you know, don't ever talk to me again. You know, they can cut you off. So we have to stay on the right side of the value equation as well as the illegal equation doing that. Got it.

And that comment reminds me of Seth Godin's book, Permission Marketing, which, you know, he published, gosh, it's probably been at least 10 years ago, right? You know, but the principle still very much applies. Absolutely. Absolutely. Cool. So before we get to our, you know, the last three rapid-fire questions, to sum up this conversation, you know, let's pretend that I'm, you know, I'm leading an organization at a medical device company or a biotech company.

And, you know, I've only got 30 seconds, you know, to kind of hear, you know, hear about what you're doing at Premier and some of the things that maybe I should think about incorporating. So maybe, you know, can you sum up, you know, maybe two to three things that. I should begin to act on now with respect to, you know, messaging to patients in a more, you know, meaningful way. Yep. Number one is remember that people do health is a means to an end. So you have to ask yourself, who am I being healthy for or why am I, what am I being healthy for?

What in my life is this going to do for me? And that whenever we're building messaging, we have to answer those questions for people. the what and the why in the context is the why in my life, the what in my life. If you do that, that helps you think about what message is, and they're not just simply saying this is going to make you healthier. It's to take the Walgreens ad at the corner of happy and healthy is probably more focusing on the happy. And what does happy mean for an individual?

And happy, I mean by that, what is fulfilling and healthy? meaningful, as opposed to just happy. So just think of that, that message, if you don't understand the why behind the issue or the procedure and why that's meaningful to that person and how it will help their life, you're not going to be effective, however accurate you are. So that would be number one. Number two would be look for the technologies, and they're now out there that can help you build those capabilities.

And, you know, I think in the past we've just assumed that there's. not there, and in fact, they are. But it means talking to people who may not have been the traditional marketers of the past. And I would say, think about personalization and tailoring, not segmentation.

Got it. That's great stuff. So, thanks again for wrapping that up, Neil. I appreciate it. Let's get to the last three rapid fire questions. They're rapid fire questions. They don't necessarily have to be rapid fire answers, but they certainly can be. So first one is what's your favorite non-fick?

What's that? Am I getting in favor now? In trouble now with these kind of questions? Oh, no, no, not at all, not at all. They're rapid fire just on my end, right? They don't feel like you have to answer very, very quickly or abruptly on your end. But if you want to, more than go right ahead. But first question is, what's your favorite non-fiction business book?

it's surprisingly an old book it's from the 80s it's a book called entrepreneurine by gilford pincho and it talks about how do you make change happen within how do you do innovation within large corporations you know i know we're in a big world of tech startups and everybody wants to be you know the next the next uh facebook or google or something but once you're in those kind of organizations how can you facilitate, how can you facilitate change being made? How can you create the skunk works that really create real changes? And I think if you look at that, because a lot of the things I'm looking is really about social information, and a lot of that grew out of places like

Park and, you know, with Xerox and folks like that. And how did that, you know, and really, if you go way back to, I think it's, you know, like RCA research and IBM research, and and they built these huge capabilities. And now it's, how do you actually do that in a more modern world and how can you facilitate speed within the bowels of the beast, so to speak? So I'd really recommend that book. It's fun. And that's called intrapreneurring?

Entrepreneurring with an eye instead of an E. Got it. Okay. It's like a 30-year-old book. Some of the examples will sound old, and indeed they are, because, you know, some of these, those brands have come and gone, but the principles make sense. Yeah, yeah, that's, I like it.

So second question, is there a business leader that you're following right now or maybe one that really you find inspiring? Inspiring, too. Neither of them are doing anything today. So I'm an old guy too. One was Dave Lawrence, who was the CEO of Kaiser. I got to know Dave, and I found he was a model of servant leadership. He walked into a room.

Everybody was delighted to see him. He had clear vision and yet a huge warm personality that made people both light. The vision was clear and the desire to follow was great because he was just a warm human being. So he's one of the guys I've always emulated. The other is a guy you've never heard of. His name is Richard Catlett. and almost 40 years ago, in fact, goodness it was 40 years ago, I was this director of a street drug crisis center in central Missouri. And we handled some very strange people in the mid-70s in terms of the kind of people who had been released from the mental institutions, drug abuse issues, all sorts of things, street people.

And he was the president of the board of directors. And Rich Catlett was a Quaker who, when you asked him when he got involved, And this was a guy at the time, I think he was in his 80s. So he's not with us anymore. But at the time he said, when did you get involved, like, for example, in the peace movement? And he would go, 1933. And you go, wow, that's interesting. And, you know, so he was a conscientious objector during the Second World War, which is a very rare thing.

And then he ended up opening in the health food store after he got through the war. and just everything he did was principle-based. He had clear principles, and yet at the same time, he was an amazingly flexible guy because he would try and say, how can I be effective? How can I help manage circumstances and stay within those kind of the guardrails of my principles and yet be maximally flexible and warm in the process of meeting those principles? And so those have been two guys. I mean, somebody who absolutely, I mean, he actually into the way.

up, he refused to give money to any government that supported war, which of course included the United States, and he ended up being put in jail. And they put a lien on his, they were going to put a lien on his health food store, so he just gave it away. They put him in prison, so he started organizing people in prison, so they got him out of prison as quickly as possible. And all the prison guards just love this guy. And what he showed was decades of tenacity tied to principle, tied to humanism. And so I think those kind of things become, to me, huge ways of thinking about leadership.

Wow, that's amazing. And what was his name again? Dave, what was his last name? The first guy is Dave Lawrence, and he was actually the chief executive officer of Kaiser at one time. He's retired now. And the other is Richard Catlett. Richard Catlet.

Catlet, yeah, and he was, I mean, just going to health food store in Columbia, Missouri. Got it. That's very, that's very, cool. And you knew him personally? Oh yeah. I knew both of them personally. Okay, great. That's good stuff. Last question. When thinking about your career in healthcare, what's the one piece of advice that you tell your 30-year-old self if we had the option to rewind the clock? Keep a sense of humor. Keep a sense of vision. As I've looked back and over all

all the years, there's just a couple of major themes that I have found in my work, and I would tell myself that's the thing to do is find something you care about a great deal in terms of a vision. And in my case, it's always been around personalization to drive population change, and it's manifested itself in all kinds of ways, whether it's helping open clinics at the workplace, because that brings it right to work and makes it convenient and personal, or through tailoring technologies. And so I'd say, you've got to have that vision. And a sense of humor helps because that's what helps drive the tenacity to keep doing this. Because some of the things I've started, I find, take years and decades before they come into fruition. And that's where the humor helps

get you through. That's what provides the tenacity. And so I'd say a little humor plus a lot of vision will equal tenacity or the resilience. because you understand why you're doing it. There's meaning for you in it. Great. That's a... I can totally appreciate that. I can absolutely understand kind of where you're coming from.

That's great advice. So thanks a ton, Neil, for taking some time today to share your insights. You've got a wealth of knowledge when it comes to, you know, engaging with patients and making sure our messaging is not only appropriate, but meets a true need. in a way that, you know, that's transparent and authentic. So I appreciate you taking the time. I'll have you hold on the line real quick while I end this particular episode. But just two quick messages for the audience.

If you're fan of the MedSite or podcast, really appreciate it if you'd rate us on iTunes. That really helps in terms of increasing the visibility for these episodes. And then if you want to kind of be, you want to stay current on the latest. the latest Medsider interviews, I would encourage you to go to medsider.com and subscribe to the email newsletter. Don't send it out terribly often, but when I do, I try to make sure it's meaningful. So with that said, thanks again, Neil. I'll have you hold on here in a second. And thanks for your, to you listening to this interview. Thanks for your attention.