e-Patient Dave on HIE’s marketing implications

One of the joys of active social-media involvement is quickly and readily connecting with people – interesting, generous, accomplished people. Three days after I first noticed “e-Patient Dave” deBronkart’s tweets, and admired his perspective, knowledge and good humor, I was interviewing him on the phone.

e-Patient Dave deBronkart

Although my beloved AP Stylebook demands I refer to him as “deBronkart” on second reference, I can’t help but call him anything but e-Patient Dave.

After beating Stage IV kidney cancer, e-Patient Dave became a full-time activist, advocating for health care transformation through participatory medicine and personal health data rights. Earlier this summer, e-Patient Dave participated in the policy meetings in Washington which helped define “meaningful use” for the Health Information Technology for Economic and Clinical Health Act, or HITECH. e-Patient Dave feels strongly that patients should be able to access their own medical data, check it for errors, question it, and take it with them to another care provider if necessary.
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I wanted to talk to e-Patient Dave about Health Information Exchange and Electronic Health Records, the changes they’ll bring to health care and, most of interest to me, the implications for marketers. He concurs: HIE and EHRs present a “terrific opportunity to transform health care marketing. If you resonate with this idea, you will be way ahead of people in your trade. People who understand will have an enormous advantage.”

One of the advantages he foresees is message targeting. According to e-Patient Dave, marketers and organizations that target messages to different patient segments will have a tremendous head start. e-Patients – shorthand for empowered, engaged, equipped and enabled patients – demand and need different information than patients like his dying father, who didn’t want to know anything about his condition, medications or treatments.

e-Patient Dave’s major concern about the HIE opportunity for marketers, not surprisingly, is privacy. In the view of the strictest privacy advocates, the arrival of an email or postcard could disclose to someone, maybe even your mail carrier, that you might have a particular condition. As HITECH rolls out, more discussions are going on in Washington about exactly what marketers will be allowed to do. Obviously, it’s clear that marketers should not, and will not, have access to a patient’s medical history solely for the purpose of marketing.

However, e-Patient Dave acknowledges there are borderline cases where a pharmacy knows you have particular condition, or take a particular medicine, and there are some gray areas in privacy regulations about whether an organization could then offer you something that’s reasonably related. This is exactly why I’m interested. Marketers, believe or not, have a role in fostering health, and an important role to play in America’s health care system: Helping patients find health resources, treatments, providers and technology.

Keeping a cool head about HIE and HITECH

Use Emotion to Drive Adoption, Not Rejection, of Health IT, a recent post by Lygeia Ricciardi on The Health Care Blog, demonstrates why I am so intrigued with health information exchange in the first place: consumer perception.

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I’m not just a marketer, I’m also an armchair sociologist. This quote from Ricciardi is exactly why I am interested:

The struggle to control public perception will grow more intense as health IT becomes more mainstream via implementation of HITECH. It’s important to get the infrastructure, the policy, and the MESSAGING right if the public is going to participate.

There are many, many potential benefits to health information exchange, as Ricciardi enumerates in her post. And there are downsides too. Some of them may be ugly. All of this will impact health care marketers. We’ll be key in shaping and responding to the messaging that Ricciardi refers to.

That’s why I’m here: to follow along and see how this implemention is shaped for the public, and how consumers respond.

Conversations about the good

Marketing is still an ever-so-slightly dirty word in health care. To some, marketing smacks of sleight of hand, subtle deception and self-interest.

When I began my career in the marketing and PR department of an acute-care hospital, there were still practitioners in the field – and my organization – who felt any advertising or marketing for health-care services was unseemly. Marketing departments dedicated to communicating services to consumers came late to health care compared with almost every other industry: They were almost non-existent until the mid-1980s.

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Much of this reluctance against marketing and its most-visible tactic, advertising, is historical. For decades, the American Medical Association prohibited its members from advertising, originally due to concerns about medical quackery. Since physicians normally play a significant role in guiding and leading hospitals, this marketing stigma bled over there as well. In 1979, the Federal Trade Commission ordered the AMA to rescind its rules banning advertising due to concerns about potential price-fixing, opening the door to the eventual creation over the next decade of hospital marketing, public relations and communications departments staffed with dedicated practitioners.

Some of that stigma remains in health care: Marketing is “bad.” Marketing is not in the patient’s best interest. Marketing is selling. However, I would argue that in acute health care, especially the not-for-profit realm, marketing serves a greater good, informing consumers about services to save and improve their lives.

Much of hospital and health system marketing – my preferred term is marketing communications – is focused on wellness, education and helping patients find essential services and resources. Marketing health care is different than marketing just about any other service.  No one wakes up in the morning and decides to have a cardiac cath. Certainly, letting a potential Type 2 diabetic know about a weight-loss program is “good.” Reminding mothers-to-be about the importance of prenatal care is “good.” A lot of what is labeled marketing in health care is really about communication and education: What are the signs of stroke? What types of cancer treatment options are available in my region? Where can I find a doctor?

Health information exchange will only broaden and deepen these communication opportunities. As health systems begin to use greater amounts of data to reach greater efficiency and promote evidence-based medicine, someone will need to communicate those changes to the people affected, the patients and community. Will it be marketers?

Journey to the land of health information exchange

Doing means learning. Learning means mistakes.
— Jeffrey Pfeffer, Stanford Business School professor

When I first read that quote, long before I knew anything about Jeffrey Pfeffer, it sang to me. It perfectly describes my blog direction shift: I’m about to do something. I know it entails learning – that’s why I’m embarking on the project in the first place. And I know that learning necessitates mistakes.

Back in April, I read an appealing job description. I have 13 years of health care marketing experience, and I’m always looking to expand my knowledge and experience. The job title was “Manager, Health Information Exchange.” Since I didn’t know much about health information exchange at the time, I embarked on a journey to find out.

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By coincidence, three days later I received an email from my MBA program looking for students to work on an independent-study project for the State of Nevada’s Office of Health Information Technology, which is developing the state’s Health Information Exchange Cooperative Agreement, an initiative funded through the American Recovery and Reinvestment Act of 2009. I ended up assigned to lead a student team to explore communications planning for the state’s strategic and operational plan.

This led to reading other states’ plans, and webinars, and watching videos, and questions. I find the privacy aspects of health information exchange, or HIE, fascinating. How will consumers respond once an electronic health record that follows them everywhere is a reality? How will this data be used by marketers within individual organizations? CAN it be used by marketers, and under what parameters? What role will marketers play in communicating their organizations’ HIE policies? Will it give health care providers more time with patients, and perhaps a more personal experience? And perhaps most interesting of all, how will a shift to evidence-based medicine affect health care marketing?

So this is where the learning, and the mistakes, come in. So far, I’ve not been able to find much information on the marketing aspects of HIE – but given how much information is already out there about the policy, IT and operational issues, there’s a lot to comb through. Maybe it’s a non-issue – maybe this will have no impact on health care marketers.

But clues are emerging it might be of interest to healthcare marketers:

And what does the study have to say?

Referrals become an unexpected bonus
It turns out that the same time-saving benefit that brought
all of the EPSC physicians on-board the EHR transition was
also fulfilling an unknown need for referring physicians.
“We started getting a lot of referrals from new sources we’d
never even met,” says Herst. “Our referral base was growing
about 10 percent a year.”

Hmm. Let’s see what we find out.