The Emergence of “Clinical Response Marketing”

Seasoned tech entrepreneurs Dr. Philip Marshall and West Shell III founded Conversa Health, headquartered in San Francisco, in 2013. Conversa’s platform delivers automated digital checkups, helping physicians manage relationships with patients between office visits.

A Shared Vision

Early in 2014, Marshall and Shell met with Dr. Danny Sands, a leading figure in patient engagement, to discuss the concept. A few months earlier, Sands had written an article for an academic publication about non-visit-based care. “The theme of the article was that we need to be thinking differently about healthcare,” Sands says. “In this age of consumers doing all kinds of things [digitally], wouldn’t frequent light touches in between visits be much more impactful than the way we’re practicing now?” The three found that they shared a common vision, focused on the need for more contact with patients between office visits. “Our visit-based system is just so flawed because we have no idea what’s going on between those visits, and health happens between visits,” Sands says. He joined Conversa Health as Chief Medical Officer soon thereafter.

Greenfield Health Pilots Conversa’s Platform

The initial pilot of the platform was conducted at Portland-based Greenfield Health, a primary care group practice founded by Dr. Charles Kilo in 2001. Kilo is currently Chief Medical Officer of Oregon Health and Science University.

According to Kilo, Greenfield Health had a long history of finding ways to interact with patients, and from the earliest days, the majority of contacts with patients were through email and phone and not physical visits. “Conversa came around [and was] interested in the concept of the digital checkup, a way of making checkups more automated, and also in a way that would engage the individual in their own care,” says Kilo.

Here we’ll share the results of that pilot and explore how Conversa Health’s approach to digital patient communications opens new roles for healthcare marketers.

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The initial pilot focused on patients with hypertension. Four physicians and 200 patients participated. “We get an extract of all of the clinical information about patients,” says Sands. “We use that to build a pretty sophisticated profile of each patient.” The profile enables the Conversa platform to draw inferences and drive rule sets. “The system reaches out to patients electronically and asks them a series of questions,” says Kilo. “There could be action steps that are required of the individual that it reminds them of, so there’s a whole set of interactions, in this case, around hypertension.”

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Pilot Proves Model, Supports Case for Expansion

The pilot demonstrated that patient engagement significantly increased as a result of the digital checkups:

• 70 percent of patients invited to engage completed one or more digital checkups.
• 45 percent of the completed digital checkups identified an action patients needed to take.
• 30 percent of patients who completed the digital checkup required clinical intervention that could be handled by phone, including:
  • Medication change
  • Dietary intervention
  • Monitoring

Kilo was impressed with the results, noting, “From my perspective, if you take a simple chronic condition and it produces that kind of engagement and those kinds of results where you then have a meaningful interaction with [patients], that’s a pretty cool thing.”

The participating physicians, initially “edgy” as Kilo describes it, felt that the program was successful. “You’re asking busy clinicians to help you innovate. They’re trying to fit a lot into their day,” he says. “But in general, the whole group decided to move forward with the next level of the pilot.”

Greenfield Health plans to expand the hypertension pilot to all physicians and patients, and expects to add other diagnoses over time. “I think finding a way to continually interact with people in a non-intrusive and meaningful way, driven by interactions with their primary care practice, is a really positive thing,” says Kilo. “There’s a lot to be learned and a way to do it that is functional and really works for everybody.”

Flexible Architecture, Authoring Environment, Tools, Interfaces

Besides hypertension, Conversa Health has developed modules for other chronic conditions, including diabetes, congestive heart failure, chronic pulmonary diseases, deep venous thrombosis, and orthopedic conditions. Board-certified, clinically active specialists on Conversa’s medical advisory board develop all digital checkups. “Our initial notion was really focusing on how we deal with longitudinal care and chronic care of various conditions,” says Sands. “We can apply this technology to all kinds of different medical situations.” There are plans to extend the platform beyond primary care to specialties, and adapt it for hospital-related patient communications, including:

• Helping patients connect with primary care following an emergency room visit
• Preparing for surgery
• Follow-up post-surgery
• Follow-up post-discharge

Reaching a Bigger Piece of the Pie

Speaking from the physician’s perspective, Sands states, “Doctors are seeing patients who don’t need to be there two-thirds of the time.” He believes digital checkups could reduce the need for office visits, and staying in touch with patients digitally has the potential to benefit everybody, not just the sickest 2 percent of the population. “If you’re part of the 98 percent and you’re really doing well, you’re not going to need a digital checkup for maybe months,” he says. “But if you’re getting increasingly sick, we’re going to send you messages more often because we want to prevent you from getting into the 2 percent.” And for those patients who need to come in for an office visit, Sands states, “I’d rather see patients who really need my attention.”

Positive Signs for Healthcare Marketers

Conversa Health is calling its approach to digital patient communications “Clinical Response Marketing,” and the company is currently advertising for a Clinical Response Marketer. Here’s an excerpt from the job description:

…We seek a digital response marketing professional who can help [Conversa] build and execute its “Clinical Response Marketing” strategy centered around its powerful technology platform. This individual should have a strong grasp of consumer-friendly communications, be proficient in digital media including social media, and have the ability to lead the testing of different data collection and messaging approaches to find those that are most effective.

Clinical response marketing is a concept that has demonstrated the ability to improve patient engagement in this specific application, but it represents a larger emerging opportunity for marketers and clinicians to collaborate. The lines between marketing communications and clinical communications are blurring, and forward-thinking clinicians are beginning to recognize they need the complementary skills of innovative consumer marketers to effectively engage patients.