2021 Stericycle Communication Solutions U.S. Consumer Trends in Patient Engagement Survey Results

matt dickson senior vice president stericycle

Matt Dickson

Senior Vice President, Stericycle

john lynn founder healthcare scene

John Lynn

Founder, Healthcare Scene

sarah benight director marketing stericycle

Sarah Bennight

Director of Marketing, Stericycle


This webinar sheds light on the current high and low points in the patient journey based on our 2021 Consumer Trends in Patient Engagement Survey results and discuss how these consumer preferences and expectations will impact health systems.

Topics include:

How the pandemic has affected patient trust in healthcare providers

Patients’ increased interest in hybrid care

Which communication channels drive the most action and adherence

The continued friction points in patient scheduling

The growing usage of emergency rooms and home health


Sarah Bennight:: “Good afternoon. I'm excited to be here with you, virtually joined by 2 amazing thought leaders in the healthcare space. John Lynn and Matt Dixon. We're going to give you a first look at the results from our 2021 US Consumer Trends in Patient Engagement Survey and compare some of the insights from last year's survey data. And then we'll discuss how these findings will impact health systems and patient engagement. Before we get started, we have a few general housekeeping items to bring to your attention. This webinar is being recorded and will be sent to all registrants’ inbox within 48 hours. You'll also receive a link to our survey results to take a deeper dive for yourself. You can also download our 2020 survey results to learn how the pandemic affected patient engagement on our website at StericycleCommunications.Com. If you're having trouble with the audio, try refreshing your browser and make sure the volume on your computer or audio output system is turned all the way up. We'll be answering some questions at the end of the webinar, and we'll try to get to as many as we can. I'm Sarah Bennett, Director of Marketing for Stericycle Communications Solutions, joining you today from Dallas, and I'd like to introduce to you our guests for today, John Lynn and Matt Dixon. John, could you tell us a little bit about where you are, what you do and why you're excited to dive into the data today? And then we'll move on to Matt.”

John Lynn: “Yeah, great, Thanks for having me, so I come to you live from Las Vegas. This is when you live in Las Vegas wintertime. So happy to be here. And I'm the founder of Healthcare Scene, which includes both our Healthcare IT Today Community, focus on health IT professionals and also HITMC, which is focused on healthcare marketing professionals, excited for the discussion.”

Matt Dickson: “And I am Matt Dixon, I wish I was joining you from somewhere warm like John is. Unfortunately, I'm just outside of Chicago, so winter is here. For those of you who are in the Midwest, which I don't have to tell you, but my role is I'm the Senior Vice President of Product and Strategy. As well as the general manager of Communication Solutions here at Stericycle really excited to see how the pandemic has continued to shift consumer preference, how those trends are evolving and certainly has created a moving target. So happy to share some of those insights and hopefully share some ways that you can think about how to rise to some of these challenges that the health system will.”

Sarah Bennight:: “Great guys, thank you for the intros. Let's dive in. Last year, when the pandemic hit healthcare, we saw the industry rail a little bit and some of us in the communication space saw providers a little shy to send out communications. What was going on? What did we need to do for our providers? What do we need to do to keep patients safe? Do we shut down everything? Do we continue visits, move to telehealth? And so Stericycle Communication Solutions went out and surveyed healthcare consumers to find out how this shift was impacting them and kind of give a little bit of insight to providers and health systems on and how to fix some of the challenges we had in the patient journey during the pandemic. And what's really interesting is we surveyed a different set of healthcare consumers this year, and we asked a little bit different questions as the pandemic shaped the healthcare journey. And as we had vaccines available and starting to look into a little bit different side of the patient journey. And the interesting thing is, each of the surveys has shown us one overall theme. Last year it was at patient satisfaction was down, patients were rushed. Patients didn't have enough communication from their providers. Right there were like, where do I go for information? What do I do? How do I schedule? How do I get back in? This year our overwhelming trend that we've seen is in patient trust, which we'll talk about a little bit. But I wanted to give you some information on how we surveyed and who we surveyed. So if you'll go to the next slide, we surveyed across all 50 states in the United States and the following demographics, and you can see here all ages. All genders. And some other demographic data, you can go to the next slide, please. All right. I'd love to pick your brains, Matt and John, a little bit about patient trust. It's one of the overwhelming things we saw with our survey this year in a couple of different areas. Where are we at with patient trust with providers and how has the pandemic really influenced how much patients trust their providers and why they need to trust their providers more than some of the places they can get information?”

Matt Dickson: “John, I'll let you go first.”

John Lynn: “Yeah, so I mean, I guess I would say that, you know, the data is clear. And you can see it patients still trust providers. You know, if we listen to the media, we'd probably think that wasn't the case because they like to report on the 2% that drives the headlines, right? So I think that's why we have to be careful. I actually saw Jimmy Kimmel post perfectly in a really timely kind of thing, he said: “If Aaron Rodgers breaks his leg on the football field, he's not calling Joe Rogan to get his leg fixed right.” He's going to call a provider because he trusts providers to be able to do that right. You're not going to go to Google to try to get your heart replacement right and do a stent right. You're still going to trust your provider. So, you know, I think the media overplays it some. And so it feels like there's many people who don't trust their providers. But when push comes to shove, we really do trust our providers.”

Matt Dickson: “And I think it's kind of A Tale of Two Cities here in that even people who maybe have vaccine hesitancy and maybe have a little bit of distrust in the medical establishment in general to your point, John, when they get sick, they still go to that doctor. Right so overall, I think that the level of trust is very, very high and will continue to be. There is a niche area, though, to your point, that creates a lot of headlines and a lot of sensationalistic headlines that leads some of that quote unquote distrust. I'd say the other thing there I was surprised to be perfectly honest with you how high this was, and I asked quite a few questions about how we even went about doing this survey because my theory was that we captured only people that had consumed healthcare over the last 12 months, meaning that the people that were distrustful, that were avoiding healthcare altogether wouldn't be represented in our survey. But we certainly surveyed not only people that had consumed healthcare in the last 12 months, but are truly a representative sample of anyone that could have right. So we weren't doing any qualification to say, have you used healthcare and then only serving those individuals. So we've got a really good representative sample. And I guess it warms my heart to see this a number that's high because certainly to your point, John, if you listen to the media, you would think this number would be much, much lower than it is. So it's a good thing to see, in my opinion.”

John Lynn: “and it's worth noting that trust can still be lost, and it is lost by many providers who aren't communicating the right thing. You know, I think being absent loses that trust, right? Because if they're not present in their life, then you don't have a trusting relationship because you don't have a communication channel with them. So I think that's the other thing is like, OK, they do trust providers, but they do. You have a relationship with them. So that they can trust what you're saying, and many of them have gone absent.”

Matt Dickson: “Yeah, absolutely, and see that in our data, too. It's astounding to me that during one of the largest health crises, at least in my lifetime, that 3% of people are reporting their provider doesn't communicate information on public issues. I mean, this is something where every provider across the country should be making concerted effort to communicate this information. And some of that may be, I think, back to the early pandemic. Certainly, it was a moving target. You know, and I think there was a lot of frustration about that, right? One week it was you got to wear a mask. The next week is as long as you're here or there, you don't have to. Now we're back to you've got to wear a mask. Vaccinated people don't need to wear a mask now in Illinois, at least, I've seen a lot of that, right. So for a while, my wife laughs with me. There was a day in Illinois. They said, if you're vaccinated, you don't need to wear a mask. I took all of the masks out of my car, made a big deal out of it. I'm free of the mask in about three weeks later, they said. Regardless of your vaccination status, you need to wear a mask, right? So I think that's part of it, too. You know, we didn't dive in here, but I wonder for those providers that maybe aren't as communicative, part of that may just be the challenge of boy, it's such a moving target that and perhaps feeling that people are getting that broader guidance and information from public health officials as opposed to from their personal provider. I would argue that the best place for them to be getting that information, especially when you see the amount of trust in your personal provider, is directly from that individual and not just broader generalized public health officials.”

Sarah Bennight:: “Yeah, absolutely. If you look at the next slide, you can actually see in patients who had not received the COVID 19 vaccine at the time of the survey, they overwhelmingly stated that the information from providers education advice information about side effects would make them reconsider. So even if they're not getting this information from their provider, they are looking for it. They're looking to you for guidance, for information. And I think the data is pretty clear that whether or not those people are vaccinated or unvaccinated, what would make them change their mind or what would make them do other types of treatments aside from COVID 19 vaccination, is that communication and the trust that through the provider like you were mentioning, John.”

John Lynn: “Yeah and what this data tells me is something that we've seen across all of healthcare, and that is that doctors are no longer the only source of health information. And that's a shift we've been having, you know. I mean, they like to complain about Dr. Google. But the reality that we're facing, whether it's vaccines, whether it's by cough or whether it's my headache, whatever it is, you are no longer the only source of information as it was 30 years ago, right? And so I think just grappling with that and understanding that it's now a collaborative relationship. And that I'm going to do research, I think that's the shift that we see in this vaccine information.”

Matt Dickson: “Yeah, I'd say that in many ways. I read a study that was published recently that did some of the same thing we did very focused on COVID and vaccine hesitancy, though, and they came up with some very similar numbers to us. So their respondents were about 80% vaccinated. I think our respondents were right around that number as well. So you had this 20% of that weren’t and they asked some of these same kind of questions what would change your mind? I think the good news for me. And I think this has changed through the pandemic. Only half of that 20 percent, so 10% in total said there is nothing that can change my mind. But 90% that means we can still reach and realistically hope to achieve a 90% vaccination rate for individuals. So I think there is still some really good data that supports that. We can really get to a place where we've kind of said we need to get to be close to or achieve Herd immunity through vaccination. So I think again, there's good news here in that over time here, some of that hesitancy has eroded and we're starting to see more people that maybe haven't had it yet being open to the idea of getting it. So and certainly to Sarah's point, the tip of the spear there to driving that further change is communication from your health provider. You certainly can sway their opinion at this point, which is good news, I think, for everybody.”

Sarah Bennight:: “Yeah, absolutely. And I. And you guys can comment on this. I think it's really important to have multichannel communication because we're speaking to five generations who are making their own healthcare decisions. My son's Gen z, he's in his early 20s and he finally said, mom, I don't need you to make my healthcare appointments, but he's not going to read his email. He's just not so that information probably needs to come from social media or from influencer. Which is which gets a little hectic, but what do you guys think about how they communicate? Is there a is there a preference there? Should it be all channels?”

Matt Dickson: “It's got to be all, to your point. I mean, what? What has happened? And by the way, we're going to go into this, I believe later here, right? Email is more effective than we've been led to believe. At least our survey tells us that. But that's the reality. It is more difficult to be a healthcare provider today than any time in human history, and it's because John spoke to it. You have Dr. Google, right? You have people that are going to react very, very differently to different channels of communication. You have non-traditional players coming into this space that are trying to compete in a much different way than how traditional healthcare has been delivered. So I think the unfortunate news for legacy health, if you want to think of it that way, is they got to be prepared for everything. They have to be prepared for in-person virtual messaging over social messaging via SMS via email messaging over the phone. So the complexity of how you have to manage your organization continues to increase. But Sarah, I would certainly share your thought there that you've got to communicate across all methods channels if you truly do want to have the deepest reach.”

Sarah Bennight:: “Yeah, so so keeping with that theme, we actually looked at provider communications and whether or not they were satisfied with the level of communication, whether or not they were reaching them in their channel of choice or preference, we looked at, are you satisfied with provider communication? And if you look at the pre-pandemic levels, this would have been before March of 2020 you know, people were mostly satisfied, somewhat satisfied, only 2% not satisfied at all. And then you look at the pandemic levels and we know that from sitting on this communication solution side, we know people just stopped communicating right. But if you look at post-pandemic levels, you know, people are back to being satisfied again, and I think part of that is providers are starting to learn. I think it's part of it. They're starting to learn that you need to communicate this information because your patients will follow you. They'll come in and get care if you communicate with them about what's coming and what to expect. But I also think that part of that is also kind of understanding where they're going with the pandemic, making their own assumptions, their own covid…how to follow COVID protocols, how to keep patients safe, they've seen they can do it. So patients are starting to see that and lean a little bit more. I think so. Also disinformation, what do you guys think about this satisfaction level with provider communications?”

John Lynn: “I mean, I look at it and I think COVID kind of opened this Pandora's box, if you will, that we were all afraid to open for whatever reason, many practices looked at it and said, you know, oh, should we communicate with patients? Is that our job? Do we have the time to et cetera, et cetera? And then COVID kind of forced their hand and said, you need to communicate these protocols, or your workflows are going to be a mess if they don't know how to come in, should they come masked, should they not, should they stay in the waiting room, should they stay in their car? Like all of that information, they realize, oh, we need to do this or it's going to be a mess in our front office. So, you know, COVID forced the hand. That said, you need to communicate some information to it. And it's opened up this box. It's like, oh, I could communicate with my patients, you know. And so it's almost like this discovery of like, yeah, I could do this in patients actually like it. OK, now that I've started communicating, what else can I do with it? And so I think in that regard, it's opened up the fact that many doctors who before would have thought, should I communicate, how should I communicate? Do they even want me to communicate? Are now saying, I have to communicate. So how can I use this for good? And I think that's why you know; these patients are more satisfied is because many provider organizations realize I need to do this and it's creating a better experience for patients.”

Matt Dickson: “I would say the thing that jumped out to me here is the polarization more than anything. So, Yes. 82% are saying they're satisfied, but now 19% are saying no. So you're seeing much stronger reactions on both sides of the spectrum. So the question here is how can you communicate in a way that doesn't create that polarization? And unfortunately, I don't have that magic answer. I wish I did, but certainly that's what you've got to start to think about is are we communicating in a way that will further alienate or entrench either distrust or dissatisfaction? And how do we address that? So I can tell you broadly the things you need to think about, like A/B testing, for example, my guess is very few healthcare providers are running deep analytics on A/B testing about communication, right where you send out two versions of the same communication and figure out which one resonates better. Right? one, it's sometimes difficult to gather that feedback to figure out which is resonating better and two, of course, it requires a much deeper level of sophistication. But I think that's the takeaway here for me is it would be simple to say, boy, we're at 81% Yes, what a great job we're doing, stories over. I think you've got to focus on the polarization and the fact that we're seeing the number of people saying they're not satisfied. Also at an all time high. And what are we doing and how can we address this polarization and very different reactions people are having to that communication?”

John Lynn: “And I would offer two points for that one is communicate the right info, and the right info means you've got to get out of your own, head your own needs and you've got to get into the patients' needs. What's their perspective? They don't have the knowledge that we have because we live it every day. And so making sure you're communicating the right info to them, I think that's step number one to dissatisfaction is when you communicate stuff that isn't relevant, that isn't complete, et cetera. And then second is what we talked about before. I think there's a lot of dissatisfaction when they don't communicate. And so there's still a fair number of organizations that are absent in their communication and absence creates the same dissatisfaction.”

Matt Dickson: “And John, I think you make a good point there. When you say you've got to get out of your own head in the patient's head, you cannot think of patients in a monolithic way. Mm-hmm right. It's not all of my patients want this. That's not how it works, right? A subset of your patients prefer this. A subset of your patients prefers that, right? So you really got to start to get into potentially more granular strategies around how you're communicating. And that's where I say that deep analytics comes in, right? Use this data points. You could potentially use social determinants of health, for example. You probably want to communicate very, very differently based on education level, for example. These are all things that I think are critical and important that we need to start pulling more data into determining how and when and the content of the communication, as opposed to saying, here's this one communication about x that we send to all of our patients. So I think that is another way to begin to your point, keep it more relevant, and it's certainly to really make it more impactful as well.”

Sarah Bennight:: “Yeah that's great, I can see healthcare marketers being a really key asset. Next year in 2020 as people try to tackle this. So moving on, we've got a lot of data to look into here. So trust is high. Communication remains an important part of maintaining that trust is what we're seeing here. So let's look back a little bit about the technology plays during the pandemic that were really spurred to keep communication with patients to keep a touch base with patients when things were during the shutdown. And also to work at getting patients back into care, so what is the current survey data say about the future of telehealth visits?”

Matt Dickson: “I mean, it's here to stay. Is it here to stay at the levels that we saw when it reached its highest eyes? No, I don't think so. Right? and I know that some of our latest survey data talks about how people are getting more comfortable coming into the office, right? And again, this goes back to the earlier challenge, I said, is that traditional health systems now have to be capable of competing and offering services. It's the smorgasbord approach now, the buffet approach, right? And again, I do not envy those that are having to reach and address those challenges because you are going to have to continue to be prepared to offer appointments via telehealth where they make sense. And I think that's the most important thing is for health systems to think about. Where does telehealth make sense? Where can it be most impactful? There are certain appointment types, and we see this in some of our data around preference of where they are, what kind of appointments they wouldn't mind getting through telehealth. There are certain telehealth appointments that fit very well are certain kinds of appointments that fit very well into the telehealth paradigm. Mental health is one that really jumps out at me, but certainly you've got to make sure that you're not deploying telehealth so broadly that you're just creating another step in the journey where, yep, I need you, I'll see you via telehealth. But 99% of the time, the outcome is I still need to physically examine you, right? I still need you to come in and get certain diagnostic procedures done. Now, I think you made it from something that could create more convenience to the individual to actually doing quite the opposite, right? You're creating a burden for them. But John, happy to hear your thoughts here as well.:

John Lynn: “Yeah and the obvious is it's going to be more telehealth than pre-pandemic, right? I mean, that's what this data tells me is that the patients still want it. I think the not so obvious thing actually ties back to what we talked about before, around trust and the impact that the decision provider organizations make will have on trust. And that is, if you don't offer telehealth, what are patients going to think of you? Doctors no longer have the excuse of, oh, we don't know how to do it. We can't do it. No, you did it. During the pandemic, you proved that it was possible, and patients experienced it. So you can no longer say, oh, we can't do that. We don't have the technology. We don't that won't achieve the same goals. No, they no. And so you can't say that anymore. You know, it's kind of like, I like this analogy. I don't know if you know about horses. And if you feed horses, you've got to feed them the hay first. If you give them the carrot, they'll never eat the hay, right? So it's kind of like patience. You know, we fed them the telehealth. And now they've had it, and they don't want to go back to the hay and a lot of cases, right, because they already tasted what the carrots like. And so then the taste of the hay isn't good anymore. And so I think that's kind of like telehealth that, you know, for many patients there, if you don't offer telehealth, you're going to lose their trust in many ways. And they may go somewhere else.”

Sarah Bennight:: “Yeah, absolutely. If you go to the next slide, you can see how that's evolved from pre-pandemic use of telehealth to 2020 and then and then further on to this year. I think what's really interesting is the not at all. 29% pre-pandemic, it's 22% in 2021. I mean, that really surprises me. Is this more barriers to telehealth? I can't do it. They don't speak my language. Is it? They're not offering it? Why do you guys think that not at all chunk is still so big?”

Matt Dickson: “Well, part of that may be people are still avoiding care in general, right? So if you look at the demographics of some of our survey, I'll tell you if you look back to 22-year-old Matt Dixon, he wasn't going to the doctor very often, telehealth or not, right? So some of that, I think, is just there's always much like unemployment, there's always a number that's the baseline. And I think if you take any representative survey, that percentage of people that say they don't do something at all is always going to be at a baseline level. I don't know if 29% is the baseline, but certainly there are because we engage with people that are potential consumers of healthcare. There's certainly a number there that is representative. But to your point, it could also be, I think we dive into some of this data around where people talk about some of the issues they have with scheduling. The other problem we have today is provider availability is very poor in a lot of areas still where people can't find appointments. So we've got to kind of work through this backlog that has been built up due to people avoiding or deferring care during the pandemic as well.”

Sarah Bennight:: “Yeah and we've seen in the data this year that in-person visits are rebounding to some extent. So on the next slide, we kind of asked, why are you still choosing telehealth? And the interesting thing to me here is last year we saw telehealth because it keeps people safe and six feet apart and not in a COVID transmission type of situation. But now 41% say I'm still using telehealth for convenience, and I am 100% that way. I had never used telehealth prior to the pandemic, and now my provider will do it. I have to see her once a year. I have visits every three months, but this is my one visit that has to be in-person. Have I delayed that several months because I don't want to drive 30 minutes to my doctor? 100% So I'm all about the convenience. What do you guys think about this trend here moving away from safety a little bit into more convenience?”

John Lynn: “And I think that is the reality. It is convenient for patients, and we actually have always known this, we've always known that patients want to do telehealth. The problem is COVID didn't really change and make it more convenient for providers. We didn't lower how much documentation they have to do. We didn't make it. We didn't pay them more. I mean, we kind of temporarily did, you know? But you know, that's not happening. So I think that's the problem. And, you know, I hammered providers saying, you're going to lose trust with patients if you don't do this. But the reality is telehealth is the same experience from a provider standpoint. And so you really have to be a patient focused organization to embrace telehealth because it is more convenient for the patient, not for the provider.”

Matt Dickson: “Yeah and the reality is, again, we talk about the Amazon cares of the world. Walmart went out and bought WeMD. These non-traditional players are going to do everything they can. I'm going to coin this phrase today. So you've heard me say it before when you and I talked. I'm calling it accidental healthcare. The emergence of accidental healthcare, or maybe incidental healthcare where you just happen to be at Walmart, and you had a congested or sinus headache for a few days. And normally you just let that go and you walk by the clinic that's going to be at your Walmart and say, hey, you know what? Nobody's in line there. Maybe I'll just pop in and see if there's something they can do for me. So what you're seeing these non-traditional players do is trying to put healthcare in the way of your everyday activities, which makes it super convenient to consume. And you're right, John, I think that if health systems do not embrace more convenient means or methods to consume healthcare, they are a real risk from either other traditional health systems that are doing that are certainly some of these non-traditional players, especially the ones, you know, Ro Healthcare, for example. They mail it to you. You get on a telehealth to the point you never have to leave your house, everything just showed magically shows up at your door that you need. So certainly I agree with you that while it's been a terrible inconvenience for them in many ways to have to brace, embrace telehealth, it's something that I don't think it's an option anymore. It's going to be a hack to have to compete in this brave new world of non-traditional players funneling into this space. And certainly some of your traditional players that you compete with that may be offering that level of convenience.”

John Lynn: “Yes, it is a killer competitor, like convenience in our culture wins every time.”

Sarah Bennight:: “Yeah and we see that in the next data with virtual waiting rooms, you know, we asked, is the physical waiting room dead and if given the choice, of course, during the pandemic. Yeah, I want to wait in a virtual waiting room. I don't want to be around somebody who might have COVID. But if you look at post pandemic or not, really post-pandemic, but 2021 levels, they're still a good, healthy preference. And this is not what they thought when we surveyed them in 2020 after the pandemic. I want to go back to a regular waiting room and read my 10-year-old magazines, but they're finding, hey, I've gotten a taste of this. It's pretty convenient. I know I don't ever want to go back to a waiting room. Of course, I have my own form of transportation, so that's not a barrier to me. However, what do you what do you guys think? I mean, convenience is really a theme here. Convenience is key. We're seeing it in the virtual waiting room data as well. But what do you all think?”

John Lynn: “I mean, I haven't seen Judge Judy for a while, so, you know, because I haven't been sitting in those waiting rooms to catch up on the latest talk show. I don't even know who the latest talk show hosts are because I haven't been sitting in those waiting rooms. But, you know, jokes aside, like, I think what people loved about the virtual waiting room was that we were forced to communicate what was happening. And they love that, right? You know, I love that as a patient that when I was virtually and I'm sitting in my car, you had to tell me there's three people in front of you. And so then I knew, oh, I have time to go get a Starbucks or whatever in the physical waiting room. We were captive to them and their workflow, and so they never communicated really occasionally a nice front desk person, hey, you're next in line, right? And that helped a lot. Well, when we're virtual, we're forced to communicate better. And I think that's where the satisfaction comes from in the virtual waiting room versus the physical is, we're actually communicating with them and creating a better experience for the patient. And I think that we love that. And then I think there is still, of course, some fear of safety and things like that it just feels safer to wait in my car than in the waiting room where you're not sure who's next to you. So I think that's still at play and probably will be for quite a while going forward. In fact, it's always been I mean, think about our pediatric. They had a sick kid’s area and a, well-kid visits because of this very fact.”

Sarah Bennight:: “Yes Yeah. And if you look at the next slide, we actually see the actual data from the survey to show why now are you saying you much rather prefer virtual waiting room? Why is that convenience safety is right up there? A little bit of privacy, too, which I can see because you know when your counter to counter and they're asking you private information about your health insurance or your previous or you're using a tablet and someone sitting right behind you. So I thought the privacy thing was a little bit interesting. But Matt, what do you think about the data here?”

Matt Dickson: “Well, I think the key takeaway, though, is the preference has. Decreased over time for virtual waiting rooms. What are those drivers, right? So the 2020 data set virtual waiting room 81 percent, if given a choice, would prefer virtual waiting room 2021. That number down was down to 64% Yeah, but I think, John, that comes back to your point. Um, I think people want to go back to the actual physical waiting room because it's easier for you to keep track of where you're at in the process. Because you're right, I don't think what happened, you go out in your car and you sit there and 20 minutes later, you're sitting there wondering, is anyone ever going to call me to come in like, what's going on? Have they forgotten about me? I think that for virtual waiting rooms to continue to be prevalent.”

Sarah Bennight:: “I think you, froze up a little bit there, Matt, but I have a perfect solution to that. I mentioned a couple of years ago was the grocery store type of app where you buy your groceries online and they track you via GPS and you they know where you are. You say which space you're parked, and you tell them what color your car is you. You give them all this information. So they can find you and then you check in. I am here physically in the parking lot, and they use all of this wayfinding technology to figure out where you are. And then they kind of can tell you, like, have you ever been to Sonic John with the app, and you check in and it's like, Hi Sarah, welcome back. I'm so glad you're here. We're making your food right now. And then it's like, so and so's on their way with your food right now. And then when you're done, it says, Thanks for Thanks for checking in or when I pick up my groceries, it says you picked up your groceries at 5:40 PM so I think it's really interesting. I think there's a lot of ways we can innovate and experiment around virtual waiting rooms. All right, changing gears a little bit. Let's talk about friction points and interesting data in patient communication channel preference, as you can see here, 33% of respondents said email was the most likely communication channel to respond to. 29% phone call and 27% text. And that what's the lesson here for healthcare organizations?”

Matt Dickson: “The lesson here is throw away what we've been hearing for the last 10 years. Email still works. Now I have a pet theory here, and I don't have the data to confirm or deny this. But my pet theory is this that we've seen such a better job with spam protection on email. We've seen a better job with what Google is doing by categorizing and classifying your email that we've actually seen the effectiveness of email increase over time instead of decrease. I think back, as you know, just a general consumer over the last 10 years, five years ago, you'd open your email box. And you'd have more spam than anything. I can't remember the last time I saw a spam email in my Gmail inbox. And not only that, but it’s also conveniently categorizing things for me to say. Here's what's important. Here's what our updates right? Here are things that are related to shopping or consumerism. So I think because of that, because it's killed some of that noise, we've seen the effectiveness of email increase over time. We've seen the opposite, though with text. So now spam has transitioned to text. Now we're getting better tools there as well. We've seen some legislative changes as well that should fight robocalls, spam text. But I think the reality here is as the noise increases in a channel, that channel becomes less effective and as the noise decreases in a channel, that channel becomes more effective. And I think that's what's happened with email.”

Sarah Bennight:: “Yeah and I think what's interesting too, is if you download and take a look at the full survey readout, we did ask consumers, do you fully read your whole email because I get some long emails from some of my providers, very long detailed instructions and different providers coming on. And they said 53% said they quickly scan their email, but only 39% said they fully read it. Oppose that with text. 59% of patients fully read their text messages. So I think it's not just channel and preference, it's also the type of message you're trying to send, right? If you're closed because an ice storm came through and you're in Texas and you have no power. I think a quick text message is going to be much more easily read and you know, your patients are going to read it all because most people fully read their text messages as opposed to email, which I thought was really interesting.”

Matt Dickson: “Well, 160 characters a lot easier to consume, right? So maybe this makes the argument that when you do communicate over email, you need to break it into more digestible nuggets. If you truly hope to get somebody to read the entirety of the content, right? So instead of trying to communicate three things in one email, break that out right into more digestible chunks, I guess, is one way you might want to think about making email certainly is effective, but to make it even more effective and going beyond just cursory scans to complete comprehension. John, any thoughts there?”

John Lynn: “Yeah, so I mean, obviously, email never gets the credit it deserves. The death of email was prematurely reported. I mean, probably every couple of years, it's pretty much earlier reported. But I think the other interesting thing here is the word about driving action, right? When you look at it from a text perspective, if the action is verify that you're coming to the appointment or a reminder for the appointment, that works really effectively because the action is something that's easy for me to take. Whereas when you're talking about driving action through text to schedule a follow up wellness visit, that may be harder in a text because text needs the immediate response. And if I need to think about my schedule and think about, do I want a wellness visit and is my insurance coverage there and all that like, that's a harder decision. And so in my text, I might forget about it and I might forget about the text, whereas in the email, usually it's a little slower. I have a little more time. And so I could do it. So I think there's that response. But I think the big challenge with all of this is that it changes, you know, the MGMA president at the recent MGMA conference, they held. She told this amazing story about her, her senior mother-in-law. She was like, why hasn't my doctor reach out to me about the COVID vaccine? How come they haven't called me? And she's like, you thought your doctor was going to call you about this? She's like, they probably sent you an email and she went into her email box. Sure enough, six emails from her provider saying, come get your vaccine. And so she's like, OK, great. And she booked the vaccine a couple of weeks later. She needed to do some follow up appointment for a visit, and they were playing phone tag with the Office and she couldn't schedule the visit. And the mother of the MGMA president said, why don't they just do it through email? That's a lot more convenient. So like even just in this two-week timeframe, the senior patient change from why aren't they calling me to, why don't they do everything by email? And so I think that's the other challenge we face is this stuff evolves quickly.”

Sarah Bennight:: “And I think it really depends on the patient, too, because if you look at my junk email box where a lot of communications non-work-related go, I have over 10,000 unread emails in there, so I do a quick scan of what's important and move on. And if you looked at our survey last year, if you download that data, we asked were you impacted by COVID cancellations? And the majority of them had a canceled appointment? And what prompted you to reschedule? And these same patients are consumers who said email was my communication preference. What more often prompted them to reschedule was a phone call, not an email. And we found that also with mental health patients even more with mental health patients there prompting to reschedule wasn't by email. It was a phone call. So, you know, they said phone calls are going to be dead eventually. I just do you see that happening Matt?”

Matt Dickson: “Absolutely not. Because here's what you have to understand. There's a channel of preference and there's a channel of activation. Those two are not always the same channel. You spoke to Sarah; I know you're acutely aware of this because we talk all the time. So your call out the mental health was a good one. Here's the secret in healthcare that should be publicly available and much more widely published. Incredible study done out of the UK because they have socialized medicine, the access to data is unprecedented and they looked at what were the drivers for missed appointments? Why did people miss their appointments right? They're still interested in driving down missed appointments. Very interested in doing that in the UK because it's a limited resource, right? So you want to make sure it's consumed. The number one predictor of a missed appointment was the number and severity of mental health conditions you had. That was it. So to your point, especially when you look with people that may have mental health challenges, certainly their channel of activation is unlikely to be email or text. It's that personal touch that actually does matter to them and gets them to take action. So I don't see that changing. And my again, my focus, and maybe it's because of my data analytics background keeps showing up in this conversation, but you've got to start to go beyond self-reported data. So today we use self-reported data around channel of choice, and we presume that if we communicate in someone's channel of choice, it's most likely to create activation. And that is not the case. You've got to change your channel over the part pattern or course of communication and find the one that actually creates activation for the individual.”

John Lynn: “And I think this goes back to that question of action again. And there's a marketing principle here that's involved. If I call you, I feel a certain debt to you because you're spending your time calling me and I feel like I need to repay that debt by taking some action. Whereas if you email me, my debt to you is not as great because you didn't spend as much time and resources to me. And so it's easier for me to say, oh, I'll get to it later, right? And so I think there's a really interesting marketing play when you talk about action, when you're just informing them. Sure, the text is fine, the email is fine. But when you want to drive action, there's a debt that happens when you call. And so I think that's something to think about, too.”

Matt Dickson: “Absolutely.”

Sarah Bennight:: “Yeah, so moving on, we were talking about reminders and what drives patients to get back in and you can see from 2020 to 2021 patients got busier and originally they wanted one reminder for the majority. And now it's two, sometimes even three. So what is this saying about reminders? Do they work and can you get too many reminders? Do they eventually just snooze them and just forget about them? What does the data show here, Matt?”

Matt Dickson: “You are having to walk a thin line when it comes to reminders because what you don't want people to do is opt out of getting those. So here's the best advice I can give to any health system. Tell you this just for my own. Certainly, the data supports this book from my own experience. Make sure that you are able to suppress on confirmation. My dentist drives me nuts. He'll email me and say, click this link to confirm, and I click the link, and three days later, I get a text that says, don't miss your appointment reply C to confirm and I reply to confirm. And then one day before the appointment, I get another text message. I confirm 14 times you're driving me nuts here, right? So I opted out. How many times do I have to tell you I'm showing up, right? So I think the right number again, this is the question between preference and what's effective. But I think the core key takeaway for me is to truly be effective, you have to make sure you don't overwhelm. And the best way to ensure you don't overwhelm is to suppress on confirmation.”

John Lynn: “Well, they don't trust you. Matt”

Matt Dickson: “I mean, that's right. I'm not the individual, John.”

John Lynn: “No, I mean, I think that I said that somewhat sarcastically. But I mean, that's what they're telling you as a patient when they don't respect you and your response, right? And so I think that's, you know, one of the overarching messages here, although I would disagree with you on one point, I am not going to suppress that message ever. I mean, maybe if I was seeing 10 doctors a week and that was my life like it is for many seniors, maybe I would. But you know, I have, you know, an ortho, orthodontist appointments that I get 6 messages, at least for every appointment. The other one three months out, two months out, two weeks a day. And I'm sick of it. But have I unsubscribed from it? No, I'm just slightly annoyed, but I also know I don't want to miss it, and I'm probably going to forget it. And so I just subsist, you know, I've already verified it's on the calendar six times. But guess what? I'm not going to unsubscribe because I want to know the next one where I may forget it. And so I think, you know, you're definitely burning. Some people you're hurting the relationship to some extent. But I also don't think the damage is going to be what we think it is because people don't unsubscribe from those reminder messages because we forget easily.”

Sarah Bennight:: “Yeah the next slide, we've got some, some older data from last year to show that these. More than three, you know, they're very small, none. I want no reminders. 18% So, you know, the data really, really has changed just a little bit. But you know, I think one thing and then I know that you had a comment. One thing that would really help me in the span of reminders is my two girls are both in orthodontic care right now, and I get one girl's confirmation and rescheduling reminders on my phone and then my husband because he happened to take her the first time, he gets the other daughters. Why don't they give to both parents? I don't know, but maybe they think I don't know. But that would be so much more helpful if we had multiple patients seeing the same provider Isabel's this day as this day. And then you need to reschedule for both of them. But that's kind of the things I see as a consumer of health. Matt, any thoughts on this?”

Matt Dickson: “Well, I just wanted to say react to one thing, John said, because it did resonate with me, and maybe that's why I react the way I did. I don't feel like they respect me, and that irks me to a great degree. Yeah, right? You don't trust me. You don't respect me enough to believe me. When I tell you three times, I'm going to show up. But I think John's other point is a good one. And this is why I've said you've got to have personalized plans when it comes to this. So John's never going to unsubscribe. I certainly will. And there's a lot of Johns in the world. And there's a lot of me's in the world, right? So you got to think through your strategy and individualize it around reminders. This this idea that we can have a one size fits all approach to any kind of communication, whether it's something as simple as reminders or as complex as scheduling follow up care with a specialist. You're going to have to really start to think about how you individualize that messaging so that it is most effective for the individual. So I think that's kind of the key takeaways is certainly we have moving targets in healthcare that are accelerating by the day.”

Sarah Bennight:: “Yeah.”

John Lynn: “The issue is something Matt actually pointed out in our pre conversation, so I'll give him credit for this. But you know, to your point, when you send that and you send it over and over, you're really putting your own profits ahead of your desire to make a great patient experience. Because that's why they have confirmed over and over. That's why they send me six. It's because if I miss that appointment, that's going to hurt them financially, it's going to hurt their workflow, et cetera, et cetera. And so they're putting their own needs above that of me. But the ironic thing to your point is there are solutions out there. I know Stericycle Communication Solutions offers these types of solutions right, that are personalized, that do allow them to stop the messaging once it's confirmed, right? I mean, it's not like in the past where, OK, well, we send all those messages because that was all we had available. You know, you have created a technology solution that's available that could solve this problem while still addressing their problem, which is I don't want to have a no show. So I think it's just maturing our understanding and use of technology. So we can achieve both goals, great patient experience. And reduce no-shows.”

Matt Dickson: “Agreed, absolutely.”

Sarah Bennight:: “Yeah, so let's look at our map last main friction point in the patient journey, which, believe it or not, still remains scheduling. Folks are somewhat and very satisfied with their scheduling experience, but we have seen that this is a friction point when we asked, why are you not satisfied with your scheduling experience? I mean, you can see some of the data here. It took too long and no appointments available soon enough. I think that's a huge thing right now, especially in mental health language barriers. Other no available providers. So how do we address this? Because we know convenience is King and when we looked and if you look at the larger survey, we do talk about how soon do patients want an appointment when they pick up the phone and schedule or they book online, they want it typically within that a week. And how many providers can you get into within a week? And that's where these non-traditional healthcare providers players are really going to thrive in this convenience and in open appointments. But where do you all see us overcoming these access challenges? Because if scheduling is a barrier and that's one of the earlier steps in the patient journey and people can't even get into care, we're going to have a problem with action and adherence eventually, right? So how do we overcome these barriers?”

Matt Dickson: “Well, I think there's a couple of things you ought to look at, right? So how do you tackle no appointments available soon enough? You've got to have solutions that say, I see what you're looking for. You go down into a very specific provider. Doesn't look like they have something that fits your need within that seven-day period, here are viable alternatives for you. Mm-hmm Right so I think it's important more and more as you think about the technology when you don't meet a need. Making It easier convenient for them to assess other viable alternatives that could meet their need. Right so this may be showing them, hey, it may not be your doctor, but here are some other primary care physicians that could see you in the next 24, 48, 72 hours week, or whatever the case may be. I'd say the other thing is, you know, it took too long. I would encourage anybody that is making patient intake part of scheduling the appointment to break those things up. So if you're scheduling online and then you're also asking them to upload their insurance card, go get their driver's license, get their pre-authorization, and maybe upload that you are making the process very, very long. I would say that you want to make it easy for them to schedule, but then you have to have good backend workflows that collect that pertinent information, whether it's information about their medical history, whether it's their insurance card, whether it's an image of their driver's license. I would say segment that, but I think the reason a lot of health systems don't do that is because if they don't get that, potentially it impacts their ability to Bill for that service, right? So if you show up and I find out you never gave me your insurance card, you told me you had Cigna healthcare. But now that I see your insurance card, you're actually not covered or this, that and the other. So now you've got to build in some strong intake workflows that at some point basically say, hey, if we don't get this stuff from you, we're going to have to cancel your appointment, right? But I would say those that's what makes it take a very long time is if you're asking too many intake questions and asking for too much documentation at the time of appointment setting. I think it makes more sense to address that at a different time.”

John Lynn: “And I think you had the money point, Sarah, when you said this is like a huge opportunity for these outside organizations, whether it's Amazon, Walmart, Dollar General or these start-ups where they have hundreds of millions of dollars going after primary care. That's a perfect opportunity for them to eat off of your margins. You know, if I look at this as an entrepreneur and I say 33% of people can't get an appointment soon enough. I look at that and I say I can solve that problem, right? Like, I can make that easier, right? It took too long to schedule. Oh, I can solve that as well, right? So, you know, these entrepreneurs that are kind of cutting at the edges and eating off your margins, that's what they're going to look at this and say, oh yeah, we can solve this problem. And I just think about it, even from my own personal standpoint, I need to schedule an appointment with an ortho. I've actually already had the MRI. I've already done all of this and I need to schedule it. And all I know; all I have to do is call them and I'll schedule an appointment. And I haven't done it because I know, like, I don't know why that barrier to calling just feels like this massive thing. And I think the problem is this isn't like Netflix, where I will go whatever barrier, because I want to watch Netflix tonight. No, I mean, a healthcare visit is like one of the most miserable things you can do in life. I mean, sure, it helps if you're in pain, right? And that drives you to do it or you know, your future health, but it's not like something I want to do. This isn't something I'm like, oh, I can't wait to go see my heart though, right? So, you know, we're not driven to do it. So if it's not simple, I'm going to procrastinate it. And that's what I think this data says.”

Matt Dickson: “Well, John, I'll tell you, when you think of those non-traditional players that are coming in, here's how they're trying to solve these problems. They're creating a whole new paradigm. They're creating on demand healthcare. There is no need to schedule. Amazon Cares status goal is that they will connect you with a healthcare professional within 1 minute of your request. One minute. So there are nothing to schedule. There's no appointment to wait. You literally will pick up an app or log into their platform and say, I need to speak to somebody. And there goes 1 minute to connect you with someone. It's branding.”

John Lynn: “I want to go to quick care because it's called quick care, even if I go and sit-in the waiting room for two hours. I know I'm going to get the immediate gratification and, in my head, I'm getting quick care rather than the doctor that I have to schedule two weeks away, right?”

Sarah Bennight:: “Yeah like the one time I went to MinuteClinic, it took a lot more than a minute.”

Matt Dickson: “But certainly that's the challenge. Right to your point is you have these entities that are trying to shift the paradigm to on demand healthcare. But Sarah you made a good point. Here's my fear that's going to fragment the patient journey even more. So what does that mean when I'm consuming some of my care from Amazon Care platform? Some of it at the MinuteClinic? Some of it with my traditional healthcare provider. There's no cohesive way to pull all that together and help you make a better long-term decision about your health. And wellness. So it's going to be a challenging environment over the next 5 to 10 years here, with non-traditional players really shaking up the space. But certainly, I think it's going to lead to greater fragmentation, which is going to make it much more difficult to ensure compliance with care plans and to make sure people are getting the right information to ensure their long-term health and wellness.”

John Lynn: “And the patients want that right. Do they want that coordination? I mean, yeah, we all say we want that. But if I put coordinated care that you know, informs me about what's happening improves my wellness against convenience. Convenience wins.”

Matt Dickson: “The problem is, you don't want it until you figure it out. It would have saved your life if you had it. Yeah, yeah, right. Well, that's the problem. Yeah, we're seeing this matter of fact. We're seeing this today that people that are now being diagnosed with cancer are being caught much later. So coordinated care. They didn't even know they needed it, and now, you know, hindsight is 2020, it's like, oh my god, like if I would have had a better coordinated care approach, I would have caught this sooner, which makes it much more likely that it wouldn't have become an issue for me. So I think that's the problem, right? Is, you're right, the consumers don't want it because it's an inconvenience. It means more appointments or more having communicate more information with your provider. But the reality is they need it. So how do we make it more consumable for them and more convenient for them to get it and then to act on it as well?”

Sarah Bennight:: “And unfortunately, we're out of time to cover a lot of questions, but a lot of these questions, I'm seeing pop up have a general theme, so I'm going to give Matt and John each about 10 words to summarize what is one actionable insight or takeaway for a health system or a healthcare marketer that they can take away from this data that they should be focusing on in 2022 And since we're short on time, like really short one sentence to the point.”

Matt Dickson: “I'm going to start with one word personalize, personalize your communications. You’ve got to do that. Don't be monolithic. You got to move past that.”

John Lynn: “My short response is show that you actually care because if you care about patients, it changes everything that we've talked about.”

Sarah Bennight:: “Empathy and personalization. I love it. Enjoyed the conversation today, John and Matt, thank you so much for joining us and we're out of time. We will be continuing the conversation on our social media platforms. And blogs, so please make sure to follow and subscribe to take part in the conversation. We do have a fireside chat coming up with Matt Dixon and one of our partners, Yext, Carrie Liken of Yext will be talking in December about what to look forward to in 2022 or what you should be planning for. A look back and a look forward as we round out the year. So make sure you register for that again. Once you leave today's webinar, you'll receive follow up email within 48 hours. The link to view the recording of today's discussion, as well as a copy of this year's survey, you can download last year's survey on our website. Again at StericycleCommunications.Com.  On behalf of Stericycle communications and our presenters, John and Matt. Thank you so much for joining us today, and I hope you have a great rest of your day.”