Embracing the Evolution of Modern Healthcare: the Impact of Retail & Big Tech in Healthcare

Transcript

Matt Dickson: “Welcome, everyone. This afternoon, I think we're going to give maybe 30 seconds here for people to finish joining in and we'll get kicked off momentarily. Well, let's dive in. Hopefully, we've got everyone in and ready to go. So, welcome everyone. I am Matt Dickson, the Senior Vice President of Product Strategy and the General Manager of Communication Solutions. We are focused on patient engagement. Joining me today, we have Adam Rice and Reed Smith. I'll have them introduce themselves momentarily. But today we are going to be part one of a multipart series where we're really examining the impact of retail and big tech and healthcare and how that's changing the approach of what we would call traditional health systems and really curious to see how they're thinking about that and maybe how that's changing there, their go forward strategy. So, part one of this series is going to be examining that through the lens of our marketing leaders. And we have two very esteemed leaders joining us today, and I'll ask them to introduce themselves. Adam, your first on the list. I don't know how you got that honor. I don't know who you paid off or what that looked like. But Adam, your first there, so you would introduce yourself, Adam, give us a little bit about your background. We'd appreciate it. Looks like Adam’s on mute, maybe I'm not hearing them. There we go.”

Adam Rice: “How's that?”

Matt Dickson: “Perfect Thank you, Adam.”

Adam Rice: “Wonderful so Adam Rice, thank you obviously, for having me today. I lead marketing across CommonSpirit Health. So many of you probably haven't heard of CommonSpirit health, where a large health system that approximately three years ago was formed through a merger between Catholic Health initiatives and Dignity Health. We deliver clinical excellence across 21 states, 140 hospitals, 1,000 or so care sites and through our 150,000 employees. So, within that, we have a. Broad range of environments that I'm sure will relate to most of those in the audience anywhere from, you know, clinics and critical access hospitals all the way to big academic medical institutions and large facilities. So, looking forward to the conversation today.”

Matt Dickson: “Great thank you, Adam, Reed?”

Reed Smith: “Absolutely Thanks for Thanks for inviting me. Matt, appreciate it. I need to update my head shot. I've added a lot of gray, I think, since probably some of which have a result of what we're talking about today. But thanks for letting me join in. Yeah so Reed Smith, I'm the Vice President of Digital and Innovation at Ardent Health Services, where a company based in Nashville, Tennessee, and own and operate hospitals all over the country. So we've got hospitals in Texas and Oklahoma, new Mexico, Kansas, Idaho and New Jersey, and I've got purview or oversight of all things digital, which includes a lot of the kind of consumerism, digital front door type tactics and topics, as well as the innovation side, tends to bleed a little more into our clinical side, the care delivery, workforce optimization. So remote patient monitoring, hospital at home, some of those types of topics. So, I've got kind of an interesting foot in a couple of worlds as it relates to the consumer, both how they find us and what happens when they're here and how we connect with them even after they go back home.”

Matt Dickson: “So excellent. I thought nobody had more jobs than me, but you may have more jobs than IBM. Well, let's I just wanted to just set the table rather quickly before we dive into the questions here. So, people really understand what we're talking about. So, we're talking about the influence of big tech. So, everybody, I'm sure, is familiar with Amazon, their care platform. Maybe not everybody is up to date with the goings on there, but they've announced that they're going to be in 20 major US cities in 2022. So, a big push from them to physical, right? So that initially launched as a virtual platform. They've got plans to make that much more clinic based. Very ambitious plans, right? 20 states in a year. That's, that's ambitious. We've seen the rise of direct to consumer or startups or app-based models. Sesame Health, for example, just got another $27 million in funding backed by Google ventures, and their specialty is cash-based pay. As you go healthcare right where doctors are, clinicians are on their platform. And they just want the cash payments. They don't want to deal with insurance and they're just going to go right to the consumer. And if you think of it that way, cut out the middleman. If you want to think of it that way, you know better health or Better Help, which is really focused on mental health, app based model, web based model Ro Health direct to consumer, which historically is kind of specialized in men's health, hair loss, erectile dysfunction. They've now got a component where they're focused on those same kind of challenges for women retail. Everybody knows what's going on there, right? But Walmart's very ambitious. They've acquired a telehealth provider in BMD. CVS has just rolled out their virtual care platform and its primary care chronic condition management, mental health kind of all in one. CVS announced plans to close 10% of its US locations, which is 900 stores, and convert those to primary care offices. Walgreens to $5.2 billion investment in a retail clinic partnership with Village M.D., Homeward is partnering with Rite Aid for 700 rural Rite Aid locations. Concierge healthcare like One Medical. So, I feel bad for you guys. Because it feels like you're getting hit from just about every angle. So hopefully you guys stretch before this because I think we're going to start with. I think maybe one of the most difficult questions that we'll have today is what do you think the primary advantages of traditional healthcare systems are? And maybe more importantly, how are you marketing to those?”

Adam Rice: “Matt, I mean, way to start us off in the gutter.”

Matt Dickson: “You're up to the task. I can see it, though.”

Adam Rice: “OK, I'll dive in. And then. Person, we'll just kind of. OK, perfect, so. Yeah, no, it's interesting. On the one hand, I mean, you brought up the negatives around what I'll call kind of cherry picking either good risk or niche opportunities by these providers, you know, that is that's the glass half empty, glass half full, I would say. You know, these service providers are pushing us to do better work to, you know, I don't think it was up until maybe three years ago we got comfortable actually using the word consumer when we were talking about those that we were engaging with and interacting with. The idea of bifurcated experiences was our reality. Now the idea of connected experiences becomes our focus. So, you know, the threat of competition that we've been talking about Matt over the last 10 years really wasn't enough, in my opinion, to get us to move. It was really seen these competitors come into our space and begin first. With that, those front door services begin chipping away and eroding parts of that consumer journey, parts of that relationship. So, whereas traditional health systems are we focused? One: I think we still have an advantage, although I think that it's becoming less and less as time goes on. But I still think there is certain trust that we establish with our past patients that comes more reputational and historical. I think we still have the benefit of embedded behaviors. So, most of the models that you just spoke of are really hitting much earlier on. I wouldn't even call them episodic. I'd call them primary care or urgent care, type based services, virtual services, et cetera. So, I think the more that as health systems, we align and extend our front doors and side doors, making it easier for consumers to interact with us in the same manner that they're seeking out these niche providers. I think that's still an advantage. Meaning if we can, if we can deliver on some of those expectations and experiences of those consumers, we still have a chance at capturing them early on. I think the idea of having care teams and networks and connected data connected experiences are still a competitive advantage. We just have to learn your scale more rapidly to get those services extend. And what I mean by that is it's only a matter of time before consumers also start to throw their hands up about the eight disparate providers that they're meeting with, right? The provider I work with for hair issues, I have the virtual care service that's not connected in my primary care service that's not connected to my cardiologist, and I'm trying to as a consumer, now piece all of these experiences together. I think over time, large health systems will serve as more of a connector, right? Both connectors with communities, partners, some of whom you actually mentioned that we I think as healthcare continue, a large health systems continue to form those partnerships so that we can kind of connect that experience and be the glue that holds it together, the connector that holds it together to help unify that for our patients. I mean, the example I gave you talked about Google and Amazon. And, you know, if service providers like that, we're going to launch an airline, right, I may try it. But if as a frequent air traveler, it doesn't fit my needs, it just becomes a novel additional option, right for infrequent circumstances. And I think some of these niche providers will probably fall into that category versus where we see opportunities to partner with some of these, which is when you see those same service providers and Amazon and Google, even in Apple, begin to be aggregators of access. So how do they extend access to me? So use the same travel analogy if they were providing and Google does this, Amazon does this for shopping, but if they can connect all of those parts and make it easier for me, you help me use my data to connect those which would be inclusive of traditional healthcare systems and providers and whatnot to give me that more expansive view to give me the easier access. I think there's probably there there that over the course of the next few years, you'll start to see take shape.”

Matt Dickson: “So Adam, you hit on something that I found interesting there. A lot of my expertise is UI, UX as well and a well-known, phenomenon when you're talking about designing user experiences, the more choices you give people, sometimes the unhappier they are. And I think that speaks to your point is consumers at some point are going to be frustrated or overwhelmed when navigating that experience. So, I think that's a very valid point. I'm curious how you kind of market specifically towards being that connector. There are certain things are changes you've made in the way you think about marketing the consumer to kind of really reinforce that message as being the glue or the connector that a traditional health system can operate that way.”

Adam Rice: “Yeah and I know we're going to talk about it a little bit later, and I just chewed up a bunch of airtimes and I want to give Reed a chance to talk. Yeah, I would say Yes. And as we talk about what I'll call retention, loyalty and engagement of those that have had experiences with us, I think that's where the next and I hate using war analogies, but that's where the next battleground will be fought, in my opinion, is how we've been so focused on demand generation and attracting new that my opinion marketers and healthcare. And I'm sure this doesn't hold true for all of you, but I see and speak with many of you frequently. This still becomes an area that's neglected by most meaning. When you look at the percentage of your time and your effort and your capital that's actually spent keeping the people you have connecting and embedding and creating stronger experiences with them and then connecting those experiences against sites of service, making that a priority. How you use their data, how you extend their data. I just see that as being a neglected or I'll say, an area of opportunity if I'm looking at it.”

Matt Dickson: “Perfect you're right, Adam. We're certainly going to address that later because that is a thought that we've had internally. So, we'd love to hear your thoughts on the first question, and we'll have plenty of time to pull on some of those other threads here shortly.”

Reed Smith: “Yeah, I think, you know, for most, it's probably not hard to imagine that as the acuity levels go up, the traditional healthcare system is maybe the only option in a lot of cases. So, a lot of what we're talking about is that entry point, and so much of that is based on convenience. Right so that's where a lot of these real estate plays are coming in through CVS and Walgreens in different, you know, the combo inside the grocery store where you've got the pharmacy and the doctor's office and things like that. And those all make a ton of sense. But you know, where our industry is so much different. I think we're probably overstating the value of loyalty to some extent and underplaying the idea that it's really more about preference. So, there is preference. I'm not totally convinced that in all these types of cases, especially in the lower acuity space, that there is loyalty there. Now, I do think there's relationships with physicians and certainly as like if it's a chronic disease management piece or, you know, as that kind of scale goes up, there is that I think when we think about the consumerism piece and kind of how we talk in the experiences that we create, we've also probably done a disservice historically if just being assumptive that everyone that comes to our website, for example, knows what they're looking for and really knows what they're trying to get out of that experience. And we forced them into this model of scheduling with a particular provider and having to navigate around our website and in and out of different things. And now we've got to get a better and do a better job of knowing that not everybody is looking for the same thing. So maybe somebody does need a pediatrician, but can they wait till Thursday at 8:00 a.m.? Do they need a virtual visit right now or do they want to drive down the street? Well, we need to present all of these options to them versus just assuming that we know what they need and what they want. And we're making it hard in a lot of cases for folks to choose us, quite honestly. And so, I think the traditional healthcare system still plays a big role in this. But the way that we've seen the last couple of years play out, the preference in the convenience piece is becoming in just the willingness to try some new things, right, which we've kind of mentioned. So virtual visits being one of those is probably something that we'll stick around not quite to the peak that it did during the pandemic, because that was kind of your only choice, but it'll still continue to play a role.”

Matt Dickson: “Reed, as you put on your other hats because since you're head of digital as well, do you feel a lot of pressure to kind of escalate that arms war and match them? Blow by blow to build solutions that kind of mirror their level of convenience. We talked about CVS telehealth platform and how it's knitting together both the physical experience. And do you feel a lot of pressure to kind of say, hey, they're doing something that creates a new level of convenience? We've got to match that as well. Or is that does that drive some of that decision making and investment process?”

Reed Smith: “Yeah, maybe to some extent. I do think because we have obviously payers that are involved in other parts that it's not just totally up to us in some cases, whether or not a consumer uses our product, if you will, or our service offering. But I do think there is some of that. I think it's less about the reactionary nature we may or find ourselves in, of trying to duplicate or make sure that we have exactly what someone else has. But I think this is where we really need to spend time talking to the folks that come and see us. And use our services to understand what makes the most sense right? Is there a partnership with the local school district where we can provide, you know, more expertise to the school nurse via virtual capabilities and keep those kids on campus at the school, reducing the amount of time people are in cars driving back and forth to doctor's offices? Same thing with large employers know we think about the virtual Med opportunities that we see or medication adherence to virtual pharma type programs. So how do you reduce readmissions? How do you keep people at work? How do you keep people at school? I think these are some of those things that we can, you know, maybe we're uniquely equipped to solve a little bit. And then I think from a consumer's experience and kind of from the marketing or even kind of digital marketing side of the equation, understanding that, you know, our website, to be perfectly honest, is not where anybody's coming to research, you know, topically about ACL tears or, you know, sinus infections and things like that. There's transactional and they're there to do something. So how do we try to meet them and give them the tools to do that. And take that action?”

Matt Dickson: “Awesome, so thanks for that additional thought there and commentary. So leans perfectly in our next question, things both you and Adam were saying. What do you think marketing's role is in building patient loyalty and how do you think that aligns with care compliance? Adam, I was glad to hear you say that I do talk to marketing leaders on a regular basis, and often they tell me the metrics that are measured by his new patient acquisition. And I've thought a lot about, hey, how do you decide to wear that? Spend should be on making sure people are continue to come to you and consuming services through you. What's the ROI on that? And more importantly, how does that play into their overall health and well-being? So I'd love to hear either read or your thoughts on that.”

Adam Rice: “I would say, Reed, go for it first, please.”

Reed Smith: “Um, well, like I kind of mentioned a minute ago, loyalty is a weird word for me. You know, I would guess most people in our community don't use our services, right? They're relatively healthy or they're young or whatever it may be. So you're in this weird spot of like, well, how do I build loyalty with somebody that doesn't really ever think that they're going to need to use our services outside of maybe even young families and childbirth kind of labor and delivery track is sometimes people's first kind of introduction to a hospital. And thankfully, like I mean, that's know, ideally how you hope this goes is an individual right? So the idea of loyalty and it's like, well, how do we keep them connected? I think we've got to do a good job of what we talked about earlier. But you know, there is the attracting the patient part, but there is also the OK, well, how do we stay connected with you not only through your visit, but post your visit? And you know, there's lots of ways to do this. Certainly, there's stuff we used to do historically, like the brand awareness, marketing and some of that to try to stay top of mind or have that kind of recall. But I think around cure compliance specifically, it's building that trust with individuals within the organization. So you've got to create these instances and these experiences with physicians, specifically or clinicians, where those consumers that are spending time with those individuals have the ability to connect in a way where they can get questions answered and have things like up at the medication adherence and some of those types of things. So we don't. How do we keep them from not coming back but provide services in their communities that allow them to stay connected to us.”

Matt Dickson: “Really, have you guys gone a little more tactical from a marketing perspective, even such things as appointment reminders, right? Typically, those are kind of one size fits all. There's not a lot of A/B testing there. Have you guys thought more tactically about how the actual content of the things that play into care compliance, such as appointment reminders or, you know, we identified during your visit that the next step for you is to get a certain diagnostic test, as marketing your organization, become any more involved with that level of communication down to that lower level of familiarity.”

Reed Smith: “Yeah, we do. And we've tried a number of different things. And kind of both from the technology and the process side of like, how do you do that? What what makes the most sense? So there is some A/B testing there, certainly from a messaging standpoint, I think it pretty quickly gets to and we all get this now, whether we're getting our haircut or whatever, you get the text message right of like, hey, you got an appointment Wednesday, you know, confirm or you know, well, now we're moving kind of into that transactional element of like, OK, well, how do we give people through that SMS communications the ability to reschedule into the EHR, you know? So a lot of this is an interoperability play of how do we have a platform or system in place that allows people to operate in a way that they do in the rest of their lives? And so but we are in marketing spending a lot of time with that care gap, pace and the reactivation. The appointment reminders some of those types of things. And so this is where over the last several years, which I'm sure Adam can attest to the idea of where marketing starts and stops, it's not quite as clean as it used to be. Like, OK, we did because we did advertising. We were an advertising department historically and we were not a marketing department. We didn't do the other three P's. We only did the promotion p, right? And so now when you talk about experience and technology, clinical operations, even operations and finance revenue cycle, et cetera, we're in the middle of all these conversations now, which is a little bit different in recent years than it was when I got into this 20 years ago or whatever.”

Matt Dickson: “All right, Adam would love to hear your thoughts as well.”

Adam Rice: “Yeah, I'll build on that. That same thought. Gartner's put out some interesting information over the past, maybe a year or so on the CMO and the marketing teams as being kind of the great connector within an organization which is taking on a new role. So the role of the CMO to Reed's point had very much to do, especially in healthcare, very much to do with communicating very much a push to outbound, like pushing a message out there. Very little to do with the magnet of the inbound. Although with the great work that. Some others in healthcare, i.e. Mayo Cleveland Clinic have done on their content side, I think it served as a guide for others. But I see that connector role being so much more pronounced, and so I'll just build on that from Reed’s comments. I think. How do we align some of this one, I think you need a metric, so I came in 11, 12 years in the payer space, and when I came into the provider space, it would blew me away that we didn't have a metric like lifetime value. At least my organization did not, you know, we had this kind of bifurcation between what we were able to track. As Siemens and other integrated network arrangements have taken hold, we now have much more flexibility in how we can connect some of those data to truly understand what's happening with the patient and understand this kind of consumer to patient to consumer model that we live in now. It used to kind of be consumer to patient. Once you had a patient, there was kind of embedded loyalty based on how their health plans are structured. They really were pretty much captive to you, obviously, with the emergence of PPO plans. And now with everything you talked about, Matt, the new entrants, it is absolutely every single encounter you have. You move from the consumer you attract to the patient, you have to the consumer again. So we've also taken a step and are heavily focused on this idea of longitudinal records. So you talked about compliance as marketers, we can work with consumer records all we want. It's when it crosses over to that patient data. How you use those data and how you associate them is so important to the consumer data, right? We all know the world we live in post HIPAA on how we can use those data. But to me, the step one is first, let's get the databases aligned. Let's allow ourselves to work in connected databases, but with disparate information, meaning you can partition information off based on use. Why is that important? Because as we make this transition as marketers, we've lived, like I said on that consumer side behaviors, attitudes, demographics, propensity models, right? All predictive information on who we think we could attract, who we are trying to attract, how it's performing. We're now in this world where it's so much about what do we know about the patient? How do we connect it back to some things we know about them as a consumer? How do we use that to not only deliver the transactional work that Reed talked about, which I consider those missed appointments over to appointments, the basics, but then also moving it into more of that life stage and orchestrated marketing, right? So obviously, retail hospitality has been doing this far better than we have. And as long as we also where we're building out these databases, work with our consumers to get a permission based approach to how we will use their data to notify them. So think about moving from transactional appointment overdue into predictive nudges that are based more upon what we think you may need because we're working together through your data, some that you provide us. When you think about contextual data coming from the consumer, that's happening often in population health kind of type arrangement or risk based arrangements all the way into what we see within our systems, our ability to kind of mine your data. And so that's that Amazon idea, right? It's the idea of like, can we use your data with your permission? Not sure they always use your permission, but we can help deliver information to you. That might be useful because now what we're starting to do is build that loyalty loop, right? You're building services outside of the actual encounter that may be relevant to you, that keep you connected to us, that use one of our biggest resources untapped usually, which is data. I know we're going to talk about that, so I won't go too much into it. I think that idea of how do we do it, I think there is with the consumer permission based, all of the fun stuff and all the shiny stuff that all of our other executives probably point to that others are doing outside of healthcare. So journey orchestration, eventual automation, personalization, all of those things get unlocked to me with the data and the permission. So I think that's how we do it, but it has to get past the transactional. Our lives have been based as marketers on the transaction. I need to send an alert out here. I need to send a message out here, send us out to these people who fit these criteria. And I think it has to be much more if we're really going to get into this loyalty loop and how we're building loyalty has to get much more into kind of that, that idea of lifecycle and orchestration.”

Matt Dickson: “So Adam, before we moved on to the next question, you're doing so good at transition us from a question to. They were even jumping slides. It's working very well. But before we do get in that next question, I did want to touch this momentarily on something you said about having different metrics now or different measurements in your organization. Is referral compliance something that you're tracking under the marketing umbrella now? I know it's not just yours to own, but is that something you guys do track under marketing as well?”

Adam Rice: “We, we don't. It's actually a sister part of the organization, which would be akin to a physician liaison function. We call it our physician sales function. So it spans all of our geographies, and that's really the part of the organization along with our managed care area that are understanding those trends and patterns. And then actually introducing some high touch measures to help create awareness. And I, I use the word connection a lot. It's super big for us. The idea of connecting the relationships amongst providers within our network that tends to be again, a sister function. So we focus less on it. We we may take note of it, right? But it tends to be coming from a different area, not marketing.”

Matt Dickson: “OK awesome. I appreciate the insight there, so let's formally move to our next question, which is about big data. So how do you know, you've already touched on much of this, Adam, how are you thinking about the role of big data and creating touchpoints to further refine your engagement plan and strategy around the individual? I think that what we've seen historically is more of a one size fits all approach to communication in many ways. Or maybe there's one kind of primary data point driving a communication. Hey, you're over this age and you haven't had this diagnostic procedure. Let's just send you out or, you know, a communication that's one size fits all for that particular bucket. The reason I think I'm probably most interested in this topic is we talk about big tech coming into this space. And if there's one thing Amazon knows how to do well is use big data, right? We all go on our Amazon and they're saying, hey, you might want to buy this, you might want to buy that. And I think often as consumers and humans, we conflate feeling like somebody understands us with feeling like they care about us, right? So Amazon, through their really deep expertise on big data. Sometimes it feels like they know us very well. And I wonder how that translates into how we feel about if they care about us and they've got some opportunities to use that data, for example, once they have medical data. And to your point, with the permission to use it, if they know you've got a gluten sensitivity, I see the day you're going to go on your Amazon app and they're going to say, hey, you might want to add this to your shopping cart, right? Here's gluten free bread, right? So I'm wondering how you guys think about big data, how that's further refining your strategy and really go forward, how you're pulling together those touchpoints?”

Adam Rice: “Yeah so we, I think six years ago went down the path of a data management platform for marketing and it was simply out of necessity. What we were finding was the data that we. Historically used wasn't sufficient. The data we wanted access to was convoluted, and what I mean by that is it was kind of buried in what I'll call reams is the wrong word to use. But hopefully it gets the point across reams of other data from within the EMR and within our other systems. That made it a big barrier for marketing. So we could and our ability to do other things with the data like anonymize it, like apply predictive analytics against it and then output it. And or on the flip side, help it understand who we're attracting, engaging with in our efforts that are actually becoming patients. So that was six years ago. It went down this path. And I think we did it because we wanted closed loop and where it took us, because we want to prove out, we making a difference? Are we actually driving growth within this organization? It actually took us down the point of also engagement. How do you use those data and that limited data set. And so what we did, unbeknownst to us, was we were really building out a what would now, I guess, be considered more of a CDP, right, which is the aggregation of multiple data sets for marketing purposes to be able to better engage and connect to consumers, users, et cetera, and then connect all of that back to the experiences that you're delivering. So we are. I like neck deep in a MarTech transformation that started about two years ago with kind of the final icing on the cake being now moving to a dedicated CDP. The idea of data and how we are using it still works well for us on the outbound side. In fact, I would argue that part of the machine. It's kind of what we call precision marketing, which is kind of have a known series of prospects like we all do, derived from models that are based on propensity and predictive in nature that deliver messages out. Now what we're doing is using those same data sets or similar data sets in an anonymized way to start to shape the experience of those people coming to us. So, as Reed said, even if we're only getting 30% of those, those users, those patients, how can we make the most of that and help to deliver that kind of end of one experience that we all strive for? It all comes back down to this data. So using the data, getting signals from the data in a way that us as marketers can use and/or automate against, obviously with strong partnership from our IT and digital brethren. But that's really becoming pretty transformational for us, because not only is it delivering the more of the right information for the consumer, less of the one size fits all information, it's helping us kind of, nurture them along the way. It's connecting to other outbound systems, so as we pick up signals, as we pick up PII, as we pick up permissions kind of using that to build an experience no differently than many and most services industries do. And then and then as I touched on earlier, where I get really excited about this. And on the one hand, and where I see it being a huge challenge for us is the role that the consumer patient will play in all of this. How do you use my information to deliver what I want you to deliver to me a little different than the Amazon. Amazon just tells you, hey, based on your preferences, here's what we think you need in our case and healthcare, I think we have to take an extra step and get those permissions sorted out. But if you get your data right in the first place. And you start to now think about that positioning engine as being the next component. Once you have your longitudinal recording and marketing database built out, you start to get into some real novel applications, right? How do you based on the permission and the things that those consumer and I'm not talking, I would like information on. Heart disease, I would like information on orthopedic procedures I'm talking about know, based on the information that we have in our database and based on patients that look and act like you with similar, you know, medical histories as you anonymized. Here are some things you need to acknowledge and take care of super big brother he and creepy without permission. Yeah, completely novel and innovative with, yeah, absolutely. You're talking about taking data to a place where the competitors can't wear the big data. Companies can't, and that's it, in my opinion, which also then touches and builds your loyalty. It builds the value that you're providing. You're not just showing up for episodic services, you're not just there. When when patients need you, you're starting to become an important part of how they manage their lifestyle and how they manage a lot of the things that happen outside of those more, the acute or common encounters that they're having with you episodically.”

Matt Dickson: “So, Adam, it sounds like you're using. You talked about clinical data lot and pass medical histories. Reed I ask you that same kind of question. Are you finding that you're using medical history, clinical data as another data point within your communication strategy? And is that something that you've seen a marked increase in doing over the past few years here?”

Reed Smith: “Yeah, know, we've started kind of re-evaluating kind of how we're. How we're delivering messages are connections in our local markets, and so that is one data set and then certainly, you know, third party data or claims or payer data or whatever it may be, you know, it's really getting us to a place where, you know, it's not just these broad advertising campaigns, right? And then you started kind of targeting a little bit with some of the demographic data, maybe like in a social platform or a Google product or something like that. And so it's just over the years I feel like we're refining a little more, a little more and now people are getting to a place even if they don't, you know, I don't know if they like it or dislike it, whatever. But, you know, people complain about like, hey, I just mentioned, you know, Casper mattress, and now I'll get ads all over everything, you know and all this stuff. So people are already kind of in their Life, adapted to this idea that there is personalization. And quite honestly, if they knew exactly what all was happening, it really would probably freak some people out. But as we think about where people go and what they do. And even device IDs as we see like the cookie go away and some of those types of things, there's just a different way of, you know, getting away from the spray and pray kind of method of advertising that we've historically done to just make sure that we're putting information that's meaningful in front of someone at the right time. All the while being very cognizant of the privacy piece, which is why we couldn't really do the retargeting pieces around certain service lines and some of those things historically. So again, it's just this is a constant kind of refinement and kind of thought process of like, all right, well, what's the right way to do this? And who needs to know about these types of services? And at what point do they need to know? And how do we make sure that we're delivering the right message that we can ultimately then bring people into the fold. And then have a good experience clinically so.”

Matt Dickson: “Yeah, I want to we have one more question I definitely want to leave time for, but as a consumer, it heartens me to know you guys are thinking about not being big brother because to your point, read with Casper mattress, I feel like I have a conversation in my house and then I get an ad for something I was talking about and it freaks me out. I'm like, is my phone?”

Reed Smith: “I apologize to everybody now that I've said, Casper mattress out those ads.”

Matt Dickson: “But Yeah. So it's good for me. Not necessarily a question, but more, just a general comment. As a consumer, I'm glad to hear because I think it becomes even creepier when you're talking about your medical condition, your medical history. So certainly, I'm glad to hear you guys are thinking deeply about that as you form out these strategies. So we do have one more question, and I thought maybe we started off with the most challenging question, but maybe we're finishing with it, which is what do you guys think the biggest challenge healthcare marketers will face in the next three years?”

Reed Smith: “Oh man. Well, I'll maybe take this maybe a little bit of a different direction. We've talked a lot about the disruptors in the space. I'll talk a little bit just. And we've seen this certainly and to pretty dramatic effects on the clinical side of the equation. But this idea of the Great Resignation and kind of workforce shortages and some of those types of things. We have a lot of people have a lot of people on my team that quite honestly, can just go work in any industry like there's no tie to healthcare based on their skill set, right? I mean, they're not, they're not, you know, clinical in the sense that a nurse is, well, I mean, they're going to be a nurse. They may there's different parts of healthcare, but they're going to work in healthcare, right? So, you know, I'll worry a little bit about just the folks on my team, you know, just kind of their mental health and kind of where they are. And there's different people on the team that I think about reputation management, for example, all they're dealing with people giving feedback right now, a lot of cases, it's very positive and that's great. But then they're having to solve issues all day long, and you just want to make sure that these folks are taken care of. And I think that's a challenge coupled with the idea that this is a space that's growing very rapidly in a lot of different areas. And so the need to have that subject matter expertise and more people on the team. And how does it all work together? And it's just it's something that's moving very, very quickly. Just like I mentioned earlier, it's getting harder to delineate where what I do or my department does kind of starts and stops working with those others across the organization. And then making sure our people are, you know, taking care of and feel like that they're making a meaningful difference in these communities that they serve. I think it's going to be a big challenge.”

Matt Dickson: “Adam, your thoughts?”

Adam Rice: “Sure I'm glad you brought up capacity constraints, Reed, you know, I would say over the last three years, it was kind of the first time as a marketer for what we were doing for kind of push messaging your outbound that we were actually told to pump the brakes because we couldn't handle the demand or the perceived demand that we would be capturing or intercepting and. And I think that's real. And I think that I'll piggyback off of that and say, in addition to that, I think the funding pressure that we face. So Reed you talked about how our administrative overhead is just out of control due to the great resignation and just general shortages. But generally, and I would say, I didn't look at the attendee list. I'm going to guess the majority of people sitting around this room are facing significant year over year pressure on your margins. And so how do you protect the marketing and communication budgets that are needed to welcome the growth back in? When we're not seeing some of that volume return, we estimate around somewhere between 8 and 10% based on the models that we run are generated from marketing and communications, right? So you can imagine the situation we get in when funding is scarce and volumes aren't coming back the way they were, it's very easy to say, well, we must not be doing a good job as marketers, right? Because if we were, we would be seeing those growth numbers come back. But behaviors have changed, right? So how we show up the seat that we get at those tables we show up to is going to be really important and it can present a challenge because if your organizations or anything like ours. When when margins are good, people are a lot less concerned with what we do. There's a little bit more autonomy there when margins are challenged, everyone tightens the belts and now marketing turns from a strategic growth driver into just an expense. And I think that's something that we all are a challenge many of us will face. I think I talked about marketing as a connector understanding the role that marketing will play and experience again as a large system, we tend to bifurcate things. It's the patient experience, it's the consumer experience, it's the digital experience. It's just it's just the experience, it's the experience of those who seek our service, engage with our services, use our services and have opportunities to use them again. It doesn't need all these distinctions, so that just complicates it. The role of marketers in digital transformation. For those of you that are further behind on this, I guess, is your organizations are going and building these big digital towers, right? Let's do it all separate. Some of you that are going to be much, I would assume, have maybe a little bit more foresight or looking at this. How do you integrate digital into everything that we do? And I hope that more of you around the room are facing those kinds of things because I see that as an opportunity, not a challenge, right? That's simply an enablement of what we're already doing. Which brings me to my last point about challenges as we expect more and more about from our people specifically in marketing communications. Healthcare is such that at least my experience, many healthcare marketers group as healthcare communicators, and then they kind of learned marketing. And then over the course of the last 10 years, we started to bring in new skills to help transform us specifically or most importantly, as it related to the digital transformation. So this next wave, when everything we talked about today. Focus on data. Focus on modeling. Focus on orchestration, automation, personalization, all of those require very, very different skills and far more technical skills than most of our marketing teams have ever had to support. So I think this idea of what those support models look like, what the team and the team dynamics look like, do we look more like marketing functions where we have solutions, functions that focus on some of our tech and partnership with our IT and digital areas? Do we have far greater firepower as it relates to insights and analytics, and maybe even data scientists embedded in teams or at least available for teams? What about this idea of how models show up? What about this idea of how nurturing happens? What about this idea of what we choose to automate? All that takes new skills? And again, when you get back to point one, funding pressures make it difficult to do that. So that's a concern. When I think CommonSpirit challenges, I'd say we are still three years into a merger dealing with fragmentation, specifically as it relates to service providers and even in our tech stack. That's that's a challenge that we face because we're trying to do apply similar practices to different systems. But then everything else we talked about today, right? I don't see retention and loyalty as a challenge, I see as an opportunity. I don't see personalization or even inbound, you know, that kind of content at scale as a challenge, I see it as an opportunity. But with all of those things and all the buzzy words I mentioned today, I do see a challenge being, making sure we get the foundations right in what we're doing before we start to move on to the shiny because the inclination of executives would be like, wow, you know, I just heard Reed talk and what they're doing is pretty amazing. They're doing blah blah blah blah blah blah blah. Personalization at scale and journey orchestration and. It's very easy to get caught in that trap. And then look back and realize, wow, we just focused all this time over here, and we can't even do basic, multivariate or A/B testing on what we are doing. We can't get basic information and signals back from our data to understand if what we're doing is actually working. And here we are, focusing all of our fire or all of our brainpower and brain trust on these shiny things. So that would be probably the last challenge.”

Matt Dickson: “So great. Great thoughts. Today, we're almost at time. I did want to ask just a follow up question. And if we can briefly hear your thoughts on this, one of the things you talked about, Adam, is resource challenges. What we've seen in this space is the American Cancer society, for example, I think came out and said they expect 10,000 1,000 additional deaths to cancer because of the impact of delayed care. So as you think about, you were asked to pump the brakes trying to get these patients back in. How are your organization? And I'd love to hear your thoughts as well. How are your organizations thinking about where to target that messaging to induce people to come back in and using either clinical data to drive that are the ones that are most at risk, potentially for having an adverse long term impact to their health and well-being? How are you guys kind of thinking about that with some of those resource constraints you talked about.”

Adam Rice: “Lag impact and capacity. Where is there a lag? Where can it have the greatest impact positively for a service intervention, if you will? And where do we have the capacity to handle the business?”

Reed Smith: “Yeah similarly, I think we're very fortunate and maybe a hair unique that across our entire enterprise we have one HER, one instance. And so we're able to identify where these opportunities are and then provide maybe new care avenues like on demand video visits and other types of things of like, OK, well, how do we re-engage and then give people transitionally something they can do to connect with this? And so again, it's I think like Adam said, you know, where's the opportunity? Where's the biggest critical need? And then building programmatically something around that where we can actually get people engaged and kind of back into the system. So again, the virtual piece like on demand, virtual visits and things like that are great because that care provider doesn't physically have to be in that town, for example. So we can take some capacity and move it around a little bit easier than just like, hey, I'm sorry, the clinic's full, you know, kind of a thing. So so not that we've got that all figured out, but that's kind of what we're exploring, and trying to figure out, and you'll see some other providers and kind of solution providers in this space, if that's what they're doing right with behavioral mental health or other specialties where they can supplement whether it's nights, weekends, capacity or overflow type coverage with their own kind of staffing, if you will. So Yeah.”

Matt Dickson: “All right. Well, fantastic. Thank you so much for both of you joining us today. I thought we covered a lot and some really good thought. So again, really appreciate your time today. Thank you so much. Thank you for those of you who've joined us today and hopefully all of you have a great rest of your day. Thank you.”