Trends & Challenges in 2022

December 9 at 2 PM ET

The healthcare industry has witnessed many changes over the past year, with more changes to come in 2022. Join Carrie Liken and Matt Dickson for a fireside chat where they will give their predictions on what’s to come in 2022 for the healthcare industry.

Topics include:

Health equity

Digital health transformation

Gaps in patient access due to COVID-19

Big tech in healthcare

carrie liken yext

Carrie Liken

Head of Industry, Healthcare, Yext

matt dickson stericycle

Matt Dickson

Senior Vice President, Stericycle


Matt Dickson: “Thank you for joining us today for our fireside chat, where we're going to discuss some of the trends and challenges, we see in 2022 for health systems that things they need to think about and things they need to prepare for. So I'm Matt Dickson, Senior Vice President of Product Strategy and also the General Manager for Stericycle Communication Solutions. We are the division within Stericycle that focuses on patient engagement. And joining me today, I think for the third or fourth time now, Carrie. So again, for your continued participation is Carrie Liken and Carrie, do you want to introduce yourself?”

Carrie Liken: “Yeah hey, Matt, Thanks for the opportunity to chat again. We always have very spirited chats during these, these presentations, and webinars. So yes, my name is Carrie Liken. I am the head of industry for healthcare at Yext. I have a very similar role to Matt. Actually, I wear lots of different hats. I'm the GM of the healthcare business at Yext. I do everything from marketing to strategy to work with our sales team and work with our product marketing team. I mean, pretty much anything that touches healthcare is my responsibility, and I've been at Yext for five years. And prior to that, I actually spent a good chunk of time, 8 and 1/2 years at Google, where I was helping to start the healthcare team out of the Google Boston office. And I have to admit, I've been talking about the digital patient journey for longer than I probably thought I would. So this is interesting, and we know like 2022 is going to be maybe the year that organizations are going to really lean into the digital patient front.”

Matt Dickson: “Because it keeps changing. There's always going to be something to talk about.”

Carrie Liken: “Yeah, exactly. I guess I have a job because of that.”

Matt Dickson: “So I think good segue talking about your experience there with Google, let me start with this observation and throw it to you, because I think you're much better suited to kind of speak through some of these challenges. And the observation I'll make and see if you agree with is that health systems have a new front door, and they all share the same one. And it's called that we saw yesterday. For example, Google made a pretty public announcement that they're making it easier to filter results physician results by insurance with a big focus around Medicare as you look at that, as that kind of shift is happening in real time. I've read some statistics from various sources that say anywhere from 60% to 3 in five of consumers are starting their healthcare journey in a search engine. And at least here in the United states, we know that Google, of course, owns that search engine market. Tell me, when you think about those challenges, what are the health systems have to think about? What are they got to change with their own front door strategy? How can they kind of prepare for this transition where unfortunately, I guess, in some way they've lost a little bit of control of their front door and more and more consumers are really leaning their healthcare journey with Google.”

Carrie Liken: “Do you have about five hours to go? We do. OK, let's see. Where can we start? This is something that I've been talking about for a long time, and it's a really, I think it's a really good question. And I would say healthcare organizations need to first think about how are people searching for care. And since I've been talking about this since 2007 thousand, the journey has changed quite a bit. So people were searching for things like doctor or cardiologist or emergency room in the early 2000s. And at this point, now that we're at 2021, almost 2022 people are searching for very different things and Google is noticing it there. That's why they've put things like insurance into the GMB. Well, it's actually not called even GMB anymore. They just renamed that as well. But it used to be called Google My Business that card that you would see when you search for something. If somebody is searching for a primary care provider near me who accepts Aetna, they're seeing those searches. I mean, I used to see it. We use a tool. We used a tool called wildcat, and we could pull any search within the healthcare realm, for any region, for any state, for any zip code. We could see what the prevailing searches were. So you could see those changes. And so we started to see that people were searching for those complex things. So Google saying, OK, great. Now that I'm seeing that a lot of people are looking for things like insurance and they want to know about that then now we're going to put it out there. The challenge with that is that it's not always accurate, like Google tries to get accurate information to input into that search result, but it's not always the case that it's accurate. So who owns that data? So now that I've said all of this, I think what healthcare organizations need to think about is how can I feed that data because they own it? Their providers are their product, and I've been talking about this for a while. Healthcare systems need to think about what are they selling? They're selling a physician's specialty and their availability, and so they need to be able to demonstrate when people are off site, which the majority of people are. They need to be able to send that data somewhere and demonstrate that information is correct. So that they can bring people back. So they need to get their data together. They need to understand all of that provider information, the name, the address, the phone and now the insurances. Because even though Google is starting with Medicare, they are planning to expand with all of the different insurances. So now healthcare organizations need to say, OK, I need my product data, my provider data. I need to get that all together. And now it has to include insurance. But then it also needs to include specialties and conditions treated and all other things that people could be searching for. And that all needs to be pulled together so that you can syndicate it into what is essentially many front doors. It's not just one digital front door anymore, it's a digital experience that has many front doors to a health system. So data first, I would say, get all of your data aligned second, so know where your data is. Get it aligned, and then start thinking about the syndication piece and Google being one of the biggest places you want to make sure you're actually sending it to Google and make sure it's accurate because that's where people are starting. What do you think? I think from a link, from a scheduling standpoint, we're seeing these two organizations trying to think through like, how do I even open this up so that when people are looking for availability or when they're looking for insurance and pricing, I mean, there are all of these different elements that people are looking for that they're not going to a website necessarily for, they're going to Google.”

Matt Dickson: “Yeah and so you said, I think it was a good point, right? What is their product? They're selling a specialty and availability, but I'd also argue they're selling expertise, right?”

Carrie Liken: “Well, isn't that specialty?”

Matt Dickson: “Yeah, I mean, true, right? But there's lots of cardiologists. So maybe I'm thinking about specialty a little different or different than you are, right? So I'd say, you know, what are the things as you look at that challenge? So now you're it used to you have this digital front door where you can really push the message of why you're a leading health system or why people should select you. You can tout awards or clinical outcomes. Now you may be losing some of that option because people are going to just and we'll talk about this later. I'm calling it the commoditization of healthcare, and it frightens me a little bit with these non-traditional players coming in. What do you have any thoughts on what you can do to still kind of sell within the Google results? Sell yourself as not only do you pick me because you see I'm there and I have a convenient appointment time, but because you recognize that I'm going to provide best in class service.”

Carrie Liken: “I think the only way within the Google results to think about that is literally through reviews, because it's not as though you can say ABC hospital rated number one in US News. You can't necessarily put that in the title of the results, and it's not like there are fields in Google My Business to input that. So what else are people looking at? They're looking at the reviews they're looking at. Is this ok? Does this doctor? Is this doctor a specialist in cardiology? And OK, now is this doctor the best? I don't know. Now I'm going to go ahead and I'm going to read a little bit about it. So Google might be one of those places, but we also know that people are consulting 18 different reviews before they're actually looking at making an appointment. They're doing a lot of research around that. So I think in the Google context, that's the only place to do it. I don't think there's another way to say our brand is the best or our doctors’ brand is the best where we're ranked. No one here or no one there without you can't input it. You can't put it into Google, but you can leverage that. That reviews component of it. That's really the goal.”

Matt Dickson: “I certainly agree. So I happen to live in the Northwest suburbs of Chicago. I happen to be around some of the best healthcare in this country has to offer. If I looked at the Google My Business reviews, you wouldn't believe that was the case, really. So I'm not going to name any names on here, but the hospitals near me 2.9 stars, 2.6 stars, 2.6. I just pulled it up. Yeah, that's right. And you're looking at 20 reviews for one, 170 for another. I mean, these are people that are discharging thousands of patients a year. So I think that's certainly something health systems need to think about. Going next year is the importance of those reviews, the importance of having a process to get more people. Because in my experience, what I've seen and we don't see this, by the way, I think in the rest of consumer-oriented companies. You're letting your brand be defined by a few angry people in the grand scheme of things. And those are the only people that are incentivized to come leave a review, right? Somebody who's had this wonderful experience at your hospital. They're not going to go out and leave you a five-star review, right? It's the ones that are particularly angry or upset about something that's happened or occurred. So as you think of that? Any thoughts on, you know, how health systems can go into a process to make sure that their reviews really match their reputation? Often what I see is this mismatch between their online persona and the results they actually generate in the real world from a clinical standpoint. So is that just getting more people to leave reviews? What is the process for improving upon that?”

Carrie Liken: “Yeah well, I'll start with some stats if I can. I was just giving a presentation earlier today, so if I can remember them correctly, basically people have been trained to. Do different things online with healthcare because of Amazon, because of Google. So how do you search for a black pair of shoes? Go to. Well, I don't know. Maybe that's not a good example, but we'll pretend go to Amazon and type in black pair of shoes, women's black pair of shoes size 6 and 1/2. Amazon presents a ton of 6 and 1/2 sized black shoes. And every single one of those has a description and image and a rating. So everyone has been trained to search that way when it comes to selecting a product, and we were talking about product before, the physician is the product. So think about that. Then also what we're seeing and what we saw from July of 2020, Experian came out with a study that said that 60% of consumers have higher expectations of digital now than they did pre-pandemic, and that was literally like six months into the pandemic. So people are accessing digital, they're accessing digital more, and now they're probably going to be in this mode of now that we're in this weird omicron, we're sort of in it out of it, that type of thing. With the pandemic, it's not as though people are going to be like, well, I was searching this way before I'm going to go back to the old way. We're going to continue to search because they've been digitized. And so if healthcare organizations are going to tap into this, there are really important things that they need to consider about that because we've also seen there's been over 130% year over year growth in people leaving reviews for healthcare from November of this year to November of last year. So there are more reviews out there. There are a lot of people who are squawking negatively because people are angry. I mean, they're angry everywhere. So organizations need to tackle this. They literally need to think about what is the consumer doing outside and how can they reflect that on the inside? So how would somebody how would somebody think about if I am selling those shoes, what do I need to do if I got a bad review? I need to respond to that. You need to. You need to actually respond to that review and say, thank you so much for your comments or thank you so much for reading this review. Here's a contact information, and here's how we can do xyz recovery on it. There's a lot that needs to be done just to understand what those reviews are. So even before you can respond, how do you pull in reviews. So that you can analyze them and see overall sentiment? What's actually going on there? Then how do you develop a strategy to respond? And then if you really want to do better and you really want to get more star ratings to bump up, you have to generate reviews like you have to ask people for the review. You have to ask them; did you have a good experience, or did you not have a good experience? Like, please let us know and actually get people to do it like you said, Matt. A lot of people are just their leaving reviews because they had a bad experience. But if you don't ask people who had a good experience, they have no incentive to actually leave a review. So if you do ask them nine times out of 10, you're actually going to get a review that's pretty darn positive. And then all of a sudden that starts to balance out. And so those negative ones start to go away. Those positive ones start to increase. And then you're amplifying that off out of healthcare experience, like what people are doing when they're on Amazon. You're also amplifying that for healthcare. I had a friend who over the pandemic said that she needed to have her gallbladder removed, and she said, you know, can I? My husband's a doctor, she said. Can I talk to Brian because I realized she's like, I know lots of lawyers? I live in D.C., I know lots of lawyers and know lots of government people, but I realized I don't know any doctors. And I just talked to Brian. And can he help me understand? I just looked online for three different gallbladder specialists near me, and I didn't know who was the best one. How do I choose? And that's exactly what we're trying to tap into. So if people are seeing 2.6 stars, 2.8-star reviews for that, those doctors mark my word, they're not going to choose them. We really need to help organizations bring it up. And what did she do? She searched just like she would have done on Amazon. So it's thinking about how do you pull in the reviews? How do you understand what's being said? How do you respond to those and set up a response strategy? And then finally, how do you then generate so you can actually bump up those star ratings?”

Matt Dickson: “And I think you made a good point, too, is that consumers' expectations are being influenced not by other healthcare companies or health systems. They're being influenced by the Amazons of the world, the Apples of the world. I laugh because Spotify just did their wrap up. Everybody loves to share their Spotify top song list.”

Carrie Liken: “I’d love to know what your top song is.”

Matt Dickson: “But these are the things that people have come to expect, and you're right, I think we need to bring them the healthcare. So I think that kind of segues into another topic. I'd love to talk about, which is non-traditional players coming into the healthcare space. Amazon Care has announced that they're. Bringing their platform to 22 cities in the US next year.”

Carrie Liken: “They are coming to Boston. They're coming to Boston soon.”

Matt Dickson: “There you go. Yeah, Yeah. Let me know how it goes. Walmart went out and bought a telehealth provider. Dollar General hired a chief medical officer. So as we look to these non-traditional players coming into this space, what do you think some of those challenges are? How do you think health systems can prepare and respond to those challenges? Really, because I think my take here is and you talked a lot about data. My take here is that what they specialize in, especially Amazon, is making an understanding you as an entity better than anybody. Yes, and health systems, I don't think understand you as an entity very well. And I would say the thing that they can leverage to their advantage is not only understanding you as an entity, but and understanding as a true individual, right. Amazon is going to put you in a category or box. The health system has the ability to personalize that, but yet they don't act in a personalized way. When they communicate, they don't act in personalized way when they engage with you. So tell me kind of your own. You prepare for the Amazon's come in. You've got pure, pure remote plays like Ro Healthcare, which by the way, if you watch football, there's a Ro Healthcare commercial on every football game in this country right now, right? You know, how do you respond or how do you think health systems can respond to that challenge?”

Carrie Liken: “I just gave a presentation about this literally two hours ago. Well, yeah, so I could talk for a while about this, too. This is something that I love to talk about. I love to see the disruption that's happening, but I also recognize that I think for healthcare organizations, you know, they're sort of like Titanic's. In many senses, it's really hard to switch a strategy when you've been so heavy into, let's say, a primary care strategy for a long time, thinking that's the sole referral stream into not soul, but a primary referral stream to an organization. So this whole concept of consumerism, what's happening, I think, is changing the landscape of healthcare dramatically. And I would say. Where we're landing and where the consumer is landing is that the consumer is going to go after convenience over anything. And so when the consumer is going after convenience, they want to know things like, is there a care near me? Can I book it and in the easiest way possible? That would usually be digitally like, who wants to sit who? Who wants to sit on the call for two hours waiting? Unless that unless that call can be picked up immediately, they'll want to do it digitally. They've been trained, by the way, over the pandemic to do pretty much everything digitally. And then finally, can I get the appointment immediately? And so when I think about where things are changing with the patient or the consumer, we just pull these numbers for this presentation. On average, it takes 62 days to get in to see a primary care provider. 62 days. So if I'm sick right now hacking up a lung, you think I'm going to go and wait two months to go to a primary care provider that maybe I didn't have? Because I'm on that. I think I'm Gen-X. I don't. I'm like a cusp. I'm on the cusp, so I'm not going to wait. What I'm going to do is I'm going to say, where is the most convenient place for me to get my individual personalized problem solved? That could be Walmart care. That could be CVS. That could be Walgreens and their village. It could be any number of places actually get care in the most convenient way possible. Those are episodic moments. Those aren't moments where we're going consistently. There are certain, I think people who will utilize, let's say, primary care or endocrinologist for diabetes maintenance or, you know, there are other places where somebody is definitely going to continue to repeat. They just might have to deal with the fact that the experience isn't so great, but it's a consistent they have a consistent appointments. But for things like episodic care and things that I need, all these organizations are going to be taking some of this traffic and some of this patient segment from traditional health systems. And I think traditional health systems are going to have to think very differently about what they're going to do about it. I mean, CVS now is offering telemedicine and virtual care. They just partnered with Microsoft that came out today. They just partnered with Microsoft on a big data play that they're going to do Walgreens partners with Microsoft. I mean, these organizations are all consumer first, like they understand the consumer. Like you said, they understand the consumer as an entity. They know how to market to them. They can understand as well how to communicate with that consumer. Outside of that, just one point of care, whereas health systems have not been able to figure any of this out. So this is going to be super disruptive, I think, in the next couple of years. And it's going to really, it's already started. I think we'll see a lot of this in 2022 and we'll just start to see some what would we call it, like distribution of the patient for at least episodic care? What do you think?”

Matt Dickson: “Yeah so I was going to say, I'll double down on some of those above, and I'm going to go a step further. I'll say that the Amazons of the world are trying to even get rid of the concept of having to schedule an appointment.”

Carrie Liken: “Oh?”

Matt Dickson: “It's on demand care. So if you look at Amazon's goals, what their platform is, we'll connect you with the healthcare professional within two minutes of your request. Fascinating so now how they're going to enable that, I don't know, right? If you're going to just pull up the app and say, do I need help? And two minutes later, you're going to be talking to, maybe you start with an R.N. and then maybe a branch is somewhere else. But I think they're going to get rid of this whole idea of need you don't need to worry about scheduling anything. You press the help me button on your app, right? I'd also say if the emergence of somebody, maybe somebody will message me after this, give me a better. Maybe I need a better way to think about this, but I'm calling it incidental healthcare, which is your point. I have an ear infection right now. It's getting better, but it's a little bothersome. I'm not going to go schedule an appointment to see my physician about it. But if I was walking through a Walmart and I peek into the clinic over there and I see nobody's in line, maybe I'll pop in there and say, hey, my ear is bugging me a little bit. Can you take a look at it? They're putting healthcare in the way of what you're doing day to day. That's the level of convenience they're aiming for. They're trying to go beyond the scheduling paradigm to just get on demand or being consumed as just a normal part of your day, right? And to your point, what frightens me a little bit is it's going to create a very fragmented, patient experience with no cohesive way to track that patient through all those different touchpoints. And the people that ultimately pay the price for that fragmented experience are the ones with the highest level of care, which is the health systems. I went to Walmart, I went to CVS, I did this, I did that, and it didn't get better. And eventually I end up in the ER. Mm-hmm now, how do you work with a patient where you don't understand what medications they've been given through that journey, what you don't have any access to? Physician notes like these are the things that I think is going to be problematic for health systems. To deal with is how fragmented the journey is about to become because we are creating so many more touchpoints into it. And certainly, I think to your point, it is going to be a paradigm shift, very consumer focused, very consumer oriented. And you know, the question in my mind is, how do you meet that right? Do you double down on what you do best, which is more complex in person care? Or do you try to match them to some degree blow for blow and try to create your own facsimile or copy of some of the things they're doing? Right? Do you open more smaller clinics in more areas, right to compete with that? Do you have an on-demand telehealth offering to compete with that? If I had the answers, I'd probably be retired by now. Somebody would have paid a mountain of money, but I think it's something certainly we're here to talk about challenges. Maybe not answers. Maybe that's our next webinar, our answers to all the challenges.”

Carrie Liken: “I mean, I can tell you a challenge that I think comes out of this, but I just out of exactly what you just said right now. You know, the thing that stands out to me about what you said is all about. You know, organizations need to figure out how to meet the consumer, where the consumer is as opposed to force things on the consumer, so, you know, the old-fashioned way of providing care, you have to go into an office, a doctor's office that's it's old, it's old fashioned, it's expensive, it's inefficient. You know, there are all these different elements around it, but some people might actually say virtual care works better or maybe for an ear infection because you've had it for a while and maybe it's just a checkup. You could do that checkup or even like a post-operative visit that you don't need to do any bodily checkups you could do over virtual means as opposed to doing it in person. I think there are different ways of seeing how somebody can actually receive care and how people want to receive care. But I don't think a lot of organizations are thinking about that right now. They're also probably regulations around it. I know here in Massachusetts, MDH has said or MGB as a whole has said, you know, you really can't see patients virtually as one example. You can't see patients virtually unless you're licensed in one of the neighboring states, but you can't be licensed in all of the states. We just won't pay out for that. So that makes things difficult. So it's forcing people to come in when they don't necessarily want to come in, and it might be more efficient or easier to do things virtually. That's just one example. But what you're saying, too, I think, is fascinating because. See? you're talking about a scenario where there's going to be fragmentation and. Really, the only way to win with fragmentation is to open up data, you know, traveling data like the concept of data interoperability and connecting platforms. And I think we've always had a problem, especially with Epic. We've always had a problem with Epic saying, sorry, we're going to operate within the bounds of Epic's walls, and I'm sorry, we are Epic focused. We're not even health system focused. We are Epic focused first where health system focused second. And by the way. OK, maybe you will be patient focused after that. They just don't. I'm throwing it out there. I'll be controversial. Write to me later. But I really do think that organization where they have, let's say, over 50% of the market for them not to really have, you know, free flowing opportunities to connect via API for data flow. That's going to be a bigger challenge. Now Epic might work with CVS. But what if they don't work with Walmart? How do we get that data to actually say, I went to Walmart for one piece of care? I need to move data over so that it's part of a repository of my patient record that maybe I also got care in my vaccine at CVS. Put that into my patient record. But then also, I have a travel clinic that's at my MGH. Put that and then I'm also at One Medical and I see my primary care provider at One Medical. How does everything come together that I think is going to be the biggest problem, maybe one of the biggest things that we could tackle in 2022. But how do we understand how they're all of these layers? And how can data move together so that we can stave off some of the fragmentation? I think if that doesn't exist, we will never have one of these perfect opportunities to have a full journey. And now CVS has a full journey. Amazon has a full journey. Google, like all of these other organizations that we were just talking about, have that opportunity to see the full consumer, whereas everything is piecemeal. Like you said, there's an article in the New Yorker from, I think 2017 about Estonia and about how Estonia has completely digitized every element of someone's life. So digital records for driver's license, for library card, for literally pretty much everything. And what's interesting about it is if you go to an emergency room in southern, I mean, Estonia is tiny, but like Southern Estonia and then you go to northern Estonia to go see your doctor because all of your records like you as the Estonia resident, you own your record. So you just have to basically let them access it. All of that is accessible. So that there is no redundancy, there is no cost, there is no expense to it, to a treatment. If we could get to something like that, that would be amazing. I just think we are way too siloed and will maybe never get to that point. I don't even know if politically we could get to that point, but that data piece, I think, is really, really important.”

Matt Dickson: “Yeah, I absolutely agree. So I think what we don't know yet and something to think about in 2022 is what's the impact going to be of the 21st Century Cures act, right, which is supposed to address some of this? How quickly will EHRs open themselves? How quickly will we see actually structured and standardize APIs? You know, our business works with a lot of EHRs to pull scheduling information. Everyone is different.”

Carrie Liken: “Yeah, they're like snowflakes.”

Matt Dickson: “Yeah, there's no yeah, there's no way I can just say, hey, I need to get appointment available information for every. Here's a standard I can use to do that, right? So certainly, it'll be interesting to see how quickly the air is rise to that challenge. I think the biggest thing, though, is when you talk about that patient record, like you said, you need a source of truth that lives outside of the EHR. Right? because you've got your patient record and Epic, but maybe CVS has their own homegrown EHR. How do we feed that into your patient record and Epic? Or do we have a more universal one that aggregates and accumulates that information from all these care points? The long and the short of it is the CARES Act is supposed to, I guess appropriately. I'm sure some of those problems. We'll see how well it does. But I think that's some of the goals there. And you're right. I mean, thinking about how your organization and particularly anyone who may be joining, that's a healthcare IT professional thinking about how you can leverage or what you need to change or think about is the Affordable Care Act matures next year and we see some changes coming to the marketplace because of that certainly is something to think through. The other thing I was going to say there, Carrie, is you talked about how consumer focused these non-traditional players are, how they can address you even outside of the healthcare journey. I've got this great little story that I've been sitting on for a few years now. It's very fascinating. I think it happened back way back in 2012. Well, too big to do when it happened. This man gets some coupons mailed to his home from Target for baby cribs, baby clothes, all this stuff.”

Carrie Liken: “I remember this story, Yes.”

Matt Dickson: “Marches into his target. Very angry demand seeing a manager and says, why are you mailing all this to my home? I have a 16-year-old daughter. Are you trying to incentivize her to get pregnant? They figuring out why did this, why, why did this happen, right? Well, what they come to find out is every time this 16-year-old daughter was going to the store and making purchases, she was using her dad's target, red circle number or whatever, and they had built analytics that looked at things like. If you're buying non unscented lotion. As one of their data points, were you buying extra big bags of cotton balls like just all these data points? And because of that, they were able to create a pregnancy prediction score and they could estimate a due date within a pretty small window.”

Carrie Liken: “Wow.”

Matt Dickson: “The guy goes home, tells his daughter about how he went to Target and how ticked off he was. And they had a little heart to heart conversation about how his daughter was pregnant, and he didn't know up until that point. So as you think of that, that's why I say they'll understand you as an entity better than anybody. And I'll give credit to my marketing team as we talk through this concept, something we talk about often. They said imagine an Amazon world where maybe they know you have celiac disease or a gluten sensitivity, and now they're going to start recommending to you. When you're shopping through Amazon fresh, here's gluten free bread or, you know, based on your medical conditions. So certainly, I think that's a challenge that they've really got a leg up on you because they can market and sell you things outside of what we would consider traditional or typical healthcare as part of that overall consumer journey. Because that's how they're thinking of you. They're not thinking of you as a patient. They're thinking of you as a consumer. So how do you raise to that challenge? Is really the question.”

Carrie Liken: “Yeah, I think no good answers, no good answers at all. I gave this example earlier during my presentation. It was exact same thing where CVS is leaning pretty heavily into diabetes. And so they knew something around the lines of someone who has diabetes will come into a CVS on average 18 times a month versus they might see their endocrinologist maybe once every two months. And so they say, OK, if that's happening and again, my numbers might be a little bit off, but it was way higher for CVS than it was for the specialist. And so they were thinking, well, what can we do? How can we do this? How can we actually help provide some more preventative type care? And so they said, OK, it's for behavioral, mental, and behavioral health. They're going to do it for diabetes. They're going to do it for a few different conditions. And the diabetes, I think, is really interesting because just what you said, they can now start to actually provide health information outside of the times that somebody is coming in and out of the CVS so they can either ping them on the CVS app. If that's just with a reminder, they can send emails because they have. I mean, we all have to sign up at some point during COVID for something, whether it was a vaccine, not they all have our email, whether we're a senior’s care customer or not, so we can receive emails from CVS so they can do preventative care there, or they can share recipes or low blood sugar recipes or any of the above. I mean, they can do a lot of that outside of care communication that I actually think health systems could do if sophisticated enough. But the challenge with healthcare orgs has been the silos. So how can you access that data? My husband has been trying for over almost 10 years now to try to figure out what's the lifetime value of a patient from his multidisciplinary clinic, like when he refers patients into cardiology, into G.I. into ortho. What is the value that his clinic has driven? Because what the lifetime value of that patient for all of these other specialties, they can't actually get that data. Why can't they get that data? Oh, because it lives over here. It lives in here. It lives in here. Look, if we could just break all of that down, then I think health systems have a very good opportunity of trying to figure out what CVS is doing, how are they doing it, what worked and what didn't work. Let's just take what worked and then let's apply it to healthcare within the system. If we can access all of these data points and then figure out an effective communication strategy so that there's preventative care, there's, you know, there's nutrition counseling, there's mental health and mental and behavioral health there. You know, whatever it might be in whatever modality, whether it's a direct mail piece or it's a newsletter, it's an e newsletter, it's an app you know everyone's talking about right now. We're doubling down on our apps. I think to myself, why would you do that? Why would you double down on your apps when somebody probably uses your app? Maybe once, maybe twice a year? It's not like it's Facebook or Instagram where you're going on it repeatedly. Why would you do that? Well, I mean, that's what we're focused on. Well, that doesn't make any sense. That does not make any sense. You need to focus on where people are discovering information about you and then utilize your app for people who are existing patients and then use that as a communication function, just like CVS does. So I don't know. I think there are interesting things that organizations could look at outside of their industry to pull into if they could just break down barriers. And that's really the data silos that.”

Matt Dickson: “Yeah. And I think that the important thing there is think about that strategy, though, is understanding early on that it is not a one size fits all approach to communication. You can’t say I'm going to have my preventative care communications for diabetics. All of it's going to go with the same content. All, it's going to be sent at the same time. All of it's going to be sent through the same channel. One of the things that we think. Deeply about here, and I think health systems have not done a great job of thinking about is the difference between channel of preference and channel of activation. I think there's this presumption that if I communicate with a patient in their channel, a preference that will lead to activation, and that is not the case. Matter of fact, anyone who hasn't listened to our other webinar about our yearly survey we do to the consumers. One of the questions we ask them is how would you prefer to be communicated by them? And if you did get some procedure, what was your impetus, our communication channel that got you to do it, those differed quite substantially. Interesting so what you've got to do and to your point, Carrie, the advantage. I think that the non-traditional players have is they're able to remain relevant outside of the appointment. Yeah so, you're interacting with the CVS app because you're going there to do 10 other things. So they're able to be kind of a relevant part of your life when you're creating a communication strategy, even choosing when to send that information to make sure that it's relevant and it lands is very important as well. So I think that's another area where health systems really have got to get a lot more personalized around their communication strategies to make it more relevant, more timely and in the appropriate channel of activation using content that really enhances activation as well.”

Carrie Liken: “The personal reason, I think is big, I've heard that over the last couple of months too, I've heard that across the board. It's interesting you say it with activation strategies because I haven't heard it regarding activation. I've heard it more on. Let's personalize our ad targeting. Let's personalize our website and the website experience and we even think about everybody's healthcare journey is different. And so you have to, you know, that's a personalized journey as well. You're looking for. You have your own symptoms. You're looking for care within different ways. You're maybe you're using Google or not using Google, whatever it is. So that's a journey. Even before you get to the organization's website or before you book an appointment before you get to the doctor. So I think that's a key critical theme that maybe organizations to just drill down on across the board from literally point of symptom to point of care to what happens in between in the span of time, in between care. And it's maybe, maybe that could be a theme for 2022 too I mean, it definitely came up this fall. And I know it was a big thing in pre pandemic, but I feel like it was hot, and it could get hotter.”

Matt Dickson: “Yeah and I think from what I've seen many of the marketing resources I talked to at our health system partners, I ask them, how are you measured? Their primary metric for measurement of success is new patient acquisition. you talked about the Roi story. So if anyone wants to take me up on this, please email me after I'm dying to do this. I wonder if your dollar is better spent not only on new patient acquisition, but on care compliance. What is the Roi you could generate if you took care? Compliance from 30% of people are going to follow up care. They need to get the additional diagnostics they need. You turn that from 30 to 50.”

Carrie Liken: “Interesting.”

Matt Dickson: “Getting marketing to drive that what would that mean to your health system? From a financial standpoint, it would be a fascinating exercise as to where you could be most impactful with some of that spend. But by and large, I haven't seen that marketing has a lot of focus on that patient communication that you said that happens between episodes of care, right? How do we get you from you? Went inside your primary care physician, your primary care physician told you should go get some diagnostic or go see a specialist to actually getting that person to do that. And I'll tell you, from my own personal experience, I went and got a check up post-pandemic. Or pre-pandemic, I wish we were post-pandemic, which for me and they said, hey, what are your results? Came back and want you to come in and get this additional diagnostic? I didn't do it. I should have there. Their strategy was somebody from the front office called me to remind me once and they sent me a letter. I said, guys, you're killing it right here. I'm very motivated based on this communication. So right, I'd be curious if you take that marketing mind, muscle and expertise and started applying it to those problems. What would that mean for health systems as well?”

Carrie Liken: “Yeah, it's almost sort of like reverse nurture campaigns, right? I feel like it's your nurturing, but it's in a very nurturing like in the traditional sense of nurture, like Mother's nurture, their children, that type of thing. Yeah, I think that's fascinating, but it also requires something to go back to the data it requires, you know, it requires maybe a different skill set within marketing and then it requires access to a lot of data that organizations just haven't been able to tap into. And I know you and I have probably seen a lot of people come in from outside of the industry to come into marketing functions within health systems, and it's been interesting to watch what their experience has been. So some have come from CPG, some have come from large entertainment organizations like a lot of organizations have said, let's bring from outside that expertise and put it inside. But what they're encountering is we've been able to do it outside pretty easily where we can actually put this together and then we come to healthcare and it's just like hit a wall, hit a wall, hit a wall. And so I love your idea of being able to figure out how to maybe shift from just patient acquisition to, you know, other metrics that can actually reduce cost, which actually could help drive a bottom line. But if they can't access the data, if they can't access different elements of, I mean, one patient might have seven different medical records, like why? That's just one of those crazy things, too. So if they can't access that, how can they be successful?”

Matt Dickson: “Yeah and again, certainly that's a challenge. So we're coming up on time here. Carrie, I wanted to end with one thought. Kind of personal to my heart or a pet project, whatever you want to think about it. And that's health equity. So my concern here as we make this digital transition or transformation, that what we will find is we'll probably actually further hurt the people that are most underserved today and create a. New level of convenience for the people that are best already served by the healthcare system in America, so any thoughts from you on how you kind of work through those challenges to make sure that as you're going through this transformation process, we don't further harm already harmed communities?”

Carrie Liken: “Yeah, that's a really hard question. I don't think I'm going to come up with a really good answer on that. I actually be interested in hearing what you have to say. I feel like there are some organizations out there like, for example, Dollar General or even Walmart too, you know, even in different communities where there might be a lack of providers know, or maybe somebody has to travel an hour or two hours to get to a hospital or to get to a primary care provider. So I feel like there are some organizations out there who are trying to tap into this where at the Health Conference this year in Boston, CVS said. You know, we are vastly undoctored or under doctored in this country. And I think in certain areas of the country, we are really vastly underfunded or under doctored. And so maybe they're trying to tap into that. I think you bring up a really good point that I don't have a good response or answer to you because I think I always use the focus group of one and that's me, which is not the smartest thing to do. But I think about how digital has enabled my life to be amazing. I mean, in so many ways, but that, you know, you and I had a conversation around virtual care during our last chat where it really dawned on me. I didn't think about this, but let's say there's someone who lives in a multifamily two room apartment and needs to do a virtual visit and doesn't have any privacy to do so. You know, they might have a phone, they might be able to do this. And yet they don't have the privacy to be able to make it to their appointment because so many people are around, and they don't want to actually talk about private things around other members of their family. So what do you do about that? I don't have a good answer except to say that we need to be thinking about it. What do you think about it?”

Matt Dickson: “Yeah, I mean, certainly that's it. And again, that goes back to that personalization. So today, in my opinion, the data points that are being pulled for them to form these communication strategies are far too limited. I don't a health system in this country that is taking into account perceived educational level or social determinants of Health to say, hey, I may have to communicate with a different kind of language to a certain population because, you know, frankly, the health literacy may be a little lower than other populations that I market our message to. So I think that in the excitement to create a best-in-class experience, and maybe this is another challenge health system have that. Maybe the CVs of the worlds don't. you've got this extra level, I think, of responsibility to your community that a lot of these non-traditional players don't. So I guess I point that out more. For again, we're talking about trends, challenges, maybe don't have all the answers, but certainly something to keep in the back of your mind. As you think through this wonderful plan, you may have around digital transformation, creating a considerable amount of convenience. Be thoughtful or mindful how that may again take those already groups that are disadvantaged from medical access type of scenario and further disadvantaging those or further leaving them behind. So I, Carrie, again, thank you for your time. Wonderful opportunity to speak to you. Did you have any closing comments or anything you wanted to share?”

Carrie Liken: “No, I mean, outside of just, it's always a pleasure to talk to you, Matt, and I love talking literally. I love talking about these things. I love thinking about these things and the trends and the challenges and trying to formulate where organizations are going next. And I'd love to do it with you again. I would say if anyone wants to get in touch and geek out about this or have any other questions, personally, I can be reached at So c a r r i e at And then, Matt, I'll turn it over to you to share your info.”

Matt Dickson: “Well, I should have known you are a rock star. One name is all you need to reach Carrie. Yes, I am. I am. Matt Dickson, Matt d i c k s o n  and its @Stericycle.Com. If you want to keep up with Stericycle Communication Solutions, you can do that at LinkedIn, at Stericycle Communication Solutions are also on Twitter @StericycleComms. So again, thank you, Carrie, for your time. Really appreciate it.”

Carrie Liken: “It was fun. Thanks again, Matt.”

Matt Dickson: “Thanks.”