Apr 10, 2023
Did you know that connecting to your doctor is literally just a text away?
On this episode of the Highmark Health Care Reinvented Podcast Series, Benjamin Edelshain, MD , Vice President, Clinical Engagement & Digital Innovation at Highmark Health, gives us the whole story on how a secure mobile text messaging platform is building better patient-doctor connections for healthier outcomes.
The platform was deployed at the height of COVID-19, immediately proving its effectiveness in a world where people could not easily meet with health care providers. Ben shares some encouraging and surprising stats on how many patients are using the platform and how text messaging has improved customer engagement.
Discover how a simple text message is part of an ever-growing ecosystem of engagement tools to ensure access to care.
Transcription:
Welcome to Healthcare reinvented, exploring the intersection of healthcare and technology brought to you by Highmark, here are your hosts, the Pittsburgh technology Council's Audrey Russo and Jonathan Kersting. This is Jonathan Kersting. With the Pittsburgh Technology Council. This is the next episode of healthcare Reinvented, where we explore the intersections of technology and healthcare. Today's interview will be a lot of fun. It's a follow up from our previous season and today we are going to be talking to Dr. Ben Edelshain, and he's with Highmark Health. And I love the fact that that Highmark is finding ways for its patients and doctors to better connect and using technology where it makes sense. And in our first interview that we had was, I can't believe it's, I think, more than 18 months ago, and I'm so excited to follow up on this. It's all about just using the simple concept of using texting to talk back and forth with your doctor. And it sounds easier than you think, especially in the medical setting. So I'm excited to learn a the progress of it and some new things they might be working on and get some numbers around this as well, too, just to see how effective it's been. So Ben, welcome to the show today. We're so glad to have you. And it's great to reconnect.
Yeah, Jonathan, thank you very much for having me. I'm honestly
super excited to share some updates. And it's always great talking
to you. And just coming back again, is a privilege and an honor.
very humbled. Yeah. Looking forward to sharing some exciting stuff.
And you know, following up from where we left off,. A year and a
half ago, just flown by and you had a child. Congratulations.
Thank you so much. Yes, we we had our second little Clara, and
she's turning one soon. So very cool. Very cool. You got to be
stoked about that. Absolutely. Very cool. So before we get things
kids, I'm just refreshing our listeners, maybe are they forgotten
or there's the first time listening, could you give us your
background and what you do with Highmark Health.
Very happy to do so. So I am Ben Edelshain. I've been with
Highmark, for about four years now, I'm a vice president in our
enterprise clinical organization. I'm originally from the UK, hence
the accent and used to be a national health service doctor back in
London, but been stateside for about 10 years. And so my
responsibilities at Highmark Health include kind of trying to push
us to be more tech driven, more consumer focused. And then
operationally I run a department to telephonic nurses who support
our customers, as well as care navigate navigation as well, helping
members find the best possible care.
That is interesting, that's gonna be a very rewarding job, because you're actually seeing the work that you do improves the quality of patients lives. It just, I think that's going to be so much fun.
I say this without any sort of sarcasm, and I love working. And I
see a lot of similar missions to, you know, socialized care where I
came from our country, slightly different by country and in the US.
And but I think in Pennsylvania and Pittsburgh, we're doing
something special to try and change the paradigm. And I'm very
excited to be part of that journey.
So that's why I love having these conversations, because I think
you said the right word. I think Highmark is doing so much to
change the paradigm. I mean, the idea is using technology to
empower people. And it's not just about the technology, because
there's technology all over the place. But how you can apply it in
a way that people can actually use it, and use it to actually make
the experience better make their health better. That's why I
thought it was so much fun when we first talked to you know, just
detailing how using something as simple as text messaging, as a
really effective way of being able to keep that connection going
between doctor and patient, which is just so vital. Tell us more
about how that kind of started up. And then really how this has
been now it's up and running for more than a year and a half
now.
Yeah, so just if we rewind the clock, you know, even beyond, gosh,
that year and a half ago, and you know, when COVID first broke out,
right, and patients were rightly scared to go and see their doctors
to engage in person with that health care. You know, what we
discussed last time was we we challenged ourselves and said, Hey,
look, we have this texting capability that traditionally use, you
know, primarily for marketing purposes, right? We have adoption,
why don't we try to juice it up and and use that one way messaging
system and flip it to two way and then as people respond to us at
Highmark, you know, let's have a nurse on the other end who's part
of the benefit structure that I have or receives, and let's enable
that nurse who's on the Highmark side, but to also be kind of that
augmentative support for the doctor's practice. And, you know, for
us that's, you know, really supporting our colleagues a lot to get
Allegheny Health Network. But it's not it's not just a
job.
So that's, that's like I didn't think about is the whole point that this is actually a way to kind of help the doctor out as well too. Because if you have a nurse that's helping out, they're able to, you know, it frees up their time to put it where it's more important, and being able to then you but still give the care to the patient at the same time. So that to me, I think is really interesting. So the docs are probably saying, Okay, this is great, it's like a little relief valve that we can talk, we can learn about something going on before it becomes a serious problem that would require someone to come in to the doctor or something like that.
I agree. And I think part of the strategy moving forward is, you
know, as a former physician myself, I empathize with, you know,
those still in practice where they're forced to have really short
consultation time. Right, right. I'm sure as patients, we
experienced that, where it feels like, you know, you have 15
minutes, and that's it. And so, you know, perhaps this evolves into
what those other topics that you maybe can't fit into 15 minutes,
and then, you know, take it offline, or actually take it online,
right, and have it in a more digitally enabled manner, and at the
convenience of the customer, right at the convenience when they
want to talk about it. And so, I mean, we've so a year and a half
has passed, we have had, you know, specific to these, what I would
call like health conversations or clinical conversations, say, a
nurse or other kind of professional, like a pharmacist or
behavioral health specialist. Since going live, we've had 30,000
interactions.
Wow. Yeah, that's, that's a lot. That's awesome. Wow.
You know, and to put that into context, that's just one year that
was lost. And, you know, we use texting for other purposes,
primarily, one way, we send about 4 million texts. You know, it's
starting to become a decent chunk of Yeah. So, you know, again,
changing the paradigm so that the conversation you have with your
healthcare insurer, but you know, really, we're an integrated
system, but the conversation you're having is more about your
health and wellness, and less about your benefits and your right
cetera.
Exactly. Just the fact that it just keeps you in closer touch with
your caregivers, I think is just so important. And you can do it in
a way that's not eating into the system and just wasting people's
time. But it's like, no, this is a great way that you know,
something's not right, you're concerned about something you're able
to easily address it before becomes that bigger problem. It just
makes me sick, more convenient. And it just, I'm curious, I think
this is going to keep growing. Because I mean, the first year, I
mean, 30,000 interactions. That's, that's pretty amazing. To me,
I'm thinking this is gonna continue to keep building, and you'll
probably find more use cases for it as well.
I hope so. And we certainly have plans. And you know what? I like
the elegance of the simplicity. Yeah, definitely. Text is
essentially free. Right? And, you know, maybe your conversation
starts with a text then goes into a secure channel where you're
drinking bidirectionally. And maybe you decide, hey, I do want to
talk to you, and then you set up a mutually convenient time.
Exactly. My dream, my aspiration by the end of next year, is to
eliminate any cold calling, that's not expected. That comes from a
nurse for my health plan to okay, just like there is no reason why
we can't achieve that. So, you know, part of where we're headed is
okay. We think texting works. Well, we know texting works, right?
I'll throw you out of fun facts. So you're familiar, obviously, as
a technologist, kind of the click through rate terminology, right?
industry average for texting, click throughs, about 15%, one, five.
But when you start due to doing two way and having a healthcare
professional on the other side, and picking the moments that matter
to the customer, we're at about 30% click rate.
Wow, you're doubling that. That's impressive. I mean, yeah, he's
looking at a 30% engagement rate like that, click and through that
you're having real conversations that I mean, this is something
that people are in there. And the cool thing is when they have this
good experience with it, they're gonna continue to rely on it,
they're gonna see it as something that they can they can use. And I
just think it builds a better relationship with your caregiver and
makes you sometimes like less afraid. There's always that little
bit that fear factor, the more you kind of start talking about
something and the more you have to get the back and forth. I know
for me, like just personally, I remember like, I've never liked
going to the doctor, I remember being like, oh, I can do my virtual
visits. And as I started virtual visits, I wasn't so free to
actually go in and see the doctor. So I think it's it's a great way
to kind of step things up as well to to get those of us who maybe
have a little bit of the white coat phobia, I guess.
You need an actual person that professional and, you know, maybe
that comes into the a little nudge that says, you should really go
see your doc. And, you know, the other added beauty over time is
that, you know, with the customer, the patient's consent, like
maybe we can prep the doctor right for the visit. So we know what's
going to be top of mind. And what's the point? Yeah, that makes so
much sense. Because like, yeah, if you're working with a nurse, and
you had a, say, like a couple days of back and forth, and like,
hey, why don't you come in next week, then that nurse can then
provide that conversation, there's probably some detail in there
that the Doc can look into, and really informs what he or she is
able to, you know, do when it comes to treat the patient, and
they're gonna, you're gonna get all that better care, when you're
there seeing the doctor have a better experience?
Well, and then, you know, as a blue plan that has a hospital
system, right? So that interaction with the nurse can be
transitioned into, okay. Why can't I just book you in right now?
Because I have access to a very cool, true one call resolution,
right? True, nice.
This is all based on a very simple technology, which I think is
just so awesome. Like, it's something that we're all very familiar
with at this point. So Ben, tell me more about the engagement rate
on this. I mean, especially across different age groups. I'm
wondering, is there a difference between like younger people and
older people using texting to talk with their doctors and
nurses?
Jonathan, that's a great question. You might actually be surprised
on this. I think, you know, in our society, we have this somewhat
unfair perspective, sometimes that older folks don't use
technology. And what we found actually, is that when you have a
healthcare professional on the other end of the phone, and you're
doing two way texting, the highest engagement rate we're seeing is
amongst the senior population.
Interesting. I'm so happy to hear that. I think that we shouldn't
underestimate kind of smartphone adoption amongst those 65 and
older. And look, if you make the tech simple. And it works, and it
drives again, drives value to the customer, we're seeing that
senior, customers are engaging nearly double the rates that from
folks who are under 65.
Well, that is just fascinating. I'm curious, are there any extra
security concerns around this being being that there's probably
HIPAA stuff at some point, depending upon what the conversation
is?
Yeah, that's an excellent question, Jonathan. And I do want to make
sure that it is clear to your listeners. So for us the text
message, what you would see in like, iOS is the initial primer. And
so it says, hey, you've got a message waiting for you. This is why
it's also elegant, no download needed, it just opens up a secure
browser. Gotcha. Which is like all sort of safe for the patient or
the member opts in to say, Yep, I'm happy to keep going. And then,
you know, we have very little security concerns at that point.
Very cool. And he had the idea that like, yeah, you're not
downloading something, or it's like, I can't do that right now. It
just opens up the secure browser. And there you go, and you know
that everything is safe. And there's there's nothing to worry
about. Very cool. I mean, makes it sound simple. I'm sure it's very
hard to implement. But obviously, the user experience is easy. And
that's what it's all about using technology to make things easy,
not complicated.
We have a great partner, the company we work with is called Relay,
and they have made our life very easy. I mean, I might have
mentioned this before, but we went from one way texting to fully
implementing two way and 12 weeks, which for any kind of tech
project is like a backup. That's just 12 weeks. Oh, my goodness.
Yeah, that's, that's very cool. Very cool.
And also some added benefits. I think that, you know, we I think about a lot, maybe consumers don't is, you know, the amount of satisfaction this brings to the health care professionals as well, that are being more efficient with their time, it's more meaningful, you know, they can have, you know, multiple chats open, if that's the way they want to work, and then, but then kind of, again, not be cold calling necessarily and actively engaging folks, and just the scale at which you can help people kind of grows exponentially in a very low fidelity manner.
I did. I didn't want to share one interesting thing with you. We
did. This is a exclusive for your podcast.
I like exclusive that's what it's all about. Come on, man. Lay it
on me.
So once we had the sort of texting apparatus if he would. We
started thinking a bit about like, the words we use in that initial
text, and we how we approach our customers, as well. Actually in in
a world where unfortunately, you know people who scam innocent
customers yes are doing more texting right and phishing, etc. So we
decided it was it was after we last spoke it was kind of in the
works, but we decided just after we spoke last time to partner with
CMU, CMU. Sorry, Carnegie Mellon University. Absolutely, yeah. In
our backyard. We partnered with Professor George Lowenstein, as
well as Samantha Hall and Sammy, who's a PhD candidate. And they
are both world renowned experts in behavioral economics. So as
applied to healthcare, so the field being, you know, what are the
words? What are what are the words, what are the kind of nudge
tactics that you can use in a healthcare setting, to really empower
an individual to be more engaged in their self care? Okay, you
know, nudge tactics, for example, being kind of things like loss
aversion, like, you know, you're missing out on benefits that are
at no cost to you, people like you are taking advantage of this,
why not engage with us? So we partnered on a project to start kind
of seeing how we could tailor the words in our messages. And in two
months, we increased our initial phone pickup rate by 16%. Just
yeah, just by saying, hey, the nurse is going to call this customer
this member, patient. Let's send a text an hour ahead of time,
saying hello. says Hi, Mark. I'm calling from your healthcare team.
I'm going to call you in an hour. Very interesting, huh? Okay.
Alone, the telephonic pick up rate by 16%.
That makes perfect sense. You're giving that little bit that warning. So And plus if you feel like you know that someone's caring for you, right, yeah, I mean, you know, that, like you're, you're being looked after, and then you got the warning that like there will be a call coming. And it's a legit call. It's not gonna it's not a telemarketer trying to like, upgrade you on something, and it's just never heard of. Yeah, that's awesome.
So we've, I mean, again, like you send the text set an hour ahead of time, maybe the person that's the beauty of a two way system is they text back saying, Hey, I'm busy in an hour. Can you do 6pm This evening and say, Yeah, sure. But we're very excited about this collaboration with CMU. We're sort of working on some other plans. And with a view to publish in the academic literature. We think this is a joint partnership between Highmark and CMU. And we think, you know, again, it makes me sound silly to say groundbreaking and texting in the same sentence. But I think we might be onto something.
No, I would call it groundbreaking because you're using a very
simple and established and safe technology and using it to empower
people to better take care of themselves. That's awesome. To me, I
think that's something that the team should be super proud of. And
that's why it's so much fun having these conversations, because,
you know, over the years, we've been doing these with Highmark,
looking at how Highmark works with the Carnegie Mellon with outside
vendors that are taught that their games, taking that technology,
and focusing it down to where it actually helps the patient. That's
just tremendous. And that's why it's so much fun to explore these
conversations. That's why I'm so glad I got to have an update with
you, Ben about what you guys are up to because it's like, wow,
you're getting people there actually 30,000 people using this, your
great open rates, click through rates and people picking up the
phone because they got a text message an hour before the call was
going to help it.
Let me leave you with three kinds of additional teasers.
Definitely. You know, one is we're working, in fact, the technology
is live, we're just piloting that, to take it one step further,
which is kind of the texting, that leads to a conversation that
leads to a scheduling module, schedule the time just like you would
with a doctor, just like with Open Table, right, like, but with
your nurse. Right. So that's going live this year. The second is,
you know, this, we're seeing good kind of engagement with
employers, right people who provide health insurance and sort of,
you know, they see the value, they see the values, encouraging
their employees to update their contact information to consent to
interactions of this nature with their health plan, because there
is value here. And then the third part is just is about kind of
value in general, I think. I think small wins like this forced us
in the healthcare industry to continue to evolve into a b2c
industry. And you can only become b2c if you deliver value to your
customers. And that starts with trust. And I think this technology
have a simple it is is an enabler towards building a more trust
acknowledge the customer, the member and their health insurance
provider, which is traditionally not the case, right. But at least
by sort of driving home, the fact that we're giving value to our
customers really, I think gives a new spin on the term value based
care.
Absolutely. I think you summed it up perfectly. It's so much fun
talking with you to tape and because this just goes to show you
technology can really improve people's lives and watching Highmark
use it in a thoughtful way. It's pretty amazing stuff. And we just
love being able to tell these stories. Very, very cool. Dr. Ben
Edelshain, you're the best. Get back to work. I know you're having
a good time. I'll let you go.
Always a pleasure to spend time with you.
Absolutely. Just remind everybody This has been Jonathan Kersting
with the Pittsburgh Technology Council, and of course tech vibe
radio, having awesome conversations like this each and every day.
Thanks for listening to healthcare reinvented, exploring the
intersection of healthcare and technology brought to you by
Highmark.
Transcribed by https://otter.ai