Embracing Healthcare Consumerism to Transform Your Patient Experiences, ft. Matt Schwabel

Matt Schwabel (00:00):
We need to do a better job of eliminating friction for our patients, for our consumers, and we’re all patients-consumers and we don’t like it in any other industry if we have to think too much.

Alan Tam (00:23):
Hello Healthcare. There’s no doubt that health systems today have a significant challenge connecting with their patients when their patients are not sitting directly in front of the providers. In fact, if you think about it, 99% of our care journey is probably outside of the health system. There’s also no doubt that health systems may have an enormous amount of data in data silos that can be leveraged to better connect their patients to care.
(00:48):
Today, I’m joined by Matt Schwabel, executive director of marketing technology and operations at UNC Health. We’re going to be exploring how health systems can better leverage first-party data to connect with their patients. Matt, welcome to Hello Healthcare.

Matt Schwabel (01:03):
Thanks so much, great to be here.

Alan Tam (01:05):
So let’s just jump directly into it. Within your role, what do you see as the biggest challenges for health systems today leveraging first-party data to communicate with their patients?

Matt Schwabel (01:15):
Oh gosh, I mean I think there are a lot of challenges, some that are really directly related to my role and some that are really broader to the enterprise. So within what I do, some of the biggest challenges are making a mental shift from relying on third-party vendors and third-party data, and particularly online, third-party tracking tools and technologies, and thinking about it in a new way that respects privacy, and some of the regulation that we’ve seen starting to bubble up around this. And that is a different way of think. Particularly for an organization like us that has relied so heavily on others.
(01:56):
So starting down a path of really a first-party data strategy, I think is a challenge, but it’s an exciting one, and one that I’m glad we’re on, because like I mentioned, privacy is huge in healthcare, it has been for a long, long time. Extending that to privacy when it comes to online activity, interacting with us through digital channels, and really knowing, understanding, and respecting you as an individual, I think those are all good things, and a good journey to be on.
(02:32):
Much more broadly, healthcare can be very siloed, particularly when you think about the different systems, types of data that we use, the groups responsible for that data. So while there may have been pockets in the past with us, pockets like population health, that have leveraged some of that first-party data to better understand the population they’re serving and do some outreach. More broadly, we’re just not as connected as we need to be. So I think that journey is a challenge, but again, one that’s a good one to be on.

Alan Tam (03:04):
Right. So at UNC Health, what steps are you guys taking today to help bridge that gap?

Matt Schwabel (03:12):
I mean there are a lot, and I think there are a lot of talented people, enthusiastic people in different pockets who are starting to build coalitions, and realize we need to have a better grasp of our own data to help us in serving our patients in the broader population. One of the big initiatives that I’m involved in right now is around master data management. Really tackling this idea of multiple silos and knowing that behind the scenes, there’s a lot of manual and inefficient process that goes into maintaining all that data, and with it separate, not being able to really fully utilize it. So I am heavily involved in master data management in the provider data domain. So we are really at the beginning of the journey, but looking at technology that can help us, won’t solve all problems, but help us with those integrations, and with the technological tools that then allow us to be better data stewards and make decisions about what pieces of data from different systems can come together and form this almost magical golden record so that we have that central source of truth that just doesn’t exist today.
(04:27):
And provider data, that’s just one domain of many, where if we can start to pull this information together, then we can better leverage it in communicating with our patients and identifying opportunities.

Alan Tam (04:39):
Right. I think it’s amazing that you guys have actually started down that process. I think for a lot of health systems, they’re just starting to look at the problem, and doing a lot of what I’d like to call problem admiration. So for those folks who are wondering, what would be your recommendation in terms of getting started, where do you even start?

Matt Schwabel (05:00):
I mean that’s a really good question, and it’s funny you mentioned that we have a leader who has said in a number of meetings, “As an organization, sometimes we like to admire the problem.” So we’re not alone in that, because I mean it’s easier to call out a problem than it is to actually solve it.
(05:19):
I think one of the things that has helped for us in starting down this path is coalition building. I mentioned we’ve got all these different groups, you’ve got smart people, enthusiastic people, but independently, you can raise concerns, you can start initiatives, but they don’t always raise to that level of a system or an enterprise priority. But once you’re able to come together and build a coalition, and this is what we did with provider data, marketing was one voice, but population health was another voice, access center, that’s another voice. IT contributed. When all these people are all saying, “We’ve got pain points, and they all point back to a common root cause,” then that I think helps to elevate it to the point where you’ve got the prioritization from an enterprise level, you’ve got that system leadership support, and you’ve got funding to tackle the problem, because it does touch so many aspects of the system.

Alan Tam (06:20):
How do you go about building that coalition? No doubt in my mind that all these different groups have those challenges, but I think one of the biggest challenges is getting everyone on the same page. What’s been your approach in helping to drive and manage that process?

Matt Schwabel (06:37):
So when I think about it and think about my role in the organization, there are things that I can control directly. There are certain areas, and tools, and aspects of the digital experience that fall under my team. So try to make improvements there, but then really try and influence where I can. And part of that’s being a willing partner. So we talked about admiring the problem, it’s been willing to, A, be very transparent when there is an issue, particularly when it touches something that also touches a lot of other aspects of the organization. So I’ve been in plenty of meetings with system leaders, where even if it’s not the most exciting topic, I’ll bring up, “Hey, you know what? I hear you that you don’t like some of our tools, that you feel like certain search results aren’t great, that you aren’t finding the providers you need. Got that. Did you know that 97% of our providers don’t have keywords attached to them?”
(07:38):
So taking it back to let’s first educate so that people understand some of the underlying causes that are being exhibited in some of the front-end experiences, and certainly being a voice, being an advocate there, but then taking it past just, “Hey, there’s a problem, go fix it.” And myself and my team, trying to be a very willing partner. So working closely with our access team to say, “Hey, we see an issue here. How can we jointly start to solve that?” And then you realize in touching that you’re also touching population health, so I think it’s been, for us at least, through those really smaller-scale initiatives, making the connections, building the relationships, and then being able to amplify each other’s voices in system level meetings that, “Hey, collectively, we think there’s an opportunity here.”

Alan Tam (08:34):
Right. Interesting. I think one of the things I want to shift gears on is actually transitioning to technology, and combining technology and data. What are some of the gaps that you guys are seeing in terms of connecting today’s healthcare consumers with your system and with your providers?

Matt Schwabel (08:57):
I think a lot of the gaps are not necessarily technology. I think there are plenty of technologies that can help you accomplish almost anything. I think at the core, it comes back to people and process. One of the things we deal with, even just a very basic front door, connecting patients with the right providers, you need to have underlying data to describe what a provider does, who they are, what they offer. And I think for larger systems like ours where you’ve got lots of different types of technologies, and each holds a piece of the pie, a piece of the information, getting good, consistent, accurate quality data can be a real challenge. And that’s what’s needed if you’re really going to be able to give patients relevant results. If I need a knee doctor, orthopedist is not enough. Right? That’s a very broad specialty. I need someone who does surgeries. And the next step for me is going beyond what we historically capture about a provider, your education, your board certifications, and starting to give people ways to evaluate both hard and soft aspects.
(10:20):
So hard being, “I’d ideally like to know how many knee surgeries did you’ve performed last year? And are there ways that I can understand, as a consumer, that help me understand quality?” As hospitals, we have certain rates that we need to report, infection rates and those types of things. That doesn’t always translate into something that a consumer understands. So I think building on those to get to hard data that people can use when they’re starting to compare. And then building on soft data. I might be looking for someone who’s open to holistic approaches, or naturalistic approaches, or whatever it may be, and that’s not necessarily data we traditionally capture. And if you don’t capture it, you have really no way of powering tools. So I think that’s where we see a gap when we think about technology, that the technology can’t fill in what’s not there necessarily. So that’s one area where we see a big gap.

Alan Tam (11:20):
Okay, makes sense. So as you’re describing this, is the onus on the patient to find the information or is the onus on the health system to provide that information, and deliver it to the patient, right? Is the health system supposed to be more proactive in this case or reactive?

Matt Schwabel (11:38):
I mean this is my own view, but I think the onus is 100% on us. We need to do a better job of eliminating friction for our patients, for our consumers. We’re all patients-consumers, and we don’t like it in any other industry if we have to think too much or it’s on me. I don’t go to Amazon and it’s on me to find just the right product and figure out are the … Amazon makes it as easy as possible right down to, “Hey, you bought this before, you might like this.” So I think the onus really is on us. When you think about all those lived expectations we have from every other aspect of our lives, that doesn’t change when you come to healthcare, you still have those expectations. So I think we bear that responsibility to do whatever we have to do in the background, behind the scenes to make it easier for our patients, and to be more relevant in their lives.

Alan Tam (12:43):
Right. I can’t agree with you more. It’s something that I’ve been talking about for so long. And I know there’s a lot of challenges and gaps and steps that need to make that happen from where healthcare is today to what Amazon is doing. What’s the first step in your opinion to help health systems get to the Amazon level of quality of service?

Matt Schwabel (13:10):
That’s a tough question. I mean, part of it I think is just a shared purpose, because I don’t know in our system, or in many systems, if you surveyed across the board, you would get total agreement that that’s the ideal. I think you still have some people who would probably very much fall into that camp of, “Hey, if we are clinically sound, if we are addressing your medical needs, then all the other stuff, Amazon, we’re not Amazon.” So I think part of the challenge for us has been to couch this growing movement that’s often referred to as consumerism in healthcare, in ways that make sense and resonate across our enterprise internally. Because for me, that is probably one of the first steps is just gaining alignment that this is the destination we’re going towards, and this is what we want to offer in terms of experiences for our patients.

Alan Tam (14:15):
So earlier we talked about building the coalition. So it sounds like you guys have that coalition well underway. Obviously, the challenges are aligned, and your organization seems to be aligned. So it seems like you guys are ripe to move in that direction now if everyone is aligned. Yeah?

Matt Schwabel (14:37):
I think I’m optimistic. I think we have a lot of the right pieces in place, but it’s still challenging work, and it’s still work that has to be done at a time when there is staff shortages across the nation, when health systems are under financial strain, when we’re still dealing with the fallout of a multi-year pandemic. So I think there’s a lot going on that can divert attention and resources. So like I said, I’m optimistic, but by no means is this an easy path forward. I think it’s going to take a lot of focus and a lot of work.

Alan Tam (15:19):
Right. You do bring up a good point in terms of the economic headwinds that health systems are facing today. I’m assuming you have a strong financial partner or maybe in the process of developing a strong financial partner. And oftentimes marketing organizations are viewed as cost centers versus revenue generators. What are some of the core and key metrics that you use with your finance partner in terms of there’s ROI, we can generate revenue, and attribute our programs and our campaigns to hopefully continue with funding, or to potentially even increase funding to help bring the business back up to a certain level?

Matt Schwabel (16:04):
Yeah. It’s an area where I think we’re still a little early in our maturity. So we do have some areas where we have some agreed-upon metrics, particularly some of my colleagues on the marketing side work with finance and our vendors to establish as much of an ROI as possible with a lot of our paid campaigns, so that we can demonstrate the value there, but also so that we can be responsible stewards and shift dollars to those channels and tactics that are most effective.
(16:38):
Beyond that, we have been making slow progress to try and develop metrics that really kind of prove out some of that value. A big win for us was being able to push some tracking into Epic when someone schedules online so that now we can go from source, whether it’s an organic search, or a paid ad, all the way through appointment scheduling, and then the outcome and associated revenue. So I think that was a good step for us to be able to show some of that. It’s still a bit of a challenge when you think about someone who calls in for an appointment, that’s a bit of a black box. But we’re really trying to move towards wherever possible, developing those types of metrics that help us understand the effectiveness of what we’re doing, and prove out internally the value.
(17:34):
Alongside that, we have a consumer insights group that’s been doing a lot of work around net promoter score and some other measures to help us understand some of the impact of some of the more reputational work and the awareness work. So I think between that and some of those financial metrics, that’s what we have today and the course we’re on, but still an area where I think we’ve got some maturing to do.

Alan Tam (18:00):
Okay. Makes sense. You mentioned channel effectiveness. Just curious, what channels are you finding to be most effective when connecting with patients?

Matt Schwabel (18:11):
Yeah, so in terms of effective channels, certainly blogs, one effective channel, more when you think about reaching the population with health information, very timely information. That was a great way to get out medically-reviewed accurate information during COVID, as lots of questions were coming up, and as really the medical view was changing as we had more data available to us. So that was very effective as a communication channel. Certainly from a marketing standpoint, paid ads, search, paid search are huge channels, and pretty effective for us.
(18:57):
And then beyond that, I think part of the reason we’re on this path to develop additional metrics is to understand as we utilize other channels, what’s working well for us, this is, I think, really important as we are in the process of shifting to new CRM system, and really trying to build up the capabilities for things like omnichannel messaging.

Alan Tam (19:26):
Okay. When you talk about paid campaigns, the first thought that came to my mind is really patient acquisition or new patient acquisition. Talk to me about the differences in strategies and approaches between the effectiveness of new patient acquisition versus activating your existing patients. How is that weaved into what you guys are trying to accomplish, especially since you’re talking about a CRM, how are you leveraging first-party data between those two types of programs and strategies?

Matt Schwabel (20:01):
Yeah. So we have been using first-party data, and again, I think we’re early on our journey, but one of the big things that our consumer insights team helped to do is to look at our patient, data and to really create attitudinal segments. So having some segmentation that allows us to craft specific messages, knowing that not everyone’s the same, and that demographically you may be the same, but what you value, your concerns, your questions, your hopes, those may be very different.
(20:38):
So that’s one area where I think we’ve done a great job of leveraging the data that we have to define those segments and now begin to explore ways to apply those. I think a good example is our New Movers Campaign over the past six months, which has started to apply what we’ve learned from segmentation to crafting very specific messaging, and next steps for people depending on the segment that they fall into. So that’s an area where I think we’ve seen some early success, and I think this is going to be a really valuable avenue to continue to pursue, but we’re still pretty early in that.

Alan Tam (21:22):
You also talked about attribution earlier, is that a manual or a automated process for you guys today?

Matt Schwabel (21:31):
In terms of attribution of-

Matt Schwabel (21:34):
It varies. Some of it is manual, some of it is somewhat automated, working through our partners. So, a Google ad, we may be able to attribute at least as far as a phone call was made. And then maybe a best guess at the outcome. With what we’re doing with online scheduling, that is automated attribution. So that’s probably as advanced as we’ve gotten so far, so that we are using UTMs to pass data into Epic, which in itself was a challenge, because Epic does not like to accept data from their clients. But then use that with our IT and our finance partners to really report on the actual disposition, so we know when we have an appointment scheduled, we can trace that all the way back to it was an organic search, it was a Facebook ad, it was whatever that source channel and campaign happened to be.

Alan Tam (22:37):
Does this apply to retention type of programs as well or connecting with patients today? I think oftentimes because new patient acquisition, digital advertising has been around a little bit longer, it’s a lot easier to measure performance. I think for health systems, activating existing patients or connecting with the existing patients is a little bit newer. And some of the challenges that I’ve heard about is really around attribution and measuring the impact of that. Are you guys experiencing the same level of challenges there or is this something that is not applicable at the moment to UNC Health?

Matt Schwabel (23:18):
Yeah, I think it’s only applicable in pockets right now. It’s certainly something that we’ve been talking a lot about. Particularly when we think about what’s the value that we can bring as a marketing team to the organization and where are the opportunities, although much of the effort has been directed towards new patient acquisition. Where it probably comes into play most is other teams within the department working more closely with population health, who I think are probably a little more advanced in doing that and reaching out to their defined populations, and really making sure that people are taking care of themselves, and that we are really making sure that we’re making the best use of our resources, and they’re making the best decisions for their health.
(24:12):
So I think that’s kind of the one area where it’s happening, but retention probably another area where we have aspirations, but we aren’t quite there yet. And certainly driving some of our thinking around CRM as we work to continue implementing that fully.
Alan Tam (24:29):
Okay. So CRM isn’t fully implemented yet?

Matt Schwabel (24:33):
CRM, yeah, I think if it were the Death Star, it’s not fully operational, but it’s hanging out there in the sky. CRM is one where, yeah, we can do some basic things. We’re using it a lot more on the population health side at the moment, and working with our colleagues internally to get the rest of the functionality for marketing really where we’d like it, to start to run some significant campaigns through it.

Alan Tam (25:03):
Who’s driving it at your organization, this CRM initiative and project? It sounds like it’s pop health, or marketing or a combination?

Matt Schwabel (25:11):
So our IT group is called ISD within UNC Health. They are primarily responsible, and we have stakeholder representation from marketing, from population health, and from a number of other aspects of the organization, rev cycle. So we’re all coming together, coming back to this coalition idea, and trying to figure out where can we get the most value next with CRM.

Alan Tam (25:45):
Okay. I mean how would you recommend to your peers in terms of getting started with that? Obviously you guys are still in the infancy stages. I think there are a lot of health systems that are in the same state that you guys are in, but there’s a lot of challenges, I think 80% of CRM implementations fail ’cause people don’t know what they’re doing. What would be your suggestions to your peer who are looking to do the same at the moment?

Matt Schwabel (26:14):
I mean it’s challenging. I think if you’re considering CRM, if you’re not there yet, probably the first thing I’d recommend is understanding your purpose and scope really clearly, and having buy-in across the organization. Because I think it’s one decision if you want CRM to manage marketing campaigns, there are lots of options for that. And I think that’s a different path to be on than wanting a CRM that gives you a 360 view of your customer that ties together different functions of your organization.
(26:53):
The experience we’ve had so far is that’s a much bigger undertaking, both effort-wise and budget. And if that’s not what you’ve committed to, then don’t go down that path, because you’re just going to, I think, find yourself in a situation where you might have a technology but you’re not really utilizing it. So certainly that, and also as much as possible, understanding what type of lift is required. Do you need a separate office stood up? What kind of staffing is required? What do you need to bring to the table as an organization to really make CRM work for you? Because I think that’s where organizations can get in trouble. You go down the path, you get a technology in place, but then you realize you’re not really set up to fully utilize and get the most value out of it.

Alan Tam (27:45):
Right. No, it’s really good to hear that you guys have such a level of clarity around it, and the purpose driving behind it. So often for many healthcare organizations, CRM is a noun, not a verb, where people just tick off, I have a CRM strategy, I get my CRM in the door, I’m done. And I think that’s why so many of those fail. So I’m very happy to hear that you guys have that cleared up and have a destination that you’re marching towards with CRM.

Matt Schwabel (28:15):
I hope we do. We could talk in a year and we’ll see how it goes. But yeah, I’m optimistic.

Alan Tam (28:19):
Right. Man, I really enjoyed this conversation with you, and I think hopefully the audience has really enjoyed this conversation as well. If folks want to continue the conversation or to pick your brain on insights that you can share, what’s the best way for them to get ahold of you?

Matt Schwabel (28:38):
Probably the best way is they can email me at a very easy email, Matt.Schwabel@unchealth.unc.edu.

Alan Tam (28:47):
Awesome. So if you have any questions on CRM, it seems like you guys are down the right path, I think Matt would be a fantastic resource for you guys to reach out to. Matt, thank you so much for joining us on Hello Healthcare today. Again, I really enjoyed the conversation. To our audience, thank you for watching and thank you for listening. And if you want to continue the conversation, please reach out to Matt. Until next time, hello.

Speaker 3 (29:17):
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