The Future of Patient Engagement

Chris Hemphill (00:02):
Hello, healthcare. Hello everybody who is watching us on LinkedIn, or if you’re watching us a little bit later on YouTube, big fat hello. We’re really happy to have you join this conversation, and we’re learning from Dr. Alice Jacobs today. If you saw the title, you saw the screen, what our focus is today is on patient engagement going into 2022. We’re going to get into things around the technical things coming on board, the culture that’s required to make it happen. We’ll talk about some of the deeper aspects and do some speculating into the future. That’s fun. But also we like to get into, we know that this audience, that you’re focused on the types of changes that you can make in your organization. And Dr. Jacobs, she said call me Alice, so call her Alice. We will just say Alice from now, very well credentialed but we’ll say Alice. And there’s a lot of background, a lot of wisdom from her experience in the clinical setting, working one to one with patients, from what she’s doing now, what she’s working on now, working on patient engagement.

Chris Hemphill (01:13):So really happy to bring that background to you, really happy to have this as the final talk of the year, final conversation of the year, as we reflect into how we plan out a successful 2022. So with that, Alice, want to give a quick hello to the audience?

Dr. Alice Jacobs (01:34):
Hi, everyone. And thank you, Chris, so much for having me here. It’s wonderful to get to spend time with you, and it’s really great to be here.

Chris Hemphill (01:42):
Great. And we’re going to start digging deep, Alice. Like I think that what’s going to be exciting is for people to understand where your background is, where you’re coming from, your experience in medicine, but also maybe your experience as a DJ, that was a funny little aside.

Dr. Alice Jacobs (01:58):
We’ll see about that.

Chris Hemphill (01:59):
Yeah. Lots going on. Oh, and hello to Marlinis, hello to Ed Marx, Melayna, Bonnie, Avneesh. I’m flipping your names up real fast, but the point I want to make is this. This isn’t just two talking heads, not doing a PowerPoint or anything like that. For those who are new here, feel free to say hello, let us know where you’re from. And if you have questions or if there’s stories that you want to share based on what you’re hearing, I’ll try to roll those up into the conversation. So flash that up on the screen, we love to hear your comments and your thoughts. But let’s go back. So we’re going to be talking about patient engagement, but I like to get into where you’re coming from, why you’ve taken this path and this journey, and the types of things, and basically what you’re up to today. So could you talk about what led you like pursuing the path of medicine, and then going into patient engagement?

Dr. Alice Jacobs (02:57):
Yeah, absolutely. So since I was four years old I actually knew that I wanted to be a doctor, and there are those moments that shape who you are. And I’m very grateful for that, because it made it a lot easier to navigate all through, and had the gift of an amazing education, made it to Stanford and then Harvard Medical School. And had all sorts of ambition of what I was going to do in healthcare, and then tripped a wire in sense of having a moment, another defining moment where I actually had a patient who ended up dying from a staph infection on my watch, and was really committed to try to figure out if there was a way to use technology to help have an impact there. So I actually took a leave from medical school, and built a business from an unmet need to being able to reduce the turnaround time for testing for infections, and be able to ship products onto five continents from our DMP manufacturing facility in Waltham, Mass. And it was an incredible journey.

Dr. Alice Jacobs (03:55):
So these moments that actually create the person you are, and it’s amazing where you think you may be going on one path, and then something happens and you end up doing something very, very different. That can be incredibly powerful. And since then I’ve gotten to do all sorts of fantastic things. Spend time on the venture capital side, got to spend time at Caltech helping them with their innovation strategy, and got to team up with some of the great living data scientists over the last few years. What they basically taught that all doctors do is introduced bias into data, and we should just step aside.

Dr. Alice Jacobs (04:29):
But there’s a lot that we can do now, and I think what I’m most focused on now and very passionate about is what can we do now, given all that’s happened in the last couple of years, to get people to be more engaged on their healthcare. You think about what has happened through the pandemic and with the pandemic, and also from the pause that people took during the pandemic. One of the big questions I’ve had for myself that I’ve asked a number of providers is, are we going to see more presentations of serious disease because people took a pause on their healthcare?

Dr. Alice Jacobs (05:07):
Now on the one hand, Chris, we’re probably going to be okay. There are things that we didn’t need to do. We don’t get everything right as clinicians. So there were back surgeries people didn’t need, they didn’t get them. That’s great. But there are probably other things, and it’s time now, how do we find out how we can actually get people to be more focused on the things that matter most?

Chris Hemphill (05:29):
So you brought up some really important points. I want to start with one though, which is the importance of how those personal experiences shape what you do professionally and in your career. And really thankful that you shared an experience that happened early on in the medical career. Like you didn’t come in that day equipped to see that happen so new, and over time those are things that [inaudible 00:05:56] really appreciate what you’re doing in response to that.

Dr. Alice Jacobs (06:00):
Yeah.

Chris Hemphill (06:01):
The other part that I wanted to talk about is this swinging pendulum, where the pandemic pushed us all the way to one side of the spectrum, where people were actively discouraged from coming in and getting certain procedures and all that, where maybe some of those that they would’ve gotten were unnecessary, but there’s a lot of care that people missed out on.

Chris Hemphill (06:28):
So we know, we’ve seen in the public response to science communication, COVID communication, that whatever the first message people stick onto, it’s really sticky. And this is just opening up all kinds of questions and challenges in terms of how we interact with patients, and how do we get them back to procedures and services that they need, while not overly promoting the things that are unnecessary. So I think to help us do that, to help us frame it up, could you talk about how you define patient engagement, and help level set for the rest of what we’ll be talking about for the conversation?

Dr. Alice Jacobs (07:10):
That’s a really great way to frame it, Chris. And as I was thinking about the topic of this conversation, I realized we brought everyone here with a specific intent to talk about a topic that I actually think needs to be renamed. I think the moment we call it patient engagement, we’ve gotten it wrong. No one wants to be a patient, no one. And so we have to start thinking about engagement from the vantage point of your experience in life as a consumer, and where you live, and where you shop, and are you lonely. Because these things are as important as anything that is captured in that maybe one day a year that you’re going and seeing your care provider. And so we have to think about a redefinition here out of the gate before we get to anything else, if we’re actually going to get this solved.

Chris Hemphill (08:12):
You know, you’re opening up a… That’s a tough door to get people to start thinking about. Because when we’re like the first word in there, the first term, patient, when people think about that, the implication is somebody in the middle of some sort of procedure, or actively engaged with health system. But it sounds like you are looking at, Hey, let’s redefine how we talk about it from a whole person perspective.

Dr. Alice Jacobs (08:38):
We have to think about the whole person. And that is the absolute starting point. We know that what we track as clinicians is just a narrow slice of your life. And it’s just a moment in time. In fact, I was talking about this with someone yesterday. And they said, well, I have this thing that happens to me whenever I get sick, and it’s a challenge, but whenever I go to the doctor I don’t have it. And so we have to change thinking about things in terms of episodes of care, and think about the longitudinal aspects of one’s life, and one’s entire journey through that life. And we know now what you eat and how you live have such determinations in the social determinants of health. We know the value to that, and what that brings to being able to care for people more successfully. So we have to start to tear down those walls if we want to be able to engage people.

Chris Hemphill (09:36):
Then that leads to… So we’re focused on tearing down those walls. We’re focused on incorporating social determinants and other aspects of other things that we know about our patients into how we approach and engage them. Patients, give me a strike for that. I should have said consumers and customers, based on what you said.

Dr. Alice Jacobs (10:00):
We’ll keep a running tally.

Chris Hemphill (10:03):
So that leads to the next question, is where is healthcare falling short? Where are we missing out? What are we… I know that as a clinician, or the folks here who have family members, or have been patients themselves, everybody is an advocate. Everybody wants this whole health perspective, but where is the hospital system falling short in being able to deliver this?

Dr. Alice Jacobs (10:35):
Well, part of it is the systems that we have in place, because what we have in place allows us to look at episodes of care, and the billing associated with episodes of care. We have the ability to import data in formats that are very difficult. Doctors are busy, care providers are busy, they don’t have time to go through all the various feeds. And so first of all, they don’t have a full picture of the person that they’re seeing, even for the moment that they do get to see them. So part of it is thinking about the technology and the tools that are in place, need to have a more holistic capacity than what’s available now. So that’s the starting place.

Chris Hemphill (11:19):
Excellent. So what it sounds like you’re highlighting is that there is a bunch of different places where information might live, but the people that are delivered care don’t necessarily have a close view to that.

Dr. Alice Jacobs (11:37):
Yeah. In fact, if you think about your own experience over the last couple of years, people talk about the digital transformation that’s occurred in the last couple years. And on the one hand, it’s incredible because we can now access care from our phones or virtually. But my experience as a consumer has been digital fragmentation. So we have all these point solutions and everything. And how do you connect up those experiences so that someone who is caring for you actually has the full view? That’s one of our great challenges right now.

Chris Hemphill (12:10):
I’m going to call Ed Marx, I saw him posting earlier. He actually wrote a book, Healthcare Digital Transformation. And this concept of, we want to make sure that our transformation’s not a fragmentation. And I actually want to latch on a little bit to Dr. Avneesh, with hospitals need to come out of the four walls of brick and mortar, which really alludes to the concept that you’re talking about.

Chris Hemphill (12:36):
And it leads to the next thought here, which is okay, so we begged the question on patient engagement and we see where those gaps are technologically. So my question is, the last time we did a webinar with [inaudible 00:12:56] we launched a poll, and in the poll we were asking what are the biggest inhibitors to the patient experience? And the top two tied answers were around culture and technology and data. So top two, culture and tech. I want to get to… I always see culture as the harder problem to address than deploying technological systems. So given the tools that are available today, could you paint a picture of what a successful patient engagement culture looks like?

Dr. Alice Jacobs (13:34):
They’re both difficult. Let’s say culture. So on the culture front, we have a couple of challenges. Number one, a lack of awareness, right? So a lack of knowledge. Another is a lack of trust. A third one which is important is a lack of empathy. And I think a fourth one, which is probably the biggest one that we’ve all really been focused on over the last two years, because I think COVID really just cracked this open, is a lack of access. We are not reaching the people that we need to reach the most. For anyone who’s digitally savvy, who’s already on a device, we can get to them. Now there’s a signal to noise problem of actually getting notifications through to people who are digitally savvy, which actually is equally as challenging as someone who’s not tech native. But we have learned through the experience of the last two years an accelerated challenge of failing to miss the most vulnerable portions of our population. And that’s something we’ve got to take on right now.

Chris Hemphill (14:47):
And that leads to another section of the conversation. Lisa Coleman made a comment. I can’t read the whole thing out loud, but the gist of this comment is really powerful because it hits on what the perspective is that the clinicians or the institution might assume more knowledge than the patient has. And in a lot of cases, I can point to lots of examples where members of my family are lucky that my mother is a nurse, because she was able to guide them through the care system. So I’m curious about your thoughts on patient engagement from that, on consumer health engagement from that perspective of how difficult it is for people to know what their next steps are, know how they should be managing their care or take their medications and things like that.

Dr. Alice Jacobs (15:39):
Well, and that’s where we have to really break out and understand how do we take the points of friction to reach people where they are, in language that makes sense to them and allows them not just to be notified. Because we know how to get a text message to someone, but how do we then reverse it and actually get them to engage and take action on things that are relevant for their care? And so there’s a whole loop that has to be closed to be able to solve this. It’s not just… People, when you think about the history, and patient engagement’s been around for 20 years, it’s not a new concept. The concept that is new is this bi-directionality, where you actually close the loop and someone, you engage them and they actually show up for the appointment, they get the ride they need, they actually adhere to the treatment plan, and they follow up and they get the screenings that they need to have. All those pieces actually need to happen. It’s not just getting to them.

Chris Hemphill (16:41):
So with that closed loop scenario, and thank you for handling that question. I know that’s one of the harder questions to answer, is that whole navigation experience.

Dr. Alice Jacobs (16:52):
It’s an important one, though.

Chris Hemphill (16:53):
Exactly. So that then leads to another question. We talked about culture, we talked about data, and the disparities of data, like where it lives and how difficult it is to access. But let’s say that we solve the data access problem. Somebody comes in with a beautiful data warehouse, and you have access to every data point and everything like that, which is an ideal. But then that leads to the next question around now that we have data that we can query against and things like that, what do you see as the role of AI to helping to support that culture and strategy?

Dr. Alice Jacobs (17:38):
AI can be helpful across the board, but it requires coming at it from the right human intent. So one of the things that’s wonderful is that if we could better understand and track and know the experiences that people have, and start to learn how and where they’re motivated and inspired to engage, we can start to predict how we can reach people in ways that are going to be productive and meaningful. And someone asked about empathy, part of empathy is reaching somebody where they are, and also being personal.

Dr. Alice Jacobs (18:13):
So the big push right now is about how do we get personal? And is there a way to use AI? When you think about natural language processing, we can use AI to actually customize how the language is shared with someone in a way that’s going to make sense to them. Some people need to hear things from a care provider. Some people need to hear things in a way that has a lot of tech speak, others don’t. So we can start to think about how we can actually get someone’s attention at a moment that matters to them. And part of that is in language. Part of that is also of just being able to reach them at wherever they are.

Dr. Alice Jacobs (18:53):
So one of the things that I’m very passionate about right now is actually, how do we get to someone where they are? So it’s easy if somebody has a $1,000 iPhone, okay, you can send them a notice on their iPhone. What do you do with the person in their 80s who has a flip top phone, where there’s no app that’s ever going to reach them? They’re never going to log in, right? And so when we talk about reaching people and using tech, we have to get to those edges as well. And for that person, it might be their television screen that’s in their home. When we talk about reaching someone on the edge, we actually have to go to where they are. And so we have to think about unbundling tech, and thinking about tech in a way that doesn’t just drive us to the same place where we are, which is in an app where it requires all these steps. How do we take those points of friction out for the tech to actually be worthwhile?

Chris Hemphill (19:52):
So I think that that’s a great point, is understanding where… If there’s understanding, are you suggesting understanding what channels are appropriate, or what outreach methods are appropriate? Could you just unpack a little bit on that, on understanding where people are?

Dr. Alice Jacobs (20:12):
Yes. I think what’s important is to be able to learn and understand whichever channel somebody’s using. It could be a digital channel. It could be Signal, it could be Telegram, it could be Facebook Messenger. It could just be text, it could be email, it could be a phone call. We all have a preferred way of engaging. And so if we can use AI to learn and understand, we can start to predict and even prescribe how you should think about engaging someone.

Chris Hemphill (20:42):
And I got a good comment from Heidi Schulte as well that feeds into a comment that you had made earlier, with regards to maintaining relationships and how basically the point that all these interactions should be more than transactions and notifications. So I guess the core of the question though, is how we talked about various channels, curious about digital channels and digital care navigation, and how that can create more of a human experience. Actually, David Dalton’s point, how does technology drive empathy?

Dr. Alice Jacobs (21:20):
Yeah, it’s a very important one, because what we know is if you just drop some standardized template into somebody’s email inbox, it’s going to be overlooked. And it turns out it that people prefer, what people are missing out on, in fact one of the gaps of the last two years is this breakdown in relationships. People want to feel known and seen and heard. And so having a relationship again with your care provider, and then using tech to scale that, so that that person’s voice can still be in your home, even when you’re not in that office, or even if you’re accessing them virtually, there are so many tools in the arsenal now that we can utilize, that can actually make things more personal. And so I think that’s the part that we really need to get focused on now.

Dr. Alice Jacobs (22:16):
And we’re starting to see that that’s really high priority for everyone that we talk to. And so I feel very hopeful about it, but really in the end, it’s about relationships, and it’s also about trust. Because there’s so much going on in your life, and there’s so much information being thrown at you, and what’s happening with my data, what’s it being used for? So we have an opportunity right now to start to rebuild that trust and regain the confidence of people by allowing them to choose how and where they want to engage.

Chris Hemphill (22:54):
So I think we’re danging a lot of carrots over people, where we’re talking about these different perspectives and these overall strategic ideals. I’m curious now about who folks here, like if we want to learn more about what organizations are driving their consumer and customer engagement strategy, I used the right word this time, driving these strategies appropriately. Or we talk all the time about the folks that are behind, but who are the leaders in this space? Who do you see as, or what are some examples of organizations that have really nailed this around the way?

Dr. Alice Jacobs (23:36):
I think the great news is that anyone who is focused on care delivery right now, this is top of mind. I’ve talked to folks who are working in traditional provider settings at major academic medical centers, small community hospitals. I’ve talked to folks who oversee and run NextGen digital health platforms. I’ve talked to folks in the retail health space. We’ve talked to payers, there’s really no one who would disagree that engaging people in a personal way and rebuilding those relationships isn’t a very high priority, because as you and I have talked about, is that we’ve reached this moment right now where if you look at care delivery, not just now, but if you look at the next 2, 3, 4, 5, 10 years, there’s no way to predict where specifically someone is going to be receiving that care. We’ve reached what I call this sort of jump ball moment, where we have new players that have come onto the scene. And care providers, certainly hospital systems, can’t just compete on reputation alone anymore. They have to be able to come into your home, come into your life. That has changed forever.

Dr. Alice Jacobs (24:53):
And so it creates a lot of opportunity, and I see there’s opportunity across the board. So is there any particular side of the healthcare system that’s getting it right right now? I think this is all of 2022 and beyond, because it’s how do we take advantage of what’s already in place and actually bridge that gap that we just got educated on just throughout the last year or two years?

Chris Hemphill (25:17):
So that leads to a question too, is a lot of the people that we’re working with here, or are attending, come from the hospital side of the equation, or the health system side. So that makes me curious on going into 2022, having this knowledge, what are the steps that people should be focusing on and thinking about to revamp that engagement perspective?

Dr. Alice Jacobs (25:43):
I think what’s important to think about are how do we think about bridging this last mile gap of reaching people wherever they are? We know there’s a gap, we know that we missed out on reaching people, and what are the tools that are necessary to be able to accomplish that? Because we’re not going to rip out all the infrastructure and the systems that are already in place, right? That’s not going to happen. So we have what we have, how do we orchestrate, and how do we connect, and how do we inter operate between systems so that we can have a single view of a patient? So we can have a single view of a consumer, so we can better provide the care now and also keep up with what needs to happen up ahead? So really thinking about the infrastructure and tools, I think it’s going to be a big piece of 2022.

Chris Hemphill (26:38):
Excellent. And we have time for a couple more questions. There was one, we didn’t prep on this one, but I was curious because I saw it from Avneesh, about can we incentivize healthy behavior with crypto? Just wondering, just overall, not necessarily just limited to crypto, but your thoughts on where Web 3 might fit into the engagement picture over last few years.

Dr. Alice Jacobs (27:03):
Web 3 has been talked about for a while. My take is that in healthcare, we’ve got some challenges, because we have very large data files. Think about imaging files, genetic records. These are massive files. These are very difficult to operate in a decentralized manner. Just there are logistical things that make it impractical, and it would require providers to actually have different systems in place, which is difficult to do.

Dr. Alice Jacobs (27:39):
So my take is right now, we need to figure out how do we harness what we have and create possibilities from those systems, because we know what we need to accomplish right now. I mean, if you ask anyone, and I think it’s a very important question I ask anyone, is what do you need to have happen in the next next year for you to be successful? And so we’ve got to get very practical with the tools that we have, and how to we drop in solutions that aren’t going to take 18 months and two and a half years and huge dev and engineering resources, that can allow us to solve some of these important challenges of getting patients back on the court and consumers back on the court to take better care of themselves.

Chris Hemphill (28:20):
From an operational perspective, I have to agree with that. I am personally excited about the potential of Web 3, but I still see it in a potential state right now, where there’s folks that are operating on the fringes and exploring, experimenting with things. But if we know the path that healthcare tends to adopt, we’ll have to see more use cases proven out on a smaller level before that starts getting adopted more widely. But I’m overall excited about those possibilities, and I’m actually doing some personal inspiration on that.

Dr. Alice Jacobs (28:53):
Yep.

Chris Hemphill (28:54):
With that, Alice, I know that there was a reason that you came here and wanted to talk to this audience and some thoughts that you might want them to have, just thinking, going into 2022, finishing out the year. What are some things that, or I guess what’s the major thing that lots of folks aren’t doing right now that Hey, when they hear this perspective maybe there’s some things they can think about, change, consider going into 2022.

Dr. Alice Jacobs (29:26):
I think that if anyone thinks that they can rely on the existing systems entirely to solve these problems, I think we’re going to be challenged. Because they were built in a different age, and now we have new challenges. And so having an open mind about how we think about new tech and integration, I’m certainly a believer that innovation can address a lot of this. There’s also a personal part of this. We need to get really personal right now, with tech and just with our relationships. We need to get to know people again, we’ve all been so isolated. And so how do we use tech? How do we use AI?

Dr. Alice Jacobs (30:07):
And how do we even use those moments when we actually do get to see someone live, to make sure that we know them? Because care comes from a place of knowing, from a place of knowledge. When you think about knowledge and AI and data science, it all comes from having a very clear understanding of who the person is, and that requires data integrity. That requires data quality. That requires a lot of things that we need to get very serious about right now, because of what’s upon us in terms of the pandemic and chronic disease and other things that are happening. And I think it’s also really important to think about your possibilities, and you think about what you want for yourself in your life, in your role in your organization, or wherever you sit, and be really clear on what those are. Because if you’re not clear on your possibilities, it’s very difficult for them to happen.

Dr. Alice Jacobs (30:57):
So I think it’s a moment where we need to look at tech, we need to have an open mind, we to be really excited and focused on innovation, but we also just need to get to know each other again.

Chris Hemphill (31:09):
I love it. Especially that end. We need to get to know each other again. And the crazy thing is 20 years ago, 30 years ago, the types of personalized engagement that you’re talking about out wouldn’t have been fathomable. We didn’t even have the data available to do it. But now, I guess in the 2010s, it was all about, Hey, how do we slice and dice and segment this data. But now the thinking now that we can process and personalize at much more advanced levels than we could in the past is, how do we get back to a place of empathy? How do we use this AI approach to.

Dr. Alice Jacobs (31:45):
Exactly. We need to bring it all the way home, literally back into your home. And the need is now, and the moment is now.

Chris Hemphill (31:55):
Well, I just want to thank you, Lisa, for the happy holidays, and happy holidays everyone here. It’s so fun, Alice, to be able to sit here and talk about a deep conversation. And it’s not just in private, we have a whole squad of friends out here listening in.

Dr. Alice Jacobs (32:12):
Such a pleasure, Chris, and really wonderful comments. I look forward to engaging with all of you coming into the new year. We’ve got a lot we’ve got to create now, our country and the world really needs people like the folks on this call to really take action. And so anyway, I look forward to seeing you all, and connecting sometimes soon.

Chris Hemphill (32:34):
Thank you, and appreciate that. And folks, this is our final LinkedIn live session for the year, but you can… We were talking about podcast binging the other day. If y’all would just go and find us on Apple or Spotify or wherever you get your podcasts, there’s actually a whole host of episodes where we go in depth with a lot of awesome leaders like Alice on where healthcare is going, and that intersection between empathy and data science. With that, wish you a really happy holidays and hope you enjoy your weekend.

Dr. Alice Jacobs (33:11):
Thanks so much, Chris. And thanks to everyone. Happy holidays.

Chris Hemphill (33:13):
Thank you.