Transcript Putting the *mind* into personalized medicine

Putting the ‘mind’ or the ‘me’ into
personalized medicine
Howard R Moskowitz**
Kenneth Rotondo
Bert Krieger
Mary Becker
Mind Genomics Advisors, LLC
White Plains, New York
1
**Presenter
Topics
 People differ – what does that mean
 People want pleasing experiences – even in illness
 What better things can do you say and do when you knew




2
what people want to experience
Examples of such knowledge
Does it really work
Outcome metrics – congestive heart failure
Scaling up for the future
People differ in how they respond
emotionally in a medical experience
3
Person to person differences
 You don’t have to be a scientist or any type of expert to know
that there are differences
 Just look around at the stores .. Not at the products .. At the
stores
 People want different experiences
 Some want simple in and out
 Others want entertainment
 Others don’t even want to be there … use web
 The same thing happens with the medical experience
4
People differ in what they want
 How do you get inside a person’s head?
 And even if you could, what would you do?
 Can science help?
5
People want ‘pleasant, positive’
experiences – even in medical
situations
6
Today it’s all about the customer
experience
 Fred Reicheld developed the NPS .. Net promoter score ..
Would you recommend….
 The NPS value is a placeholder for customer-empowerment
 Technology gives the customer the vote
 Look at all the instant polls of experience
 And in the medical world … the Press Gainey value … just
one
 So when we talk personalized medicine…we ought to
remember the person, his/her MIND
7
A poor experience is a bad thing financially
8
How do you create a pleasing
experience
9
Typical approach - questionnaire
 Ask the respondent (e.g., patient) to describe the experience
 And then use that as a report card
 Objective …. Improve the experience for the patient using
feedback
 This isn’t personalization … it’s merely general quality
control
10
HCAHPS – Hospital Survey
(32 questions)
Hospital level results are publicly reported on the Hospital Compare website 4 times a year. HCAHPS
results are based on 4 quarters of data on a rolling basis.
Composite topics
Nurse communication (questions 1, 2, 3)
Doctor communication (questions 5, 6, 7)
Responsiveness of hospital staff (questions 4, 11)
Pain management (questions 13, 14)
Communication about medicines (questions 16, 17)
Discharge information (questions 19, 20)
Care transition (questions 23, 24, 25)
Individual topics
Cleanliness of hospital environment (question 8)
Quietness of hospital environment (question 9)
Global topics
Overall rating of hospital (question 21)
Willingness to recommend hospital (question 22)
11
Examples from the Questionnaire
5. During this hospital stay, how often did doctors treat you with courtesy and respect?
1 Never
2 Sometimes
3 Usually
4 Always
12. During this hospital stay, did you need medicine for pain?
1 Yes
2 No If No, Go to Question 15
13. During this hospital stay, how often was your pain well controlled?
1 Never
2 Sometimes
3 Usually
4 Always
14. During this hospital stay, how often did the hospital staff do everything they could to help you with your
pain?
1 Never
2 Sometimes
3 Usually
4 Always
12
Point of view
 The questionnaire is an evaluation of the experience (bad to
good)
 There are NO SPECIFICS listed as being desirable
 There is NO WAY TO USE for an individual to drive
change..other than by guessing
 There is NO TEACHING HERE, just a report card
13
Mind Genomics ----- Understanding the
patient’s ‘mind’ without years of
analysis on the couch
14
The reality of today pushes for
measurable experiences
 The strive to measure makes ‘measurement’ the end all and be





15
all
ITRS (it’s the rating, stupid)
We behave according to the laws of reinforcement
Reinforcement scores..and whatever gets a high score is
important
And thinking…think about what will raise the score
Reminds us … of school…study for the exams, like the SAT …
rather than learning
An alternative idea
 Let’s understand what the patient feels about different touch




16
points, experiences in a hospital
But without massive expenditures
Without masses of fairly expensive in-depth interviews
..which are valuable but can’t cover the full range
So I’ll talk about our approach
In the formative stages, with data
How we do it:
S-R (stimulus response)
 Present vignettes of the experience .. Different aspects
 Get responses
 Adherence – can you comply
 Experience – do you find this pleasant
 Use statistics to deconstruct vignettes into what components
‘drive’ the response
 Result – understanding the experience
17
We illustrate with data
1.
2.
3.
4.
5.
6.
18
Understanding: Teens facing the hospital
Understanding: Talking to adolescents about weight
Understanding: What Afro Americans want for health care
Convincing: Woman to select hospital in which to give birth
Convincing: Communicating to the poorer Afro American, for
colo-rectal screening
Convincing: Congestive heart failure patients to adhere to a
healthier life style (and 70% DROP in within-30-day-readmit)
The Process Flow
Target Clients
Distribute Online Survey
Strongest Messages Identified
Identify Target
Population
Develop 6x6
Survey/Statistics
Matrix
Conduct Online
Survey
Mind Genomics
Viewpoint Groups Segmented
Analyzes Survey
Results
Viewpoint Identifier Assigns
Consumers To Identified Groups
19
Case history #1– Understanding
The teen facing the hospital
20
Teens and doctors in hospital
Personal Attention
27%
Permanent
Bond/Mentorship
Honest/Open
communication
35%
38%
Messaging one group doesn’t appeal to the other…
The test stimulus: A vignette
Cannot be ‘gamed’ . No PC here
22
Structure of data – What you will see
What each messages delivers (estimated by regression)
Is it a relevant message, and to whom
“Propensity” score is the unexplained variance in the regression model. Represents motivation which cannot be attributed
to any single message but must be taken into account when assessing overall motivation of an analytical group.
Data Example
<-- Not at all interested
Messages may
not have similar
impact across
analytical groups
Even scores
which appear
neutral for Total
Sample may
mask strong
differing opinions
among other
groups
Total Sample
Base
522
% of Base
100%
Propensity to be interested in the product
36
Positive Messages Among Total Sample
Message #31
7
Message #2
6
Message #26
6
Message #4
5
Message #21
5
Neutral Messages Among Total Sample
Message #11
2
Message #16
2
Message #20
1
Message #15
0
Message #33
-2
Message #19
-3
Negative Messages Among Total Sample
Message #34
-6
Sorted by Total Sample : Highlighted >+5 & <-5
F1
A2
E2
A4
D3
Category 2
Category 1
Category 5
Category 1
Category 6
B5
C4
D2
C3
F3
D1
Category 4
Category 3
Category 6
Category 3
Category 2
Category 6
F4 Category 2
23
Very interested- ->
Some messages
hold no appeal
regardless of target
Analytical
Subgroup #1
219
42%
36
Analytical
Subgroup #2
149
29%
39
Analytical
Subgroup #3
154
30%
34
7
8
-3
4
5
11
-1
12
-2
-6
2
9
14
12
14
4
8
2
5
1
1
1
7
-11
6
-3
-16
0
-11
10
-11
-5
4
-3
-8
-8
Driver
Detractor
What these numbers mean
• Constant represents people’s initial propensity to say yes (rating 79) on the 9-point scale
• A baseline.. In the absence of elements
• Each element generates an estimated driving power
• We are looking for standout messages which break through the
clutter
• These stand out messages are the ones to use
24
Mind Genomics revealed three mind-set
segments for teens facing hospital
Base Size
Constant
25
Seg 1
Medical staff always have a smile on their face
Medical staff constantly checks up on teenage patients and
insure their comfort
Medical staff genuinely tries to help patients which makes
teenage patients feel special
Seg2
Medical staff always speaks the truth to the teenage patient no
matter how traumatizing as it will help in the long run
Wittiness helps medical staff seem more human
Medical staff communicates and gives advice to teenage
patients for their present and future lives
Seg 3
Medical staff develop a teacher-student bond and help teenage
patients who want to be medical staff themselves
Medical staff develops bond with teenage patient to make it
easy for them to vent
Medical staff develop a permanent friendship with teenage
patient that carries on even after their release
Seg1
43
42
Seg2
55
56
Seg3
59
71
18
-8
-3
18
8
-4
16
-1
-7
5
2
15
15
-5
-4
3
15
-4
3
-8
25
7
0
14
-3
-7
14
Case history #2: Understanding
Teen girls with eating problems
26
Three Unique Segments Emerged
The Control
Seekers
27
The
‘Aware, But Don’t
Care’
The Low Selfesteem Team
27
The Survey begins with an orientation screen
28
Each respondent evaluates unique combinations of elements
29
The Control Seekers- These are girls who are not necessarily overweight, but
feel as though they have little control over their lives, and therefore seem to
seek this control by limiting how much they eat.
How well does this screen describe you?
<-- Does not describe me at all... Describes me exactly-->
1
2
3
4
5
6
7
8
9
Seg 2 of 3The 'Aware, Seg 3 of 3The Low SelfBut Don’t esteem Team
Care'
Total
Sample
Seg1 of 3The Control
Seekers
102
16
-3
0
0
1
4
0
-1
0
3
2
1
1
1
32
24
11
10
9
9
8
-7
-7
-8
-10
-11
-11
-11
-13
46
22
-9
-7
-9
-3
1
6
-4
3
3
4
10
5
2
-7
-14
-15
Sorted by Seg 1 : Highlighted >+9 winners & <-9 losers
BASE SIZE:
CONSTANT:
You don’t get along with your family because you think they are too controlling
You are a perfectionist, and do not tolerate failure
Going on the scale depresses you
You get extremely frustrated when things don’t go your way
If you feel like you ate a lot one day, you will starve yourself the next day to compensate for it
You wish that you could look more like the actresses you see in movies
Many of your immediate and extended family members are overweight
You think if you were thinner, people would like you better, and you would be more popular
Your mother or caregiver would cook, or does cook healthy, balanced meals for your family
As a child your parent(s) or caregiver(s) encouraged you to be physically active
You think that society places a great importance on being thin
Your immediate family members make an effort to keep in shape
You were born with big bones or a big frame
When you go shopping, you buy clothes a size smaller than you really are, hoping you will soon lose
weight and they will fit you
24
-3
-11
0
3
0
3
-2
14
3
20
15
-1
7
17
30
19
The 'Aware, But Don't Care’-These girls are average in body weight and selfesteem. They are aware of how much they eat, and know that it might not be
the healthiest way, but aren't motivated to change their habits out of
stubbornness and/or laziness.
How well does this screen describe you?
<-- Does not describe me at all... Describes me exactly-->
1
2
3
4
5
6
7
8
9
Seg 2 of 3- Seg 3 of 3The 'Aware,
The Low
But Don’t Self-esteem
Care'
Team
Total
Sample
Seg1 of 3The Control
Seekers
102
16
6
8
1
9
4
5
0
1
-1
-1
0
0
-3
1
-4
32
24
-7
-2
-11
7
2
7
-7
9
3
-7
10
9
11
1
-7
46
22
17
12
10
8
8
7
6
-3
-4
-4
-7
-9
-9
-9
-11
24
-3
2
12
-1
12
-1
0
-2
0
-2
14
0
3
-11
22
15
-7
-14
-15
19
Sorted by Seg 2 : Highlighted >+9 winners & <-9 losers
BASE SIZE:
CONSTANT:
If you were thinner you would be happier
You have erratic eating habits
You think that society places a great importance on being thin
You eat till you are full and don’t pay attention to portion sizes
You live to eat rather than eat to live
You are very organized and hate surprises or spontaneity
You wish that you could look more like the actresses you see in movies
You get extremely frustrated when things don’t go your way
You feel incompetent when compared to a lot of your friends
Many of your immediate and extended family members are overweight
You are a perfectionist, and do not tolerate failure
Going on the scale depresses you
You don’t get along with your family because you think they are too controlling
You feel ugly in comparison to your friends
You weigh yourself every morning and get upset at yourself if you gain weight
When31you go shopping, you buy clothes a size smaller than you really are, hoping you will soon lose
weight and they will fit you
The Low Self-esteem Team- These girls have very low self-esteem, criticize
themselves frequently, and feel inferior to their peers due to their weight.
Additionally, many have some sort of family history of health related problems
due to poor eating habits.
How well does this screen describe you?
<-- Does not describe me at all... Describes me exactly-->
1
2
3
4
5
6
7
8
9
Seg 2 of 3- Seg 3 of 3The 'Aware, The Low
But Don’t Self-esteem
Care'
Team
Total
Sample
Seg1 of 3The Control
Seekers
102
16
4
1
3
32
24
-6
1
-10
46
22
0
-9
3
24
-3
25
22
20
-7
-14
-15
19
1
3
-4
2
-1
2
9
8
6
-3
-2
-13
-6
-7
-11
-7
-3
7
-2
7
11
-1
2
3
-11
4
-4
-1
8
12
3
-9
5 32
17
17
15
15
14
12
12
12
10
-11
-14
Sorted by Seg 3 : Highlighted >+9 winners & <-9 losers
BASE SIZE:
CONSTANT:
You feel self-conscious about your appearance
You feel ugly in comparison to your friends
Your mother or caregiver would cook, or does cook healthy, balanced meals for your family
When you go shopping, you buy clothes a size smaller than you really are, hoping you will soon lose
weight and they will fit you
You were born with big bones or a big frame
Your family has a history of health-related problems as the result of unhealthy eating lifestyles
You weigh yourself every morning and get upset at yourself if you gain weight
As a child your parent(s) or caregiver(s) encouraged you to be physically active
Many of your immediate and extended family members are overweight
You think people judge you based on how you look
You eat till you are full and don’t pay attention to portion sizes
You have erratic eating habits
You skip breakfast in the mornings
You don’t get along with your family because you think they are too controlling
You only eat when you are hungry
Case history #3: Understanding
What Afro Americans want for health care from the
US government (election year platform)
33
The approach
 Identify elements from key websites and government





34
information
Put them into the Mind Genomics format
Afro-American respondents
20 elements, combined into 25 different combinations …
standard Mind Genomics ‘torture test’
Look at total panel, and identify interpretable segments
Four segments emerge …different desires
Total – all Afro Americans –
No clear pattern of elements
35
Afro-Americans on Health Policy
Mind set segments 1 and 2
36
Afro-Americans on Health Policy
Mind set segments 3 and 4
Case history #4: Convincing
“Selling” a hospital for birthing
38
I’m expecting a baby…
What hospital do I choose for delivery?
39
What appeals to the majority of surveyed
women? What turns them off?
Sorted by
Total Sample
Base Size
Constant
Our Neonatal Intensive Care Unit, adjacent to our LDR Unit, is included every year in the national list of
"NICU's that achieve the best outcomes"
9
Our highly trained staff of experts includes Board Certified Maternal-Fetal Medicine Specialists, Perinatal
Nurses and Imaging Technologists specializing in obstetrics and gynecology, plus we have the only fetal
surgery unit in the region
8
We encourage mom and partner to room together in the hospital after childbirth in order to adjust as quickly as
possible to the new family experience and encourage bonding
6
We treat all patients and their families with compassion and consideration, and provide a physical environment
that is conducive to patient care and comfort
Experienced physicians and nurses qualified to handle both high and low risk pregnancies
6
An anesthesiologist is present (and not just on call) at each delivery, from the very beginning to the very end
We were the first hospital on Long Island to have certified midwives and today we continue to be bearers of
excellence in maternal/child care
Nurse to patient ratio that guarantees someone is always aware of your needs
Immediate access on-site to the most advanced technology and skilled professionals in case of an emergency
Free 24-hour TV channel available in English and Spanish on breastfeeding, parenting, postpartum, child
safety and sibling rivalry during your hospital stay
Have your favorite foods and drinks…a refrigerator is in your room!
40
304
66
5
5
5
1
0
-1
-2
Different women – different preferences
Seg 1: Professional
Staff (33%)
Seg 3: Realistically Prepared (18%)
Seg 2: Family Utopia (33%)
41
Seg 4: Pamper Me!
(16%)
Let’s look at the 4 different segments or
mind sets
Sorted by
Seg1 of 4 Seg2 of 4 Seg3 of 4 Seg4 of 4
Total
Sample
Base Size %
Base Size
Constant
100%
304
66
33%
101
69
33%
99
75
18%
56
51
16%
48
62
Our Neonatal Intensive Care Unit, adjacent to our LDR Unit, is included every year in the
national list of "NICU's that achieve the best outcomes"
9
13
9
-1
13
Our highly trained staff of experts includes Board Certified Maternal-Fetal Medicine Specialists,
Perinatal Nurses and Imaging Technologists specializing in obstetrics and gynecology, plus we
have the only fetal surgery unit in the region
8
16
7
1
2
We encourage mom and partner to room together in the hospital after childbirth in order to
adjust as quickly as possible to the new family experience and encourage bonding
6
-2
6
13
14
We treat all patients and their families with compassion and consideration, and provide a
physical environment that is conducive to patient care and comfort
Experienced physicians and nurses qualified to handle both high and low risk pregnancies
6
1
5
12
10
5
13
2
-4
6
An anesthesiologist is present (and not just on call) at each delivery, from the very beginning to
the very end
5
4
6
6
3
We were the first hospital on Long Island to have certified midwives and today we continue to be
bearers of excellence in maternal/child care
Nurse to patient ratio that guarantees someone is always aware of your needs
5
6
6
-6
10
1
2
5
-1
-10
Immediate access on-site to the most advanced technology and skilled professionals in case of
an emergency
0
1
-9
14
1
Free 24-hour TV channel available in English and Spanish on breastfeeding, parenting,
postpartum, child safety and sibling rivalry during your hospital stay
-1
-7
3
1
1
Have your favorite foods and drinks…a refrigerator is in your room!
-2
4
-8
-4
-1
42
Segment 1 (33% of population) – interested primarily in
professionalism of staff. Not concerned with atmosphere.
Sorted by
Seg1 of 4
Professional
staff
Base Size
Constant
Our highly trained staff of experts includes Board Certified Maternal-Fetal Medicine Specialists, Perinatal Nurses and
Imaging Technologists specializing in obstetrics and gynecology, plus we have the only fetal surgery unit in the region
Experienced physicians and nurses qualified to handle both high and low risk pregnancies
16
Our Neonatal Intensive Care Unit, adjacent to our LDR Unit, is included every year in the national list of "NICU's that
achieve the best outcomes"
Private spacious room with extra bed and your own bathroom
All of our postpartum nurses are certified lactation specialists
Board certified obstetricians are polite, supportive and do not rush from one patient to another
Nearby waiting rooms for your family and loved ones to welcome your new baby
13
We were the first hospital on Long Island to have certified midwives and today we continue to be bearers of excellence
in maternal/child care
6
We appreciate that women need and deserve special care and special treatment in a family centered environment
43
101
69
13
11
10
9
8
-4
We'll help you ease your way into the responsibilities of a growing family with our parenting workshops and classes
such as childbirth preparation, breastfeeding and sibling big brother/big sister day camp
-4
During your labor and delivery, your family may wait in a spacious waiting area, which has comfortable furnishings for
adults and children
Quiet and peaceful atmosphere to help maintain your ideal relaxation state
-6
Free 24-hour TV channel available in English and Spanish on breastfeeding, parenting, postpartum, child safety and
sibling rivalry during your hospital stay
-7
-6
Segment 2 (33% of population) – looking for family-friendly
atmosphere. Not concerned with private rooms or emergency care.
1) Would you deliver your baby at this hospital?
<-- Definitely NO
Definitely YES -->
1
2
3
4
5
6
7
8
9
Sorted by Total Sample : Highlighted >+5 winners & <-5 losers
Sorted by
Seg2 of 4
Family
utopia
Base Size
Constant
44
99
75
We'll help you ease your way into the responsibilities of a growing family with our parenting workshops and
classes such as childbirth preparation, breastfeeding and sibling big brother/big sister day camp
9
Our Neonatal Intensive Care Unit, adjacent to our LDR Unit, is included every year in the national list of
"NICU's that achieve the best outcomes"
9
Our family centered care is designed to help the entire family adjust to a whole new life when a new baby
arrives
7
Our highly trained staff of experts includes Board Certified Maternal-Fetal Medicine Specialists, Perinatal
Nurses and Imaging Technologists specializing in obstetrics and gynecology, plus we have the only fetal
surgery unit in the region
7
To enhance your parenting skills, several classes, including "Baby Care" and "Breastfeeding", are offered
by a "Baby Friendly" designated hospital
Friendly, helpful and caring nurses provide a supportive atmosphere for you and your family
Friendly, supportive and understanding environment that makes you feel at home
7
We encourage mom and partner to room together in the hospital after childbirth in order to adjust as quickly
as possible to the new family experience and encourage bonding
6
Immediate access on-site to the most advanced technology and skilled professionals in case of an
emergency
Our hospital is equipped with specialists to treat premature and sick newborn babies
Private spacious room with extra bed and your own bathroom
-9
7
6
-9
-9
Segment 3 (18% of population) – wants to be prepared for any
outcome. Not too concerned with luxury care for moms.
Sorted by
Seg3 of 4
Realistically
prepared
1) Would you deliver your baby at this hospital?
<-- Definitely NO
Definitely YES -->
1
2
3
4
5
6
7
8
9
Sorted by Total Sample : Highlighted >+5 winners & <-5 losers
Base Size
Constant
Our care extends to women anticipating both normal and high-risk pregnancies and delivery
Our hospital is equipped with specialists to treat premature and sick newborn babies
We encourage mothers to have skin-to-skin contact with their baby and those who wish to breastfeed to
begin immediately after delivery - it will benefit your baby and help you relax
Immediate access on-site to the most advanced technology and skilled professionals in case of an
emergency
We encourage mom and partner to room together in the hospital after childbirth in order to adjust as
quickly as possible to the new family experience and encourage bonding
We treat all patients and their families with compassion and consideration, and provide a physical
environment that is conducive to patient care and comfort
All of our labor and delivery nurses are certified in advanced life support and trained in electronic fetal
monitoring
You’re greatly involved in any decision-making regarding the hospital where you are going to have your
baby
Have your favorite foods and drinks…a refrigerator is in your room!
Moms can make an appointment with a licensed massage therapist during their stay
We were the first hospital on Long Island to have certified midwives and today we continue to be bearers
of excellence in maternal/child care
Board certified obstetricians are polite, supportive and do not rush from one patient to another
All of our postpartum nurses are certified lactation specialists
45
56
51
19
17
14
14
13
12
12
12
-4
-5
-6
-8
-9
Segment 4 (16% of population) – wants to be pampered. Looking
for Mommy-centered experience.
Seg4 of 4
Pamper me!
Constant
Moms can make an appointment with a licensed massage therapist during their stay
Private spacious room with extra bed and your own bathroom
We encourage mom and partner to room together in the hospital after childbirth in order to adjust as quickly
as possible to the new family experience and encourage bonding
14
Meals are served to you in a room-service fashion, giving you a variety of wonderful meal selections as well
as the flexibility to dine at your leisure
13
Our Neonatal Intensive Care Unit, adjacent to our LDR Unit, is included every year in the national list of
"NICU's that achieve the best outcomes"
State of the art “rooming in” facilities for mother and baby to enhance your new family experience
Private rooms (birthing suites) to have your labor, delivery, and recovery in one place
13
We treat all patients and their families with compassion and consideration, and provide a physical
environment that is conducive to patient care and comfort
10
To enhance your parenting skills, several classes, including "Baby Care" and "Breastfeeding", are offered by
a "Baby Friendly" designated hospital
-8
You’re greatly involved in any decision-making regarding the hospital where you are going to have your
baby
Nurse to patient ratio that guarantees someone is always aware of your needs
Guided tours through the facility to help future parents feel familiar and comfortable
Nearby waiting rooms for your family and loved ones to welcome your new baby
46
48
62
17
15
12
10
-8
-10
-12
-12
Case History #5: Convincing
Communicating to poor Afro Americans need
for colo-rectal screening
47
Short background
 Goal – how to motivate poor Afro-Americans to get regular
colo-rectal screening
 Early detections saves hundreds of thousands of dollars
 Results – Four mind-sets
 Create viewpoint identifier – four questions to identifier
which mind-set, to give correct messages
48
Colo-rectal screening
The four mind-sets or viewpoints (segments)
Viewpoint 1
I Am Convinced
57% of sample
This viewpoint is motivated to get a screening test to prevent
colon cancer. There is no discrimination across the test
messages because all of the messages are motivating.
Viewpoint 2
Screening and Prevention
15% of sample
Talk about the benefits of screening…early detection prevents
death from colorectal cancer and why without screening
symptoms appear to late to cure. Also encourage the client
with concerns about the procedure to speak to someone they
trust.
Viewpoint 3
Personal Appeal and Early Detection
For A Cure
14% of sample
This viewpoint is motivated when the messages relate to a
personal perspective and early detection to stop cancer.
Viewpoint 4
I Am Convinced…Don’t Talk About
Risks and Consequences
14% of sample
This group is highly motivated to get a screening test. Avoid
discussing risk factors, death and concerns related to colon
screening because these messages are behavioral barriers.
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The 30 second Viewpoint Identifier identifies segment
affiliation when administered to a client
Click to See Live
Demo of Typing Test.
Click Here
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Questions asked in the Viewpoint Identifier for colon cancer
screening among poverty level African-Americans
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Case History #6: Convincing
Communicating to discharge patients with
congestive heart failure to ‘adhere’
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What do you say to drive adherence?
 The statistics suggest that at least 1/3 of prescriptions are
just not filled
 And of those that are filled, many are not taken long enough
 Not to mentioned when the doctor tells you to stay off
certain substances
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Let’s focus on understanding the
experience and personalizing
• Go through the drill
• Present vignettes about the experience
• Ask whether you could live with the regimen
• Develop individual models
• Identify segments
• Create the viewpoint identifier
• Implement it in an A/B study
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To Review … the process flow
Target Clients
Distribute Online Survey
Strongest Messages Identified
Identify Target
Population
Develop 6x6
Survey/Statistics
Matrix
Conduct Online
Survey
Mind Genomics
Viewpoint Groups Segmented
Analyzes Survey
Results
Viewpoint Identifier Assigns
Consumers To Identified Groups
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Knowing the mind of the patient can reduce readmissions
dramatically …presumably through adherence
56
Compliance Messages – ‘raw material’ (1 of 2)
57
Compliance Messages – ‘raw material’ (2 of 2)
58
Overall:
Positive numbers indicate that message encourages the user to comply;
Negative numbers indicate that message discourages people from taking the medications
61
Three Unique Mind Set Segments For Compliance
Segment 1:
It’s My Decision
Segment 2:
It Takes a Support
Group
Segment 3:
Faith in the Medical
Field
42%
31%
27%
Different cohort groups require different,
segment-appropriate messaging
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Three distinct Mind Sets or Viewpoints
Light – drives compliance Dark – detracts from compliance
Out of 36 elements, more than half show that compliance may occur for some
segments, not others
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It’s My Decision (Segment One – 31%)
Messages which encourage medication compliance
•Your doctor has fully informed you of the benefits and side effects of taking
your medication
•You believe that your medication is helping your condition
•You understand the benefits of taking your medication
•You believe that not taking your medication can be harmful in the long run
•You believe that taking your medication helps you to live longer
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It Takes a Support Group (Segment Two – 27%)
Messages which encourage medication compliance:
•Your healthcare plan makes your medication affordable
•You can feel or see the benefits of taking your medication as prescribed
•You have been taught why taking your medication is important
•You believe that your medication is helping your condition
•You believe that taking your medication helps you to live longer
•You have a support group that encourages you to take your medication
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Faith in the Medical Field (Segment Three – 42%)
Messages which encourage medication compliance:
•You believe your condition warrants taking your medication
•You believe that taking your medication helps your condition
•You understand the benefits of taking your medication
•You trust your physician to prescribe the correct medication
•You trust your choice of physician, pharmacist and healthcare provider
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Identifying the mind-set of this NEW person
6
7
Feedback & Action Page
When a person’s pattern suggests Seg 1
68
Feedback & Action Page
When a person’s pattern suggests Seg 2
69
Feedback & Action Page
When a person’s pattern suggests Seg 3
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So..what happened
• Step 1 – Apply viewpoint identifier
upon discharge … instructions to
read the discharge instructions
each day
• Step 2 - Measure re-admission
rates in an A/B test
• Step 3 – Look for commonalities of
those readmitted (most Segment
or Viewpoint #2 …It takes a
support group)
• Step 4 – Pay careful attention for
Segment 2 discharges
7
1
Knowing the mind of the patient can reduce readmissions
dramatically …presumably through adherence
72
Moving our patient understanding
to ‘industrial strength’
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Up to now and forward
 We presented different studies, done for different groups, at





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different times
We have good data, and when applied, meaningful outcomes
There are many touchpoints in in the health/wellness continuum
What about creating a series of these studies (20+), to provide us
foundational data
Then create the corresponding 20+ viewpoint identifiers
And type people all over the country, putting the information in
their medical record!
In other words
 Can we know the person, the way we know the person in our
CHF?
 And then create a knowledge base of the
health/wellness/illness EXPERIENCE
 Then…mind-type millions of people
 Ensuring local, nation-wide, and then world-wide optimal
health messaging, and optimal experience with the healthcare systems?
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Here is an example for the business
A retrospective from 2018
 Identified 20 ‘health touch-points’
 For each touch-point, did Mind Genomics for the US population
….Identified the mind-set segments
 Created a ‘typing wizard’ of 3-4 simple questions which assigns a person to
the segment
 Created a set of 20 such 4-6 question viewpoint identifiers
 Used that to sequence the health-mind of the US customer
 Now that sequenced health-mind is part of a patient’s electronic
health record
 Any doctor or hospital know show to make the experience exceptionally
positive for that individual
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For more information
Howard R Moskowitz, PhD
Founding Partner & Chief Scientist, Mind Genomics Advisors, LLC
President, Mind Genomics Associates, Inc.
11 Sherman Ave
White Plains, NY 10605
Email:
[email protected]
Skype: hmoskowitz62
Mob:
914 572 1673
Web:
www.MindGenomics.com
Mind Genomics DropBox & Mentoring:
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https://www.dropbox.com/sh/vlyiqp6p5eom0m1/AAC1WRPuHOGpax6TLqmd824a?dl=0