Overcoming the Barriers of Virtual Care Utilization

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For the first time in history, technology has made high-quality virtual care a reality. But virtual care simply doesn't work if nobody is using it. From the most technologically savvy healthcare consumers to the least, interest in telehealth far outpaces utilization in confounding ways. For instance, while 52% of people over the age of 65 report* a desire to give telehealth a try, only 1% have. What is the reason for this disconnect, and how can healthcare providers overcome it? Hundreds of thousands of patient encounters across the nation have revealed that creating the most effective virtual care program possible requires information, access and a high-quality customer experience. Utilization has been slow to grow due to a perception that telemedicine is impersonal, imprecise and difficult to use. Successful healthcare partners have leveraged the incredible potential of virtual care through three fundamental actions:

*Based on American Well’s 2019 Senior Consumer Survey.

Building awareness of the benefit your offer

Improving customer access to virtual care

Ensuring a customer-centered experience

1.

2.

3.

Contents

3 BUILD AWARENESS

7 IMPROVE ACCESS

10 CREATE CUSTOMER-CENTERED EXPERIENCES

13 WE'RE HERE TO HELP

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The most significant barrier to accessing a telehealth benefit is awareness. According to a survey from J.D. Power, only 17% of consumers know that their health system or insurance provider offers telehealth or virtual health services. Most, when asked, will erroneously state that their insurers don’t offer any virtual services at all. There is little wonder, then, as to why some of these providers see engagement rates in the single digits. The California Telehealth Resource Center has published a marketing guide that delineates telehealth’s benefits, including access to clinical specialists and the elimination of long wait times, drive times and time off of work. By highlighting these points, healthcare payers and employers can help make the emotional connection between the benefit they offer and the end user's overall healthcare experience.

These clear and resonant connections make a difference between a benefit that no one knows about, and one that becomes an indispensable part of a person’s healthcare journey. The greater the awareness about your telehealth offerings, the more

Build Awareness

Overcoming the Barriers

18.5% Year 1 Utilization

48% Loyal Return Users

CIRRUSMD'S UTILIZATION*

24 days

Book an appointment with a doctor**

28mins

See a physician in an ER, nationwide+

20mins

Book a traditional telehealth appointment†

19mins, 16sec

Sit in a doctor’s waiting room�

< 1min

CirrusMD encounter across all platforms*

*Based on CirrusMD's member data. **Forbes, "Doctor Wait Times Soar 30% In Major U.S. Cities," Mar, 2017. +ProPublica's ER Inspector, updated Sep 19, 2019. †eVisic's "20 Stats: How Do Patients Feel About Telehealth?". � Becker's Hospital Review "How long is the average wait at a physician's office?" Mar, 2015.

AVERAGE WAIT TIMES

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SOLUTION 1 | Consider the Message

Marketing departments work tirelessly to prevent customers from feeling bombarded with unwanted ads and information. This is the right instinct, as clever words and dazzling graphics are useless if emails go unopened. However, this approach can sometimes lead to a reluctance to market anything – no matter how unique and important to a customer’s quality of life. The most effective strategies involve taking a step back to consider your overall communications picture and how telehealth fits into it. At CirrusMD, we believe that crafting messages that reflect users’ real lives is critical; it’s no longer enough to send out a monthly email tying our product to the latest health-related holiday. Promoting a benefit like on-demand, text-based virtual care that improves health, reduces friction and improves access to care will likely fit into any planned benefits marketing strategy. Timing and tone play a critical role in what is communicated and when. For example, companies that notice that their customers’ demand for virtual care access tends to spike after the holidays can capitalize on need and tailor their marketing schedule accordingly. Similarly, promoting a healthcare benefit to people who are currently healthy can help keep virtual care options top-of-mind when customers need them most.

EFFECTIVE COMMUNICATION

effectively you can leverage these benefits to recruit and retain customers and improve the customer experience.

SOLUTION 2 | Test Your Approach

Testing is another key ingredient in any successful marketing effort. Some payers and employers have found that a “meet and greet” message, which encouraged healthy people to register and just “say hi” to a doctor was far more successful than a standard “register today” prompt. By testing these disparate approaches,

The messaging speaks to Alaskan users who may find it difficult to access a doctor due to their remote location.

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*Entrepreneur "One Metric for Testing a Successful User Experience" Nov, 2018. +Invesp "The State of A/B Testing." † Digiday "Emojis By the Numbers: A Digiday Data Dump" Mar, 2015. �LivePlan "Do Visuals Really Trump Text?" Jun, 2018.

We also test for time of day, demographics and even emojis. No really, emojis.

2 billion

Smartphone users all over the world†

41.5 billion

Messages sent every day†

6 billion

Emoticons sent every day†

60k faster

The brain processes visuals faster than text�

SOLUTION 3 | Consider New Channels

While emails remain an effective marketing tool, broadening to other channels can yield tremendous results. Studies have found that while people read 80 to 90% of the text messages they receive, emails get an open rate of about 30%. The key is knowing what resonates with the desired audience.

As companies explore different communications channels, including social media and text, it is also important to remain educated about communication laws. For marketers, compliance means more than just adhering to rules and regulations. A well-

companies are finding that their customers feel as though they are test driving an innovative new service well before they need it – which translates to a measurably significant effect on utilization rates and customer satisfaction.

400% increased conversion rate by better UX design*

1 out of 8 A/B tests have driven significant change for a company+

GLOBAL COMMUNICATIONS SNAPSHOT

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*Text Request "How Many Texts Do People Send Every Day (2018)?" May, 2016.

SOLUTION 4 | Create the Journey

Once a payer or employer has a handle on where to reach customers and what the legal requirements are, it is time to move on to the fun part: Creating the Journey. Delivering an omnichannel, integrated message tells customers that their healthcare provider understands them – and that a company’s brand and the benefits offered match their lifestyles and sensibilities. Gone are the days that a company can send an email about an amazing offer and expect to see results. Today, multi-touch approaches that reach customers on social media, via text, in their in-box, and within the tools they are already used to using builds awareness and interest that translates to conversion.

defined marketing compliance strategy involves protecting brand integrity and consumer trust throughout the entire creative process. 8.5 billion texts sent

every day

32 texts per day per person

SOLUTION 5 | Educate Your Team

From existing in-network providers and administrators to call center employees and case managers, a payer or employer's greatest communication assets are the people on its team. Take the time to educate the entire team about the virtual care benefit that the company offers. Provide brochures for doctors’ waiting rooms, scripts for call center employees and one-sheets for employers to email to their employees that can help patients - and providers and teammates - communicate more efficiently and more effectively. When your virtual care solution becomes an integrated element instead of an outlier in your care continuum, the patient experience improves, and so does your effectiveness in delivering the right care access at the right time.

TEXT IS KING*

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Once customers sign up for text-first telehealth, they use it. Again, and again. The results are improved access to care, lower ER utilization rates and reduced costs. So, how do successful companies get customers to register for telehealth? After awareness, access is the greatest barrier to utilization. A recent study reported that only 2% of all Americans have actually had a telemedicine consult, while another employer-focused study reported that, on average, only 7% of all eligible employees have actually accessed their telehealth benefits. The struggle? When a solution that’s supposed to make your life easier is still painful to navigate, utilization is going to suffer. For virtual care to meet its full potential, it must be fast, efficient, omnichannel and priced competitively.

Improve Access

Overcoming the Barriers

*Based on 3rd Party 2018 Member Survey Reporting. †2018 Patients who self-reported through a 3rd party survey that without the ER Doc app they would have instead visited an Emergency Room. ^Based on reported ER Doc physician encounter notes in December 2018. **Claims-Based Data shared by Texas Health Aetna. †Mercer "Everyone Wants Telemedicine. So Why Aren’t Your Employees Using It?" Aug, 2018.

SOLUTION 1 | Rethink Fees

The most innovative payers in the market today are enticing their customers to try something new by trying something new themselves – namely, upending their old approach to fees. Many traditional telehealth solutions layer the old brick-and-mortar fee-for-service approach onto their telehealth product and are then surprised to find low utilization rates. Working with a next-generation virtual care provider to develop payment models that attract and retain customers can create a truly transformative experience that moves the needle on patient health and cost savings.

46.2% ER diversion�

94.2% in-person follow-ups happened outside the ER^

$398 approximate savings per avoidance**

Utilization rates of 10%+, the median copay was $15 for telemedicine†

Utilization rates < 6%, the median copay was $30 for telemedicine†

LOYAL RETURN USERS & ER DIVERSION*

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*Reuters "The doctor will see you now - but often not for long" Nov, 2017. **eVisc "20 Stats: How Do Patients Feel About Telehealth?" +Based on CirrusMD's member data.

SOLUTION 3 | Offer It Everywhere

Meeting customers where they are ensures that their experience is fast, seamless and friction-free. For example, at CirrusMD, we work with our healthcare partners to develop successful

SOLUTION 2 | Let Your Customer Set the Pace

The promise of virtual care is speed. What’s important here is that “speed” is measured by the patient, not the doctor. Leveraging an asynchronous communication system allows customers to be in control of the pace of the communication. This means a patient can text a doctor on her way into a board meeting and then read the response on her lunch break. Her medical issue will be resolved on her time, at her pace. It also means “office visits” can last for a few minutes at a time over the course of several hours (or even days), depending on the patient’s needs. Moving at the speed of chat means that your benefit keeps pace with your patients’ patience.

As mentioned above, virtual care not only lengthens

patient encounters with physicians but shortens the

wait to “see” a doctor. While the average wait to schedule an appointment with a physician is 24 days, it takes 42 seconds to connect with a doctor on a platform like CirrusMD. This is the speed of business, and customers will notice.

20mins

Doctor's office visit*

20mins

Traditional telehealth visit**

33mins

CirrusMD encounter+

AVERAGE CARE DURATION

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models that allow customers to access doctors via desktop, web, app, phone, video and chat. In response to what we’ve learned about our users and their needs, we’re also launching a new benefit of being accessible 24/7, 7 days a week on Jan 1, 2020. By giving patients choice, these providers have seen an increase in utilization and satisfaction. Our work with some partners has resulted in annual utilization rates of more than 21%.

“Where you see banner ads everywhere for video visits with physicians and all the rest of

it with very low traction, you put out a 'chat with a doctor' button, and traffic instantly finds

its way through. Nobody has a question of what’s about to happen. 'I click the button, I’m at some point going to be connected with a

doctor. And if it’s fast I’m really going to like it.' Patients will show you what they like to do if

you can just give them that opportunity.”

LIZ ROCKETT | DIRECTOR, KAISER PERMANENTE VENTURES

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Whether healthcare is being delivered in a brick-and-mortar building or virtually, customer experience is key to a patient’s satisfaction. How customers perceive the care they receive is based on a benefits provider's ability to create experiences that are familiar, helpful and of high-quality.

Create Customer-Centered Experiences

Overcoming the Barriers

*Text Request "How Many Texts Do People Send Every Day (2018)?" May, 2016. **Gallup " The New Era of Communication Among Americans" Nov, 2014.

SOLUTION 1 | Meet Them Where They Are

Texting is now second-nature to most of us. It is comfortable, and it is how many of our most pressing needs get met. That is why CirrusMD has placed chat as the driver of our patient encounters. Instead of adding digital barriers to virtual care, we leverage the asynchronous nature of text to give patients a pleasant and engaging experience. They feel cared for because their care is no longer transactional, it’s conversational.

ADVANTAGES OF TEXT

Rather than the standard fee-for-service, transactional encounter that customers find with ERs, Urgent Cares, traditional telehealth or even some doctors’ offices, chat-based telehealth allows for the development of a relationship across multiple touch-points. The

Only 20%

of people answer calls they aren't expecting*

Within 5sec

texts read once received*

68%

millennials say they "text a lot" daily**

Texts are instant and mobile**

Texts are read and exchanged at any time**

Texts are thought-out rather than reactionary**

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2.

3.

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*Becker's Hospital Review "1 in 5 Consumers Trust AI-Generated Healthcare Information, Survey Finds" Jun, 2019.

SOLUTION 2 | Put Humans First

Customers aren’t just looking for treatments, they are looking for care. When customers say they don’t trust artificial intelligence, what they’re saying is that they recognize the value of human judgment. By leveraging the potential of AI to enhance human physicians’ skill, judgment and expertise, a healthcare company can deliver care that is as compassionate as it is efficient.

immediacy and intimacy of those text encounters provide patients with a deep feeling of being well cared for – both in terms of quality and in terms of the length of the encounter.

78% of millennials don’t trust healthcare delivered by A.I.*

90% of seniors don’t trust healthcare delivered by A.I.*

Studies have found that traditional visit-based telemedicine doctors are prescribing more antibiotics than pediatricians would during an in-person encounter. And some telehealth companies use computer algorithms to self-select for “rubber stamped” prescription requests. Unthoughtful automation bears the brunt of the blame for these deviations from standard care, as cases that are run through computer models lack the judgment, skill and instinct of human physicians. AI is enormously effective in assisting in care. Serving as a “second set of eyes” for radiology screening or finding patterns and clusters in disease cases can speed up care and save lives. But for AI to be truly effective, it needs to serve as a tool for physicians - not the other way around.

It's often said that the best technology is the technology that don't even know is there. That's why an invisible AI solution designed to help providers make faster, smarter decisions and support better outcomes in real time is the AI solution that will drive meaningful satisfaction and utilization rates.

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*Pediatrics "Antibiotic Prescribing During Pediatric Direct-to-Consumer Telemedicine Visits" May, 2019.

SOLUTION 4 | Navigate Them Along Their Journey

While the vast majority of a customer’s telehealth experience can be handled virtually, there are, of course, cases that need to be followed up in person and by a specialist. In those situations, continuing the warm, engaging care experience is critical to the overall care journey of the patient. A quality virtual care partner can create an opportunity for patients to be guided to their next point of care seamlessly and with compassion - further building patient trust and reflecting well on a partnering insurance company’s brand.

SOLUTION 3 | Give Them High Quality Care

Working closely with a virtual care company can ensure that patients have access to doctors who are among the best in their fields. These are well-trained physicians and intuitive listeners; doctors that other doctors send their family members to. The asynchronous nature of chat enables these high-quality doctors to revisit/renew conversations (or have the patient touch base) in an organic way that doesn’t exist in any other modality. Patients no longer have “one bite at the apple,” one chance to communicate with a doctor and have their problem “fixed.” And doctors no longer have a harried 15 minutes to make a decision about what to do for a patient’s complaints. With the luxury of time, doctors and patients can take a “wait and see” approach that generally reduces extraneous tests and eliminates unnecessary antibiotics prescriptions. When done well, virtual care offers a nationwide platform of expert providers, actual humans (not computer algorithms) who can care for patients at anytime, anywhere with thoughtfulness, expertise and compassion.

41% Traditional telehealth visits

33% Urgent care

22% Primary Care physician

OVERPRESCRIBING ANTIBIOTICS*

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Quality care, improved outcomes and increased customer satisfaction begins the moment your customers download your white-labeled chat-first telehealth benefit from the App Store. By marketing your benefit to your customers clearly and across several channels, you communicate to them that they now have access to healthcare that fits their lifestyles and caters to their needs. This is a new era of healthcare delivery, one in which communication between doctor and patient can exist without any barriers – no receptionists, chat bots or faulty algorithms. Greater access to healthcare is better healthcare. And greater access begins with communication. Let us know how we can help you build awareness, improve access to your white labeled product and ensure a customer-centered experience. We are always just an email, call or text away.

We’re Here to Help

CONTACT US

getstarted@cirrusmd.com

CIRRUSMD.COM

This paper represents the views of the author, not America’s Health Insurance Plans (AHIP). The publication, distribution or posting of this paper by AHIP does not constitute a guaranty of any product or service by AHIP.