Author: iambeastwood

As the HIMSS Trade Show Changes Hands, I Can’t Help But Shrug

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Most of my healthcare technology network has spent the past few days speculating on the impact of the proposed sale of the HIMSS trade show to Informa. This isn’t surprising. I met most of these folks in person for the first time at HIMSS, and the annual event has been a big part of our professional (and a small part of our personal) lives for quite some time. It seems like the end of an era – something akin to your favorite dive bar closing because the new owner of the block wants to build lab space.

I’d argue that the Healthcare Information and Management Systems Society can easily let go of the trade show and still support its members. In fact, without the burden of planning a huge event, it may arguably serve its members better, with more local in-person events through its dozens of chapters and more virtual events that can help members earn continuing education credits and come with a fraction of the operating expense. (Both could also increase accessibility for anyone unable to travel great distances for any number of reasons.)

Of course, there’s also HLTH (and, more recently, ViVE). The event has been largely successful, in part because it has focused on bringing people together in a festive atmosphere. That may seem trite, but particularly after the pandemic, there’s value in being able to convince people to convene in person. HLTH’s hosted buyer model is also the envy of many an event planner – it gets the provider and payer audience in for free while guaranteeing vendors the meetings with the decision-makers they crave.

Like any established entity facing an upstart – and especially one with some VC money behind it – HIMSS has felt pressure to compete. But it’s not without blame. The event was cancelled in 2020 – with little notice and with no immediate refunds available. (If you’ve ever worked for an event company, you know why this decision was made.) Partial credits were subsequently offered, but the decision left a bad taste in a lot of people’s mouths.

Like I said, I primarily remember HIMSS fondly. I first attended in 2010, when TechTarget was launching its healthcare vertical site. I went most years between then and 2019. In 2015, I moderated a roundtable discussion, having had accepted a speaking submission proposal that I based off an article I wrote for CIO.com. In 2018 and 2019, I was a social media ambassador, having been picked mostly because I spent a lot of time on Twitter questioning whether the industry was truly engaging patients as it claimed to.

By 2019, though, the cracks were showing. That was the year attendance peaked at 43,000. (It was back up to 35,000 this spring, which was a pleasant surprise to me.) The expo hall floor was a maze, heavily favoring vendors with big pockets There wasn’t enough coffee or food, and little of the latter is healthy. The hotel shuttles – necessary, as HIMSS is so large it can only take place in sprawling cities – were perpetually late, and the ride share surcharges were more hilarious than painful only because I wasn’t paying for them myself. The agenda was crammed, which on the face of it isn’t bad but means it’s impossible to take in all the sessions you want to see.

Since then, my appetite for business travel has diminished substantially. By the summer of 2021, when the first post-pandemic event happened, I was a new father. I’ve yet to feel the tug of HIMSS, HLTH, ViVE, or any other large-scale event since then. (Full disclosure: Digital Health Insights, one of my clients, is run by the College of Healthcare Information Management Executives, which is a partner in ViVE.) It probably helps that I was able to use the previous events to build and cultivate a network that has lasted more than a decade and gotten me a fair share of my work.

That may be why I’m meeting the end of HIMSS as we know with a bit of a shrug. It’s still going to live on as the industry’s leading trade show. In fact, without direct attachment to the HIMSS organization, it may finally become the trade show it’s been trying to be for years, with more emphasis on vendors and less on speakers who have gone through a fairly cumbersome application process to get on the agenda and present in the seventh conference room on the right past the giant pillar with the wraparound banner for the company advertising its new AI assistant. Whether decision makers from provider organizations see value in attending remains to be seen, but the event will still make money.

As I said, HIMSS the organization may benefit from addition by subtraction, too. Smaller events may help people build local connections, and virtual events may let HIMSS remain a partner for professional development. The providers that can be hard to find at a trade show may play a more prominent role as well, whether directly as event hosts or sponsors or indirectly in their ability to send more people to an event now that hotel and airfare (plus ancillary costs like childcare or elder care, transportation, meals, and so on) are out of the picture.

Maybe the metaphor isn’t a dive bar closing so a lab can go up. (For my Greater Bostonians, that would be Sligo Pub. Did I go there? Yes. Do I miss it? No.) Maybe it’s a crappy bar getting sold, renovated with newfangled things like credit card machines and windows that open, and updated with local beer and decent food. (In this case, that’s Elm Street Taproom replacing the Joshua Tree, which I don’t think anyone misses.)

Time will tell, of course, but at the moment I’m not sure that I see much changing as the HIMSS trade show changes hands.

Hopefully, Panda Health’s Predicted Digital Health “Shakeup” Won’t Be Too Hasty

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Earlier this summer, application marketplace Panda Health released a reported called The Great Shakeup suggesting that upheaval is coming to the digital health landscape.

The rationale is sound. At the beginning of the pandemic, hospitals and health systems implemented just about any technology application that would enable them to maintain care continuity, if not keep them in business. Given the severity of the need, the typical buying cycle of 12-18 months was truncated significantly – in some cases, to 12-18 hours. Considerations like system integration, workflow compatibility, and change management were an afterthought at best.

This was understandable given the circumstances. But three years have passed. That’s an important milestone if for no other reason than, as Panda Health points out. the typical contract with a digital health vendor is three to five years.

In other words, it’s renewal time. Given that health system leaders have had a lot of time to reflect on their decisions, things might get ugly.

Lots of churn in telehealth, as one might expect

In an interview with Healthcare IT Today (a client of mine), Panda Health President and COO Ryan Bengtson said the highest level of vendor churn is expected to be in the technology categories of telemedicine and remote patient monitoring.

As the saying goes, this is shocking but not surprising. As I wrote back in April, telehealth has evolved from a necessity to a luxury. Absent a transition to full-scale value-based care, telehealth only really makes sense in behavioral health and for Medicare beneficiaries being seen under an accountable care organization (ACO) model. It also just so happens that the market is ripe with point solutions representing seemingly every medical specialty or point of care within the patient journey.

Take these two points together and it’s clear that smart health systems will be taking a long, hard look at their telehealth portfolio. Bengtson said any point solution that doesn’t integrate with a health system’s larger clinical technology stack may be in trouble. Add to that the omnipresent desire to reduce the complexity and cost of managing multiple products that do the same thing and it’s clear that vendor consolidation is coming. (There’s probably a Game of Thrones reference to be made here, but I never watched it.)

An unclear path forward

The next couple years are going to be very interesting, in part because some of the most obvious solutions, like objects in the rearview mirror, are less appealing than they seem.

Platforms could solve the technology side of the point solution problem. It makes sense to host all the telehealth stuff in one place, right? But unless there’s some way to curate disparate telehealth offerings, surface recommendations to patients in the interface they’re familiar with (a portal, probably, sigh), and ensure that clinicians can connect to them as well, the care experience isn’t going to be much better.

Plus, doing the platform thing right really requires an all-or-nothing approach. It’s not just telehealth; it’s medication adherence, chronic care management, remote monitoring, and basically anything else that involves provisioning care in between appointments. After all, if some solutions are on a platform but others are floating harmlessly somewhere on the Internet, then there’s not really much incentive to go to the platform. Frustrated patients will abandon the telehealth experience in favor of the sometimes inconvenient but always familiar in-person appointment. As usage rates plummet, even the biggest technophile decision-makers will have a hard time justifying a renewal – and point solutions will suffer.

What about going all-in with a big vendor? They’ve been acquiring companies or otherwise expanding into specialties left and right, haven’t they? Well, yes – and Wall Street seems far from impressed with this approach. Teladoc Health is trading at 8% of its winter 2021 peak. Amwell is trading at just over 6% of its peak, also from winter 2021. (Both are as of July 20.) To roughly paraphrase Hello Health and Sherpaa co-founder Dr. Jay Parkinson, there are only so many cases of ink eye you can treat virtually.

The problem – as I also pointed out in my recent treatise and as others have said many, many times as well – is that patients are going to seek telehealth no matter where it comes from. They don’t care if it’s from their hospital, from retail health, from their insurer, from a concierge service, or from an app that advertises a coupon code on Facebook. Health systems that ignore this risk losing a lot of patients at the top of the funnel, only to see them in the ED years from now and not know a damn thing about their recent medical history.

All of this is to say that a cautious approach to digital health vendor churn may be warranted. Just because the revenue or year-over-year usage data is in the red doesn’t automatically mean a solution should get the axe. Health systems need to look a little deeper and consider who’s using a telehealth product and what they’ll do if it goes away.

If there’s a suitable alternative, or if they’ll maintain strong enough ties to stick around, then the health system may be able to get along without it. But if patients may walk out the (digital) (front) door and may not come back, then the telehealth tool may be worth keeping. Rewriting a vendor contract is harder, but engaging with patients who have come and gone is even harder.

Telehealth’s Day of Reckoning

~ iambeastwood ~ 3 Comments

In the board game Life, there’s a space near the end marked Day of Reckoning. At this point, players have to decide if they think they have enough money to win. If they think they do, they can keep playing. If they don’t, they place everything they have on one number (out of 10), spin the dial, and hope for the best while knowing there’s a 90% chance they’ll go bankrupt.

I’m beginning to think healthcare is facing a day of reckoning of sorts when it comes to telehealth. Three years after the pandemic, when sudden (and largely successful) adoption had us wondering what telehealth’s future looks like, utilization has plateaued. That has put organizations in the difficult position of trying to decide if they can move ahead with what they have – that is, if their existing telehealth offerings are enough to compete with All Those Disruptors Out There, not to mention the health systems down the street – or if they need to gamble on a strategy with a slight chance of succeeding.

It’s an unenviable position. Extenuating circumstances aren’t making the decision any easier for health system leaders who must tread carefully with telehealth investments but face external pressures to Do Something and avoid being disrupted by forces they can neither control nor predict. Vendors are equally challenged, as their accumulated expertise in the use case they have so carefully developed, tested, and rolled out smacks into the stark reality that point solutions (save for behavioral health) may not have a place in the long-term future of telehealth. Fortunately, knowing that utilization has plateaued but that demand remains strong can give the industry some direction – not a lot, admittedly, but some – for determining where to go next.

Providers are using telehealth – just not all that often

Recently, the Office of the National Coordinator for Health IT (ONC) released data that put a pretty positive light on telehealth. The agency’s report suggested that 85% of physicians used telehealth at least once in 2021, up significantly from 15% in 2018-2019. In addition, 62% of physicians were fully or somewhat satisfied with their use of telehealth. Tellingly, there was little urban-rural divide when it came to utilization – an important data point in light of concerns that rural areas are in danger of being left behind as telehealth takes off. (Slightly higher percentages of telephone and video conferencing for telehealth in rural areas, as opposed to dedicated telehealth platforms, helps to explain how physicians and patients may be closing the gap.)

Peeking behind the curtain, though, the data presents some concerns.

  • Utilization is highest among physicians in a value-based care model such as an accountable care organization (ACO) and affiliated with large health systems. It’s lowest among physicians in small practices. (We’ll dive into this later.)
  • The majority of physicians (53%) use telehealth for less than 25% of their total patient visits.
  • A telehealth platform integrated with an electronic health record (EHR) – the option that arguably provides the best continuity with in-person care – is the least commonly used form of telehealth across all types of physicians, payment models, and care sites.

In other words, utilization and access aren’t being distributed as as equitably as the industry would like. Provider interest is there, but it depends largely on how a provider is being paid and whether they have the resources to support the technology being used. Our long-held suspicions about who uses telehealth, it turns out, continued to hold true through the pandemic.

Aside from behavioral health, utilization seems limited

Additional data on telehealth utilization highlights other concerns about where utilization is headed. First, there’s the FAIR Health assessment of commercial health insurance claims. From January 2022 until December 2022, telehealth visits as a percentage of all claims remained largely steady at 5.5%. This is less than January 2021, when utilization hit 7.0%, but an increase from December 2021, when telehealth was less than 5% of all claims.

The more interesting data point to me is the dominance of behavioral health, which accounted for roughly 60% of all telehealth claims. That means the dozens of other medical specialties – including primary care – only accounted for 40% of telehealth claims. It roughly aligns with McKinsey’s take on telehealth, too, which shows that telehealth accounts for 54% of all behavioral health visits but 14% of medical specialty visits and just 5% of procedural specialty visits. (Again, it confirms long-held suspicions about who is and isn’t interested in telehealth.)

Next, there’s the Bipartisan Policy Center’s assessment of Medicare claims. This report pegged telehealth at roughly 6.8% of all claims for the first nine months of 2021, with behavioral health accounting for a little more than one-third of all telehealth visits. (Primary care accounted for nearly 27%, which is far more than in the under-65 population.) If Medicare claims followed the same trends as reflected in FAIR Health’s look at commercial claims, then the 2022 figures are probably a bit lower.

Looking at these data points, and then looking at them in the context of the ONC data, it’s hard not to nod in agreement with the early 2022 assessment of Trilliant Health, which came to the following sobering conclusions about telehealth’s broader impact on the economy:

  • Nearly 46% of patients had just one telehealth visit in all of 2021, and another 34% had fewer than five. That explains, per the ONC’s data, how so many physicians had used telehealth “at least once” and also only used telehealth for a small percentage of their encounters.
  • In only one specialty – behavioral health – is telehealth a “substitute good” for in-person care. In all other specialties, including primary care, when choice isn’t constrained, patients prefer in-person care. (That doesn’t account for a return to the requirement for in-person visits prior to remote prescriptions of controlled substances at the end of the public health emergency, which the American Telemedicine Association is not too happy about.)
  • Accounting for the wide disparities in reimbursement rates for virtual care episodes as compared to in-person care episodes, telehealth’s potential total share of the healthcare market is all of 1%.

Is telehealth a luxury now?

Clearly, healthcare faces a dilemma. The technology that quite literally saved the industry in the spring of 2020 is no longer a commodity. Two separate studies, one of the general patient population and another of patients in oncology, both found that preferences have shifted to in-person visits, even if in-person visits were to cost more out of pocket that virtual visits.

In fact, Trilliant Health likened telehealth’s total addressable market to that of a luxury good, given that the total number of patients using telehealth more than several times a year falls at less than 10 million. The comparison of a virtual healthcare visit to a BMW or a Peleton may have ruffled some feathers, but it’s not that far off base.

One of telehealth’s most persistent criticisms has been that it’s largely available only to healthcare organizations that can afford to support it at scale and patients that can afford the technology to access it regularly. Audio-only telehealth filled some access gaps in the early days of the pandemic, but it has always remained a fraction of the total number of virtual visits. Until that changes, patients without broadband, reliable cell signals, and unlimited data plans won’t bother with telehealth. The same goes for small office physicians who, as the public health emergency ends, can no longer use video conferencing software but don’t have the technology budget, expertise, or willpower to invest in dedicated telehealth technology.

The other main complaint is that, under current care delivery and payment models, telehealth only makes fiscal sense in two scenarios: When reimbursement for virtual care is at or close to parity for in-person care, and when enough patients are covered under a value-based contract such as a Medicare ACO. Linking these scenarios to the data presented earlier, the first example explains the popularity of telehealth for behavioral health, and the second example points to the higher adoption levels for primary care in Medicare. (If you think telehealth for low-acuity urgent care makes fiscal sense, well, I have some stock in publicly traded telehealth vendors to sell you. It’s pretty cheap.)

The idea of telehealth as a luxury good and not a commodity stings even harder when we recall McKinsey’s rosy projection from 2020 that telehealth would be a $250 billion industry. It doesn’t help that a share of 1% of the market also comes with the stigma of 1% – a figure that to many represents privilege, wealth, and ignorance of the true needs of everyone else.

The thing is, the 1% figure is probably pretty realistic. After all, the types of medical visits associated with telehealth (behavioral health, primary care, remote monitoring, follow-up, etc.) reimburse at a lower rate than in-person visits. This is obvious for things like inpatient procedures, sure, but it’s also true for specialty consults, imaging scans, and a host of other in-person encounters that require the use of expensive equipment or a discussion among multiple providers. It shouldn’t be surprising that telehealth’s total market share is significantly less than its total share of visits.

Plus, if you’re going to be 1% of a market, it might as well be healthcare, which as of 2021 is a $4.3 trillion industry in the United States. One percent of that is still $43 billion. Heck, the far more impressive-sounding $250 billion is still only 5.8% of that figure – which isn’t too far off from telehealth’s utilization as a percentage of all visits.

Of course, there’s more to the story

It would be fine if the story ended here. Not great, not terrible, but fine. Telehealth would be a niche market, albeit a $43 billion niche market, focused largely on behavioral health and occasionally on primacy care, with additional use cases available thanks to a tech-savvy physician group here, a willing payer there, an innovative vendor over here, and a large employer over there. It might integrate with the EHR, or it might not – but since it’s not really being used for high-acuity care or specialty care all that much, there really isn’t all that much missing from the patient record at the end of the day. It would probably continue to drive inequity in care, at least initially, though continued investment in technology infrastructure could combat that to a certain degree.

It would be a fine ending because, for once, we’d actually know where telehealth stood. Before the pandemic, writers like me put out stories every year with the theme “This is finally the year for telehealth to take off!” Analysts and consultants would crunch numbers and grossly exaggerate telehealth’s projected total impact on the industry. (If you’d have projected a market cap of $12 jillion for telehealth as it surpassed eleventeen percent of all visits, you honestly wouldn’t have been that far off.) Vendors would claim their total addressable market was every American with a smartphone with no regard for the need to narrow the digital divide before things like continuous remote monitoring or synchronous visits would be possible.

Now that healthcare first had no choice but to embrace telehealth to survive and then returned to in-person visits in all cases but behavioral health, we know what telehealth represents. We know the limits it faces broadly in fee-for-service medicine and specifically in so many types of specialty care. We know that Wall Street is a lot less bullish on telehealth than it once was. It’s like when your favorite baseball team begins the season with promise but wakes up on May 1 in last place with a 6-20 record. We know exactly where we stand, whether we like it or not.

The story doesn’t end here, though. There are a few important reasons why.

One is the demonstrated impact on clinical and financial outcomes. An Epic Research evaluation of nearly 19 million telehealth visits to primary care found that 61% of visits didn’t require an in-person follow-up within the next 90 days. A second paper, which got a lot of press when it was released last year, found that telehealth is as good or better than in-person care on 13 of 16 HEDIS measures (Health Care Effectiveness Data and Information Set). One paper even showed that remote monitoring improved blood pressure monitoring “despite a nationally observed disruption of traditional hypertension care” during the pandemic. In other words, telehealth is quite effective when it’s done right.

The second reason is that telehealth in behavioral health has shown the industry what can be possible. There are startup CEOs, healthcare executives, and even physician champions looking at behavioral health, with 54% of all visits being done virtually and a 60% share of all telehealth claims, and wondering why their specialty of choice can’t do better than a handful of visits here and there. Arguably, no one else will achieve such lofty numbers, to be sure, but even doubling the number of virtual visits in any given specialty will represent significant progress – and begin to provide evidence to contrarians simply convinced that virtual care cannot work in their specialty. At some point, the other shoe will drop.

Plus, at the risk of sounding cliché, patients will start to come to expect it. Anyone who frequently sees a behavioral health professional virtually will start to wonder why every other specialist demands an in-person visit. Anyone who has had fairly seamless virtual visit experiences – whether for check-ins during the pandemic or for behavioral health appointments using purpose-built telehealth products – will ask why the experience is so much more clunky everywhere else in the hospital. Even those who understand the complexities of managing their chronic condition will question why they must go to the office to review numbers that both they patient and their provider can see in the same database when they can talk to a behavioral health provider from their couch.

Finally, the concept of the “digital front door” doesn’t seem to want to go away. Vendors continue to push it, and health systems continue to invest in it. Even with telehealth utilization at less than 6% and market share at 1%, they’re scared of losing patients to entities that do telehealth better – whether it’s the standalone app advertising discount visits on the subway, the service available through the region’s largest employer at no cost to employees, or the payer that knows that getting more members to use telehealth gives it leverage come contract negotiation time. Even with executives touting the value of personal relationships with physicians and the wonderful amenities in their new brick-and-mortar facilities, they’re scared that a digital front door that only opens partway will be the end of their business, especially if patients say there’s no discernable difference to the patient experience when they use virtual care.

Now what? It pays to choose widely

So what, pray tell, can the industry do as it faces its day of reckoning with telehealth? How should the industry move forward knowing that utilization is basically flat but demand exists in pockets here and there – that opportunities for expansion are paradoxically both constrained and yet available under the right circumstances? Well, it’s complicated.

Under current reimbursement and care delivery models, point solutions will have a rough go unless they serve 1) behavioral health or 2) a specialty that has seen demonstrated improvement to clinical and financial outcomes in value-based care models. In the second case, vendors may need to set their sights on specialty physician groups, as the business case will be easier to make for these stakeholders than for large health systems hosting dozens of specialties. The one exception here may be post-natal / early childhood care; since many state Medicaid programs are extending coverage for the first 12 months or more of a child’s life, we can expect a corresponding push for broader care coordination and a small but significant role for telehealth under such a new care model.

Along the same lines, any new value-based care model – whether designed by Medicare, Medicaid, or commercial insurers – should consider telehealth from the perspective of the utilization threshold that can be reasonably expected for a given specialty. Obviously, some specialties are literally more hands-on than others; care pathways, treatment plans, and patient engagement approaches also differ tremendously. Figuring out where and when encounters can be handled virtually will require significant work, but I think it’s imperative to get that right before any sort of value-based specialty care model is put in place. Otherwise, the Powers That Be could easily be seen as imposing their will on providers who either feel they’re being asked to use telehealth when it doesn’t make sense or are given a bar that’s so low that they only need to see a handful of patients virtually a handful of times to hit the mark.

Meanwhile, health systems need to look long and hard at telehealth’s role in their near-term business strategy. I know that’s not exactly groundbreaking advice, but leadership needs to decide if they’re comfortable with sticking to telehealth for behavioral health (and possibly primary care or urgent care) for the time being, or if they feel the need to broaden their horizons in the face of unforeseen competition. If it’s the latter, where’s the greatest danger to their business, and does it make sense to invest time, resources, energy, and attention into rolling out technology that will apply to roughly 6% of visits and 1% of revenue?

It’s an unenviable Catch-22. Most health systems likely have to spend money to make money on telehealth, and they don’t have much to spend given the many financial pressures they face – but those retail, pharmacy, and digital health competitors do. These circumstances only put pressure on health systems to act quickly, which has never been their preferred approach to telehealth adoption, what with so many purpose-built applications serving one business unit within one building and never scaling much beyond that.

Those types of solutions proliferate because, up until March 2020, that was the best way for most vendors to get in the door: Present a compelling use case tied to a specific clinical outcome for a given population, get buy-in, and work alongside provider staff to get the ball rolling. It’s hard to blame vendors for taking that approach, especially when large platforms have struggled to integrate both technology and service offerings – and when, stop me if I sound like a broken record, it’s worked so well in behavioral health.

At the same time, the integrated platform appears to be the more pragmatic path forward. It gives patients a more unified experience (especially if they must navigate multiple specialties), it lets health systems deploy to new specialties without custom development, and (implemented properly) it gives point solutions something to plug into so they aren’t lost in the shuffle (and a partner that can help them scale – or that can acquire them, if that’s the end goal).

I wish there was an answer to the “Now what?” question beyond “Think before you leap.” (I know if I were paying a consultant, and they came up with that after months of work, I’d be none too pleased…) At the same time, every healthcare stakeholder is looking at telehealth for different reasons both now and in the future, so I don’t think a specific piece of advice is going to apply.

However, I do think that looking at the evidence presented here of where and how telehealth utilization has stuck, and coupling that with business priorities, will help steer organizations toward a better decision. It won’t result in enterprise-wide deployment or a sudden digital transformation, but it also won’t leave leadership in a position where they feel they have no choice but to spin the wheel and hope for the best.

Unraveling the Patient Experience, One Form Letter At a Time

~ iambeastwood ~ 1 Comment

Recently, my wife and I welcomed our son into the world. From admission to discharge, we had a very pleasant experience amid some trying circumstances. Her care team explained every facet of her care, provided a plethora of printed educational resources, and ensured that we were prepared for parenthood when we left the hospital. They even offered advice to skirt the rules about room service so Dad could pretend to be Mom and get a meal delivered at no extra charge. (Hint: Order food that you’d expect a brand-new mother recovering from birth to be eating.)

Then my wife got a letter from the hospital a few days later. I tore it open, expecting a bill, a request for a donation or – in my sleep-deprived naivete – perhaps a congratulatory letter.

“Our records indicate that you were recently a patient…” the letter began. The hospital was asking my wife to fill out a Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.

For the uninitiated, HCAHPS surveys help hospitals retrospectively track the patient experience. Survey results in hand, the Centers for Medicare & Medicaid Services (CMS) ranks hospitals based on care quality and experience metrics, assesses financial incentives to high achievers and penalties to laggards, and (theoretically) increases transparency about overall care quality.

That’s all well and good. I mean, paper-based surveys are passé, and retrospective assessments are inherently inaccurate and biased, relying solely on what a patient remembers days (if not weeks) after the fact. Back in 2018, I wrote a report for Chilmark Research about the emerging market for point-of-care patient surveys and why they’re in a much better position to meet hospitals’ patient experience reporting needs.

Still, paper-based mail surveys help hospitals cast a wide net. (They were nice enough to send a prepaid envelope to mail it back, too.) Plus, old habits die hard in healthcare, so paper surveys aren’t going away – especially if folks aren’t going to answer phone calls from unrecognized numbers. And, let’s be real, those who have just given birth aren’t exactly well-positioned to answer a few questions on an iPad amid check-ins with the anesthesiologist, the obstetrician, the lactation consultant, the nurse collecting vital signs, and the friends and family members sending a flurry of text messages.

So I wasn’t irked to get a HCAHPS survey in the mail. I get it. It’s how the world turns.

It was the cold tone that got to me.

Good friend Jen Horonjeff recently wrote about why healthcare often gets empathy wrong. Jen was diagnosed with juvenile diabetes at a young age. She has spent most of her life hearing otherwise well-intentioned people say they “know what she means” because they once tore an ACL or sprained an ankle. “[I]n that moment it felt that they were not interested in what I was going through,” she writes about those attempting to equate an acute injury that has healed to a chronic, debilitating autoimmune disease.

A form letter for a patient who spent five days in the hospital – admitted for a labor induction after an onsite obstetrics appointment, only to have a C section roughly 17 hours later, and then staying to recover for four days – shows no interest in what that patient went through. It shows interest solely in accomplishing the business objective of getting another completed survey in the mail.

When it comes to patient experience, healthcare often talks out of both sides of its mouth. In the moment, it’s possible to receive world-class care from practitioners clearly and genuinely devoted to their craft, holding your hand and handing you a tissue and running to get those little packs of graham crackers so you’re not taking pain medication on an empty stomach.

After the fact, it’s paper-pushing. It’s a faceless administrative task. I’d go so far as to say that it’s worse than accounts payable, since at least no one’s expecting cheerful language on a bill.

But “Our records indicate that you were a patient…?” For a request to fill out a patient experience survey for a woman who just had her first child? Or anyone who spent days recovering from an unplanned surgery? Or anyone who suddenly felt their life change due to a procedure or diagnosis?

The bar’s so low that it’s resting on the floor. Do better. Stop sending form letters and start putting forth a hint of effort.

Until then, don’t expect too many surveys to come back, even if the postage is paid.

UPDATE #1: In a discussion of this post in LinkedIn, Dr. Adrienne Boissy, the Chief Experience Officer at the Cleveland Clinic, pointed out that the language in the form letter is required for HCAHPS correspondence. So that puts it on CMS, and not the hospital, for being so cold.

In my mind, I see this as an opportunity to be seized. Prior to discharge, most patients have a conversation with a nurse – especially after delivering a child. Why not take a moment to let them know the survey is coming?

“You’re going to get a letter in the mail with a request to fill out a survey. It’s going to say, ‘Our records indicate that you were a patient.’ We know it’s impersonal. Government regulations, am I right? Anyway, we hope you can give it a look when you’re ready. Your feedback helps us provide better care, and it helps patients like you know which hospitals provide the best experience.”

UPDATE #2: The hospital sent us another survey…

You Say You Want a Content Strategist – But What Do You *Really* Need?

~ iambeastwood ~ Leave a comment

My last three official roles all involved content strategy to some degree. Two even included “content strategist” in the title.

None of the three roles really focused on strategy, though. While that’s not the lone reason I’m no longer in any of those roles, a lack of clear expectations certainly played a part.

As I’ve continued my transition to full-time freelance writing, I’ve been thinking about why none of these roles met my expectations, and whether my experience is solely related to me or emblematic of a larger challenge for anyone seeking to fill a role with what they believe should be a content strategist.

Strategy Is Easier Said Than Done

The biggest challenge, I think, is that strategy is easier said than done. When you hire or promote someone to a role with strategist in their title, whatever the job or the industry, your primary aim is to project to the outside world, “We’re thinking big. Change is coming.”

Are you really, though? And is it? Consider the following.

  • If your strategist is limited to working within the confines of your existing processes and systems, without having much leeway to operate differently, then, well, you’re not thinking big. You can’t and shouldn’t be surprised if the results turn out to be pretty much the same. You can only fix a broken dishwasher so many times.
  • If the bulk of your strategist’s work is actually tactical, that’s also a problem.
    • Perhaps this role, like many others, involved a new title but not a new job description. How many companies have a Senior Associate Somethingorother who was given the title mostly to justify a higher paycheck because they’ve been there so long? In this case, you’re not innovating; you’re perpetuating existing bureaucracy. Don’t string the person along with a false sense of hope.
    • Maybe there’s just too much tactical work that needs to be done. If that’s the case, and you move ahead and hire someone for a strategic role, all you’re doing is reeling them in with a bait and switch. Don’t do that.
  • If your strategist isn’t given any guidance or direction, then you can’t expect to get much out of the role. Yes, some degree of autonomy is necessary – and, to reinforce the first point, you can’t innovate inside a rigid box – but you need regular check-ins (or at the very least a set of requirements and expectations) to guide their work. This is especially true if you’re bringing in someone who’s proven in your subject matter but new to your industry vertical, or vice versa. Simply saying “We’re trying to be like a startup” won’t cut it.
  • If you confuse strategy development and product development, there’s a good chance you’re going to hire the wrong person. These require different skill sets, not to mention different ways of thinking and approaching a problem. If you’re in a rush to fill a role, step back and figure out what you truly need. Simply putting a body in a seat rarely succeeds.

(OK, So I *Might* Not Be An Expert…)

I think each of these problems is solvable, to a degree. But before offering solutions, three caveats:

  • I’m not a recruiter or hiring manager (and likely never will be). So there’s a chance I don’t know what the hell I’m talking about. I also recognize that you need to shoot for the stars in job descriptions. Noting that 50% of a job is wrestling with an home-grown and obsolete content management system, or that 40% of a job is sitting in meetings that could have been emails, surely won’t bring in top candidates.
  • It’s entirely possible that I didn’t like or succeed in my content strategy roles because I’m simply not cut out to do that type of work. I operate best when I have a clear assignment, objective, and deadline. Strategy obviously is more fluid. Sometimes I can work with that; sometimes I can’t.
  • Two of my three recent roles were in conference production. I learned the hard way that I really, really don’t like that work. The expectations of the role, coupled with how the work tends to be done, is a stark contract with how I prefer to work and am motivated to work. I’d like to think it’s not clouding my judgment here, but I can’t promise that it’s not.

Four Possible Fixes to Your Content Strategy Conundrum

Now that that’s out of the way, let’s talk about how to try to fix these problems.

Rigid processes. Don’t hire someone to change something that’s already firmly established, whether it’s an event that’s already been planned or an editorial calendar that’s already full. A strategist can have minimal influence over something that’s already set in stone, and trying to change what someone else has already created is bound to lead to conflict. Instead, put a strategist to work on new projects – or don’t hire them at all.

Too much tactical work. In one sense, there’s a simple solution: Hire someone who will do, and is expecting to do, the tactical work that actually needs to be done. This points to a bigger issue, though: What do you need to fix? Are the Big Ideas really not there – or are they there, just not trickling down into your finished products? In the former case, a strategist might help, but you also need to explore why you’ve been missing the Big Ideas for so long in the first place. In the latter case, you don’t need a strategist; you need an experienced manager of products, people, or both. Again, these are different roles with different skill sets.

No direction. The temptation to hire a strategist and send them on their merry way to concoct business-changing ideas is great. But, let’s face it, that’s not how work gets done (unless you’re a tenured professor or inventor). A strategist needs to know where to focus – new or expanded markets, new clients, new content types, etc. – along with when, how, and who to coordinate with to begin execution. Arguably more so than with any other employee, set clear guidelines and milestones for specific tasks to be done. Establish a clear reporting structure as well. “Dotted lines” to multiple managers will only add to the confusion for the strategist – and it gives managers a valid reason to pay less attention, since technically they’re not “in charge” of the strategist.

A need for product development, as it turns out. If the aforementioned Big Ideas aren’t there, but your company knows how to turn ideas into reality, then a full-time strategist won’t help you. Because – here’s a feel-good moment – you actually know what to do! You just need a nudge. Hire someone on a freelance or contract basis to hand you a polished idea and then run with it. Yes, there are a lot of details to work out, but keeping a full-time strategist on your payroll to do work that you know you are better at managing isn’t going to help your business. You’re going to be overpaying someone to do a job that, most of the time, isn’t really what they signed up to do.

Let’s Think About It

While I’m happy with the direction that my career has taken in recent months, I’m also a bit sad that my content strategy roles didn’t pan out. I liked my coworkers and managers, and I appreciated the work that we were able to accomplish together.

I don’t think my experiences entirely reflect the shortcomings of the places I worked. I think it’s part of a larger trend: Content companies think they want a single strategist, or even a team of them, but their true need is a bit different, and they haven’t taken the time to explore what (or who) will best impact the business. (It’s not unlike data analytics – everyone says they want AI, but really they just need better business intelligence.)

I hope these rambling thoughts are helpful for anyone who’s either planning to hire someone for a content strategy role or looking for a job with that type of title. They aren’t easy roles to fill, or jobs to do, and I hope we can all give them a little more thought as we work to create better content.

Making the Most of My Time (Most of the Time)

~ iambeastwood ~ 2 Comments

During a recent conversation with a connection on Twitter about time management, I received an interesting reply: “I wish more freelancers would talk about this!”

After exchange messages with this person, I realized that others might find a shred of value in hearing my approach. Here are my thoughts on how to manage my time as a full-time freelancer (which I have been doing for about six months now), coupled with how I also made things work as a part-time freelancer (which I did from mid-2015 until roughly the end of 2018).

*** CAVEATS: I’m married, in a household with no children and two wage earners, and I’m covered by my wife’s health insurance. This grants me substantial privilege in developing my schedule and taking on work, which I recognize many of you may not have. I have done my best to present this advice while being sensitive to challenges that you may face but I do not. ***

Break the day into chunks. When I have several projects on my plate at a time, I try to organize my day into 90- to 120-minute blocks. That way I’m able to focus on 3-6 different tasks in a given day. If all goes well, it means I don’t have to scramble and spend several hours on a piece the day that it’s due. (Yes, I was in fact That Kid in school.)

Depending on the time of day or the status of a project, the work done in this block could be outreach to potential sources, secondary research, writing, or a final edit. Sometimes I set aside a block of time for general administrative what-have-you, which can include outreach as well as invoicing, doing my taxes, trying to fix my printer, and so on.

Write when the brain is ready. I’m a much more productive writer in the afternoon and early evening, especially for anything that’s rather technical or research-driven. Other freelancers prefer to do their writing in the morning, to get it out of the way, or as they sit down to have lunch. If you’re able, I suggest trying to write when your mind and body are most up to the task.

Do the easy stuff first. Since I don’t tend to do my best writing first thing in the morning, I focus on other tasks if at all possible. Sometimes it’s reading and research. Sometimes it’s interviews and meetings. Sometimes it actually is writing, but it’s not stuff that requires a lot of deep analytical thought.

For example, one recent project involved writing profiles. The vast majority of the work involved straightforward secondary research and plugging sentences into a pre-formatted template. This was a great task to do for 90 minutes while I sipped my morning coffee and got my brain working.

Take a break when focus fades. Between 2 and 3 p.m. every day, I start to lose focus, no matter what I’m working on. In a 9-to-5 desk job, there’s a temptation to try to power through – but in making my own schedule, I use this time to step away from my desk from a bit.

If you find yourself losing focus around the same time every day, and you have flexibility in your schedule, try to do something else. In my case, I usually go running in the middle of the afternoon, or if it’s an off day I may get a head start on dinner. The key, I find, is to do something you like to do, as opposed to something you have to do, like laundry or dishes. Yes, it’s nice to get those chores done, but if your intention is to take a break, and you just replace one work-like task for another, then it’s not really a break.

Set concrete boundaries. For me, this is less about when the work day begins, pauses, and ends. It’s more about when or whether to extend the work day or week. In past lives, I’ve gone to grad school and written a thesis at night, and I’ve worked a second job with morning, night, or weekend shifts. From my late teens into my mid-30s, the beginning and the end of the work day / week was always a bit blurry.

Now that I’m able to work only one “job,” I value my nights and weekends. If I have to do work outside the bounds of the typical work day, these are my preferences (in order):

  1. Get up early and start before breakfast. Might as well get it over with, right?
  2. Work past 5, but stop for dinner. That way, there’s a clear end to the day.
  3. Work until 5, stop for dinner, and then resume after dinner. This is if I know that the project I need to finish will take a couple hours.
  4. Work on the weekend. I only do this for a couple hours at a time, for a single project, and as a way to get ahead. If I need to catch up, I save it for Monday.

Note: I have done this maybe 5 times in the last 6 months. This is by no means a habit, nor am I suggesting that you make it one. Instead, I’m suggesting that it’s worth thinking about how you’d prefer to tweak your schedule when you have more work to do. That way, when it does happen, you can anticipate the impact to your schedule, plan accordingly, and avoid preventable stress.

Build time for prospecting. It can be hard to do what amounts to unpaid work, but it’s important to build time into your routine for actively looking for new work. Even if things are going well, you should at the very least be making a list of the publications, institutions, or clients for whom you’d like to work. I keep a running list, and when I have free time that isn’t on a Friday afternoon I’ll send some inquiries or follow-ups.

For some people, this is a process that happens organically; the list grows as they read the news or social media and find something of interest and plunk it in a working document. Other people may prefer to devote a couple hours at a time to doing the research and finding contacts, so it’s a more formal part of the work schedule. Whatever you prefer, just make sure you keep it up.

Naturally, these are general rules of thumb and aren’t written in stone. Right now, for example, it’s closing in on 3 p.m. and I’m writing instead of running. Lately I’ve also been more likely to work past 5 p.m. than before 9 a.m. — in large part to mirror my wife’s schedule, which is much less flexible. And at the end of this week the “chunks” of the day were more like 3-4 hours instead of 90 minutes.

That said, I’ve found that having some general guidelines for when and how I work has made it easier to maintain my focus when I have a lot to do. This ensures that I’m organized instead of overwhelmed, and it leaves me time to do the things outside of work that need to be done – whether it’s running, folding laundry, or spending quality time with my wife. If you haven’t yet created some guidelines for how to manage your time as a freelancer, I encourage you to do so.

Reflecting on the Power of Language – Or, “Am I Making Myself Clear?”

~ iambeastwood ~ Leave a comment

I’ve been thinking a lot recently about words and, more broadly, language. (More so than usual, that is.) Part of this stems from the way current events and historical context have been discussed. Part of it comes from wrapping up a contract gig as a writer and editor for a healthcare IT consulting firm, where I learned that the combination of healthcare IT jargon and consultant-speak can be quite the word salad. All of it, I think, is related.

One key goal of writing, regardless of genre, is to establish credibility and authority with your audience. There are typically two ways to do this.

One is simplicity – breaking a topic down into words, phrases, and sentences that a general audience can understand. It’s the “Can you explain this to your parents?” principle. It’s a cornerstone of good journalism, approachable nonfiction, and relatable marketing.

The other method, conversely, is obscurity – discussing a topic in a convoluted way to elevate the author’s expertise above that of the reader. This isn’t necessarily about using big words and lots of semicolons, though that doesn’t necessarily help. It’s about writing in a way that makes a general audience feel excluded.

I’ve seen this happen in three key ways. They seem similar but have nuanced differences.

The first is sticking to language that’s meant for a niche audience when your goal is to inform a larger audience. This happens frequently in the trade press, where the assumption is that the audience “just knows” what the alphabet soup of acronyms and abbreviations means. (I have been guilty of this.) Character limits on social media posts and in headlines certainly don’t help. This can reflect that a seasoned writer knows their stuff, which is certainly helpful for covering complex topics. However, it also conveys a level of insider status that separates the writer and the audience.

The second is declining to modify language that was written with a specific intention in mind. Think about the times you’ve seen language lifted from a press release, police report, earnings statement, or research paper and plunked, unedited, into a news report. The ethical ramifications of this practice notwithstanding, this suggests that an author and their editors have left it up to the reader to define a non-compliant patient, a digital therapeutic, a payvider, and so on. Those words are made-up at best and loaded at worst, and it’s the job of the writer and editor to explain what they mean (or just avoid them altogether). Just because a source said it doesn’t mean it needs to be restated verbatim.

The third is neglecting to explain, or outright excluding, meaningful information. As a local news reporter, I had to provide context in every story, even if I was covering the proposed housing development for the 45th time and was sick of writing the same details over and over again. When those details are omitted – the location, the number of units, the name of the developer, etc. – you imply, “You don’t know? Well, you should have been paying attention all this time.”

As we write, we need to avoid obscurity. (Or, as Dennis Miller said in his short-lived stint as a football announcer, eschew obfuscation.) The last several months have taught us that accurate, meaningful, and relevant information – about what happened in the past, how that is affecting what is currently happening, and how that will drive what needs to happen – is both deeply valuable and difficult to find. I’m committing to making my writing clearer, and I hope that you do the same.

New Clips (Or, Why I’ve Been Too Busy to Write Blog Posts)

~ iambeastwood ~ Leave a comment

When I was laid off in early April, I had no idea how the subsequent weeks were going to play themselves out. My mind wavered between immediately finding work and spending months searching. Some days offered great promise; others yielded nothing.

It turns out – very fortunately – that things have ended up being much closer to the former than the latter. (This explains why I haven’t been writing as much on this blog as I would have expected several weeks ago.)

First, I was lucky to get some freelance assignments from former clients.

Then, I received some assignments from old healthcare IT contacts I’d never written for but frequently talked to (sometimes on Twitter and sometimes in real life). A lot of this work has been marketing and research content that’s still in production, but I do have one link to share.

Finally, I took on a short-term contract position with the consulting firm Healthcare IT Leaders. The role primarily involves working with consultants on their content, to help them demonstrate expertise and ultimately land another consulting role, but I have had a chance to do a bit of writing for myself.

All in all, I have had a lot going on. Frankly, under normal circumstances it would likely be a bit too much.

My rationale for staying busy right now is twofold. One, it’s helping to set me up for when my contract role is over and I will need more assignments. Two, being productive when there’s not much else to do keeps me focused and, in a way, grounded.

That said, if you find yourself where I did several weeks ago – with no full-time role and a need for paid writing assignments – please feel free to get in touch. A big part of how I was able to get assignments, and land firmly on my feet after getting laid off, was through personal referrals. I’d be happy to pay it forward if I can.

Finding New Routines in a New World

~ iambeastwood ~ Leave a comment

One of the strangest parts of the last couple months has been trying to figure out a new routine. (I almost said “hardest” instead of “strangest,” but in the grand scheme of things, many people have had a much harder time over the last month.)

I’ve never really had a set routine in my professional career.

February 2003 to April 2005: Newspaper reporter. My schedule was at the mercy of, um, the news. (Mostly long School Committee meetings.) I filed all my stories from the office, usually while eating a meal I’d delayed.

April 2005 to June 2019: Technology journalist, research analyst, and content person at a PR agency. At several roles and for several companies, my schedule was fairly flexible, with the option to work from a couple days a week. Some companies wanted this firmly scheduled; others just wanted an email or other notification that morning. In one role, I was a remote worker with a set start time to my day. Dress code was mostly business casual, but there was no fashion police. My routine was that I didn’t really have a routine, and it worked fairly well.

June 2019 to mid-March 2020: Conference producer. This role, for reasons I don’t fully understand, required me to go into the office every workday, with set hours every day pr my contract as well. I also needed to wear dress pants and button-down shirts, except for casual Fridays. I initially welcomed this, as it brought some structure to my work schedule, but it wore out its welcome.

Mid-March to early April: Suddenly a full-time remote conference producer. Glad I remembered to bring home my mouse and laptop charger. Regret leaving behind the mouse pad with the wrist guard. Miss my second display. No longer wearing dress pants or button-down shirts. Work day bookended with meetings.

Early April to present: Feeling like a lost child wandering through an unfamiliar department store. Up and working at 7 a.m. some days while staying in bed past 9 a.m. other days. Calling it quits at lunchtime some days while working well past dark other days. Wearing jeans some days and Simpsons lounge pants other days. Running before work, or after work, or during work, or maybe not at all. Eating too much some days, and not enough other days. No real meetings on the calendar.

Lest you worry: I am getting assignments, hitting deadlines, and generally feeling good, all things considered. Only once in the last month have I had cookies for lunch. I’ve been outside (either running or walking) at least six days a week since mid-March. I’m not talking to the cat any more than I usually do. (She doesn’t listen anyway.) Caffeine intake is no different than usual, and sleep schedule is (mostly) circadian.

My concern isn’t Getting Things Done or Keeping a Clear Head. Rather, it’s swinging the pendulum somewhere between a regimented schedule and a free-for-all. It’s been particularly strange due to the inability to leave the house; the temptation to take on additional work is strong because, well, what else am I going to do these days? (That said, we did order some puzzles this week.)

I want to resist that temptation. The new routine I see for myself is full-time remote work without much externally imposed structure. If I’m combining a too-big pile of cobbled-together assignments with the sudden and wonderful ability to go outside, see people, and do things, I can imagine myself in a world of hurt.

I have a few steps for myself, and I’m writing them here so that I have no choice but to commit to them.

Resubscribe to healthcare newsletters. I used to begin my day with a scan of the news – more than I cared to, really. But I did it out of necessity. Now I can be more selective in what I read, and it will be a more relaxing start to the day than whatever I am doing now.

Give myself time to write. I don’t (yet) think this will come down to, say blocking off the entire morning or afternoon. For now, it’s more about doing it in large chunks of time, as opposed to wedging it in between phone calls or waiting until the end of the day and hoping I can finish my deep thought before dinnertime.

Get that second display. Don’t it always seem to go that you don’t know what you’ve got until it’s gone? The improvement to my productivity will be well worth the investment. (I had no idea that external monitors were so cheap.) And while I’m at it, I just might get another nice mouse pad, too.

Stand up. Some days, once 3 p.m. rolls around, I move my laptop over to a vacant shelf on my bookcase and work while standing up. I don’t always remember. I should – it helps me focus a bit more and lets me stretch my legs.

If you have tips for developing a routine while you work from home, I’d be glad to hear them.

Thoughts on Health Experience Design from #HXD2020

~ iambeastwood ~ Leave a comment

I’ve always enjoyed the Health Experience Design Conference, as it rather seamlessly merges the topics of patient/member experience (which I like to think I know well) as well as user experience research and behavior change design (which I know I do not know well but find fascinating nonetheless). On top of the content, which has inspired my writing more than once (look here and here), the event has yielded a fair number of professional and personal connections that I maintain many years later.

This year’s event pivoted to a 100% virtual format in a matter of weeks. On top of that, the discussion clearly pivoted as well, with the widespread and clearly long-term impact of COVID-19 becoming a focal point of many conversations. We heard about the impact of loneliness, the stress of the unpaid and unappreciated caregiver, the importance of shared decision-making, and the role of design in physical spaces — valuable topics at any time but all the more important these days.

Here’s a recap of the anecdotes, sessions, and concepts that caught my attention. (The #HXD2020 conversation on Twitter captured more insight as well.)

Empathy is at the center of HXD every year, and that was even more readily apparent in 2020. In this case, it’s not just the sort of empathy where you put yourselves in someone else’s shoes. It’s taking steps to show that you accept and respect another person’s point of view. It’s not just describing yourself as an ally; it’s actively using LGBTQ imagery on your websites. it’s not just saying that you are a patient-centric organization; it’s incorporating the patient experience into every part of the design of the digital and physical space.

Speaking of which, physical spaces hold power. People who go to a hospital or doctor’s office are vulnerable. They are sick; they have questions; they are afraid. Foreboding buildings with cold floors, bare walls, spartan exam rooms, and poor lighting aren’t going to make patients feel any better. Spaces for providing care — especially for and when people are feeling their worst — should be designed to put people at ease. (I would add that you need to walk a line between inviting and gaudy. Large windows for natural light? Sure. Big-screen TVs to welcome and educate patients? OK. Waterfalls? No.)

And as you consider those physical spaces, it’s important to design for equity. Mary Brown of Spectrum Health described how so, so many patients have been marginalized by the interwoven “systems” around them: Education, transportation, criminal justice, housing, labor, financial markets, and so on. Health care institutions need to view health, and care, through the lens of equity. Even when social determinants of health have been removed, the impact of marginalization due to the longstanding effects of SDoH will remain.

We are lonely. Dr. Danielle Ramo of Hopelab and UCSF Psychiatry presented research showing that college students, despite the connections that technology enables, feel disconnected. Obviously, the last month-plus of social distancing has made everyone feel disconnected. One important point from Ramo: Loneliness exists on a continuum, like many elements of mental health and well-being. Some days it’s worse than others; some people feel it more than others; sometimes it hits harder, even when circumstances seem to suggest that it shouldn’t.

Figure out what people need. Groundbreaking, no? But it gets to the heart of health care’s biggest challenges: Insurance products, digital health apps, clinical services, physical spaces, educational materials, and countless other offerings that are often well-intentioned but don’t actually meet the needs of patients, their caregivers, and their families. (I say “figure out” instead of “ask” because it’s important to recognize that not everyone is in a position to provide an answer if you ask a question, and you may need to do some further investigation.)

One more thing: The Center for Health Experience Design is hosting a challenge called Innovation at Home: Solutions for a Pandemic. The Center seeks create solutions to educate folks on two important measures for maintaining health: Washing your hands and not touching your face. (I did my part by shaving the social distancing beard that I would stroke whenever I was in deep thought. I’m often in deep thought, so this was A Big Deal.) Check it out if that’s your thing.