Health Innovators
Health Innovators

Episode 90 · 3 months ago

Uplevel consumer engagement: Getting up close and personal with digital health w/ Kathleen Ellmore

ABOUT THIS EPISODE

Consumer behavior can be fickle, change on a whim, or be influenced by unseen stressors that most folks on the outside may not ever consider.

That makes it difficult to get to the heart of what really drives those behaviors - that is, unless you know how to weigh and measure stressors and trends and reach your customers.

When it comes to nailing down consumer health behavior and driving more positive choices, Kathleen Ellmore knows the deal.

In a world where marketing and “knowing” your customer has taken a backseat to driving sales, she’s tapped into A/B testing and taken it to a whole new level.

Driving engagement and commercialization can be a tricky business for sure, but when you’ve got all the data at your fingertips - and strive to take it personal - you’re going to go further, faster.

Using real world examples and serving them up in common settings, Kathleen shows our listeners and viewers how to truly drive customer engagement.

Here are the show highlights:

  • 3 best practices to increase adoption & engagement (4:25)
  • Common challenges to an omni-channel approach (7:12)
  • The digital transformation that’s taking place in healthcare (12:03)
  • Two key ways SMS is a fantastic channel (14:13)
  • Do this to stand out in an omni-channel approach (17:08)
  • Getting personal with digital health (18:02)

Guest Bio

Kathleen Ellmore is the Co-Founder and Managing Director of Engagys, a company that leverages behavioral economics with evidence based communications to increase consumer engagement.

A pioneer in bringing the best of consumer marketing and data-driven methodologies to healthcare, Kathleen’s focus is to motivate and drive better consumer health decisions.

Kathleen has an undergraduate degree from the University of New Hampshire and an MBA from the Kellogg School at Northwestern.

If you’d like to reach out to Kathleen, you can find her on LinkedIn at Kathleen Ellmore.
 

You're listening to health, innovators,a podcast and video show about the leaders influencers and early, adoctors who are shaping the future of health care on your host doctor roxeymovie welcome back health innovators. Ontoday's episode i am sitting down with kathleen macquaid elmore, who is the cofounder and managing partner for engages, welcome to the show kathleen.Thank you, dor roxy, on thrilled to be here. It's so good to have you so todaywe're going to talk about a topic that we haven't really touched on a wholelot: we're going to focus on a lot of engagement so when we're usually havingconversations around commercialization on this show we're talking a lot aboutthe business strategy targeting product messaging branding, but what i reallywant to focus on with you today is you know that last mile of communications,because a lot of folks that are in our audience would be folks that haveinvented some kind of innovation and they're selling to health plans orproviders, but they're in some type of beds, bbc model right and so being ableto sell their innovation. To that, customer is one thing but being able todrive engagement within those members of that patient population is reallyjust as critical for that commercial success. So so, let's just talk a little bitabout your background and what you do and then we'll just jump right in astarte my career companies, likegeneral mills and proctor yaho, i like to say getting you to eat when youweren't hungry and buy things you didn't need, and so i was thrilled tocome over to health care in two thousand and five and start using allof those consumer methodologies. Behavior science data analytics abetesting to get to do good things instead of evil. It's i landed in acompany called sober lank. There i launched over a billion and a halfconsumer interactions using av testing...

...and very quickly fill back that onionas to what works to drive. What specific populations to what specificbehaviors and the cool thing is, is against really personal fast and sohaving all that insight, it's not a one size of its message to get folks to dothings. You really need to understand what not only what motivates you butwhat your barriers are and how to overcome those and then kind of getsyou out of your inertia. Even if you believe the motivator i've ill becomeyour barrier, it's still not like buying sneakers right you're, notrunning out there to get it done. It's right drive your feet, and so we couldcover the end and spectrum of engagement for folks to help nurturebehavior change all the way through to final action, and so we started engageus my partner and i about five years ago, basically to dig couple it fromthe technology. We were working with and help everyone drive betterengagement. Well, and i like what you said on thepositive side right: the good side of motivation and driving consumerbehavior exactly en digital health. I always saythe folks. Just you know if you build it, they don't necessarily come andthat's the challenge with all these amazing innovations and technologies.We have to help consumers minas their health and yet they're not using themright right. That's that last mile piece you mentioned is to really getthem now only to trial and adopt, but to actually sustain their engagementthroughout yeah, and i think that it's kind of amiss in part of the equation. You know as entrepreneurs and innovators. Wehave so much to pay attention to write and so manydecisions that we're making that are part of that. You knowcommercialization strategy, and sometimes we often think that, once wegot a custom paying customer like that's the end, instead of driving the paying customerscustomers to do the things that they hired us to. Do that's so right, and you know it. Whenyou sell into a health plan or provider...

...system, they don't realize the valueuntil those consumers get engaged, and so just because you can't overcame thathurdle, you still have to help them get those consumers on that platform. Usingthat ab, you know engaging the digital health, otherwise, at the end of theday, there's not enough value for the person that you sold to so yeah yeahexactly, and you know. I think that that's why that oversight is why wehave so many mobile health apps that are just cobwebs right and it's justyou know, they're great solutions, but they have really low adoption ratesand low engagement rates, and so, let's talk about some of the things that ouraudience can do going forward to increase that adoption in thatengagement really kind of generic. Like for all innovations, whatare some of the best practices that you've gleamed over over the years sureso one of the cutest practices that were seeing more and more from folks ismulti channe. It can never be one size, it's all channel and the great newsthere's no good news in a pandemic, but the only positive is it reallyaccelerated move for consumers to accept and use digital health and tellhealth- and you know ss programs and things like that. So, if you're notcurrently at you, know kind of offering consumers multiple different channelsof which to engage with you that you've got to start that, i mean think of likeappo right, you can go to the genius spar. You can call apple cares. You cango online for the f, you can call in right. It's a d and all of those getused. Consumers are the same thing in their health. Some coats are going tolove. Tell of help. Some people still want humans. Some people, don't even totalk to humans, would rather manage to the act. So you have to have all ofthose different channels. Another best practice is really understanding thehavor change and an example. I love to use with coleret screenings. If i askedfive people that looked demographic ally, similar hey, go, get your callreclose ing, and they said no. I hear...

...five different answers of. Why not? Itmight be that you know some one like you rocky just doesn't have time, butsomeone else is afraid of that prep, and so, if i say to you, roxy, okay,the crap is so much easier these days, the liquids not as bad or whatever andyour various time. That's just noise and yeah. It's really again, coning inon that personalized message to help those consumers overcome whateverstopping them and then the last area, that's really become a best practice.Is to closing those barriers that are driven by social, determine of healthand that's a much bigger deal right. I don't have a one size, offed solution,or you know all of the oficina health folks of how to do that, but there'sall kinds of baby steps to take to make sure that you're engaging those folksmeeting them where they are, and a great example of that is, you might say, to someone hey go getyour a n c. If that consumer hasn't even picked a primary or gone to a belt.Well visit you driving them right to something. That's a little bit moredown the path. Yes again going to be too hard for them. You really want tomeet them where they are and that journey and just keep you know,nurturing them along which is so important. So you knowthese are practices that other industries, like you pointed out, havebeen really applying to their businesses for so long right and sohealth care as a health care, is an industry. We have such a greatopportunity to kind of catch up on how we engage patients. What aresome of the barriers right? So you know when you're working with innovators orwhen you're working with some of your clients, when you give them thestrategies and these best practices, what are some of their resistance thatyou see of really adopting this type of omni channel approach, sure sodifferent by kind of by setting up the industry. So you know when it's whenit's health plans, what is their biggest barrier is their own kind oflegacy, ecosystem they're dealing with some cases, antiquated technologies,asylum that are operations, legacy...

...infrastructure, and so even somethingas simple as sharing data right. If by that, you tell your health plan, yourprefaces, i only want you know, email with possible, and i want to speak onmy primary language of spanish. Their ability to share that across all ofthose state holders is challenging and so you'll be annoyed. If someone asksyou and marketing delivers on it and then three days later clinical, sendyou an english message and how how to overcome those really kind of legacy.Boulders is their biggest challenge in the difine health area. They need to beable to have integrations with these larger systems to become part of thatecosystem in terms of data sharing, because all of these point in time,solutions only have a fraction of the picture and we're humans right. It's ayou know, it's a whole centricity of how i manage my health and so nothaving other kind of inputs or pieces of the puzzle leads you you knowhampered basically and then that last piece is, i think, we're slow to adoptbehire science. I love in using the harol science into health carecommunications and just seeing the magic happen, even something as simpleas we were. Helping a health plan get help their cap scores, and so they weretalking about their medicare rewards program, and so they set our medicalrewards program. You know that y senior and we said no. No, it's not ourmedicare awards program. If you are medicare rewards program, becauseownership needs to satisfaction and there's this whole idea of bomo right,if i own something already, i'm going to be more likely to use it than ifit's something just kind of out there that i could join, you know that little simple change canbe so powerful and it's so overlooked. You know to mean you know it's reallyeasy to look at just broad, strokes of health care communications and see how,even today, in two thousand and twenty one a lot of it is about them it'sabout what they do, what they offer, how they benefit you, and it is, youknow, for yearss, it's a lot of arm...

...wrestling of really going. Hey! Guesswhat it's not about you and it never was about you. That's right. I love to use theexamples from the outside and bring them in. You know that we take forgranted and by the way consumers no longer compare us to their other healthcare. Experiences they're compared is to their favorite brands, and so thatbar is high to examples. Actually i love to use is one as how manydifferent ways can you do you think you can personalize a beverage at starbucks?You want to take a guess. Oh gosh, i don't know i mean i would say at leastfifty forty to forms. It's eighteen senddifferent ways you can had at your average right i mean crazy town andthen a example. I love to use is nefew en you get back on nele. You is rightwhere you left off. They know exactly one of the things you like. They knowwhat your family likes and can make recommendations, and you go to into youknow your health care system and there's so much that's kind of just runoff right. You call the call center and you feel like you're, telling the storyall over again of late. You know it's transpired three calls before and sotiming. Those interactions together to become in a interactive, cohesiveexperience is also that next frontier that we need to conquer you know it'sfunny. I call it the amazon effect right, it's. It is kind of like we alllove that amazon experience, at least for the most part, and it is reallylike you said it is sucour expectations and raise that bar so high that we justexpect all consumer experiences to be that smooth that easy and that personalvised that's right and they use the hap of science beautifully. Rent like fourleft in your car, my kids run and say i've got to order it and i'm like no,it's a tactic and they don't believe they right. Soit's like we've done that when home visits you know if consumer, if we want seniors to acceptthe one visit will say: hey, there's one left next week of one of our bestwraps. Can we squish you in versus? You know you want to schedule and thenpeople say well call you back. You know, so there's lots to be learned from that,but i will say that the current...

...industry has the advantage, because asmuch as they have to consumer principles, health cares hard and sofor the looks that are already in it. They will win the long game, butthey've got to pull in these tactics and these strategies from outside ofhelper. So one of the things that i think is so fundamental to set thesehealth care organizations up for success do applying a lot of the thingsis just really an overall digital transformation, minse. First right, then the technologyin the platform, but just this mind, set because it really in order for you,know, people to organizations to really benefit from the things that you'retalking about. You know we're not going to be able todo that with just humans and being able to you know manage these huge data sets.So what is your experience or perspective on just the digitaltransformation? That's starting to and kind of taking place within health care?I am super excited. I have been talking about consumer engagement since twothousand and five and at the time it was really about a whisper and evenwhen the ac hay had happened. You know people were still kind of thinkingabout consumer engagement as tweaking the message, but honestly, in the lastthree years, our clients are everything from national plans to provide asystems to small plans. You know digital healthy name that yeaheveryone's thinking in the transformational mind set. Now, maybeyou know the head thinking and the body hasn't caught up yet, but everyone'sthinking, the right things and what's cramble, there's no one way to getthere. We have plans that have done. You know, inventories of all theirprint to decide what can be re imagined what can be consolidated. You know howdo i think about applying that idea of next best action? We have folks thatare taking it from the top down. How do i just personalize the heck out of thisand coordinate across the data streams? You know so there's all kinds of greatislands of excellence happening, and so we're just going to continue to seethat grout yeah. I definitely agree- and i think that's kind of a must rightso for those organizations that have...

...that mind set and are starting toconnect it a little bit more, like you said, between the head and the body aregoing to have a competitive advantage, that's going to be a winning strategyfor their organization and for those that take much longer their risk oflosing. I say: losing market share one paster percent, especially our neditconsumers, can now vote with their feet. So, if they're not getting what theyneed right, they'll go elsewhere. We've been trained so to let's shift just a little bit,but to text messaging, so we're seeing in other verticals this mass exodus. Ifyou will, i shouldn't say exodus, but this mass shift from email,communications to smas communications, and i think that that's so important inhealth care for a number of different reasons. But tell me what yourperspective is on about. What's happening with ss communications andhealth care. Sure no ss is a fantastic channel. First of all, it's with youright and when you're making health, you know you're in the doctor's office.For fifteen minutes and then you're making health decisions, twenty four byseven for the other three hundred and sixty four days do i eat that burder atthe restaurant or the salad? What's the pollen count today, all those kinds ofthings so estimas tax is a fantastic way to communicate with consumers oncondition management programs and be there in the moments of the decisionsthat they're making and provide that support and guidance. The second thingis: is a little time you reminder is, like you know, refill, you know orexodermal well visits all those kinds of things text is also a beautifulchannel for that so and we're finding the consumers. Even when we push outone way, messages they're responding their reaction wanting to have a torelationship with their plan, which is really exciting and with the provideroffices, and things like that. So i think skies the limit for how valuabletext is going to become to help me focus, manage their health and we'restill really at the end on a yeah. I completely agree a lot of the work thatwe've done: we're seeing that you've got at least ninety percent, sometimesninety five percent engagement via sm,...

...where you might be closer to aroundfifteen or twenty percent. The email channel- hey it's dr roxy here with a quickbreak from the conversation. Are you trying to figure out what moves youneed to make to survive and thrive, and then you calotin economy? I want everyhealth innovator to find their most viable and profitable pivot strategy,which is why i created the co. Vid proof, your business pivot, kid. Thepivot kit is a step by step framework that helps you find your best pivotstrategies. It walks you through six categories. You need to examine for athree hundred and sixty degree view of your business. I call them the sixcritical pivot lenses, as you make your way through this comprehensive kit,you'll be armed with the tools, tips and strategies you need to make sureyou can pivot with speed without missing out on critical details andopportunities, learn more at legacy: hyphen daco back kit, so it doesn't mean that you want to goaway with email, do away with email because, like you said it's still aboutpersonal preferences, so you still want to engage that other percentage thatmaybe doesn't prefer s ms, or still have the humans on the phone for thosethat don't want digital at all, and they still want that human touch.That's right and the thing has to be careful about. Is you know? Consumersare a dynamic. You know living breathing entity in the sense that,right now, it's still pretty news. We have tons of engagement, weoversaturate or we stop driving value through that channel and will so it'sreally critical to make sure that your text programs count. We did a greattext, progam mit folks in the medicaid population, which are traditionallyharder to keep engaged yeah. We had over. Eighty percent stay engaged tofifty two weeks of messages on their condition: menaphon programs- and i idon't know about you, but i like unsubscribed from north drum threeweeks into my emails, because i'm no a n e getting those messages. So the bigcount value in all fifty two weeks and...

...messages. That's the critical piece iswe have to personalize that we have to make it valuable. We have to make itabout that consumer or will saturate that channel and hurt our chances ofcontinuing on, but that if we, if we don't treat it sacredly, you know yeah,and so what i hear you say it is really kind of three things that stand out isthat this omni channel right being open to other communication channels beyondfacts, right, yeah being having a personalizationstrategy, so be knowing enough about your patient population to be able tosegment that in an appropriate way, and then this emphasis on value, because ithink what you're saying is that you know we might have a text campaign.It might be personalized. But if we're not delivering value i mean all you dois just stop and now you've just opted out of that channel. I mean it's soeasy compared to some other channels to just off down exactly so make if youhaven't already used it in health care. Make sure your first program is amazing,because that's going to start that relationship off right, yeah and ithink also i want to just kind of touch on you know. I've seen this shift overthe years where you know i might have a patient population, and i speak to themall as one homogeneous group right and then i maybe get a little bit moresophisticated and i go oh well. You know what these oncologist are verydifferent than these ms patients, so i need to talk to them differently, butwhat i hear you saying is that that's still not going far enough, becauseeven all on cology patients are, ms patients are still not the same. When we've done, he rents like a bytesting, where we'll say to all folks that are living with diabetes, heyyou're behind us some screenings for your your condition, you know, go getyour screenings when we say hey, dr roxy, your overdo for your a one c andcaplin your over do for your eye exam. We actually get three times the lift,because we called out once actually for...

...you and not even just she was a segment,so it works all across the board. So how do you know so? One of the thingsthat i hear in response to this is: how do i even do that like? How do i cutpersonally? You know like what am what am i supposed to put in place to beable to have this type of segmentation and then to be able to deliver thesepersonalized messages across that population sure so that it's all aboutthe data and so sharing that data across your ecosystem and in doing itin the ways that protects phi. That you know is usable for the right reasonsfor the right, apps and all those kind of things is a giant challenge, and sowe see in some cases we have. You know, plans that we see that you know itmight be. That kathleen is the first name is in the first field in part ofyour organization, and then your last name is in the first field in adifferent part of the organization. So there's a lot of data data,standardization and normalization that needs to happen and then putting in thepeople process technology to be able to kind of use that data in an actionable,dynamic, sort of way things like communications control, next bestaction personalization, but it all starts with the data yeah yeah. That'sso true, so one of the things that i want to point out to that you'retalking about is you know you can have a messaging strategy where you have onesegment of the population where it motivates them and drives them, andthen that same exact message actually be counter intuitive orcounterproductive to what you are accomplishing right. So, instead oftaking the action or be neutral, they actually may be apt out, or theyactually make vert back to right, dig their heels in a little bit. That's thebehavior, a science part that you're talking about. How do you help clients navigate thatbeing able to match those motivations and those behaviors to what thatmessage is going to be and how it's being delivered? Absolutely we do. Weactually have due to science dusios scientists on staff that do a lot ofwork with us on predictive analytics...

...willingness to engage the out wherethey are in their journey, folks that have had simil done over two hundredfifty sand, varier studies in the past, so you know what those common barriersare and you can attach them to segments based on. You know who looks likesomeone else, and so we start there, but there's always opportunity for someav test and to get better and better, because you know all of the populations,although they might be similar, they're, not the same and so kind of testing onyour population. What is that best strategy is always helpful yeah. So youmentioned something a phi, so that's one of those things that i find thatoften compliance and legal teams will just kind of use it like up. We can'tdo that. It's hip in phi right. They just throw these things around. Youknow. I think that, like like us, you know people that are commerciallycommercializing innovations or marketing innovations. You know we wrestle with them. I mean go, let'sright, let's get like now, let's get specific on really what those thingsmean and what we can and can't do, instead of just kind of using it as ablanket, but you you- and i were talking earlier- and you had touched onthis new ruling by the supreme court around face book with s. Ms, so justgive our audience a little bit about the information about that new rulingand what are the some of the implications that you think it couldhave for those innovators in the end in the audience for sure an we don't liketo give out. You know legalibus, obviously, but the ruling actuallygives a little bit more opportunity to reinterpret the text messaging and youknow not thinking of it as pam, and so we've pulled all of our clients go toyour compliance groups and talk about this, because i think it really opensup the opportunity to do much more and at the same time i actually do lovewhen you you know, can capture permissions from a consumer, becauseeven if the ruling says go crazy right, it's going back to the idea of likewell. What do i want the attacks? What i what i want, a email- and i like mybank statements via you, know electronically, but i might likesomething else in paper. I still get to...

...choose, and so i do think that there'sa lot of opportunity and permissions, but we should all be driving towards asmuch digital as possible because it allows you to have that two way:interaction with the consumer versus the one way yeah, which i think isreally important to, because it's not even a one side. It's all with thepermissions, as you just kind of mentioned here, so you know as aconsumer. Don't just give me the choice between do. I want to communicate theattacks or email or phone, but make that even more granular, because, likeyou said some things i might want tea tex, but some things i might want emailor a phone call and that flexibility and personalization at that level is socritical, absolutely yeah. So what are some of the lessons learned that wehaven't talked about yet that you want to make sure that our audience walksaway with sure? So i encourage everyone is listening to do av testing. Now,we've learned so many of the insites already for our billions and halfinteractions that a we're still in our infanit. As you know, health care,consumers and the lessons have not all been learned. Yet i like to getexamples from my past. Life ace work to digitus and we had twenty years of dataon. You know helping american express in eteroi, and so we knew that if youtook that a stamp, you know even like ten degrees. You get five percent openrate on the direct mail and if you did a second window on the envelope, youget something else we have yet to find out all the secrets right. It's not onesilver bullet, it's no or sober bullets, because it goes back to the idea thatthe best heavers and the benefits and the farriers and the inertia around theanagrams are different around our exagerate, i'm great of getting mygreetings on terrible at men, adherents so figuring out the ways to motivateand all these little different actions. It takes understanding and work andinsight and data. So everyone out there keep a by testing and then email me andtell me what you found out. So what do you sink? Thoseorganizations that or leaders that...

...don't feel like they have either thebudget or the time to be able to do that. Ab testing and one kind of skipover that research or skip over that testing and kind of have maybeconfidence because of previous experience, maybe of a specificdirection. Do you ever encounter that so all the time we always hear? No, wecan't do control groups, we have to talk to everyone, and so we do a coupleof things we say. Well, you know what for sure you know if it's a cancer, ascreening you're not going to hold it back but might hold out for like sixweeks and then you'll know you know, treat them as a whole. Our group andthen you'll know what the difference is and then let the rest of thecommunications go or don't do a control group and just do an av and just pickone tiny thing to change. You know the subject line who signs the letter? Whatthe call the action was. Did you you know, give an eight hundred number ordid you do a qr code? You know those kinds of things we're seeing like. Isaid every day, thousands of tests across clients and the insight is it'sreally valuable to help iterate and prove thus prefrent forward. I thinkbuying into and supporting that type of experimentation is so fundamental tojust every business is success right, so not even just patient engagement orconsumer engagement just really across the board. This idea that it's notgoing to ever really be this one and done, but it's going to be thisirritative strategy, where we have so much data that we can look at, we cantake the guest work out and we can make decisions going forward based upon thedata and then experiencet. I mean i've heard of companies that were justfailing being bought by other organizations and maybe just tweet thecall to action and then all of a sudden they have a viable business right. No way like. Let me said before.Changing one word yours to ours. Greater yours to yours makes te muchdifference on the examples i love to get this. You know when i was atcherias. I had one goal. I needed...

...people to buy trios, i didn't evenfrankly need them to eat curios, and then my target market was super defined.It was, you know, new moms, but had brandnew babies or husbands with thatcholesterol, and so you think about the messages to drive. Those behaviorscould get really tight and succentor. Now not ledge. Do i have you. I needyou to do thirty, seven things or exierunt versus screenings vers as wellvisits versus p, your bills, etc. But i have every walk of life: every income,education, you know socioeconomic and so there's no way that we can know allthe answers, but we have a lot of the starting answers and so continuing torefine refine. Until we get a hundred percent engagement across i mean ourhealth should be wore to us than our flat screen tv or i tom. You know itshould be our favorite thing that we invest in. We still have so much workto do, don't we catholine, so i want to just kind of you start toend on this note, because i want to make sure i answer this question.You've got so much experience around consumer engagement in your previouswork, so i want to ask you what is hamburger helper, betty, crocker andhealth care have in common? Absolutely they have. They all need to drive thehater change and so whether we're driving behavior change throughrepositioning hamburger helper to more of a home style helper or we're gettingyou to eat bay, cropper deserts, but instead now we're getting you to dothings that are better for your health granted. Sometimes there's not thatendorsin at the end, when you, you know, buy something amazing, but at the end of the day, all of thosesame principal supply data science. Here ol economics, you know predictivemodeling, all of that comes into play and can really really drive behavior ona beautiful way, yeah yeah. So you just made me think of one morequestion. You know we think about. We think about outcomes and being ableto have real world evidence that are...

...solutions that we're bringing to marketactually develop can generate the value in the roi that we said that they wouldso that the the performance of those tools are just so critical. You knowtalk about a little bit about maybe some of the work that you've done andhow you're playing into being able to develop the real world evidence that'sneeded to be able to have that success story to lead to future sales goingforward sure. So we work with clients all the time to drive those outcome. Soit's not just engagement matrix right, it's not just who open the email or whoanswered the call. It's really about driving those outcomes. Did they getthe screening? Did they go to the well? They said yeah and then our otherstrategy that we love is to just find quick winds and no matter what projectswere doing, and so we were helping medium side. Health land figure upthere, all of their print inventory, to figure out what to re imagine todigital, and in doing so we opened a bunch of letter. So we saw this letterthat we needed some optimistic, and so we rewarded it added a phone call to itand one of the things that i mentioned before is it didn't address hiddenbarriers. It was asking women for a home visit to do their ostio arthritismeasurement for stars, and so we said hey, you know you don't even need totake your clothes off and we didn't say it that obviously you know directly be. That is a barrier right ifyou're thinking, by having a home visit and having the last o arthritis measureand he end up driving a verdict by percent your of your increase in theirhe disease. So you like just let herald right, huge, real world business impactright so, like you said we're not talking about fluffy stuff of, like ohopen rates for emails, real business impact. Well kathleen! This has been sovaluable. I know that our audience is going to walk away with so much wisdomto impact their business strategy and their engagement strategy going forward.So thank you so much for sharing your time and your wisdom with us today,thanks lock the routh roxy for having...

...me in his terrific, very fun. Thank you so much for listening. I knowyou're busy working to bring your life changing innovation to market, and ivalue your time and attention to get the latest episodes on your mobiledevice automatically subscribe to the show on your favorite podcast tap likeapple podcast, potii and stitcher. Thank you for listening, and iappreciate every one who shares the show with friends and colleagues, seeyou on the next episode of health innovator.

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