Health Innovators
Health Innovators

Episode 90 · 1 year ago

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


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 adoptors who are shaping the future of healthcare. I'm your host, Dr Roxy Movie. Welcome back health innovators. On today's episode I am sitting down with Kathleen mcquaid Elmore, who is the CO founder and managing partner for engages. Welcome to the show, Kathleen. Thank you, Dr Roxy, on Thrill to be here. It's so good to have you. So today we're going to talk about a topic that we haven't really touched on a whole lot. We're going to focus on a lot of engagement. So when we're usually having conversations around commercialization on this show, we're talking a lot about the business strategy, targeting, product messaging, branding, but what I really want 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 have invented some kind of innovation and they're selling to health plans or providers, but they're in some type of BBC, B, TOBDC model, right, and so being able to sell their innovation to that customer is one thing, but being able to drive engagement within those members of that patient population is really just as critical for that commercial success. So so let's just talk a little bit about your background and what you do and then we'll just jump right in. Background, I started my career a companies like general mills and proctoring gamble, like to say, getting you to eat when you weren't hungry and buy things you didn't need. And so I was thrilled to come over to healthcare in two thousand and five and start using all of those consumer methodologies, behavioral science, data analytics, a be testing to get you to do good things instead of evil. And so I've ended up a company called silver link. There I launched over a billion and a half consumer interactions using a be testing and very quickly feel back that onion as to what works to drive...

...what specific populations to what specific behaviors. And the cool thing is is it gets really personal fast. And so, having all that insight, it's not a one size all fits message to get folks to do things. You really need to understand what not only what motivates you, but what your barriers are and how to overcome those. And then kind of gets you out of your inertia, even if you believe the motivator. I've overcome your barrier. It's still not like buying sneakers, right. You're not running out there to get it done. It's right drive your feet. And so we kind of cover the end to end spectrum of engagement for folks to help nurture behavior change all the way through to final action. And so we started engage, as my partner and I about five years ago, basically to decouple it from the technology we were working with and help everyone drive better engagement. Well, and I like what you said on the positive side, right, the good side of motivation and driving consumer behavior exactly. So then you have digital health. I always say to folks, just you know, if you build it, they don't necessarily come. And that's the challenge with all these amazing innovations and technologies we have to help consumers manage their health and yet they're not using them right. That's that last mild piece you mentioned is to really get them only to trial and adopt, but to actually sustain their engagement throughout. Yeah, and I think that it's kind of a missing part of the equation. You know, as entrepreneurs and innovators. We have so much to pay attention to write and so many decisions that we're making that are part of that, you know, commercialization strategy and sometimes we often think that once we got a customer paying customer like that's the end, instead of driving the paying customers, customers to do the things that they hired us to do. That's so right. And you know, it's when you sell into a health plan or provider system,...

...they don't realize the value and so those consumers get engaged. And so just because you can't overcame that hurdle, you still have to help them get those consumers on that platform, using that APP, you know, engaging the digital health otherwise, at the end of the day, there's not enough value for the person that you sold to. So yeah, yeah, exactly, and you know, I think that that's why that oversight is why we have so many mobile health apps that are just cobwebs right, and it's just, you know, they're great solutions, but they have really low adoption rates and low engagement rates. And and so let's talk about some of the things that our audience can do going forward to increase that adoption in that engagement really kind of generic like for all innovations. What are some of the best practices that you've gleaned over over the years? You're so one of the key best practices that we're seeing more and more from folks is multi channel. It can never be one size fits all channel. And the great news. There's no good news in a pandemic, but the only positive is it really accelerated the move for consumers to accept and use digital health and tell a health and, you know, SMS programs and things like that. So if you're not currently, you know, kind of offering consumers multiple different channels of which to engage with you, that you've got to start that. I mean think of like apple right you can go to the Genius Bar, you can call apple cares, you can go online for the FA Q's, you can call in right it's and and all of those get used. Consumers are the same thing in their health. Some folks are going to love tell a health some people still want humans, some people don't e want to talk to humans, would rather manage through the APP. So you have to have all of those different channels. Another best practice is really understanding the havior change, and an example I love to use its colorrectal screenings. If I asked five people that looked demographically similar, hey, go get your color rectles screening and they said no, I hear five different answers of why not. They might be that you know someone like..., Roxy, just doesn't have time, but someone else is afraid of that prep. And so if I say to you, roxy, Hey, the prep is so much easier these days, the liquids not as bad or whatever, and your barriers time, that's just noise. And so it's really again honing in on that personalized message to help those consumers overcome whatever stopping them. And then the last area that's really it become the best practice is to closing those barriers that are driven by social determinans of health, and that's a much bigger deal. Right. I don't have a one size offfit solution or you know all of these digital health folks of how to do that, but there's all kinds of baby steps to take to make sure that you're engaging those folks, meeting them where they are, and a great example of that is you might say to someone, Hey, go get your ac if that consumer hasn't even picked a primary or gone to a bet well visit you. Driving them right to something that's a little bit more down the path is again going to be too hard for them. You really want to meet them where they are in that journey and just keep, you know, nurturing them along, which is so important. So you know, these are practices that other industries, like you pointed out, have been really applying to their businesses for so long. Write. And so healthcare as a healthcare as an industry, we have such a great opportunity to kind of catch up on how we engage patient sits. What are some of the barriers? Right? So you know, when you're working with innovators or when you're working with some of your clients, when you give them these strategies in these best practices, what are some of their resistance that you see of really adopting this type of Omni Channel Approach? So different by kind of by segment of the industry. So you know, when it's when it's health plans, what is their biggest barrier? is their own kind of legacy ecosystems. They're dealing with some capes of the antiquated technologies, asylum or operations, legacy infrastructure, and so even something is simple as...

...sharing data. Right. If, if, if you tell your health plan your preferences, I only want you know email when possible and I want to speak on my primary language is Spanish. Their ability to share that across all of those stakeholders is challenging, and so you'll be annoyed if someone asks you and marketing delivers on it and then three days later clinical send you an English message. And so how to overcome those really kind of legacy boulders is their biggest challenge. In the digital health area. They need to be able to have integrations with these larger systems, to become part of that ecosystem 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 a you know, it's a whole centricity of how I manage my health, and so not having other kind of inputs or pieces of the puzzle leads you, you know, hampered, basically. And then not last piece is I think we're slow to adopt the Habal Science. I love in using the Habal science into healthcare communications and just seeing the magic happen. Even something as simple as we were helping a healthful and get help their cap scores. And so they were talking about their medicure rewards program and so they set our medicure rewards program you know, Betty senior, and we said no, no, it's not our Medicare rewards program it's you are medicure rewards program because ownership needs to satisfaction and there's this whole idea of pomo right. If I own something already, I'm going to be more likely to use it than if it's something just kind of out there that I could join. You know that little, simple change can be so powerful and it's so overlooked. You know timing. You know it's really easy to look at just broad strokes of healthcare communications and see how, even today, in two thousand and twenty one, a lot of it is about them. It's about what they do, what they offer, how they benefit you, and it is you know, for years it's a lot of arm...

...wrestling, of really going hey, guess what, it's not about you and it never was about you. That's right. I love to use the examples from the outside and bring them in. You know that we take for granted. And, by the way, consumers no longer compare us to their other healthcare experiences, their comparing us to their favorite brands, and so that bar is high. Its two examples actual I love to use as one is, how many different ways can you do 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 least fifteen. cording to Forbes, it's Eighteenzero different ways you could put your beverage right, I mean crazy town. And then other example I love to use as Netflix. When you get back on Netflix, you it's right where you left off. They know exactly one of the things you like. They know what your family likes and can make recommendations. And you go to into you know your healthcare system and there's so much. That's kind of just one off. Right. You call the call center and you feel like you're telling the story all over again of what you know is transpired three calls before, and so tying those interactions together to become an interactive, cohesive experience is also that next frontier that we need to conquer. You know, it's funny. I call it the Amazon effect. Right. It's it is kind of like we all love that Amazon experience, at least for the most part, and it is really, like you said, it is such our expectations and raise that bar so high that we just expect all consumer experiences to be that smooth, that easy in that personal eyes. That's right. And they use the behaper science beautifully right, like, for left in your cart. 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. So it's like we've done that with home visits. You know, if consumer, we want seniors to accept a home visit, will say hey, there's one left next week of one of our best reps. can we squish you? In versus, you know, you want to schedule, and then people said, all, 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 as much as they have the consumer principles. Healthcare's hard and so but the folks that are already in it, they will win the long game. But they've got to pull in these tactics and these strategies from outside of healthcare. So one of the things that I think is so fundamental to set these healthcare organizations up for success do applying a lot of the things is just really an overall digital transformation mindset first, right, then the technology din the platform, but just this mindset, because it really in order for, you know, people to organizations to really benefit from the things that you're talking about. You know we're not going to be able to do 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 digital transformation that's starting to and kind of taking place within healthcare? I am super excited. I've been talking about consumer engagement since two thousand and five and and at the time it was really about a whisper and even when the ace hey have happened, you know, people were still kind of thinking about consumer engagement as tweaking the message. But honestly, in the last three years our clients are everything from national plans to provider systems to small plans, you know, digital health, you name it. Yeah, everyone's thinking in the transformational mindset. Now, maybe, you know, the heads thinking in the body hasn't caught up yet, but everyone's thinking the right things and what's Kul is, there's no one way to get there. We have plans that have done, you know, infant tours of all their print to decide what can be reimagined, what can be consolidated. You know, how do I think about applying that idea of next best action? We have folks that are taking it from the top down. How do I just personalize the heck out of this and coordinate across the data streams, you know. So there's all kinds of great islands of excellence happening, and so we're just going to continue to see that grow. Yeah, I definitely agree and I think that's kind of a must right. So for those organizations...

...that have that mindset in are starting to connect it a little bit more, like you said, between the head and the body, are going to have a competitive advantage. That's going to be a winning strategy for their organization. And for those that take much longer, their risk of losing, I say losing market share, one PSOR was out, especially a metacare. Consumers can now vote with their feet, so if they're not getting what they need right, they'll go elsewhere. We've been trained. So let's shift just a little bit, but to text messaging. So we're seeing in other verticals this mass exodus, if you will. I shouldn't say exodus, but this mass shift from email communications to SMS communications, and I think that that's so important. And healthcare for a number of different reasons. But tell me what your perspective is on about what's happening with SMS communications and healthcare. So or no, SMS is a fantastic channel. First of all, it's with you, right 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 by seven for the other three hundred sixty four days to I eat that burder the restaurant or the salad? What's the pollen count today? All those kinds of things. So SMS tax is a fantastic way to communicate with consumers on condition management programs and be there in the moments of the decisions that they're making and provide that supporting guidance. The second thing is is a little tiny reminders, like you know refill, you know our expherents, well, visits, all those kinds of things. Text is also a beautiful channel for that. So and we're finding that consumers, even when we push out one way messages, they're responding there are actually wanting to have a two way relationship with their plan, which is really excited, and with their provider offices and things like that. So I think skies the limit for how valuable text is going to become to helping folks manage their health, and we're still really at the INSENCY. Yeah, I completely agree. A lot of the work that we've done we're seeing that you've got at least ninety percent, sometimes ninety five percent, engagement via SMS, where you might... closer to around fifteen or twenty percent via email channel. Hey, it's Dr Roxy here with a quick break from the conversation. Are you trying to figure out what moves you need to make to survive and thrive in the new vid economy? I want every health innovator to find their most viable and profitable pivot strategy, which is why I created the covid proof your business pivot kit. The pivot kit is a step by step framework that helps you find your best pivot strategy. It walks you through six categories you need to examine for a three hundred and sixty degree view of your business. I call them the six critical 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 sure you can pivot with speed without missing out on critical details and opportunities. Learn more at legacy and DNACOM backslash kit. So the doesn't mean that you want to go away with email. Do Away with email because, like you said, it's still about personal preferences. So you still want to engage that other percentage that maybe doesn't prefer SMS or still have the humans on the phone for those that don't want digital at all and they still want that human touch. Right. And the thing has to be careful about is, you know, consumers are a dynamic, you know, living, breathing entity in the sense that right now it's still pretty news. We have tons of engagement. We oversaturate or we stopped driving value through that channel and will use them. So it's really critical to make sure that your text programs count. We did a great text program with folks in the Medicaid population, which are traditionally harder to keep engaged. Yeah, we had a were eighty percent stay engage from fifty two weeks of messages on their condition, Meta from programs that I know. I don't know about you, but I like unsubscribe from nordstrom three weeks into my emails because I'm right ten of getting those messages. So then they found value in all fifty two weeks and messages. That's the critical piece is.

We have to personalize that, we have to make it valuable, we have to make it about that consumer, or will saturate that channel and hurt our chances of continuing 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 is that this Omni channel, right, being open to other communication channels, beyond facts, right, yeah, Um, being having a personalization strategy, so be meat, knowing enough about your patient population to be able to segment that in an appropriate way. And then this emphasis on value, because I think 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 we do is just stop and now you've just opted out of that channel. I mean it's so easy, compared to some other channels, to just opt out exactly. So make if you haven't already used it in health care, make sure your first program is amazing, because that's going to start our relationship off right. Yeah, and I think also I want to just kind of touch on you know, I've seen this shift over the years where, you know, I might and have a patient population and I speak to them all as one homogeneous group, right, and then I've maybe get a little bit more sophisticated and I go, Oh, well, you know what, these oncology patients are very different than these MS patients, so I need to talk to them differently. But what I hear you say and is that that's still not going far enough, because even all oncology patients are invest patients, are still not the same. When I we've done programs like a be testing where will say to all folks that are living with diabetes, Hey, you're behind on some screenings for your for your condition. You know, go get your screenings. When we say hey, Dr Roxy, your overdue for your a one see and coupling your overdue for your eye exam, we actually get three times for the lift because we called out what's actually for you, and not even just you as...

...a segment so it works all across the board. So how do you know? So one of the things that I hear in response to this is how do I even do that? Like how do I cut personally, you know, like what am I what am I supposed to put in place to be able to have this type of segmentation and then to be able to deliver these personalized messages across that population? Sure, so that it's all about the data and so sharing that data across your ecosystem and in doing it in ways that protect Phi that you know is usable for the right reasons, for the right APPS and all those kinds of things, as a giant challenge. And so we see in some cases we have, you know, plans that we see that you know, it might be that Kathleen is the first name, is in the first field in part of your organization and then your last name is on the first field and a different part of the organizations. So there's a lot of data, data standardization and normalization that needs to happen and then putting in the people process technology to be able to kind of use that data in an actionable, dynamic sort of way, things like communications control, next best action personalization. But it all starts with the data. Yeah, yeah, that's so true. So one of the things that I want to point out to that you're talking about is, you know, you can have a messaging strategy where you have one segment of the population where it motivates them and drives them, and then that same exact message actually be counterintuitive or counterproductive to what you are accomplishing. Right. So instead of taking the action or being neutral, they actually may be opt out or they actually make revert back to right, dig their heels in a little bit. That's the behavioral science part that you're talking about. How do you help clients navigate that, being able to match those motivations and those behaviors to what that message is going to be and how it's being delivered? Absolutely we do. We actually have data science of scientists on staff that do a lot of work with us on predictive analytics,...

...willingness to engage, doughing out where they are in their journey, folks that have had some we've done over two hundred fifty thousan barriers studies in the past, so we know what those common barriers are and we can attach them to segments based on, you know, who looks like someone else, and so we start there. But there's always opportunity for some AV 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 on your population. What is that best strategy is always helpful. Yeah, so you mentioned something a Phi. So that's one of those things that I find that often compliance and legal teams will just kind of use it like, oh, we can't do that, it's HIPPA and Phi Right, and they just throw these things around. You know, I think that like like us, you know people that are commercially commercializing innovations or marketing innovations. You know it. We wrestle with them and we go let's write, let's get like no, let's get specific on really what those things mean and what we can and can't do instead of just kind of using it as a blanket. But you had, you and I were talking earlier and you had touched on this new ruling by the Supreme Court around facebook with SMS. So just give our audience a little bit about the information about that new ruling and what are the some of the implications that you think it could have for the those innovators in the end in audience, for sure, and we don't like to give out you know, legualibis, obviously, but the ruling actually gives a little bit more opportunity to reinterpret the text messaging and, you know, not thinking of it as spam. And so we pulled all of our clients, go to your compliance groups and talk about this, because I think it really opens up the opportunity to do much more and at the same time, I actually do love when you, you know, can capture permissions from a consumer because, even if the ruling says go crazy, right, it's going back to the idea of like well, what do I want? The attacks what I what I want at email and I like my bank statements via, you know, electronically, but I might like something else in paper. I still get to choose, and... I do think that there's a lot of opportunity and permissions, but we should all be driving towards as much digital as possible because it allows you to have that two way interaction with the consumer versus the one way, yeah, which I think is really important too, because it's not even a one side's fits all with the permissions as you just kind of mentioned here. So you know, as a consumer, don't just give me the choice between do I want to communicate via tacks or email or phone? But make that even more granular because, like you said, some things I might want via text, but some things I might want email or a phone call, and that flexibility and personalization at that level is so in critical. Absolutely. Yeah. So what are some of the lessons learned that we haven't talked about yet that you want to make sure that our audience walks away with? Sure, so I encourage everyone's listening to do a be testing. Now. We've learned so many of the insites are ready from our billion and HAPP interactions. But a we're still in our infancy, as you know, healthcare consumers, and the lessons have not all been learned yet. I like to give examples from my past life. I used to work to digitask and we had twenty years of data on, you know, helping America Express in a teens wireless, and so we knew that if you took it a stamp, you know, even like ten degrees, you get five percent open rate on the direct mail and if you did a second window on the envelope, you get something else. We have yet to find out all the secrets right. It's not one silver bullet. It's no silver bullets, because it goes back to the idea that the behaviors and the benefits and the barriers and the inertia around the nagrams are different, around our adherence. I'm great at getting my screenings, I'm terrible at men adherance. So figuring out the ways to motivate me and all these little different actions, it takes understanding and work and insight and data. So everyone out there, keep a be testing and then email me and tell me what you found out. Okay. So what do you say those organizations that or...

...leaders that don't feel like they have either the budget or the time to be able to do that? A be testing and one to kind of skip over that research or skip over that testing and kind of have maybe confidence because of previous experience, maybe of a specific direction? Do you ever encounter that? Oh, all the time. We always hear no, we can't do control groups. We have to talk to everyone, and so we do a couple things. We say, well, you know what, for sure, you know if it's a cancer of screening. You're not going to hold it back. But right, hold out for like six weeks and then you'll know. You know, treat them as a hold out group and then you'll know what the difference is and then let the rest of the communications go. Or don't do a control group and just do an a be and just one tiny thing to change, you know, the subject line, who signs the letter, what the call to action was? Did you, you know, give an eight hundred number or did you do a Qr Code? You know, those kinds of things. We're seeing, like I said, everyday thousands of tests across clients and the insight is it's really valuable to help iterate and and prove those performs going forward. I think buying into and supporting that type of experimentation is so fundamental to just every business has success. Right. So not even just patient engagement or consumer engagement, just really across the board. This idea that it's not going to ever really be this one in done, but it's going to be this irritative strategy where we have so much data that we can look at, we can take the guess work out and we can make decisions going forward based upon the data and then experiment. I mean I've heard of companies that were just failing being bought by other organizations and maybe just tweak the call to action and then all of a sudden they have a viable business. Right. No, even like it, like me said before, changing one word, yours to ours, right, or your hours to yours, makes a huge difference. On the examples I love to give this. You know, when I was at Chereos, I had one goal. I needed people... buy trerios. I didn't even, frankly, need them to eat Chereos. And then my target market was super defined. It was, you know, new MOMS that had brand new babies or husband's with that cless draw. And so you think about the messages to drive those behaviors. Could get really tight and SUC sanct. Now not. When do I have you? I need to do thirty seven things are exherence, for sus screenings versus well visits versus your bills, etc. But I have every walk of life, every income, education, you know, socioconomic sties, you name it, and so there's no way that we can know all the answers, but we have a lot of the starting answers and so continuing to refine, refined until we get a hundred percent engagement across. I mean our health should mean more to less than our flat screen TV or I bomb. You know, it should be our favorite thing that we invest in. We still have so much work to do, don't we? CASTLING? So I want to just kind of you start to end on this note because I want to make sure I answer this question. You've got so much experience around consumer engagement in your previous work. So I want to ask you what is hamburger helper, betty crocker and healthcare have in common? Asolutely they have. They all need to drive behavior change. And so whether we're driving behavior change through repositioning hamburger helper to more of a homestyle helper, or we're getting you to eat betty crocker desserts, but instead now we're getting you to do things that are better for your health. Granted, sometimes there's not that endorphin at the end when you, you know, buy something amazing, but at the end of the day, all of those same on SIP, supply, data, science, a Aril, economics, you know, predictive modeling, at all of that comes into play and can really really drive behavior in a beautiful life. Yeah, yeah, so you just made me think of one more question. You know, we think about we think about outcomes and being able to have real world evidence that are solutions that were bringing to market actually develop a can generate the value and...

...the ROI that we said that they would, so that the the performance of those tools are just so critical. You know, talk a little bit about maybe some of the work that you've done and how you're playing into being able to develop the real world evidence that's needed to be able to have that success story to lead to future sales going forward? Sure. So we work with clients all the time to drive those outcomes. So it's not just engagement metrics, right, it's not just who open the email or who answered the call, it's really about driving those outcomes. Did they get the screening? Did they go to the well visit? And then our other strategy that we love is to just find quick wins in no matter what projects were doing. And so we were helping a medium sized health plan figure out there all of their print inventory, to figure out what to Reimagine to digital and in doing so we opened a bunch of leathers so we saw this letter that we needed some optimization and so we reworded it, added a phone call to it and one of the things that I mentioned before is it didn't address hidden barriers. It was asking women for a home visit to do their OSTEO arthritis measurement for stars, and so we said, hey, you know, you don't even need to take your clothes off, and we didn't say it that. Obviously you know correctly that is a barrier, right, if you're thinking about having a home visit and having a Saust to arthritis measure. And Yeah, ended up driving a thirty five percent your your increase in their he dis measure. So you've like just little world right, huge real world business impact. Right. So, like you said, we're not talking about fluffy stuff of like, oh, open rates for emails, real business impact. Will Cathleen, this has been so valuable. I know that our audience is going to walk away with so much wisdom to 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 for Russ Roxy, for having me in terrific, so very... Thank you so much for listening. I know you're busy working to bring your life changing innovation to market and I value your time and attention. To get the latest episodes on your mobile device, automatically subscribe to the show on your favorite podcast APP like apple podcast, spotify and stitcher. Thank you for listening, and I appreciate everyone who shared the show with friends and colleagues. See You on the next episode of Health Innovators.

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