Communication is a major, some might argue the most important element of health management, whether for sickness care cost reduction or productivity/performance improvement, and for traditional healthcare providers own workforce, other employers’ employees, or insurance plan members and beneficiaries.  The chief challenge in PHM and EHM is to achieve behavior changes among individuals and populations, and communications is the major basis for doing so.

The type of communications used vary widely, but generally fall into three categories, depending on whether their purpose is to motivate, empower/enable, or remind/prompt people to initiate or maintain a given behavior.  Unfortunately, professionals in one kind of communication may stress of use only their own kind, rather than considering other applications/reasons for communicating, and other kinds of communication.

For example, professionals who favor education, or what has become recently known as “information therapy/prescriptions (Ix), may rely solely on objective information sent to or shared with targeted HM participants in classes or seminars.  By focusing solely on the motivational power of facts, and on rational edification, the educational approach may fail to engage targets emotionally, and have little effect on enrollment, participation, behavior change and perseverance, all of which are necessary to optimal HM success.

Motivational appeals, for example, have long been understood by marketers to work much better if they engage targets emotionally, which is often sufficient by itself to elicit the desired behavior.  Rational education is often useful in enabling people to change, such as pointing out where help, peer support groups, etc. might be found, and remind people of incentives and rewards available.  But reliance on extrinsic rewards both costs HM sponsors money, threatening their ROI, and can run into trouble in time as rewards become perceived as entitlements, and no longer motivate well.

The absence of reminders for desired behavior changes is frequently absent, when HM providers rely on motivation and capability alone as sufficient.  Unless people can remind themselves, or otherwise remember when desired behaviors are needed, they may simply forget, even when they have both the motivation and capacity to act “correctly”.   Simple reminders, of the problem being addressed, the outcomes that might be achieved, and of the precise behavior needed, to the right person at the right time and place, may suffice for many participants, and cost relatively little when automated phone reminders, e-mails, or wireless communications are employed.

While my bias is understandable, as a career marketer, I believe that the inclusiveness inherent in marketing communications concepts and models will work well in HM, far better than educational or informational models, alone.  Marketing routinely reminds prospects and customers of the benefits to be gained, how to gain them, and when/where to do so, for example, rather than relying on motivational messages alone.

Moreover, marketing, when used to promote and sustain continuous relationships, understands the importance of reminding customers what they have gained, but also what they can expect to gain by persisting as HM participants, and what they could lose if they stop participating in an HM program or persisting in a desired behavior.  The effects of anticipated participation and benefits, as well as anticipation loss have been found, by marketers, to often overpower even satisfaction with past participation and benefits, in determining the continuation of relationships.

At a minimum, HM communication should include and test for the best methods, messages and media for motivating, enabling, and reminding prospects and participants.  All three kinds of communication can be combined in the same interaction when appropriate and efficient, so they need not add to the costs of communication, but they can significantly add to its effects, and thereby to the success of HM investments.

Moreover, the reminding function of communication can help in reducing costs of HM interventions.  By reminding participants of the intrinsic benefits of health and life quality improvement that their HM behaviors and achievements have delivered to them, the need for extrinsic incentives and rewards, with their unavoidable costs, may be reduced, or even eliminated at about the time they lose their impact.  It has often been shown by psychologists that intrinsic rewards are more effective, particularly in the long run than are their extrinsic cousins, and they cost HM sponsors nothing extra.

Perhaps even more important as a communications challenge for healthcare providers is the reminding of their internal and external “clients”, i.e. those who must be convinced of the total economic benefit of HM investments made.  Reminding them of carefully measured and monitored progress achieved can be helpful in maintaining current investments, while reminding them of the total gains achieved can be the source of internal approvals for next years’ investments, and external client retention, and even for results-based payment increases.

Communications strategies adopted by healthcare providers of HM services should be planned, implemented, and evaluated to achieve all the outcomes that everyone involved is pursuing, plus recognition of all it has achieved, and is likely to achieve in future.  This will add significantly to the motivational impact of persuasive communications, as well as add confidence to the capability and empowerment effects of communications used for that purpose.