We just enrolled the 1,000,000th person in our preventive health program. How did we do it?
The best digital health solutions are useless unless they engage with the people they are designed for. And those that need the support the most (the unhealthy, the impoverished, the uneducated) are the hardest to reach. Historically, the rush to invest in digital health has focused on the technology or the program or the market. If I were to invest my own money (and I have) I’d be focusing on distribution.
Voxiva’s first lesson with mass distribution came with our maternal health program, Text4baby, which we launched with great fanfare. Kathleen Sebelius (Secretary of HHS) talked about it first, Aneesh Chopra (White House CTO) formally announced it and Dr Drew (no introduction needed!) showcased it on Teen Mom. We watched enrollment surge thinking that PR was the right formula and then just as quickly we saw it stall. We then spent the next 12 months painstakingly assembling a network of over 1,000 partners to engage pregnant moms one on one, and in April of 2016, we enrolled our millionth mom. Hard work!
We knew that repeating that model was going to be challenging, so when we turned to smoking cessation, we went to the organizations that reach smokers at scale, starting first with the pharmaceutical companies that distribute nicotine replacement therapy. Although they reach millions of smokers that are trying to quit, we couldn’t make the return on investment work since the products carried such a low profit margin. Then we turned to the companies that run the state funded “quitlines” that counsel hundreds of thousands of people each year. It was the perfect formula. People were motivated to join and there was a steady flow of people needing help, there was a strong RoI (digital technology is cheaper than person to person counseling), and there was an intervention that had been scientifically proven to double quit rates. 200,000 people later, and 280,000 years of life added to those that had quit, we had found a compelling formula.
So how did we reach 1,000,000 people with our preventive care program, Connect4health? The answer lies in a federal government program called Lifeline, which provides a fully subsidized cell phone to Medicaid beneficiaries. The problem with Lifeline was that people didn’t know about it and Medicaid health plans were unable to promote it because of the HIPAA marketing rule. But combine a Lifeline phone with a preventive care program delivered through text and you create a HealthPhone™ that Medicaid health plans are highly motivated to promote.
As we turn to the future, and our strategy for creating a shared digital health utility built for and around people (not just the enterprises that serve them), we are designing a distribution model with many on-ramps and no forced off-ramps. Just because an enterprise’s relationship with a consumer may end, it doesn’t mean ours should too.