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Core Exchange: How the Coronavirus is impacting healthcare perceptions and behaviors

Exploration of new research provides actionable insights for healthcare marketers to get patients to return

On June 4, 2020, we conducted an online discussion with Rob Klein, founder and CEO of Klein and Partners, covering key highlights of the second wave of his national study: How is the Coronavirus Impacting Healthcare Perceptions and Behaviors. This study, fielded in May, 2020, provides valuable and immediately actionable insights for healthcare marketing and communications professionals.

You can listen to the podcast episode using the player embedded below, or you can read a full transcript below. Be sure to subscribe to Core Exchange on iTunes. You can also watch the video discussion here.


  • Core Exchange | How the pandemic is affecting healthcare behavior

Episode Transcript:

Angi Krueger: Welcome to The Core Exchange, a healthcare marketing podcast. I'm Angi Krueger from Core Health, Core Creative's specialized healthcare marketing practice. This week, we're going to do something a little different with our podcast. I'm going to share with you a live Zoom discussion that we'd conducted on June 4th with Rob Klein of Klein & Partners and Sue Spaight, our director of insights and strategy here at Core Health. They talked about new consumer research on how coronavirus is impacting healthcare perceptions and behaviors.

Sue Spaight: Today, we will share some particularly actionable highlights from Rob's latest study, which is about how the coronavirus is impacting health care, perceptions and behaviors. This is the second wave of the study, the first was done in early April, the second was done in early May. So a few weeks ago now. The next will be done very soon and we'll share that with you at that time also. So Rob has been gracious enough to share his insights with us so we can share them with all of you. And I will turn it over to him to talk just a little bit more about the study methodology, and then we'll jump right into what we learned.

Rob Klein: Great. Thanks Sue, we can advance to the, there we go. Thank you. So thanks everyone for being here. Sorry. I'm kind of shadowed here because I'm out of my Palm Springs and it's 110 already and it's a lot of sun. So my background is real. It's a little bright, but anyway, so thank you again for joining us. So, again, as Sue is saying given how the world is changing so dramatically in such a short timeframe, I typically do an annual omnibus study one per year, here, I'm doing three to four waves. So as Sue said, I did the first wave in early April. This is wave two, which we did in early May. And then next week I'm getting ready to do wave three, and I may actually be doing the wave four in maybe July or August because the world is just changing and people's emotions are changing it seems almost daily.

So it's important that we keep our data up to date to see how those I'm really most curious as what attitudes and behaviors are going to stick versus how are we going to go back to the way we were? And that's really hard to know without constantly updating our data. So it was a random sample of adults, nationally, 500 consumers that we talked to. Also anywhere on charts or tables, if you see arrows or bolded scores or letters, that just means a statistically significant difference and I'll point those out when we get to them.

So let's jump right in. Also just to let you know given the time we have today, this is just a subgroup of the larger report. So Sue and Angie can make the full deck available to you so that you can see some of the data that we didn't have time to get through today. So just know that there's even more data than we're going to talk about. This is really the most important data to really help us understand how do we get people to come back? Because we know we need them to come back and they need our help to be able to come back. So how are patients feeling and doing now?

So the first question that we ask folks is, is we give them a slider to say, because everybody is used to the news and the government talking about where we are in the curve, let's flatten the curve, things like that. So we asked them, where on the curve do you think we are? And so in the first wave, people thought we were getting close but we weren't at the apex or the height of the curve. Now in our May wave two, you can see on average, there's been a significant shift, on average now it does vary by market.

I did a local market study in New York and it's a whole different ball game. They're grown, they're kind of at the center of things for much of the country. But just on average across the country, people think we're kind of past the worst. Now, with the unfortunate situation that happened in Minneapolis with that evil cop murdering that man that has really re-upped people. We just know what's going on with all of the what people are doing in the streets and how upset everyone is. So when we do our next study, I'm going to add some questions in to see is that impacting and piling on how you're feeling about the coronavirus?

So that again is potentially changing our trajectory. But for right now in the early months before that happened, people were starting to feel that they could see the light at the end of the tunnel. Now, I want to see has that light been pushed out or not. Next one. So one of the questions we ask is we ask people to rate what their emotions, on a zero to 10 scale. Zero is very low, 10 is very high. How would they rate, we gave them several positive emotions and we gave them several negative emotions. So what's interesting is the positive emotions have not changed significantly between the two waves, but the negative emotions nationally have come down significantly.

So that's what those arrows indicate. There's been a significant decline in feelings of loneliness, anger, fear, anxiety. However, those negative emotions are significantly higher among women and those 18 to 44. Now I could say the reverse and say, women have an appropriate level of concern and men are not as concerned as they should be. It depends on what side of the coin we want to talk about. So women are the healthcare decision maker and maybe they're paying more attention to what's going on as a guy, maybe we're just like, I'm not paying as much attention.

But there is a very significant difference in negative emotions between male and female, and also younger people, those 18 to 44, they are significantly more likely to feel loneliness, anger, fear, and anxiety. I'll tell you, if you look at all the reports being written right now, you've got younger people in their 20s and 30s, all they've known is 9/11, the recession of 2008 and now this. So they haven't known a decade where something dramatic and catastrophic hasn't happened.

So many of these young people are feeling, when are things going to settle down? There's data out there to suggest their income and their career trajectory may never get back onto a normal trajectory for them. So that's why if you look at people that are out in the streets, protesting and rioting right now, it's pretty much people in their 20s and 30s. And so we've really got to address their mental health, or we're going to truly have a lost generation. So we want to be the great healthcare providers, we really have to help these young people because I'm very concerned about their mental health. Opioid addiction and death is on the rise, I think suicides are gonna go up, divorces, job loss, bankruptcies. I think this longterm lag effect of mental health is absolutely critical for us to address as a healthcare industry.

Sue Spaight: Great points, Rob, can I jump in with a question about this?

Rob Klein: Please.

Sue Spaight: So as I've told you out of everything in your study, this was one of the more surprising findings to me because we've been hearing so much research about the intense levels of fear and anxiety that people are feeling and we've certainly been feeling that ourselves too. So, could you talk a little bit more about how much this differs among women and that 18 to 44 demographic and whether the negative emotions are still outweighed by the positive emotions among those demographics, since those are really key demographics for us.

Rob Klein: Yeah. Great point. So there's kind of two questions there let me answer both. So between male and female, women have about a point higher and on a zero to 10 scale, a full point is a big difference. So for example, on anxiety, which the grand average is 5.38 on a zero to 10 scale for women it's 5.98 and for men it's 4.72. So that's even more than a full point difference. And it's the same for the other three. So it's about a point or more. But the good news is, the highest is anxiety at 5.98, that is still below the positive.

So positive emotions in an absolute sense are higher than the negative emotions even if we look at just the women who are significantly higher than men, it's still below the positive and the same with 18 to 44 year olds. And anxiety, of all four of those anxiety is the highest score in general and within subgroups. So if you think about anxiety, that's a legitimate mental health term. People are feeling anxious and we have to address that. We'll talk a little bit more about what we as providers can do because someone could be anxious to come back in for care, they could be anxious about leaving the house, they could be anxious about getting on a plane or going to a restaurant. It's a very broad term that encompasses a lot of things that they may or may not choose to do.

Sue Spaight: Good point. Thank you. Let's get into some of those more specific concerns then.

Rob Klein: So here we went in a little more specifically on what are some of your concerns, again, the same scale, zero to 10. What's your concern for a household member getting sick? That's the highest concern. It's down but not significantly from the first wave, but it's still in an absolute sense most people are concerned about someone in the house getting it. Because obviously someone in the household gets it, they may get it. Plus, if I'm married, I'm obviously as a husband, I'm more concerned about my wife getting sick or children, things like that. So financial situation it's down significantly, but it's still moderately high.

I think the financial is going to have a lag effect because people are expecting if they were furloughed, they're hoping to come back. Will they have plenty of in the short term? They have an increase in their unemployment benefits, but that's going to run out. So I think we're going to see a lag effect on the financial impact that we need to be braced for. What about restaurants not coming back? So those furloughed people may not have a restaurant to go to if there's fewer restaurants. Retail, look at all the bankruptcies.

So I actually predict a financial situation, I think that's actually going to have a re-spike. I don't think it's going to continue to go down. That's my concern, but it's a lag effect. Measuring lag effects are really hard. Can you go back? I wasn't done. And so, but you can see like personal safety. I wonder if that's going to go back up because of what's what's currently going on. But people are less concerned about their provider's ability to care for me when I'm sick, because they're hearing all the messaging that we're sending out to people like, "Hey, it is safe to come back."

So for the most part, we're seeing a decline, but again, I want to track that another time and maybe another time after that to see if this is a linear trend or not. Next slide. So then we have folks what's your concern about rescheduling an appointment? And again, the highest level of concern across all of these is I or my family will get the coronavirus. People are just very paranoid about that. They're less concerned about being able to receive care in a timely manner. We've done a pretty good job with virtual visits. If you hear people talk, they'll say, "Oh, we went from a couple hundred visits a day to 5,000."

So the exponential increase in virtual care is like we've never seen innovation in healthcare this quick ever before. They're not as concerned about supplies or that they won't be properly informed of how... If anything, people are feeling like they're being almost lectured to too much. It's like, okay, I know what to do let's get me in. So we have to balance how much we lecture about protective cover, social distancing, washing your hands. That's pretty much ingrained into people's brains and so they want to hear other stuff that we're doing to get them back up.

Affordability is the lowest. But again, I think there's a lag effect there that we can't quite get a handle on because I don't think all of the potential negatives have fully hit. And again, consistently higher among women. I'm sorry, go ahead Sue.

Sue Spaight: No, go ahead.

Rob Klein: I was going to say, and again, like the other emotions, it's significantly higher among women and 18 to 44. So that concern theme is very consistent across these questions.

Sue Spaight: Go back for one second Ang. I would have probably expected concern that my family or I would get coronavirus to be higher than a six. So this was actually somewhat of a relief or a positive that it wasn't higher. Clearly it's still a significant barrier that we all have to overcome, but people aren't completely terrified that they're going to get a coronavirus if they come in.

Rob Klein: Yeah. We tend to look at the hotspots like New York or Seattle or San Francisco. We think of those as a bellwether, but they're not indicative of every small town and there's a lot of small towns. And when you do a national survey, you're getting a representation of large, medium and small, and how people feel in midsize like a Grand Rapids, Michigan, or an Akron, Ohio, or a smaller town in Colorado. That's a very different attitude. As I said, when I do local market studies, you've got to be in a pretty big, like a Chicago or a New York, then these concern levels are much higher. So what's happening is if you look at the range of the mean, it varies, there's a pretty big range. So that's really what's going on when you have a national study,

Sue Spaight: What's the highest concern level that you've seen in any of your local studies so far?

Rob Klein: Oh, now you're relying on my memory. Thanks.

Sue Spaight: Approximately.

Rob Klein: I'd say it's a point, point and a half higher probably in the mid sevens. Which for a scale like this, I think a 10 would have to be like, we're world war three. I think people are using the scale pretty judiciously and fairly we're not getting scale creep like we do on customer stat where everybody gives a 10. So I'm pleased. I think people are using this more like a pain scale where a 10 means I'm pretty much half dead. So the fact, I think that six is actually that's a concern level. I think that's pretty representative of how people are feeling right now.

Sue Spaight: Okay, great.

Rob Klein: And then I added this question in wave two, so I don't have any trending because a lot of people you're hearing that people having heart attack or stroke symptoms, were not going to the ER because they were afraid they were getting the coronavirus and then they're dying at home. It just boggles my mind. I have one client who has seen a significant increase in women with high risk pregnancies, choosing to try to have their child at home as opposed to coming in and then they end up in an ambulance coming in the ER, because they have preeclampsia or something.

So they're trying to communicate with their pregnant moms, the safest place for you to deliver is in the hospital. Delivering at home is not safe, especially if you're high risk. So they're having to communicate with people because everyone's afraid. And so I put this question in, what's your concern about getting care? And you can see, ER is the highest level of concern. It's 7.28. Oh good question, Larry, no, this is from wave two. So this is the May current. I'll ask you to weigh three as well. So this is the most latest wave data.

So you can see there's a heightened fear for ER, and we all know on the inside the ER is probably the safest place they could be in terms of not getting the coronavirus. So there's a big gap between what we know to be true and what consumers are feeling. You may have seen that Boston PSA that all the hospitals in Boston put out to say, look, "If you're having heart or stroke symptoms, the safest place to get to the ER, do not stay home." And so it's amazing we never thought we'd have to educate people on things like that, but we really are having to.

Sue Spaight: Rob am I-

Rob Klein: Yeah, go ahead.

Sue Spaight: Am I reading this right if I read this as 53% rated their concern about going to the ER is an eight, nine or 10?

Rob Klein: Correct. Yeah.

Sue Spaight: That's pretty huge.

Rob Klein: And then Pam has a question. Do you know what percentage of participants were older adults? I have that in a table. I will tell you we wait the data to be population proportionate. So it's proportionate to the national average of 65 and older, but that'll be in the main report for you. All right. So another question we asked, it was interesting. I wanted to know what new behaviors started in healthcare because of the coronavirus. So again, wave two is the blue bar and the gray bar is wave one. The arrow indicates a significant difference. So what's the one thing that increased significantly in one month? Virtual visits, went from 5% new, like it's the first time I've tried a virtual visit to 12%.

So almost a two and a half times increase in one month. So 12% of Americans had a virtual visit for the first time. And I bet that even higher now when we do wave three next week. So again, virtual mental health, a lot of people are converting over from an in-person mental health to a virtual health visit because that's better than not being able to see their psychologist or psychiatrist. So I think we're going to see a huge increase in the need for mental health, whether it's in person or it's virtual, that's got to be a priority for us as well.

So a lot of things are happening for the first time that never happened before. So the key is as healthcare providers, we have now created our own new normal. We have just told people we can innovate quickly, we can put bureaucracy and silos apart and we can innovate quickly, especially like with virtual care. So the challenge is now consumers are going to expect us to continue to do that. We can never go back to our old ways of innovating slowly. We have now got to learn fast, which I think is a wonderful opportunity. I know that's scary to some, but you know what? It's now jump-starting us into the 21st century.

And then what are some of these behaviors whether you've done them or not during the coronavirus, which of these behaviors will you definitely do after coronavirus? And again, significant increase in virtual visit, 28%. So three out of 10 people said, "I'm going to keep doing this." Let's just take that. So if 30% of American adults continued with virtual visits, that's a lot of volume. And so again, going back to their primary care, that's not a big surprise, most people want to go back to their primary care. Texting their doctor, it's only two data points, but that's down significantly. I want to see how that tracks over time. Maybe they don't feel the need to text as much because this new virtual visit thing is so cool. So maybe virtual visits could be replacing texting. I don't know, but that's going to be interesting to watch.

Then another kind of fun question we asked both ways was, have any local healthcare providers have done any innovating that's impressed you. So 21% in wave one and then in wave two 27% said, yeah, somebody did something locally that I thought was pretty impressive. And then we had a verbatim that said, okay, tell us what, almost every single verbatim centered on virtual visits. So again, no matter how we ask the question, virtual visits popped to the top as, "Hey, this is pretty cool." And then 58% in wave two said, I want you to keep doing this afterwards.

But what I found was significantly more said, I don't know, 25% in wave two versus 11%. So I think after people, because we all know with the coronavirus people are a little bit cognitively challenged now, because when you're this fearful and anxious, sometimes your cognitive reasoning is impaired. And so I think what we need to do is not only get our operations nailed down to the virtual visits efficiently and effectively, we need to make sure from a communication standpoint that we keep telling people, "Look, this was not a short term fix that's going to go away, this is a longterm solution to access."

Because I'll tell you, as I tell all my clients, time is the new currency. You can always make more money, but you can't make more time. And so we need to demonstrate to people and convince them and say, "Look, this is a long term solution to us sucking up all your time by making you wait." So that's an important messaging perspective. Next.

Did you have any appointments or procedures that had to be canceled? Dental care, no surprise. Follow up visits, eye care, annual physical. The thing is that significantly more people in May than April had some appointment or procedure that got canceled. So that's creating a lot of pumped up demand. So we've got to figure out ways to provide alternatives to where they get that care, how they get the care when they get the care and with whom. So there's where we need to innovate. And so let's let's talk a little bit about that. Next slide.

So we asked people... I'm trying to see if my video is... there we go. I have two screens and my video is blocking my screen. So we asked people for each of these that they had to cancel, what did you do? And you can see with follow up visits, consult visits and mental health, a lot of them said, "I changed the virtual." 45%, almost half of people that had an in person mental health session canceled almost half went virtual. Now what concerns me is that 21%, so a quarter haven't rescheduled. So that means you've got a quarter of people that were getting therapy are not right now. That concerns me longterm.

But there's opportunities to switch to virtual and we need to take advantage of that. Elective procedures and surgery, 42% said, I'm waiting to reschedule. We need to get these people back in and we need to be proactive. And if your states have allowed that, and I know every state's different, but if your state has allowed you to have elective procedures, you need to get on the horn with these people and say, "You're available to come back in, here's how we're going to do it. Here's how we're going to keep you safe and here's how we're going to be able to get you in. We're going to extend our time."

Some of my clients are doing surgeries up till 9:00, others are switching inpatient surgeries to outpatient if it's safe. So we've got to be very, very innovative and how and where and when and with whom we get people back. So how do we get patients back? So things we need to do to ease their safety concerns. It really comes down to what they've heard. Wear a mask here, social distancing and wash your hands. And so they're spitting it right back to us. So they want us to demonstrate what we're doing. And so no surprise, we just need to keep doing and demonstrating, people want to see it and they want to hear it. They want you to say, "Here's what we are doing." You know the old saying, a good plan today beats a perfect plan tomorrow. Consumers want to know what you're doing now, not what you're planning on doing later. So it's got to be very action oriented.

Sue Spaight: Yes. And very specific, Rob we're seeing a lot of people with messaging like we're taking extra cleaning measures. I think one thing that was clear from these findings is we have to go past those vagaries and be very specific about what we're doing.

Rob Klein: And visual cues matter. I have a client that put a PSA together that I tested, and it had nurses and doctors in the hospital talking about everything they're doing and stressing the importance of wearing a mask, none of them were wearing a mask. So everybody in the verbatim that said, "Oh, I should wear a mask. Why aren't you?" So it's these little visual cues that we're doing, or they were they too close to each other. So people are watching what we're doing. It's like when your parents say, "Do as I say, not as I do." That's not cutting it for patients. We need to make sure we're doing exactly the same things we're telling them to do. So if you're putting out any videos, make sure you're wearing masks and make sure your social distancing and washing your hands because people are watching what you're doing

Sue Spaight: Before we advanced I just want to make sure, does anyone have any other questions that they want to pipe in right now? A few people have typed some stuff in the group chat, but I just wanted to make sure I'm not missing anyone if you had something, but we'll get to questions at the end as well. So feel free, I'll move on to the next slide though.

Rob Klein: And then we also ask them what can we do to ease your access concerns? And so, number one, people said, offer virtual visits in place of an in person appointment if it's medically appropriate. That was significantly higher among women and those working at home were most interested. I'll say I do a lot of virtual care research market sizing and product development for clients pre-COVID. And I can tell you the number one way to a mom's heart to make her a brand ambassador to your brand is to offer a pediatric virtual care visit because urgent care is plan B when my doctor fails to see me.

So if you've got a virtual visit that the pediatric oriented and formatted, and you bailed that mom out when she didn't know where to go, you make a brand ambassador out of that person for a long time. Not only having a virtual strategy, but having a pediatric specific virtual care strategy, if that's your business is absolutely... the benefits to that for your brand are multiplicative. The other interesting thing is people are more interested nationally and extended hours during the week than on the weekends.

I'm not saying don't open up on the weekends if you've got to figure out how to catch people up, but going forward, people like extended hours, early mornings and after work more than on weekends. Because you always seem to feel sick later at night, plus that's when you're off work. So again, it's respecting their time. So that's an opportunity, not only short term to get more people caught up, but in the longterm, the days of banker hours and in the early '80s, I was in banking. So I remember bankers hours. It was a negative. I remember how people said, "Oh, you've banked those hours." It meant you didn't work very hard.

Now we have healthcare hours and we need to get rid of those because consumers want us to be available. Banks now have longer hours. So we need to do that as well longterm. Next. Now let's talk about messaging and what do people want to hear from us? You'll notice that the top four that have the most impact, all start with the word explaining. Explain what to prepare, explaining how they are handling. So basically your messaging should start out with, let us explain how we are dah, dah, dah. Or here's what we are doing dah, dah, dah.

I went back and watched FDR's inaugural address in the '30s, his first term. And one thing he focused on was I love this quote, "Americans want action and action now." What he was saying is, we're in a depression. I'm not going to tell you what we're going to work on a year from now, Americans want to know what are you going to do to fix the economy now. That's what Americans are saying to us in healthcare right now. What are you doing now? Not tomorrow. So I thought that was a perfect quote for what we're facing right now. So your messaging should be, here's what we are doing now.

Another question I added in wave two, the most recent wave. I want understand what are some things that would either irritate you and make you want to switch or could attract you away. So safety is not number one, it's attitude, then access. So it's the two As, attitude and access. So let's look at those. So attitude is, my current provider has been difficult to work with in getting me rescheduled. That's kind of a combo attitude and access. Then the 21%, my current provider lacks empathy for my situation. The call center people, the people that they call at the doctor's office to reschedule not only do you have to be able to schedule, but they've almost got to be therapist in a way.

So your people have to really be empathetic and understand that people's emotions are on razor's edge, and so they want to be reassured and calmed. They're not just calling, "Yeah, I'm busy on Monday can we reschedule to next Tuesday?" No, they're calling up like, "Is the world okay? Can I come in and get my... I'm not feeling good? My hip is killing me, I got to get the surgery done. I can't wait anymore. Is it okay?" "Yes, Rob it's okay. Here's what we're doing to make it safe, here's how we're going to get you in."

So those call center people, their job has never been more important as it is right now, because if they do a bad job and they're just cut and short with these people, and it just matter of fact, they're going to lose people because they're looking for somewhere else to go that can treat them well and get them in. So that's it. Attitude and access are key. So let me start with some key takeaways. We've talked about a lot about these, but I just want to cement them in your brain. There'll never be a better opportunity to build on the goodwill you've instilled in consumers and patients to grow your brand.

They're calling you heroes. You're getting people to come outside of their houses at 7:00 at night and clap. We're getting flyovers, you're being called like first responders and heroes. We've never been called that in healthcare before. So now more than ever is the time to come out of this, ready to go. As a friend of mine says, "How we treat people now will be remembered." So what you do now is going to either help your brand to grow as you come out of this, or it's going to make it harder to grow if you haven't treated them well.

So plan for post COVID and start executing it now, because there will be a post COVID at some point. And so we need to start really treating people, not only with access but with compassion and seeing the whole person. This is not just about fixing the broken body, this is about fixing the broken emotions. I think emotions are going to have a bigger longterm effect than any physical. People will forget physical pain, but emotional pain can last a long time.

We've just proven to everyone we can innovate quickly. I mentioned that before. So this is our new normal that we kind of created. So that means it's an either an opportunity or a threat, but it's in our control to keep innovating. You know how the tech world says, you need to fail fast, I turn that around in healthcare, we need to learn fast. And that's what I say, the new roadmap is we need to be solution oriented, we need to learn fast and we need to be empathetic. That's our mantra.

And the opportunity to change behavior regarding where patients seek care. Can we move them from inpatient to outpatient and with whom? We didn't show this, but in other charts I have, consumers are open to seeing an advanced practitioner. And so it's a matter of us just saying, "Hey, Dr. Smith is backed up, but we have our PAs or we have our nurse practitioners, they can see you and do a great job and then you're within our system. So we'll know." So people are open to that. Position virtual care so that PCP is the hero.

I talked about that earlier. Make sure to train your physician on how to educate so they come off as the proactive hero. "Hi Rob, I'm sorry I can't see you but we've got a virtual visit. Here's how it works, I'll know you had the visit, I can look at your medical records. We've got your back." That's much better than someone saying, "Oh, Dr. Smith, can't see me I don't know where to go." And that makes the doctor look like they're not coordinated.

So make sure when you position virtual visits, it's not just getting an operationally correct, it's convincing consumers it's a longterm solution to access and training physician offices, doctors and their staff, here's how you position it with consumers so it makes us look coordinated not reactive. Is the under 45 age group open to the mid level health conditions? I didn't ask them why they're open we just asked them if they were. I think that's age. In other studies I've done, younger people are more open to virtual care. They're not as wedded to their primary care physician.

They're the ones more likely to go see someone at a Walgreens or CVS. So I think they're just not as concerned that they have to have a doctor. So I think that's a wonderful opportunity for us, and younger people have been exposed, absolutely. And then beyond virtual visits, they want extended weekdays as we talked about. We didn't talk about costs a lot, but we have to be innovative, maybe consider lowering out of pocket costs or somehow establishing some type of extended payment plan, like car companies. No payments for 90 days.

So I don't know what we can afford to do or what we can legally do, but we've got to do something to recognize that they're hurting financially to say, "We're trying to do something." Insurance companies are giving, I just got 50 bucks back from Nationwide because they're like, "Hey, we're trying to help in any way we can." So we need to consider what are some ways we can help financially. I know we're hurting too, but if we're going to prime the pump, we need to get revenue back in before profits. And so that's a hard thing to try to address, but we've got to prime that pump, and that means revenue has got to happen first.

One method of communication does not fit all. We've got to be multi-method. So that means we've got to drive where we want people to go so that they can focus on us. So SEM, SEO, social media, email, we need to be proactive so that people are getting our message because right now they're just going to the CDC website for the most part. Or they're going to Facebook. We want to be the ones that are their trusted source, but that means we need to be more proactive. We can't sit back and say, "Oh, maybe they'll come to our website." Well, they're not.

I've done other research and people are going to a hospital website for other reasons, they're stumbling across your COVID link on your homepage. They're not coming for that link specifically. We need to drive people to us. And then the last thing on my part is focus your messaging on, let us explain what we're doing now. Remember Americans want action and action now.

Sue Spaight: Great. Thank you, Rob. So we'll wrap up with just a few of the key takeaways that we at Core Health have been using most day to day with clients to apply the findings here, to messaging and communications. So we talked today about how consumers feel, all the feels. They feel fearful and anxious, and they also feel hopeful and optimistic. At times during this crisis, we've had clients feeling like, well, this messaging maybe is too positive, too happy. And I think that was probably true maybe initially, and now as we move on there's more of a need to reinforce that hope and optimism that people do feel and that they need to feel to stay in a mental state where they can make good decisions. I loved Rob's point earlier about how, when people are overwhelmed by fear, they really can't make good decisions.

So part of our job as communicators is helping them stay calm and striking the right balance between that reassurance. Everything's okay, there's reason for hope here. So this has been really useful for us to know. We also saw here today that anxiety about contracting coronavirus if they're going into a physical care location is moderately high that will vary significantly from market to market. It's really, as we craft our safety messaging about communicating and creating separation, here's how we're handling coronavirus patients, COVID-19 patients. Here are the very specific and visualized ways that we are protecting you to ease your safety concerns.

We really would encourage everyone to think about how they can a patient through what they will experience if they come back in, very simple terms, soundbites, images, here's what your experience will be like. It's all going to be okay, you're going to come in. We've got check-in handled well, you're not going to sit in a waiting room forever. Here's how it's going to work when you get your care, all of the necessary measures are being taken. So walk them through the journey.

And then Rob talked about the critical provider attitude. That's really critical to why patients stay or leave. Let's not give people a reason to leave right now. There's probably more openness to that right now. There's more opportunity if one provider can't get you in, I'm just going to go somewhere else. Somebody else has this virtual visit or this doctor who can see me now. So we've got to be empathetic and easy to work with. That's not new, that's just like pre pandemic times. But I think hypothetically it's even more critical now.

Then Rob talked about access and how essential that is. It remains key to both patient retention and acquisition. We've got to be scheduling and rescheduling appointments quickly and not giving them that gap again to go somewhere else. And then we talked a lot about virtual care, so many great data points in this study about virtual care that Rob recapped and others about consumers already signaling that I want to continue using this later, I would like you to continue offering this later. We all need to keep pressing forward with our virtual care strategies and getting the word out about it.

We're finding a lot of health systems who don't have a lot of clarity around the specific barriers to telehealth in their markets, and that too will vary from market to market. We know, for example, that consumers in rural markets have very specific concerns about telehealth being impersonal and things like that. So this is an opportunity that if you're really you're struggling with getting people in for virtual visits or you're struggling with getting patients back in general. I don't want this to be a sales pitch, but consider working with Rob on a local market study. He's priced them very, very accessibly and affordably for people during this time so that they can find out specifically what's going on in their own market and communicate accordingly.

So with that, thank you guys so much. Let's see what's happening in chat here as far as questions Does anyone else have any questions before we wrap up here?

Angie Krueger: Definitely let's take the time, if you're on this feel free to just pipe in right now, show your screen if you'd like or in the chat box. We want to be able to talk with you. So let us know. Otherwise, like I said, we are going to have this recording available on our website later on. If you want to share it with more members of your team as well.

Sue Spaight: And then Rob, I believe you're doing your next wave next week, right?

Rob Klein: Yeah. So I'll have results in two, two and a half weeks.

Sue Spaight: Great. So I believe we'll be doing this again and we'll keep everyone informed and invited and we'll continue the discussion.

Larry: I had a quick question.

Rob Klein: Yeah, go ahead.

Larry: You had showed on the switching sort of being a leader in the COVID pandemic was not really a switching factor. And then in the very next slide you talked about, we're seen as heroes. I guess I'm wondering, can you cut the data not by an individual local market, but if you grouped all of the areas that did have a lot of cases or when you were fielding the cases were growing pretty dramatically. Would that be different than the overall national population? We're wondering about that. Beaumont was a leader, we treated the most COVID patients. We're kind of leveraging that expertise in more of a safety message, not a come to us, we're just trying to keep our own market share. We don't really need to feel anyone else's, but still, that is a interesting finding.

Rob Klein: Are you from Beaumont, Larry?

Larry: Yes, I am.

Rob Klein: Oh, great. I'm from Royal Oak and John Fox is a good friend of mine. So small world. So let me address your question. So I think I can answer that without even actually going back and regrouping it, by looking at the data like New York. New York is kind of a bellwether for a really stressful area. What I'm finding is some of the hospitals that are getting a lot of press and people think they're the heroes. Those actually, it's almost like a double edged sword. Those are hospitals that people are like, "Eh, I'm not so sure. I love them, they're heroes. I'm a little concerned going back to them."

I think they're concerned there's a concern level that you really need to get past this and get cleaned up and let these people get a rest before I go there. So I think the more you're seen as a hero, there's concern about maybe you're beat up a little bit much and I'm going to not want to come back to you right away. So I'm almost seeing kind of a, no good deed goes unpunished type of a reaction happening in those big markets.

Larry: New York, they were hammered worse than any other or at least even the Detroit though we didn't have the overwhelming myth of it. I think that's a real concern. We're struggling with how to leverage our expertise. But yeah, I can't argue with someone wanting to go do a knee replacement at a ASC that's been closed for the last two months has never knowingly seen a COVID patient versus coming to Royal Oak where we could talk about how clean it is and everything we're doing, but we're still treating COVID patients. So I'm personally trying to struggle with how do we answer that argument?

Rob Klein: Well, Larry, like I mentioned before, can you offer different locations? And so instead of coming to the mothership on Woodward in 13, do you have an outpatient surgery center that they can have their hip done? So offering them an alternative location, if that's possible, that's one way. You're not admitting, "Oh yeah, it's not as clean here." You're just thinking like, it is clean here, but if you're not comfortable, we have an alternative for you. That's one way to maybe address that safety issue.

Larry: Yep.

Sue Spaight: There was one other question Rob, about, have you done any research in the longterm care arena?

Rob Klein: I haven't done anything regarding the coronavirus and asked people, but actually yeah, that's a good set of questions maybe to add in terms of, does anyone have a family member there? What are their concerns? But I think what we're watching is that's where most of the people are passing away unfortunately. So I'd be more interested to find out how concerned are you sending a family member there? How long would you wait before you put mom and dad or grandma and grandpa in a longterm care facility? I think that might be interesting and I think we might find that maybe you're going to find more sandwich households now for a while. Was that you Pam, that asked that?

Pam: Yeah. Rob I'm an elder care consultant and one of the owners of Vesta Senior Network in Milwaukee. What we're experienced saying is obviously very challenging. We have people perishing because of this... I can't draw the conclusion, but I believe it because of the social isolation. I literally just closed two cases in my CRM yesterday of folks who passed away waiting to be placed. And our message has been not to be cavalier at all, but we've been trying to explain to our clients that just the whole idea of leaving mom at home. You were going to place mom in the first place because you're not a professional caregiver. These places have professional protocols in place, these places are used to and have a normal procedure around infection control.

And sadly, the statistics don't support what we're trying to say, but this goes back to, even my 17 years in pharmaceutical sales, the people who are dying by and large are the highest risk group. That's not necessarily related to the fact of where they are. Statistically, and we don't even know right now, these folks who are dying, do they really have COVID or is that the primary reason? The gentlemen that I-

Rob Klein: So you're talking-

Pam: Go ahead.

Rob Klein: I was just going to say, yeah, you're right. Is it a spurious connection? Does A lead to B or is it spurious? And the problem with stuff like that, all you need is what's going on in New York where the governor let those people in that had COVID and people see that on the news. And again, people are not thinking they're most rational, so they're buying into something that may not be accurate, but once it gets out there, you can't reel it back in. And so right now, longterm care facilities are the poster children of, send your parents there to die. And that's a really hard one to get ahold of.

Pam: And that has always been. That's the number one obstacle we overcome on a daily basis. Even when there isn't COVID. You're not sending your parents somewhere to die, you're sending your parents somewhere to live. But so many adult children have promised that they would never put mom in the home. But this is a big conversation, Rob, I won't go down this path, but my point simply is that this is a whole separate silo of healthcare that is so frequently forgotten. People aren't really talking much about this. That's why I asked the question and maybe encouraging you to ask the questions.

Rob Klein: Well, I'm definitely going to. And Pam, you see my email there, if you want to chat more, I'm happy to.

Pam: Great. Thank you.

Rob Klein: Because I think that's a really good question to add into my wave three.

Pam: Thank you. I'll throw my email up here too just in case you have any questions on how to ask the questions.

Rob Klein: Well, I definitely would like to talk to you about that. Thanks Pam.

Pam: Thank you.

Sue Spaight: All right, well, thanks so much everyone, and stay tuned for the next wave.

author

Angi Krueger is the Vice President of Marketing at Core Health, Core Creative’s specialized healthcare marketing practice.

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