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Episode 6 – Building a Healthcare Product

Time, technology, and innovative thinkers have revolutionized what the healthcare system stands for today. Regardless of these achievements, though, the entire system remains very health-centric, focusing only on what happens when something goes wrong and a patient must seek out help. Imagine a framework that flipped this concept on its head, putting the patient at the center versus the health event. Imagine a system that gives users the tools and resources they need to create a healthy lifestyle that’s based on their wellness needs, motivations, and interests. Ultimately, a healthcare system that’s not just approachable, but promotes a better, more healthy existence for the entire population.

In this episode, we sit down with University of Rochester’s School of Nursing team, Renu Singh and Brian Harrington to get a behind-the-scenes look at a cutting-edge wellness application they brought to market for University of Rochester employees, YoURHealth. Our hosts Sean and Joe not only look at how this power team brought this beautiful concept to life but also their process for continuously innovating the framework to provide care to the ever-changing needs of the different organizations it now serves.

renu-singh-itx-guest

Renu Singh
Renu Singh is the CEO at the University of Rochester Medicine’s Center for Employee Wellness, as well as the Senior Associate Dean of Finance and Operations at the School of Nursing. Renu Singh spearheaded the development and implementation of the Center for Employee Wellness for U of R. As Associate Dean of Operations, Singh oversees the school’s technology, personnel, and facilities management. This year, Singh was bestowed the Women of Excellence Award by the Rochester Business Journal due to her career accomplishments, community involvement, leadership, and commitment to mentoring.

 

Brian Harrington
Brian is the director of Information Technology Services and Building Operations for the University of Rochester School of Nursing where he leads teams and projects to deliver high-quality integration of technology with the School’s academic, research, and practice missions. With over 20 years of technical expertise in healthcare environments, including leading the technical efforts of the flagship UR Medicine Employee Wellness program, he has also contributed to technical success with the University, Kodak, and Xerox. Brian has an MBA from the Simon Business School currently is an executive board member for Goodwill of the Finger Lakes and ABVI.

Joe: [00:00:00] OK, so we are here with Renu and Brian from the University of Rochester. And we want to talk to them about the application that they’ve been deploying and launching and selling, essentially, at this point. Because what we wanted to talk about today was really the behind the scenes of project management and actually getting it into market and all the fun and challenges that that comes with, so Renu and Brian thanks for joining us today.

Renu: [00:00:24] Absolutely. This is going to be fun to talk about.

Sean: [00:00:27] Super excited to have you guys on. Can you tell us a little bit about your business and your roles for our audience just to bring them up to speed?

Renu: [00:00:34] Sure, absolutely. You know, I can start us off. Our business, we actually developed this business as part of the University of Rochester and we developed a product that’s part of the UR Medicine product which means it’s basically a clinical product. And what we do is we provide wellness assessment and wellness intervention programs to the community. We are a program that contracts directly with employers, and at a population level, we are engaging individuals to really take control of their health. And we also help coach individuals with chronic diseases to live a healthy and productive life.

Sean: [00:01:21] Great description. And what’s your role, Renu, with the organization?

Renu: [00:01:26] I am the CEO of UR medicine and Play Wellness program and I’ve been involved from the very early days, which was really not that long ago, but it has been involvement that really started with developing a technical platform in partnership with a wonderful tech company that’s in the area. And in that platform we’ve continued to further develop to essentially fulfill the demands of the workplace. Now, we’ve actually implemented our program in thirty nine organizations today.

Sean: [00:02:07] Holy cow, that’s amazing.

Renu: [00:02:09] Isn’t that.

Sean: [00:02:10] And do you happen to know how many lives you touch through this program?

Renu: [00:02:16] So the lives that we touch really is close to probably about forty five thousand.

Sean: [00:02:22] Wow.

Renu: [00:02:22] And yes, it has grown substantially. And by touch, you know, industries really define touch very uniquely and independent to what they do when it comes to wellness. But from a touch perspective, our platform has grown significantly, the number of lives we cover has grown significantly, and the programs that we’ve touched individual lives with is probably about thirty thousand.

Sean: [00:02:51] Wow. Brian, you mind jumping in and telling us a little bit about what you do for the organization?

Brian: [00:02:58] I’m the director of information technology services for the School of Nursing and the employee wellness program. As Renu indicated, started a few years back and I was immediately part of that kind of getting the technology going that would help the clients get their biometric information, their personal health assessment information, and as well as linking that information through to where the nurses and coaches could have access to it in order to provide you know the quality support that they do from a clinical perspective. So the technology kind of is the glue that holds everything together and makes everything work.

Renu: [00:03:44] And in fact, what Brian didn’t tell you is he also served in the early days as my translator when we really moved a clinical product and built the technology infrastructure and the platform to support that. And that required a real crash course in understanding technology and the language around it, so Brian was also my translator.

Joe: [00:04:10] That’s cool. So can you talk a little bit about how the idea initially kind of came up and how it was brainstormed. How did you, you know, UR is a very big organization. How did you kind of get the approval and the funding and get everyone’s buy in to do this?

Renu: [00:04:25] So it was an interesting process and I think that I can honestly say that we were in some ways fortunate that it was a concept of ours in early days, even earlier it was Dean Pat Shiverton in fact that probably about 15 years ago showed an interest in wellness and that was before the wellness industry really took off. And and she saw that the role of nurses was really instrumental in being able to coach and to educate individuals on their health and wellness.

Renu: [00:05:04] And so the interest was there early. However we didn’t have the infrastructure, we really were not able to be mobilized at that time. The University of Rochester, then I think they had about twenty four, twenty five thousand employees, and they were interested in moving in the direction of wellness because it was something relatively new in the marketplace at the time. And they contracted with a national vendor, I think they’re located somewhere in the Midwest, and that vendor though they had a beautiful concept, they were really unable to engage employees at the University. And the impact that the organization made really didn’t justify the cost of the program itself.

Renu: [00:05:52] We, recognizing that, worked with the University of Rochester’s human resource department and and finance office to make sure that they didn’t drop a concept that was beautiful but instead looked at programming and how it was most appropriate to deliver, you know, the program that we wanted to deliver. And so with a lot of discussion really around the clinical framework that really is important to successful outcomes for wellness programs was what we knew best. And that’s what we knew how to do and what we needed to do in order to be able to provide that was to build the technical infrastructure to support it. You know, there were many platforms that were available in the marketplace that were not designed around the clinical framework that we understood to be very important for us. And so the University said, “listen, if you think you know how to do it, we believe you. We see the science behind what you’re talking about and the programs that you’re wanting to develop. We will help you within reason.” And so what they did was they invested in us by actually allowing us to contract with them. So we had a guaranteed contract with the largest employer in Rochester, which was nice, but we also had to demonstrate great value and build our program to support the value that we that we proposed to them.

Joe: [00:07:29] Got it. So kind of piggybacking that, you know, we have product managers who may be working at a startup and that’s more entrepreneurship, versus other product managers who are working within a larger organization and launching a new business line, some people call that intrepreneurship, so in your opinion, where are the differences in how to approach launching the big new product line at a big company versus what a startup can do more nimbly.

Renu: [00:07:55] So you know, that’s an interesting question. I would say from an internal perspective there are some advantages that are inherent. You have an organization that is supporting your growth and helping you to really achieve your metrics and they’re partnering with you. So in a sense, it’s a little bit different than a customer relationship. It is a bit more of a partnership. What I will tell you is when you are providing a service to any organization, internal or external, partnership only lasts as long as you deliver. And so you’re still very tied to exceeding metrics. And we built the program knowing that if we could do what we conceptualized, then we would want to be entrepreneurial in the sense that we want to offer our programs to, at the time we were we were thinking just in the region. And so about two years ago we started to do that and our growth has just been very rapid and well received.

Sean: [00:09:08] That’s amazing. So I’m going to take a little side step here and ask sort of a different question. So I have this belief, this personal belief, that the health care system has evolved to where it’s at because it was the right thing to do in a past time, but things have changed. Like we now have access to people’s information and their attention through digital products like mobile phones and things of this nature, that we can actually take a completely different approach to health care now. And a lot of the complaints you hear, no matter where you go, about the health care system, I believe revolve around the fact that it’s very health event centric.

Renu: [00:09:49] Mhm.

Sean: [00:09:49] Like we have built the entire system to be focused on the health event. Like something goes wrong and that’s when you engage the medical system, right. And you guys have completely flipped that on its head. You said, “let’s not do that.” Even from our earliest conversations we had with you when you were thinking about building this product, we had some of these conversations. “Let’s put the patient at the center of our universe and figure out what infrastructure and what tools do we have to put in place to make sure that wellness is at the center of their universe, and how do they engage with our organization to remain well so that we can build this sort of framework and platform for a better, more healthy existence in the context of the world,” right. And it’s kind of a brilliant model. And we know you’ve been pretty successful in deploying it, thirty nine organizations, forty five thousand lives, that’s amazing.

Sean: [00:10:47] My next question is really, how do you measure success? And I want you to answer the question in two ways. One is, obviously outcomes are a clear measure of success in the long run. If you get better outcomes, healthcare costs are reduced, everybody wins. But I want you to also answer it from the perspective of the software product. How do you know that the software product itself is is achieving its goals in the context of your greater goal which is better outcomes?

Renu: [00:11:14] Actually that is a great question. First I just want to acknowledge that your assessment of our health care system and the way that we’re looking to be different and still be tied in to the delivery of health care is spot on. I will tell you is you know you’re absolutely right. Outcomes, clinical outcomes are you know the easiest way to say, “yes you’re successful.”.

Renu: [00:11:41] But another outcome which is very much tied to what we’ve developed in our platform is engagement. And engagement is a critical metric in wellness because we are looking to engage people before they have an event. So Sean, you talked about the health industry really being focused, you know, triggered by a health event. We’re really wanting people to get engaged because they are wanting to make a difference in their lives and not have a clinical event. So that really entails a very different way of reaching people, and reaching people where they’re at. So it’s the synthesis of information, of data, that we are collecting. Our portal, our infrastructure is allowing us to collect information and target individuals not only on what their health and wellness needs are, but what their interests are, what their motivation is, and we’re able to engage people in an entirely different way. So our portal allows us to model our engagement strategies in a way that really is different in healthcare today. Today, if you go to any traditional health care model is going to be patient is not feeling well and there’s something going on, they’re going to initiate the engagement. Our focus is entirely opposite and that’s what our platform has helped us to do.

Sean: [00:13:17] That’s a fantastic answer. So if I could sum it up, on the software side you’re measuring engagement and how often people come back and use it, which in our world we call that like a loyalty factor. Like they’re using it because you’re getting value out of it. And if you drive that that will ultimately drive outcomes. I love it. So I got a quick question for Brian. Going back to the very beginning of time when we thinking about different ways to get the product deployed in a market and used. You guys used some financial incentives early on, if I recall. And for us, it’s like, we believe that there is this thing called the loyalty ladder. You first got to get people to trust the product, to start to use it, and then you can work on engagement and loyalty and then ultimately we want to achieve this thing called advocacy, right, where they’re telling each other you got to use this platform right, you got to use the biometric tool. So Bri, I remember in the early days we were using financial incentives. What other tools did we use to try to earn trust from our users?

Brian: [00:14:21] So yeah, in the beginning there was the financial incentive, and that’s actually still present, but going beyond that, you know making sure that the system does what people want it to do, that it engages them in a way they want to be engaged. As Renu indicated, some of the things that work toward engagement, we have questions about motivation to change, you know, maybe you’re not motivated to quit one activity but you are motivated to quit another, whether it’s to lose weight or eat better whatever. We have that information and we’re able to kind of reach out to the people in the area you know that they’re interested in. So through the various kinds of data that we collect, we are better able to customize the way we communicate with the individual clients.

Brian: [00:15:05] And you know, you mentioned before sort of the event kind of driven health system. We’re always very careful to not call the people patients, right, they’re clients. And just that attitude that we’re talking about healthy people who maybe want to fix some area of their life and want to help to coach that sort of thing. They don’t realize, you know, everybody knows eat better and exercise more. But the details of that are a lot more tricky, right. What can I do that fits my lifestyle? And the coaching that the nurses provide helps make that happen helps find a way that is right for the individual and all the data that we have in the system is what helps make that successful.

Renu: [00:15:46] I would add to that Brian, just in addition to that, I will share that many of the organizations that we’ve signed with do not offer incentives. So though the University continues to, we work with organizations that do not offer incentives. So you know to add to what Brian was stating, I think that though we now also work with organizations that do not offer financial incentives, what we’re finding is the resources that are available to them that we can put online and organized in a manner to push content directly to individuals based on their motivation and based on their needs and their interest really engages people. So we have just as high of an engagement rate in organizations that offer little to no incentives as we do in organizations that have incentives. And I think that’s an indication of the usefulness of our infrastructure, of our portal.

Sean: [00:16:51] Absolutely. I was going to say that was a great answer, and I think your product, your service really, it’s more of a service than a product, is really an interesting and cool mix of real human services, the coaching that you mentioned Brian, which which builds trust early in the process. That’s a key that’s a key trust factor for you to get people using the system and get them engaged.There’s a human to human element that’s goes beyond just the software product and I think that’s really, really important.

Brian: [00:17:22] I’m just gonna jump in with, a lot of the things too is, we’re dealing with health information, and you know, trust is particularly important there, right. You have to trust that the organization is going to care for that information in a proper manner. And so we’re always doing security assessments on the system with a security group that’s internal to the University but not part of our organization to be sure that we’re handling the information correctly. And when we took over for the organization that was here previously, there was a lot of feeling from people that they didn’t handle things correctly (the outside organization before we came in). And you know it was a big thing that we wanted to do this right, to approach people in a way that felt comfortable, didn’t feel like you’re kind of invading their space, and it’s sort of a challenge to kind of balance that and come in in a way that’s helpful, and you know, meeting what they would want but not seeming, you know, kind of spooky or however you want to word that, you know.

Sean: [00:18:24] So piggybacking that, just to kind of talk about the behind the scenes again, there’s a lot of regulations that you need to comply with, whether it’s HIPAA or ADA or other ones like that. Could you give a brief overview of the types of regulations that you need to deal with and what they kind of each entail?

Brian: [00:18:40] Sure. So HIPAA obviously is one that we deal with in multiple areas here in the medical center but specifically with our product, right, there is health information in the system that we use to, as we talked about before, to better engage people. But so along with that comes a lot of, you know, security testing, documenting process, and having everything clearly understood and meeting the different requirements for HIPAA. And the medical center works with a program called High Trust which kind of tries to roll up a lot of the things that you would need to be compliant with. And so by meeting the High Trust standards, you know you’re going to meet HIPAA, FISMA, all these other things that are out there, FERPA, all the different letter acronyms. And so that’s been our goal and we work with them closely to ensure everything that we do is compliant with all that stuff. ADA is a little different, it’s more around the accessibility of the site. And we always, you know, everything we do from student facing as well as for products like this, we always make sure that we’re ADA compliant, things work well that way. And of course working with ITX got us started off with that right from the beginning. You guys were really on top of that, even when we first launched, having that kind of stuff built in from the ground up.

Sean: [00:19:58] Thanks for the plug.

Joe: [00:20:02] So how much, just to kind of talk and reality for a minute, how much did those regulations play a role in your decision making around how the user experience played out, or different product decisions you had to make?

Brian: [00:20:15] I would say that, you know, it’s it’s always in our head, right. Because we understand the importance of securing data. But at the same time, when we’re thinking about the user, the client experience, that’s at the front of our mind right. How do we make this the best experience for our clients that we can make it? And then once we understand that, how do we make that work within the guidelines of keeping everything secure and safe? Because you know, security is one of those things you have to have but you don’t want it to be in the way, right. It needs to be kind of seamless and that’s the challenge is to have a product that’s appealing to the client that they want to come use, that they realize the benefit from it, but yet also behind the scenes making sure everything is safe and secure.

Renu: [00:20:59] So Brian if you’d like, I can start on that, and then I would love to have you join in, one of the things that I think has been really helpful for us is that that we designed a platform that we could have grow with us. And so while we looked at our clinical processes and measured our outcomes and at times adapted our operations or our programs to really reflect outcomes that we wanted to mirror or to continue to improve on, our portal and the technology I guess was minimal enough to allow us to adapt our processes accordingly.

Renu: [00:21:50] And I will give you an example that to me is a very wonderful and differentiating factor supported by our portal that allowed us in wellness to exceed national averages of a high benchmark for engagement. And that was our process that we deliver our health assessments in are done one on one using clinical specialists. And we found that that was a wonderful time to engage individuals into programs, because as you know, I think it’s probably something that you would logically think of, but it’s not something that was built into the process of what is typically done for wellness. And what we did is, we learned that if you have a face to face interaction, that is the time to really engage individuals into programs that are designed specifically for them to meet their needs. And what what we were able to do is to really align our platform to support an approach that worked very well for us with engaging individuals into programs that were completely appropriate for their needs. And the way that we did that was we took the clinical interface on our portal and we created dashboard measures for our providers.

Renu: [00:23:18] So in real time when we are meeting with clients and assessing their biometric values and looking at their lifestyle factors that could contribute to their health and wellness, we were able to provide that information to the nurse right there on her screen and also in addition provide where they are most motivated to change and what do they need most. And so our providers were able to utilize that information and engage individuals on the spot. And I will tell you we had a 354% increase in our engagement, and the national average for engagement in disease management programs, for example is on the high side, if someone says that they have 10 or 11 percent they are doing a bang up job. Ours is 18 percent and that was really supported by the infrastructure. If we didn’t have that interface for the clinicians we wouldn’t have the engagement.

Joe: [00:24:24] Got it, yeah. Perfect answer. So the next question I would love to hear both of your opinions on. So thinking about the product and as the product was built and rolled out, how did the product drive changes on the business side? Like how did the business have to adapt with their processes, their approach to accommodate the software?

Brian: [00:24:47] You know, you kind of said, you know, “how has the business adapted with the software?” I think that’s the benefit of having our own development team, having you know, started out working with ITX and then created our own team that’s keeping the product moving forward is that really the business informs the software. As Renu kind of indicated, one of the key differences with us is that we’re clinically informed. We’re evidence based practice informed, you know, so nurses are involved in all of the process, whether it’s our nurse coaches, whether it’s people like Renu who are seeing things, looking at different numbers and saying, “oh we should be doing this this way,” we then are able to take our software and enhance it in ways that support what the business is looking for, what we’re trying to make happen, whether it’s engagement or any of the other areas that we’ve kind of slowly modified. And it’s great because, you know, we can try things, right. For our care management programs we said, “well what would it benefit us if we used, like Fitbit data. And so we know quickly wrote a module, got Fitbit data in, and were able to see how does that help us? Is it useful to the nurses in trying to coach people and help people move forward? And so we’re able to be flexible and try things and see what works and make the software really kind of match business needs.

Sean: [00:26:08] Outstanding. So the work you’re doing, it’s profound on many many levels. With so many users now and so much longitudinal data, because you’ve been doing this for a few years, have you published any research yet? Have you guys, I know you’ve had some data analytics people because they’ve had concerns right from the beginning about making sure we’re collecting data in a way that we can make it useful. Have you guys published anything yet in terms of how you’re able to move the needle on human behaviors with the platform?

Renu: [00:26:40] So what we’ve been able to do, we have a couple of studies that were published on metrics that we measured through the program. But we have more to do because our outcomes are phenomenal and the data has been very useful from that perspective. We can literally measure improvements or change in behavior because of the data that we collect on a routine basis and we can look at changes over time with individuals. That’s phenomenal. We recently had three presentations at the National Wellness Meeting in 2018, it was in early June, and the presentations will eventually become publications. So we’re maybe a little early on that, but the presentations were really developed through the findings that we’ve had with our collection of data.

Joe: [00:27:42] So we’ve talked about the growth of companies signed up, the number of users. So is it a fair statement to say that this is one of those products like Amazon where anyone can be a user?

Renu: [00:27:53] So you know it’s interesting. From a technical perspective, we can see anyone anywhere. Our program design right now is more of a regional design. But it’s interesting that you mention that because we are looking at a national presence. So we’re considering that just given our outcomes and the programs that we have designed clinically that are supported through our portal have really demonstrated themselves to be beyond what we’re seeing in the wellness industry in that space. So there is interest and there is good rationale to take the program nationally. I think, you know, if we did, our platform is probably the most prepared portion. And what we really have to do is look at how we can provide the high touched clinical interventions using in-person and telemedicine. And so we’ve already started with telemedicine for our disease management and our coaching programs. And now we’re looking at different ways to also provide our biometric screening and coaching that occurs early on to bring in engagement utilizing additional technology and a point of care testing.

Joe: [00:29:23] Got it. So considering that you could have someone who’s very young versus very old and all kinds of different health backgrounds using this, plus the idea of going national, how does that play into decision making around the product and how you build it?

Renu: [00:29:41] Well so that is I think where we’re at right now. And we’re evaluating what the strengths are locally in the market and what we would need to do from a national perspective. And I think that our product actually is well suited. We are very much like, it in terms of the resources, the access, and the ability to apply our wellness platform on a national level. The platform itself is ready. It’s there. It’s very comparable to other national organizations that have moved from kind of that plug and play wellness platform to more of a clinically integrated platform. We provide a lot of resources, online modules, and more of what I consider to be low touch but high impact programs on our platform already. What we need to do is to further integrate our clinical high touch solutions with a national presence. So the platform is there. I’m not sure that I’m answering your question, but…

Joe: [00:30:58] That’s good. The platform is ready. I mean, I think Brian, you and your team have probably considered that as you think through the database and various ways you’re going to architect the system. You know, I remember when when we worked on the product years ago, we had to consider if someone was pregnant and all these kind of different flows that a user could go through. So, you know, figuring out how the those different flows could come into play because they want to apply to everyone and you know and taking people down the right path for them, essentially, and the personalization you talked about.

Renu: [00:31:29] I see, and what I will share is that because our platform is really built to be customized for each organization, we would continue to do that on a national level. What is I think helpful for us in this domain is we’re working with a population level. So we’re already working with forty thousand individuals, for example, and as you move across the country, there are pockets, there are areas where the needs may be a little bit different, but from a clinical perspective, they’re all within the range of what we would expect and anticipate and what we’ve designed for it.

Joe: [00:32:11] Got it.

Brian: [00:32:12] I can add a little from a from a technical perspective. The platform is ready in the sense of the process, but as we grow, we’re looking at, you know what do we have? So right now we have fully redundant systems load balanced, and separate sites, and you know, Tier 1 data centers kind of thing. But at what point, if we have a bunch of customers on the West Coast, do we go to a cloud service and get some support there so that we can have a broader reach from a service perspective? And little things too, just looking at most of our time, all of our times right now, because we’re regional, we don’t really pay attention to time zones. As we start thinking now, we’re like, “okay let’s make sure that we’re thinking across time zones so that if we’re scheduling on the West Coast we don’t end up not showing up for three hours, or whatever,” that sort of thing. Thinking about stuff like that just from a data structure perspective as well as from a system architecture and what kind of support we need from a server perspective to meet growing needs. And that’s the kind of stuff that we’re also constantly looking at on the back end. You know, what’s our server utilization? It is the as system responsive as we want it to be? And that sort of thing.

Joe: [00:33:22] So just to talk in the weeds for a minute because I think this is important for product managers and teams, you know, operating behind the scenes here. What kind of cadence do you have where business is talking to technology giving feedback and then technology is giving feedback to business? As well about you know how do we deploy the West Coast and what that would look like?

Brian: [00:33:42] Cadence kind of makes me think about sort of a frequency that you’re kind of going after and it’s really pretty constant. You know, we are part of a bigger organization, but this group is almost like a startup within our organization. And so, you know, my team meets very frequently with the operations team, with the clinical team, and so there’s a constant sort of feedback. We’re always looking at, you know, “what do we need to adjust here? What we need to adjust there?” And Renu as the leader for the whole organization is really great about keeping us informed, making sure we know, “OK, this is what we’re looking at now, how do we get in this direction? We want to go national, what we have to do?

Joe: [00:34:26] Communicating the vision to the technology team.

Brian: [00:34:30] Exactly yeah. And to everybody. She’s a fabulous leader. So that’s really helpful for us, right. Because it’s not like something is a surprise. You always are kind of knowing what we’re looking at, what’s coming, and you can start thinking in that way so we’re ready to meet the challenge that comes up next.

Sean: [00:34:49] All right. Kind of one last question for you here around how you collect voice of the customer and how you get feedback from your user community. A lot of folks have moved towards this thing called Net Promoter Score. Have you guys heard of that? NPS?

Brian: [00:35:08] No.

Sean: [00:35:08] OK, I won’t talk about that then. But no, so how do you gather, like what you are going to build into the software product next and how do you get a pulse on what your users are using or not using, and how do you prioritize features into your software development investments?

Brian: [00:35:30] Okay. We do a lot of surveying through different survey tools, so that gives us an idea of satisfaction and what’s working, but a lot of our information really comes from the interactions, you know, the clinical team interacting with people, saying, you know, “this is what we need.” You know it gets talked about, it gets kind of brought up as, you know, “this is something that we think would be beneficial.” Operationally we look at it, you know, “does this makes sense to do?” So it’s really, right now it’s pretty interactive. I think what we probably need to be looking to do is better ways to capture that digitally from the system. And that’s an area that we can start looking to grow in.

Renu: [00:36:12] I think I would add to that you know, the difference between our approach I would say and the approach of what I now call first generation wellness programs is, our way of reaching people is about giving them the information that is important for them in a way that they understand it and in a place that they can find it. And so much of that is driven by the intelligence of our system really looking at driving content to the right people and making certain that the content we think is most important for them and they will be most engaged with is in front of them. And a lot of that is based a clinical need as opposed to what’s most popular to look at from a “how many clicks did you get on such and such page?” perspective.

Renu: [00:37:16] And one of the things, I absolutely agree with what Brian said, one of the ways that we are able to do that is we have a high touch program where individuals are very vocal about what they’re looking for and what areas they they could improve in if they had better resources and what kind of resources those would be. And so yes, absolutely, from a technical perspective there are always new innovative ways to make sure that you’re able to to target individuals from that perspective. And so we’ll continue to grow along those lines.

Joe: [00:37:59] Okay so the one question we like to make sure we get in with all of our guests is, I guess in this case is there any book that comes to mind that really speaks to helping bring a product to market, or you know, getting a product successfully into other organizations? What do you take inspiration from?

Renu: [00:38:20] So you know, that’s a good question. We’ve read so much on what it is to build programming that that is engaging. And I think, you know, I’m trying to think about what what I go back to, and I have to I have to tell you, I’m a little bit stumped because I can’t think of what I have actually gone back to and referred to several times. I may have to get back with you on that.

Brian: [00:38:54] So it’s not so much something I read recently, but Daniel Pink’s book Drive really is something that I read during this process of building and growing this whole platform and business. And just the sort of concepts that he brings up around what drives, what motivates, people to do things? In this case, wellness. How do you help somebody develop the drive to to choose a better lifestyle to live better and healthier? And some of the stuff in that book, it’s a great read and it really felt like it was really applied to what we were doing.

Sean: [00:39:31] There’s another plug for the University of Rochester because Drive is actually based on a lot of Ed Deci’s work. He was, still is, a social scientist at the University of Rochester who has worked his entire life on human motivation and Self Determination Theory.

Brian: [00:39:47] Absolutely.

Sean: [00:39:49] It all comes back around to the U of R at the end of the day.

Sean: [00:39:57] So thanks again for joining us, you guys. It’s it’s been a fabulous podcast. I think. We’ll see what happens, what our audience says I’m sure they’ll have some great questions and we’ll have some great follow on material for this. But we’ve been a big fan watching you guys evolve this product over the last many years. And again, I appreciate both of you guys taking the time out of your day to join us.

Joe: [00:40:19] Thanks so much.

Brian: [00:40:20] Thank you very much. It’s been a great conversation and we always enjoy working with you guys.

Renu: [00:40:25] It was such a pleasure, and I have to tell you, our experience in working with ITX and developing this product, from a person who had very little technical background, it was absolutely a pleasure to see how technology can really enhance a product and help you deliver what you’re hoping to deliver.

Sean: [00:40:46] Well thank you for that plug. I appreciate it. It was a it was a great adventure working with you guys so appreciate that.

Renu: [00:40:53] Thank you.

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