Maintaining Engagement: The Role of Virtual Communication During and After the COVID-19 Crisis

By Hal Grey, Principal Consultant, Medtech2Market

Takeaways from the Medical Alley Association’s virtual roundtable with medical device and telehealth company participants.

Over 70% of healthcare providers (HCPs) use telemedicine tools for clinician guidance or education, patient interactions such as e-visits, remote patient monitoring, or information sharing through patient portals. Only 12% of European medical device companies use virtual meeting technologies.

Introduction

With sales and support people grounded due to the COVID-19 pandemic, medical device companies are scrambling for solutions to keep teams productive and motivated during the crisis. At this point, no one knows when nationwide control measures and the heroic efforts of healthcare providers (HCPs) will reduce the pandemic enough to allow for anything resembling normal hospital operations.

Even after the crisis, rep access to hospitals — which had been tightening already — is likely to be further restricted. HCP reliance on virtual meetings and asynchronous means of communication during and after the pandemic may also create patterns of rep/clinician interaction that will stick. Medical device companies may need to adapt quickly.

On April 7, 2020, the Medical Alley Association hosted a virtual roundtable to explore how the COVID-19 pandemic is impacting medical device company engagement with HCPs and what the future could be like after the crisis. Present were marketing leaders from medical device companies AtriCure and Osprey Medical, as well as senior leaders from Zipnosis and VidScrip, two companies in the digital health space. The session was moderated by Hal Grey of Medtech2Market. Below is a summary of takeaways from the discussion.

Medical Device Company Responses to COVID-19

Top COVID-19-related initiatives from one medical device firm:

  • “Project Rebound” — cross-functional “Tiger Teams” prepping for future surge in demand
  • Tackling strategic projects that may have been postponed (“never a better time”)
  • Cross-functional strategic planning — “What will our market look like in five years?”
  • Moving from quarterly to monthly goals and planning — to avoid getting “loose and sloppy”
  • Collaboration with physicians who have downtime
  • Beefing up virtual meeting and asynchronous information delivery capacity and content for physicians

Device companies agreed that downtime associated with the virus presents opportunities for tackling important projects that had been postponed (“never let a crisis go to waste”). General feedback on strategies and tactics for optimizing downtime included:

  • Daily 1 1/2 hour calls to 200 field team members to help them be more effective when demand ramps up again
  • Initiating protocol development with Key opinion leaders (KOLs) whose time is not currently being consumed (e.g., for providers who do elective procedures). Any available KOL or clinical staff time can also be used for content or evidence development, e.g. for registries
  • Maintaining strong physician relationships — express sincere concern in their wellbeing
  • Learning from HCP use of telehealth modalities, which is accelerating at light speed during the crisis
  • Developing eCME course work
  • Preparing for more restricted access to hospitals and ORs in the future

Device companies are also using rep downtime to conduct advanced sales training. Linda Lonn, senior marketing manager at Osprey Medical, emphasized that the focus of such training must be on quality (knowledge retention), not quantity (long lectures). This can mean more-frequent sessions—say, three times per week—kept short and interactive. She uses an inexpensive testing tool from Kahoot.com, which turns knowledge quizzes into Jeopardy-type competitions, to tap into the competitive nature of sales reps and keep them engaged.

“Now is a great time to engage with physicians on protocols. We’re working with cath lab teams to improve cost, quality, and outcomes when we get to the other end of COVID-19.” Linda Lonn, Osprey Medical

“There’s a large spectrum in terms of the way people take in information,” said Ahmed Elmouelhi, vice president of product marketing and strategy at AtriCure. “We have many customers and even some salespeople that just don’t like looking at a tablet or a computer screen. They require in-person, face-to-face communication. That’s one extreme.”

At the other end of the spectrum are people responsive to instantaneous, at-your-fingertips downloadable information, he said.

“If you can condense, through some smart methodology, a very long communication into top takeaways without a lot of video editing or other effort, that could really have an important part to play,” said Elmouelhi.  “We try to span the entire spectrum.”

COVID-19 Is Changing Telehealth

The roundtable included John Brownlee, CEO of VidScrip, and Ethan Otterlei, director of strategic sales for Zipnosis.

VidScrip is an online platform with a virtual recording studio that allows physicians to create videos from a remote location. These short video prescriptions (“Vidscrips”) answer common patient questions about a procedure, treatment, or other healthcare service. Vidscrip is able to deliver these videos to patients at appropriate moments of care, e.g., the night before, or in the days following, a surgery.

“If you think about a typical surgeon when they’re engaging with patients, they tend to repeat themselves over and over again,” said Brownlee. “We know that patients forget about 85% of what they learn at point of care. Our own studies have shown that there’s a 70% reduction in case cancellations when patients receive VidScrips prior to their procedure.”

Zipnosis is a telehealth platform that allows providers to remotely diagnose and develop a treatment plan for a patient in as little as two minutes. Their virtual care model allows patients to be treated through an online adaptive interview using video and phone technology. When appropriate, patients are referred to in-person care via the platform’s advanced routing capabilities.

“In telehealth, it’s really about shrinking the time it takes for a patient and provider to complete an encounter,” said Otterlei. “Provider time is one of the more expensive resources for any healthcare system. If we can condense a 20-minute video call into a two-to-three-minute review and diagnosis, we’re making the best use of provider time.”

Brownlee and Otterlei both described rapid pandemic-related changes in the telehealth space. Many of the rules blocking the advancement of telehealth technologies have been removed in connection with COVID-19. How government will regulate telehealth after the crisis remains an open question.

“Right now, providers are facing enormous challenges in responding to patient questions — for example, around cancelled procedures and patients’ level of risk — and they’re having to do it with reduced staff,” said Brownlee. “Asynchronous information delivery is often the only way to do this.”

Rebounding After the Crisis

“We’re seeing expanded use of reps delivering asynchronous content to providers. They can deliver this via a text message that gets their face and their voice in front of that provider.” John Brownlee, VidScrip

Medical device and telehealth participants were both bracing for a surge in post-pandemic procedures. Brownlee envisions a scenario in which providers will be working seven days a week to catch up with cases, even as they’re faced with the need to onboard new staff.

For device companies, this means they may need to help deliver a large bolus of training to HCPs in a short time to help them kick off the “new normal” after the crisis. Companies that begin to put more core provider training into a clickable (asynchronous) online format now may be better prepared to tackle a larger volume of synchronous virtual or face-to-face training in the future, with the online content serving as a prerequisite for synchronous training. The same goes for internal company sales training.

For telehealth providers such as Zipnosis, large-scale, short-term training efforts are a way of life, and they use their own tools to deliver it. “Over the past 10 years we’ve had to develop ways of doing training remotely across the whole country,” said Otterlei. “With COVID-19, a couple weeks ago we had one system in Texas that needed to add 600 providers and we trained them all in one day.”

Furthermore, physicians who do elective procedures and have downtime now may be all the harder to reach in the future as they scramble to catch up with caseloads. Device companies should prepare for a future in which their reps may be called upon to deliver more value to busy HCPs through shorter synchronous engagements (e.g., by offering faster HCP access to relevant digitized content) or asynchronously. Reps should be prepared to engage providers at short notice or during the micropauses between cases.

“If people are to be expected to put up with turning on a computer to read a screen, they must be rewarded with deep and extremely up-to-date information that they can explore at will. They need to have audio, and possibly video.” Bill Gates, “Content is King,” 1996

“A couple of weeks ago we trained 600 providers in one day.” Ethan Otterlei, Zipnosis

“We’re seeing expanded use of reps delivering asynchronous content to physician clients through VidScrip,” said Brownlee. “They can deliver this via a text message that gets their face and their voice in front of that provider.”

For healthcare systems, the main attraction of asynchronous communications — and a key selling point for telehealth providers — is to drive down the unit cost of delivering care. By eliminating the need for providers to deliver repetitive information, telehealth tools allow providers to spend more time on personal care that cannot be provided asynchronously.

As Otterlei and Brownlee pointed out, device makers could think the same way in terms of rep time with HCPs.

“There is likely to be a lot of information your provider customers could rip through much faster in a clickable format than they could in a conversation with a rep,” said Otterlei. “This could allow for more meaningful, less repetitive, conversations when you are synchronous with them.”

Ramping up better virtual and asynchronous engagement capabilities would also put device companies in a better position to deal with tightened restrictions to hospital and OR access that may remain in place after the crisis.

In rep interactions HCPs judged worthwhile, HPCs saved information or shared it with a colleague 60% of the time. This only occurred 20% of the time after interactions HCPs judged to be of poor quality.

Medical Device Company Takeaways

“Just listening to this conversation, I can see new applications,” said Elmouelhi. He noted that his company is responsible for many types of concomitant procedures and being able to follow up with the patients post-operatively is a huge benefit.

“A lot of us are probably unprepared for the flood of cases that may come down the pike… It would behoove us to get ready.” Ahmed Elmouelhi, AtiCure

“Making delivery of such information more efficient could be very important when you think of burden on the health system,” he said. “We could help providers come up with their own methodologies and follow-up calendars in a more widespread fashion that’s customizable to each hospital so we’re not dictating a particular regimen. This would provide a lot of value.”

As Brownlee pointed out, helping providers make optimal use of asynchronous tools in this manner builds equity for sales reps. Vidscrip works with some device companies to offer Vidscrip services to their provider clients at no charge as an extension of these companies’ support for specific surgical procedures.

Summing up, all agreed on the need to prepare for a very different future as the acute phase of the pandemic winds down.

“I think a lot of us are probably unprepared for the flood of cases that may come down the pike,” said Elmouelhi. It would behoove us to get ready.”

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The Medical Alley Association is providing COVID-19 related information, including the “COVID-19 Resource Connect” feature on its website and summaries of laws, executive orders, and government programs that may be of interest to members, as a public service.   The Medical Alley Association makes no representations, guarantees, or warranties as to the accuracy, completeness, currency, or suitability of the COVID-19 related information provided by the Medical Alley Association on its website, in newsletters, or in any other communications. The Medical Alley Association specifically disclaims any and all liability for any claims or damages that may result from providing COVID-19 related information online or in other communications or linking to third party websites or other sources of information. The Medical Alley Association makes no effort to independently verify, and does not exert editorial control over, information provided by third parties.  

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