Intro: The following SHSMD Podcast is a production of DoctorPodcasting.com.

Bill Klaproth (Host): On this edition of the SHSMD Podcast, we talk about how marketing and public relations can help advance your organization's health equity strategy with Lindsay Cosimano. She'll be presenting at this year's 2023 SHSMD Connections Virtual Conference coming up in October. Lindsay will go over how marketing and PR can actively address health equity and discover strategies to empower your providers to break down barriers to care and address social determinants of health through community partner engagement.

This is a big topic. Lindsay's going to break it down for you in this podcast, and make sure you sign up for her session in October. It's going to be dynamite. So, let's get to it right now.

This is the SHSMD Podcast, rapid insights for healthcare strategy professionals in planning, business development, marketing, communications and public relations. I'm your host, Bill Klaproth. In this episode, we talk with Lindsay Cosimano, Senior Director of Marketing and Communications at Nebraska Health Network.

 Lindsay is doing a session at this year's 2023 SHSMD Connections Virtual Conference. The topic is How Marketing and Public Relations Can Help Advance Your Organization's Health Equity Strategy. Her session is on Friday, October 20th. You can register now at shsmd.org. That's shsmd.org/education/annualconference. You'll use the same link as the annual conference. Lindsay, welcome to the SHSMD Podcast.

Lindsay Cosimano: Thank you, Bill. It's great to be here.

Host: Well, it's so nice to have you here. We're looking forward to your session for our virtual conference coming up in October. So, Lindsay, let me start with this: health equity is a rising issue for patients in many communities. So, why is our current healthcare structure failing to address these clinical and social needs?

Lindsay Cosimano: I think part of it, Bill, is because there's such a desire to help everyone. But it's not necessarily a lack of sympathy from our providers, it's that they don't know how to help. And we know that patients are struggling and we know that not everyone has equal access to care, but how do you break down those barriers of getting a patient to, one, tell you that and then, what do you do when they do? How do you know what you can do that can help them as they go down their healthcare journey?

Host: Right. And it's been proven that paying attention to social determinants of health can really help with outcomes and utilization, right? And if we understand how to do this better, just need to understand how to do it better, we can make a difference. Is that right?

Lindsay Cosimano: Absolutely. So, I think when you look at the data, you know, they'll tell you that 80% of a patient's health outcomes are things that are beyond clinical control. So, they're things like social determinants of "I don't have access to reliable transportation," "I can't afford healthy food," "I don't have somewhere to live," all of those things that really impact and can cause a patient to spiral whether or not they are vested in it and they're trying or not, they just can't control some of those. So when we think about health equity, it's how can we jump in and help those people earlier? How can we identify patients that might need a little bit extra support? And how can we connect them with resources that are locally available to them?

Host: Knowing that, what can we do in marketing and PR to actively address health equity and discover new strategies to overcome these obstacles? What can we do in marketing and PR to help this?

Lindsay Cosimano: I think there's probably two different lenses that we can look at it. From a provider standpoint, one of the things that I think is important from a marketing and PR perspective is that provider education, to let them know that this isn't something that only happens in our low-income areas. I think a lot of times when we first started down this journey and we were talking to providers, they'd say, "Well, that's great in our community clinics, our low income ones, but my patient panel isn't impacted." The reality is that can't be farther from the truth. Every single person at some point in their life is going to encounter a social determinant. They're going to have a struggle of some sort that they might need a lending hand. So when we think about from the providers, it's letting them know that just because at the surface you may not see it, there might be underlying things that are causing a patient to behave the way that they are.

The other side of that is to go to our communities, not just our patients, but looking at the community at large and say, "What can we do to help? How can we raise awareness about resources that are locally available?" And then, connect patients and individuals with those local resources that can support them.

Host: Right. So, the providers certainly know how to treat the patient when it comes to the medicine end of this, but they might not know below the surface what that person is going through.

Lindsay Cosimano: Yeah. Because you would think sometimes it's an obvious thing. But what if you have a patient that just consistently doesn't show up to their appointments? Or you prescribe a medicine and then, they never take it. And at the surface, you might say, "Well, they just don't care and they're not prioritizing it." But it might come down to the fact that they don't have transportation, so they're struggling to take a bus or to find someone to take them. They may not be able to afford the medication that you prescribed.

And so, it's kind of looking for some of those different behaviors and finding ways that we can screen patients better, break down the stigma so that patients are willing to look you in the eye and say, "Hey, I could use some assistance," and then being able to do something with it. There's nothing worse when someone says, "I can't afford my meds." But as a provider, you may not have the answer. So, we wanted to make sure that we had resources that they could easily deploy to assist people in that time of need.

Host: So, can you talk about those resources a little bit more? What a provider might see or what you might give to a provider to educate that person better?

Lindsay Cosimano: Sure. So, we started down our path several years ago, I would say, early on in the health equity buzz that we now hear about a lot more. And we looked at a number of different vendors and we chose one that was able to hit our clinical needs. So, they were able to come into from a population health perspective and help identify and connect patients with resources. But what we really loved about them was that they also empowered individuals to find help on their own. And that's where marketing and PR really came in and took an active role in this project. So,

what we've done is we've partnered with a group called Find Help, and we have white-labeled their products to community relay. And this is an online resource that absolutely anyone can use and go out and search for local services, local programs that our community benefit organizations offer to them. So if it's three in the morning and you're worried about how you're going to pay your utility bill, you could go online and you could search and do that. From a PR and marketing standpoint, then we needed to make sure that we went out to the community at large to advertise this because it wasn't just about connecting with our patients. We wanted to help everyone, whether or not they're seen within Methodist Health System and Nebraska Medicine, which are our two health systems, or if they're at a competitive place. We wanted to make sure that we could still connect to everyone with those local programs and services.

Host: So, it sounds like you do external marketing to the community and then, internal marketing to the providers as well.

Lindsay Cosimano: Yes. So from the provider standpoint, it's about raising awareness that, "Hey, we have this resource that's available that you can deploy within your clinic." We also did some education on how they could identify and maybe recognize some of those social determinants that were impacting the patient's health outcomes that may not be as obvious. We also did some screening tools through a PRAPARE assessment and other things to really help them.

And then, shifting that to the community, there was a couple different approaches. One, we wanted to go to those community benefit organizations and say, "Hey. Look, we know you're offering fantastic services. We want to help raise the bar for you. We want to make sure that everybody knows about them." And so, this was a free way for them to promote that within our communities and the areas that they serve.

And then, we wanted to connect to how do we get to those individuals that may not even know who we're. And that's where we went down this path of looking at what we considered very high trust organizations. So, we targeted employers, schools, faith-based organizations and then community groups. And in that community bucket, we had things like senior centers or boys and girls clubs or even libraries, groups of people where the followers had a high level of trust with that institution. So, they may be able to disclose to them, "Hey, I'm struggling. I need some help." And we wanted to make sure that they were aware of this resources so they could connect the individual to them.

Host: Wow. That's really interesting and very comprehensive. So, your marketing communications then, materials if you will, will try to reach these nonprofits, faith-based organizations, employers in schools. Do you do other types of outreach? Do you meet in person with these people as well to go over this?

Lindsay Cosimano: That's a great question. We've really tried everything that we can. So, we've done, I would say, a large mix of that. So if we know that there's a large group of nonprofits or community benefit organizations that are gathering for different meetings, we've attended those, we've spoken at their events, to say, "Hey, this is a free resource that's available to you," to make sure that we could connect 'em on the platform and that they were aware of it.

We've done some mailings, we've done some email campaigns and webinars to really try to do that, and really thinking about it from that comprehensive marketing and PR, what are all the different ways and the resources that we currently have available and how can we use this to promote out to each of these different groups. So, it's really been a mix of some of your traditional, media relations, public relations, and then that community relations where we're doing more of the events and the speaking opportunities to promote it as well.

Host: So, how has this worked for you in Nebraska? What have the results been?

Lindsay Cosimano: You know, they've been really strong. I think one of the things that we were able to do as an accountable care organization is data is really the lifeblood of what we do. And so, we were able to look at our population of patients and see that any patient that had a documented social determinants of health. Within our network, they had four times the cost of care, five times the hospital admissions and six times the ED utilization. So, these are individuals that are actively using our system and we wanted to find a way that we could be very proactive to work with them and try to prevent that. So, we actually have community health workers that are placed in our EDs and some of our high primary care clinics so that we can do that warm handoff between the primary care physician or the ER doc to this social worker or this community health worker that can help guide the patient beyond that clinical encounter. And that really has helped us, I think, not only from a patient satisfaction, but really that overall health and wellbeing. It's not about just their immediate acute need. It's how do we look at it from a holistic to set them up for future success.

Host: So by paying attention to health equities and improving patient outcomes and utilization, you really lift the entire community at the same time. Is that a good way to look at it?

Lindsay Cosimano: Absolutely. And that has been our philosophy from the beginning. We really wanted to make sure that this, even though we were kind of the power behind it, if you will, we wanted this to be a community resource. We didn't want it to be about our health systems. We wanted to make sure that it could go to any individual that needed it, regardless of who they see. And also, acknowledging that there's a lot of individuals that don't ever go to the doctor, unfortunately. Unless it's an emergent need, they don't have an established relationship. And so, we've really tried to look for some of those non-traditional ways to get in front of them. And the schools and the faith-based organizations and the employers has been one option to do that to really try to make sure that we're caring for everyone, not just the individual that happen to make an appointment in one of our clinics.

Host: Right. And Lindsay, you sound very passionate about this. What drives you to do what you do?

Lindsay Cosimano: I've been in, healthcare marketing a long time. And I think, unfortunately, the great side of healthcare marketing is that you see the impact that we can have every day on patients, but you also see those patients that maybe don't have the same breaks as everyone else. And so, you start to see that behavior that maybe it's unavoidable in their eyes. And if there's something that we can do to adjust it, I think we're better off there.

Early in my career, I used to work for a medical imaging company. And our founder always said, "You fix the equipment as if it's your mother, your brother, your sister is the next person on the table." And health equity is that we all need to stop looking at individuals as consumers and really think of them as friends and family that are out there trying to get support.

Host: Yeah. That's a great message. So, I know you're going to cover a lot of this in your session. Tell us a little bit more. What will people walk out of your virtual session with?

Lindsay Cosimano: We always talk a lot about how does PR and marketing get a seat at the table and how are we really helping advance some of these strategic initiatives that our systems have. And so, the goal of this session is really to give you some concrete examples of ways that our ACO has done this and deployed a strategic look at how we're going to communicate not only internally to our providers, but how can we get the community at large on board. And so, hopefully, people will walk away with some resources that, whether they apply them to health equity or any of the other initiatives that they have, it'll be a very quick and easy way for them to personalize it within their own system.

Host: Well, this is going to be a great session and we are so looking forward to it. This is part of our virtual conference again. And Lindsay's session is How Marketing And Public Relations Can Help Advance Your Organization's Health Equity Strategy. As we wrap up, Lindsay, thank you so much for your time. Any additional thoughts? Anything you want to add?

Lindsay Cosimano: I appreciate your time today, Bill. I look forward to it. I think the SHSMD Conference is such a fantastic opportunity for all of us that sit in the healthcare industry. And so, I'm very honored to be part of it.

Host: Absolutely. Well, Lindsay, thank you so much for your time today. Looking forward to your session. Thank you again.

Lindsay Cosimano: Thank you.

Host: And once again, that's Lindsay Cosimano. And make sure you check out Lindsay's session at this year's 2023 SHSMD Connections Virtual Conference. You can register now at shsmd.org. That's shsmd.org/education/annualconference. And if you found this podcast helpful, and how could you not? Please make sure you subscribe on all of your social channels and make sure you hit that subscribe button, so you get every episode. Very important, the education that we deliver on this podcast. And I thank you for listening.

This has been a production of DoctorPodcasting. I'm Bill Klaproth. See you!