e-Patient Dave is a leading spokesman for the patient engagement movement. In this exclusive interview, Dave describes health IT’s role in empowering patients and the ensuing culture war between e-patients and the clinician community, from governments running ads to stop Googling symptoms, to gadget data, to Andy Slavitt’s recent announcement that Meaningful Use as we know it is ending. How must health IT systems envision the patient as an active participant?
Air Date: February 3, 2016
Guest: “e-Patient Dave” deBronkart
|1:00||Introducing e-Patient Dave|
|2:29||How patient engagement has evolved|
|5:01||Patient engagement has evolved a lot|
|6:29||The Belgian government ran Google ads telling patients “Don’t Google it!”|
|8:33||The clinician community’s reaction to patient engagement|
|10:30||Different definitions of patient engagement|
|15:32||Recommendations for the health IT community|
|17:43||“I don’t want to!”|
|20:15||Health IT systems must envision the patient as an active participant|
|22:48||Reacting to Andy Slavitt’s announcement that Meaningful Use is changing|
|26:04||How Dave’s mother was nearly killed because of a medical error|
|27:20||Final advice to the health IT community|
|29:48||The irony of gadget data|
|32:12||Bonus question: If you could join a music group or rock band for a day, who would it be?
*SEE SPOILER ALERT BELOW
Bonus Question Spoiler Alert!
Upon further reflection, Dave later changed his answer for the bonus question to Jimmy Buffett! He is a parrothead at heart!
About e-Patient Dave
My guest this week is the one, the only, e-Patient Dave. Dave deBronkart is a leading spokesperson for the patient engagement movement and a highly rated international keynote speaker and policy advisor. He contributes regularly to the Forbes blog “Let Patients Help,” and his own site, epatientdave.com. His TED talk “Let Patients Help” for years was in the top half of the most-watched TED Talks of all time that included him showing off some mad rap skills.
He is a survivor of metastasized kidney cancer that likely could have been fatal. But he frequently credits the empowering relationship of his primary care physician Dr. Danny Sands with helping him kick cancer to the curb.
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Jared Johnson: Hello, my friends and welcome again to the Health IT Marketer Podcast, the podcast for the heartbeat of healthcare. I’m your host, Jared Johnson of Ultera Digital. This is the first and only podcast dedicated to the health IT marketing community. Welcome aboard.
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Well, my guest this week is the one, the only, e-Patient Dave, Dave deBronkart. He’s a leading spokesperson for the patient engagement movement, and a highly rated international keynote speaker and policy advisor. Dave contributes regularly to the Forbes blog Let Patients Help, and his own site ePatientDave.com, among many other initiatives. His TED Talk entitled “Let Patients Help” for years was in the top half of the most watched TED Talks of all time and it also includes him showing off some mad rap skills at the end.
He’s a survivor of metastasized kidney cancer that likely could have been fatal. But he frequently credits the empowering relationship of his primary care physician doctor, Dr. Danny Sands, with helping him kick cancer to the curb. So welcome Dave to the program. How are you doing today?
e-Patient Dave: I am doing great. It’s great to be alive.
Jared Johnson: It always is, isn’t it? I’m just going to admit right up front, Dave, I’m a little starstruck, just to tell you the truth, to have you on the program. So if there are any long pauses, it’s probably just because I’m catching my breath. I just wanted to warn you in advance. But grateful to have you on the program. This program is just one of the funnest things I get to do each week.
For me personally, patient engagement and health literacy are passionate topics for me. A little less than two years ago, I lost my father-in-law, I was very close to him, to stage four prostate cancer. It was made pretty clear to me later that if he’d had access to more preventative screenings and health information that he very well could have been with us still today.
So first and foremost, I thought a good place to start would just be to talk about what you’ve seen in patient engagement overall, in terms of what type of attitudes you’ve seen. Have attitudes changed towards patient engagement since you first started advocating for it, particularly in clinician communities?
e-Patient Dave: Well, yes. Absolutely. So it’s important to realize, several years of talking about patient engagement and patient empowerment, our conception of what it is is evolving, and this is a time of great culture change. I actually gave a speech last summer, and I posted the video of it on ePatientDave.com last week saying that we are approaching a culture war in this area, not that a war is necessary.
But as in any social movement where people’s conception of what one party is capable of evolving, there are a lot of people who say, “Oh, great. New things are possible.” But there are always some people who say, “No. This is wrong. It’s not true.” Some people say, “It’s offensive to me,” and they resist and they fight back. I gave my first speech about this in early 2009, so that was seven years ago, and our conception of what patient engagement is and can be really has evolved.
Like all change attitudes, the women’s movement, race relations, and everything, at first there’s skepticism because people have never seen the new world as possible. Then people start to realize it’s possible, and then people start to get more sophisticated about, “Oh, okay. So it means this. It doesn’t necessarily mean nothing we knew is true.” Anyway, we start moving forward.
Now, what we have a clearer picture of is what is possible when patient engagement and empowerment are done right. Then, how the heck do you do it? That’s where we’re learning. Five years ago, I gave two different talks in one year, where an experienced, [inaudible 00:04:36] but older doctor came up to me in each case and said, “Crap. My patients can’t do any of this stuff.” I just wonder to what extent is that self-fulfilling.
These days, I don’t hear that. The trade press is much more filled with questions and conferences, and speeches about how they actually do patient engagement and empowerment.
Jared Johnson: That is quite a shift, isn’t it then from like you said, from several years ago, from when you first started advocating for it and giving speeches on it?
e-Patient Dave: Well, sure. Well, at the same time, I gave a talk in London last year where I said, “The empire strikes back inevitably.” I’ve never seen a clearer example of that than in Belgium. A key part of patient engagement and empowerment is welcoming the work when a patient tries to educate themselves by getting information online. Right? Now, a lot of people say, “Watch out. There’s garbage on the internet,” and that’s certainly true. But who doesn’t know that?
Now, there are some patients who think that if it’s on the internet it must be true. I would say those people are naive. But on the other hand, it clearly is possible for patients to find useful information. I’m fond of saying that I found my wife on the internet in 1999 on Match.com. I was one of its earliest users. But before I found her, I went through some suboptimal search results. Anybody who’s been on any such website since then knows what I mean.
So here’s the thing, two contrasting stories from overseas. The Belgium Government, starting in late 2014, starting running a Google ad campaign, where in Belgium if you Google a symptom the top search result that comes back is paid for by the Belgium Government and says, “Don’t Google it.” It leads to a professional, ad agency-produced video that shows a couple at home. It starts out with the husband’s got a boo-boo on his finger and the wife bandages it, and then she goes online.
Like a babbling idiot, within 90 seconds they’ve convinced themselves he’s dying from bleeding warts on his head. The commercial ends with, it says, “Don’t Google it. Consult a professional.” When I blogged about this a couple months ago, I said, “Who says those two things are mutually exclusive. Why not Google it and consult a professional?”
The indictment of that Belgium Government policy is a story that came out last summer, where two years ago in the United Kingdom, a 19-year-old who had been cured of liver cancer, she started to not feel well again. She and her mother were educating themselves on the internet, and they found a patient group and some information saying, “Guess what? This does come back sometimes.” The doctor said, “Stop Googling,” and she died.
So this year, those doctors in the NHS, the English National Health Service, apologized for their role in her death. Now, I’m not saying those doctors were arrogant jerks. I have no idea who they are. The world has changed. A generation ago, it was ludicrous to think that a young woman and her mother at home would find information that professional physicians did not know. It is no longer ludicrous. It’s real.
Jared Johnson: Yeah. It’s very real. Another manifestation of that might be this example from the photo that I took from “Let Patients Help,” and I described on this program actually a couple weeks ago to listeners. But how during a Tweet Chat about health IT social media there was a question about how do we simplify patient-provider relationships. I really quickly took a really bad picture. It was crooked, it was off-center, the lighting was good, but it was from your book.
It was from “Let Patients Help.” It was a list of 10 things that a clinician can say to encourage patient engagement. Once I tagged you on that, you were seeing how many retweets were coming on that, and I think we’re up to 113 retweets from that and many of those were from clinicians. I suspect that wouldn’t have been the case a few years ago, like you were saying. So what do you think of that reaction these days when we get so much attention to one simple list of how to encourage patient engagement?
e-Patient Dave: So that illustrates the second thing I said. The next question once you accept that something might be possible and useful, the question comes up, “All right. How do I do it?” Sure, you can write and read long papers and books, and all that. So I had the idea for the book three years ago. Because I saw that a lot of people were talking about patient engagement, but nobody was being specific about what they meant, and that is always disabling to a movement. People start doing vague babbling, and nothing gets anywhere.
The same is true for empowerment. I’m going to come back to that word after a bit. I also saw that when the health policy journal, Health Affairs, came out with their entire theme issue on patient engagement in February of 2013, without even realizing it they had multiple definitions of patient engagement throughout the different articles. The editors didn’t even notice, “Wow. You know what? We’re talking about different things here.”
There were some people who feel very strongly, and again this is part of any cultural movement, words change their meanings. But I noticed that some people when they talked about patient engagement, they were only talking about getting patients to do what they’re told. Specifically, the most egregious example of that was the article from Pharma, where they said to them patient engagement was getting people to buy the prescription [inaudible 00:11:08].
There was no capacity anywhere in that article for the idea that maybe a thinking patient would say either, “Well, I don’t want that,” or “I want it, but frankly it’s not worth the amount of money you guys are charging. I’d rather tough it out.” Well, anyway, they said that they have given up on patient engagement, and what they meant by that was patient engagement as a way to get people to do what they’re told and basically give the amount of money to the prescription that they were instructed to.
Anyway, so I decided that I would take my talking points from speeches and just copy them into a quick book with very short illustrations, very short like one and a half pages per chapter. So I had things like, “People perform better when they’re informed better.” Talking points like that. So I had “10 Truths About Patient Engagement,” and then I had a section of “10 Ways to Let Patients Help.” Give us our data. You can’t complain that we don’t know anything if you won’t let us see the stuff.
Then, I realized people were [inaudible 00:12:27] want to know, “Okay, so should I . . .” So I published a page of “10 Things e-Patients Say,” and then I knew that clinicians were going to want what you just proved there was a hunger for. “What do I do from the clinician side?” Now, I want to point out from the patient side I said, so the number one thing and I call this “the magic incantation,” Jared, how do you let a doctor or nurse know that you want to act this way?
Now, you don’t want to go off on some long story about, “I’ve heard about e-patients on the internet and they’re empowered, engaged, equipped, enabled.” Their eyes will glaze over while they look at their wristwatch. So what do you do to create the tone for that kind of relationship? I introduce myself by saying very politely, “I’m the kind of patient who likes to understand as much as I can. Can I ask some questions.” Boom. There you go, and you’re off and running.
Now, there are, a decreasing number, but some clinicians who will say, “No. I’m the one with the medical degree. I’ll ask the questions.” In which case, you may decide to suck it up, or you may decide to look for another one. But then, from the physician side, I asked my primary physician Danny Sands, who is one of the co-founders with me of the Society for Participatory Medicine, what his advice to clinicians is.
The great thing about that is, I mean, he’s pretty well-known in the field of informatics, medical records, technology, [inaudible 00:14:07]. Here is a doctor who clearly is not a hyper-radical hippie wacko, who has been doing this successfully for 15 years. The reason physicians like his advice is because they know it’s not coming from somebody who hasn’t walked in their shoes.
Importantly, by the way, we didn’t circulate this on Twitter, but the next page, without me asking him, he added a page of “10 Things Clinicians Often Do That Discourage Engagement.” Then, I said, “There’s one other thing we’ve got to do. People are always asking, ‘All right. So if it’s okay for my patients to look at the internet, how do I guide them?’ Because there is garbage out there.” So we added a page of “Dr. Danny Sands’ Rules for Effective Internet Use.”
Jared Johnson: Yeah. I’m looking at that list right now, and it’s fabulous. I mean, there’s things like, “Here’s what you’re going to do. Stay off the internet. If you do search, don’t bring it to us. We don’t have time for it,” those kinds of things. So I think you’re right. These things are changing. It’s shifting the culture in the clinician community, the patient community, which I love your term for that.
“Patient is not a third-person word. We’re all patients. We are going to be at some point or another if we’re not now, and we all have family members who are going through something one way or the other.” Then you add kind of the other piece of that community, which is the health IT community, those who are working on and developing the health information systems themselves. What recommendations do you have for the health IT community to be involved in patient engagement?
e-Patient Dave: Well, first of all, I want to say that I have immense compassion for the people who work in health IT these days, where they have lots and lots of pressures from outside, from their management and from the government, and everywhere else, people telling them what to do. Far too little of it has been user-driven, the people who have the need, and this is behind a lot of what Andy Slavitt said.
I want to say that, now I’ve never worked in Washington, I have never worked in a medical practice, so this is just my observation looking at the dialogue that’s gone on for years about this. It’s really hard to make the system do well when you can’t build it from the ground up. I say this as somebody, my career was in industry, in high-tech, in type setting systems, in digital printing and desktop publishing. Where we had to come up with [inaudible 00:16:38] that people wanted and were willing to pay for, and that they could actually use in the pressures of day-to-day work.
Almost none of that applies to electronic medical records these days. Everyone knows that most of the big electronic medical record systems were originally built as billing computers. To try to overlay that, a billing computer is in a widely corrupt system, by the way. If you want at some point, we can talk about the fraud that I found in my medical record that accidentally landed me on the front page of the Boston Globe in 2009.
So there’s this mess where there are no controls on the quality and accuracy of the data. It’s like early websites, where it was possible to enter a phone number in the ZIP code field. Because they hadn’t figured out that if you don’t have something baked into the system that lets people get the job done but prevents mistakes, you’ll end up with garbage data. Well, anyway, the usability of the systems needs to improve and so on.
But I want to say two things of how it all looked to me while all this [inaudible 00:17:45] was going on and all the arguments and griping, and everything. First of all, it has been just reprehensible that medicine, where lives are at stake, has been the last industry to get computerized, and there’s been immense resistance from many providers. “I don’t want to,” is a tone of voice that I’ve heard more than once. But that’s been complicated by the fact that there weren’t good, usable, highly productive systems.
A lot of it is, I have said someday I’d like to write a book on the parallels between this industry and when the newspaper industry started using computers early in my career. Because both of them are high-pressure, high-volume operations. The first newspaper systems that came out stunk for usability. I, myself, as a young product manager was taken to task more than once by the publisher of a newspaper who basically in today’s language, what they said was, “Dude, in this business there’s no such thing as being ‘sorry, we were late.’ Your system has to be usable or it’s of no use to us.”
Well, anyway, in a sense it was essential that government push forward, because nobody else was going to do it, with forcing people to get into computers. The problem was that there was no really good product. I was told by authoritative people, early in 2010 before I gave a speech in Washington, that in those days there was this big thing going on at the birth of meaningful use, where the policy fights were going on about which computers would be certified as qualifying for the meaningful use’s money.
Apparently, one of the big vendors was deeply involved in this process. Surprise, surprise, welcome to Washington. And reportedly said that the usability of their product would be a criterion “over my dead body.” So that particular fight with a vendor defending what they already had to offer is the genesis, at least part of the genesis, of the bad usability that physicians have suffered with and complained about. Now, having said that, if you want to make a really good system it’s going to take time for us to get there.
But please, please envision the patient as an active participant, who has every reason and every moral right to know what’s in the chart. I’m pleased that the new guidance from HHS this month says that information blocking will not be tolerated. That’s the strongest word I’ve heard come out of Washington on the subject ever. I’m going to be watching like a hawk to see what happens when a violation is reported.
But the information blocking, for those who don’t know, HHS sent a report to Congress last April saying that they had identified that certain hospitals and certain system vendors were “knowingly interfering with attempts to move a patient’s data to somewhere else where it was needed.” Now, if that isn’t immoral in healthcare, I don’t know what is. I mean, if that were my mother or my granddaughter, I’d be looking to kill somebody for knowingly interfering with the transfer of their records. But it’s been happening, lost of stories about it.
So I hope now that if we can envision the patient as an active partner with every right to have their hands on data that we will start implementing that as a reality. I hope everyone is aware of the now famous OpenNotes Movement. It’s not a software product. It’s just the idea that your hospital, your provider’s office sort of drills a hole through the patient portal.
Most patient portals are clinically useless, except for looking up lab results. They’ll let you see what your blood tests were. But you can’t get in and see what the doctors and nurses wrote to each other about you. Well, with OpenNotes, they just kind of drill a little hole through there and let you see what the doctors and nurses wrote to each other. Amazingly, if you just Google “OpenNotes” all the evidence says good things happen when patients are informed. Who knew, huh?
Jared Johnson: Right. I imagine, like you said, you were referring to the announcement from Andy Slavitt with CMS at JPM earlier this month about how meaningful use’s current form isn’t going to exist anymore. But we haven’t been given many details yet. There was the follow-up, like you said, about data blocking won’t be tolerated. What do you think the impact will be on patient engagement, that announcement about meaningful use?
e-Patient Dave: Time will tell. Time will tell. I mean, the fact that a mandate comes out of Washington doesn’t mean that people actually do it. A lot of people don’t realize that patient access to the medical record, everybody talks about HIPAA in terms of privacy violations. Well HIPAA also says that you have a right to every word that people have written about you. They’re allowed to charge certain amounts, but they are not allowed to say no.
Believe it or not, HIPAA is administered within HHS, Health and Human Services, by the Office for Civil Rights. It is a federal civil rights violation for somebody to not give you your records, and yet hardly anything has been done to enforce that. In all my speeches and all the work I do, I’ve been kind of rant-y here on this podcast, but I always talk about what’s newly possible and how if we don’t do those things we’ll never achieve what’s fully possible. I’m hoping that people will see this can be a good thing and help move forward.
Now, on the e-patient blog, e-patients.net, just the other day we posted a proposal from a primary care physician who’s one of our board members named Peter Elias. He and a [inaudible 00:24:37] members had this brainstorming Google Hangout last week on what would a really patient-centered medical record look like. One of the first things, they spelled it all out in this great blog post, it would have to be owned by the patient.
In the same way you and I own our own financial data, we collect it from various places in Quicken or Mint.com, and we can authorize a tax accountant or financial advisor to look at it. Not only look at it, but edit it and work in it, and this is the vision they have. Now, of course, you don’t just immediately say, “Okay, doctor. I want you to start writing things in my medical record.”
But aside from the fact that there are no controls to make sure only accurate data gets into the record is that for the most part, these systems do not talk to each other yet. There’s a move [inaudible 00:25:33], but it’ll be years before it’s a reality everywhere.
In the meantime, nobody is guaranteed to be talking to each other to make sure everyone has the latest information. It is up to you, the patient or family member, to collect the information and be sure that the next doctor or nurse that you talk to is aware of it. Because it’s very common for one system to say something different from what another system says.
I’ll give you a simple example that nearly killed my mother a few years ago, and this is so trivial and yet it’s so perfect and so dangerous. She was discharged from the hospital after having a successful hip replacement and transferred to a rehab place to get her physical therapy and everything. Somehow or other, the record about her thyroid condition came across backwards. So the best doctor in the world at the rehab place would’ve prescribed the opposite medicine from what she needed.
Jared Johnson: Holy cow.
e-Patient Dave: Well, there was nothing to prevent that. So what happened, there’s a really important social dynamic in a lot of families that I call the “alpha daughter.” That’s the middle-aged woman who takes care of kids and takes care of elders. Anyway, my two alpha sisters were involved and they said, “Could we check the chart?” Happily, the rehab place said “Sure,” and they found the mistake before any harm was done. It was fixed at no cost to anyone. See, that is patient and family engagement, improving quality and outcomes at no cost to anyone.
Jared Johnson: Yeah. You’ve given me so much to think about. No matter how much I check in with the blog and with other things that you’re publishing, there’s so much more we can talk about. In wrapping up, is there anything else you’d like to share with the health IT community?
e-Patient Dave: Well, first of all, for heaven’s sake, do OpenNotes. If the people you work with are not familiar with it and don’t realize how it’s a no-brainer, just Google “OpenNotes” and you’ll get all the literature and publicity. So please, please, please do that. Well, you mentioned from the book my line, “Patient is not a third-person word.” Think about yourself, really, with your child, your spouse, your elderly parent, whatever, in crisis, and the sense that you have of, “Is there anything I can do to help?”
Well, that is a heck of a lot more if you’re allowed to look at the data, and please make that possible for people. It is culture change. You may get push-back. But cultures evolve when a majority of people say, “This is the right way to do things.”
Then, finally, be aware that gadget data, now it’s over-hyped at present, but that always happens when new things come along, gadget data is turning out to be truly useful. So you want your systems to welcome that data somehow. It doesn’t mean that everything that comes in will be solid gold. I’m a skeptic about whether so-called Big Data will ever actually produce great value.
But I will tell you right now, I have two different fitness wristbands on my wrist, just because I want to compare them. One I got for free, and the other one I bought. They count steps differently. They have different features. I hate parts of both of them. Plus the FIUs for tracking food sometimes, and my Wi-Fi bathroom scale and Runkeeper for tracking my activities.
In the last 13 months I’ve lost 34 pounds. I’m somebody who gets uncomfortable if I don’t get out to walk and run. My doctor has another patient who has just been overweight, clinically obese for years, and he started using a Fitbit and he has lost 30 pounds. When Dr. Sands talks about it, it’s hard to believe.
So anyway, the ironic thing is my doctor can’t see my device data in his big, fancy computer. You see how ironic that is? People say, “Patients won’t get off their butt and do blah, blah, blah, blah, blah, and it causes all kinds of problems and diabetes.” Well, what happens when I start having this cloud of data around me that he can’t see? That’s why Eric Topol, the famous cardiologist, he published a book a little bit more than a year ago called “The Patient Will See You Now,” because we’re beginning to have this world of home device data.
I will wrap on that with one particularly potent thing. See, every other industry, when it is computerized and gotten into devices and all that, quality goes up and prices go down, and consumers get more power. Well, the AliveCor, Alive C-O-R, is an FDA-approved EKG, electrocardiogram, some people call it ECG, that works. It’s two silver buttons that you can either hold in your hand or glue to the back of your phone and it creates an EKG on the display in real-time.
It’s $75 on Amazon and it says, “Hmm. No problem.” Or if it’s suspicious it says, “Do you want me to email this to your doctor?” [inaudible 00:31:19] device data in the same way that a continuous glucose monitor for a person with diabetes enables them to be more aware of their status and more responsible for themselves. This AliveCor let’s a person with a heart condition self-track.
So please, do what you can to enable the flow into your system of patient-generated device data. I don’t know yet exactly what we’re going to do with it. But please don’t make your doctors, your users, be blind to the changing world outside the hospital walls.
Jared Johnson: Well, thank you for representing that viewpoint and thank you for showing some potential for devices, and wearables included in that. You’re right. There’s a lot of hype for them, but I think we’re just now starting to see the potential for them as well. So I appreciate that. Our very last bonus question is usually my favorite question. It’s if you could join any rock band or music group for a day, who would that be?
e-Patient Dave: Oh, it’s got to be the Stones. Granted, I’m 65. Okay? So that would be the Rolling Stones for those who don’t know that.
Jared Johnson: Yes, absolutely and that’s actually our most popular answer now. So awesome.
e-Patient Dave: Really?
Jared Johnson: It is, yes. That’s at least the third time. I’m going to have to listen back, and I should write them down at some point. But that’s at least the third time. So Dave, thanks so much for taking time out of your busy schedule to be with us today. What’s the best way for people to find out more about what you’re doing?
e-Patient Dave: Just go to ePatientDave.com, and there’s contact information. There’s my travel schedule. There’s all my blogging. I will say, just what I’m working on in 2016 that I’ve been blogging about it for the last few weeks. It’s time for a social movement. We have enough evidence now that it’s time to get in action and create change. I’m beginning to speak at medical schools. It’s time to change medical education to weave this in.
I’m happy to say that younger doctors now obviously, I mean, they’re digital natives. They don’t come out of school saying, “Stay off the internet.” They look at the internet themselves. But we still need to figure out how to teach people the methods of how to interact with patients differently, because none of the elder mentors are likely to be good at it.
Jared Johnson: Yeah. So true.
e-Patient Dave: Anyway, ePatientDave.com.
Jared Johnson: Thank you. Yeah. Hopefully, one of these days maybe you can put in a good word for me with Eric Topol. Like you said, I’d love to have him on the program as well and just keep the conversation going about patient engagement. But thanks again for your time, Dave. I really appreciate it.
e-Patient Dave: Okay, thank you. Bye-bye.
Jared Johnson: That’s a wrap for this week’s program. A quick word about my real job. I’m the founder and principal of Ultera Digital. I generate and amplify thought leadership content, such as this program. So I help organizations in healthcare and technology answer their content marketing questions.
Things like “What’s the short term ROI? Is content just for lead generation? How do we get more mileage out of our content? How can a small team create content awesomeness? Should I use the same channels as everyone else? Should I just blog like everyone else? Is it just part of our SEO strategy?” So if you’re interested in learning more or getting answers to those questions for your team, contact me at Jared, J-A-R-E-D, @ulteradigital, U-L-T-E-R-A digital.com.
Until next time, you’ve been listening to the Health IT Marketer Podcast. For a full archive go to HealthITMarketer.com. That’s HealthITMarketer.com. Thanks for your support, and keep on listening. Tell your friends to subscribe, and I’ll talk to you next week.