Ep. 11 – Deciphering Healthcare’s Cryptic Senior Consumers, with Dr. Justin Barclay.

Transcript

 

Intro
Welcome to the Elusive Consumer. Today, Ellie is speaking with Dr. Justin Barclay, Head of Insights & Analytics at Tivity Health. Join us as they discuss Dr. Barclay’s journey from academia to the healthcare industry, Tivity Health’s approach to gathering consumer insights and the impact of AI and personalisation on healthcare products and services. Let’s get started on the Elusive Consumer.

Ellie:
Hello, Dr. Barclay, and welcome to the Elusive Consumer. We’re so happy to have you with us today.

Dr. Barclay:
Hi Ellie, thanks for having me.

Ellie:
I am very intrigued to talk about the topic of consumer insights in the healthcare sector and hear more about how Tivity health is using insights to improve your products and services. But I would like to start to talk about your professional journey a bit. If you could tell us a bit more about that.

Dr. Barclay:
Yeah, you bet. So it’s a little bit of a hackneyed story, I’ll admit. I started off as an academician right out of college and was teaching full-time in the classroom. Some management, some strategy stats, went into administering management degrees for a while there. But then, ultimately, the hackneyed part was took a detour over to consulting for a bit and did some management consulting, did some work with the DoD on their GI bill, and ultimately after making it through higher ed for a while, doing the management consulting for a while, working with the government for a bit, I was looking for somewhere else to have some impact.

Dr. Barclay:
And so I took what I knew from my time in the classroom and my time running those programs and used what I learned as a consultant to bring it into private industry and saying, what can we do with data and with insights in an organisation where they’re looking to have just as much impact in the community as I am. And that’s really how I stumbled on Tivity health was making that move from faculty turned consultant turned insights exec. And that’s where I’m at today.

Ellie:
And why healthcare specifically? You talk about making an impact, but specifically healthcare, why did you choose that sector?

Dr. Barclay:
Yeah, yeah, healthcare. Healthcare needs a lot of love, right? It’s a system that helps millions each year, but it’s also a system that, in some ways, is fundamentally flawed and fundamentally broken. And I’m not gonna be the first one to characterise it as sick care, right? But in America, that’s still where we’re at. That’s still the state of play. And so it was, if I can take what I know around strategy, around stats, around analytics and primary research, and help a team craft wellness solutions that stop the process before it gets to sick care, that’s really been the tangible benefit for me is understanding how we can use all these things, not just to design a new widget, not just to improve a ux by 5%, or get ten more people to click on an email, all those things are perfectly reasonable goals.

Dr. Barclay:
But if we can advance healthcare before it becomes sick care, that’s a lot of why that charter, that mission for Tivity Health, drove me to be part of that organisation and use everything that I’ve possibly learned in a lifetime of learning to bring to bear on the problem.

Ellie:
Right, you mentioned an interesting point there about healthcare, being sick care, particularly in America. Have you had any global experience of what healthcare might be like in Europe or other parts of the world that you could talk to us about?

Dr. Barclay:
Certainly wish I did. But what I would say is that just based on what we’ve done to understand what’s possible here, we certainly take some of those examples from what’s done elsewhere. And a lot of what we’re applying today in Tiviti’s solutions is a lot about how to move to the front of not just things like healthy ageing but also understanding the very expanded definition of wellness that it’s guaranteed to come up, and it probably will be for a couple more years. But Covid really led us to a new normal.

Dr. Barclay:
And that new normal meant that it wasn’t just basic definitions of health and fitness that were redefined, but the very definition of wellness to include things that weren’t included before, things like, just by way of a random example, we work primarily with older adults, and more than 50% of them that we talked to said that they even include things like socialisation, mental enrichment, nutrition, meditation. More than 50% put meditation in their wellness definition. And so this new normal has health and well-being and longevity at such top of mind that didn’t start here. That’s sort of finally made it here through the lasting effects of the pandemic. And so then understanding how we can then lean into those redefinitions has really been where we’ve focused our attention for the bulk of the last number of years.

Ellie:
It’s interesting that Tivity Health is focusing on the older adults, and it’s one of those groups of people that are particularly elusive to reach and to gain a bit more information on. Tell us a little bit about how you, within your organisation, try to involve them and make sure that their feedback and their voice is heard.

Dr. Barclay:
Yeah. Oh, and you could not be more right. Not only is it an elusive population, but we also have a number of dangerous stereotypes floating around in our lexicon and in our understanding of what it means to be an older adult and to navigate the aging process in America, the idea that a cell phone needs bigger, fewer buttons, the idea that a website needs to have a single click for everything, that using an app to deliver groceries is beyond them. The number of stereotypes has been absolutely insane. But it’s one of the only silver linings from the last few years in the new normal that we’ve entered, which is there was never a trepidation around technology adoption among seniors.

Dr. Barclay:

It was always, I’m not scared of the tech, but nobody’s spending the time educating me on how to use it and what my benefits are in using it. And so now that we’ve collectively taken the time to because we had to get them comfortable with telemedicine, get them comfortable with app grocery delivery, get them comfortable with buying more of their day-to-day needs on Amazon, as just one random example, the idea that technology is now fused with that UX is a huge part of how we can now do insights work that weren’t even able to do four or five years ago.

Dr. Barclay:
We would have gone straight to some of the most, again, stereotypical textbook approaches of let’s do some all intercepts, let’s give some folks a call and do some phone polls instead, what we’re doing now, we’ve taken advantage of the digital transformation on the business side of things. We’ve taken advantage of the new normal and the very transformation of consumers and how they’re consuming and what they’re consuming today and are at the heart of it.

Dr. Barclay:
Blending primary research, and consumer research with analytics and advanced analytics and AI and saying let’s build one fluid circular process that starts with concept identification, needs identification, concept testing through primary research, moving into beta and testing and release as then those solutions are out there in the wild, pairing with but then leaning a little bit heavier toward the analytic side, understanding what the different segments are of those using it and how that lines up with the research we did in the first place. And then create that feedback loop, whether during their exits from a solution or just in general on a sort of whether it’s quarterly, biannual, or yearly, depending on the roadmap and depending on the organisation creating that full circle that says I went and identified a need.

Dr. Barclay:
I then identified a core concept and segment that would likely benefit most from that need. I tracked them through analytics and omnibus surveying, among other things, as those needs were being met and coming back around to say, and for the next iteration, for phase two, phase ten, and phase 100. How can we optimise next? And so one of the things that I truly believe has been a competitive advantage for Tivity, not just in the wellness space, but as a 2020 and beyond organisation that’s gone through digital transformation is very few organisations are comfortable merging their researchers with their analytics folks. But we truly believe that melding that bridge as a single team and a single cycle of delivery is how we’re not only maximising the data that we’re capturing from older adults, but it’s also maximising how we’re serving them.

Dr. Barclay:
Because it’s not just one method or the other, or thinking we’re fancy and doing multimethod approaches for just the primary, or just doing advanced analytics for the usage and retention, tracking and segmentation, or the marketing, all of that is part of the same conversation. It’s deeply embedded in the day-to-day conversation about how businesses run. It’s not just skunk works on the side and saying, hey, business, you need to look at this thing that we found. It’s so neat. We’re part of the conversation, we get the questions asked, and it’s because we go full cycle. And it’s because that data is being collected at every step of that circular process directly from the seniors, who then directly benefit from it.

Ellie:
That’s very interesting because that’s always been the danger of insights: Sometimes, their voices aren’t heard at the right table with the right decision-makers. So embedding them within that strategic decision-making is critical. Has that always been the case at Tivity Health? Or is that something you and your team have brought about?

Dr. Barclay:

That was blood, sweat and tears for the last 15 years, honestly, and I would never give myself credit for coming up with it or even leading it, but being a part of an amazing group of folks who said two things, really, one, that isn’t different anywhere else, that if you have multiple insights groups diffuse throughout your organisation, they’re never going to have enough collective voice to ultimately alter the strategy in positive ways. So just centralising and galvanising all that talent and centralising all of that work toward a honed set of business problems was priority one. And then it was. And then how do we mature our capabilities over time? How do we mature the data we’re using the way that it’s stored and provisioned? How are we advancing our approach to analytics? How are we moving into advanced analytics?

Dr. Barclay:
The traditional descriptive goes diagnostic, goes predictive, goes cognitive, like getting us up that ladder while also evolving the data, while also evolving our research methods and the ways that we’re conducting that research. But the part of it that was really tough to pull off was you can centralise, you can optimise the toolset, you can optimise the data, you can upscale your team, but that’s still, even that moment, it still doesn’t prevent you from being ignored by the business. Because as much as there is literature and classes, and trust me, I’ve done my share of these programs. Because again, just a lifelong learner, right? Whether it was analytics with T Bird, whether it was insights with Columbia, or competing in AI with HBS, I loved my time with each one of these programs.

Dr. Barclay:
But they all taught me the same lesson and took back the same lesson to the organisation, which was that you can be great at your domain. That doesn’t necessarily mean that you’re honing in on and understanding the same problems keeping the business up at night. And to only truly understand those requires great, deep relationships, which is why so much of even the hiring problems that we’re running into now are not just supply problems; they are not anyone. I mean, we’ve all seen the articles. You can command an incredible salary right now as a data analyst, data scientist, and prompt engineer. These things are possible today.

Dr. Barclay:
But that still doesn’t say I can go beyond domain expertise and create meaningful, lasting relationships with my business partners to such an extent that I not only understand what keeps them up at night but might even have some ideas on how we can help them fix them. And so it’s yes to all the things around domain expertise, it’s yes to all the things around amazing storytelling and being a trusted advisor. But it’s going beyond trusted advisor, as in you’re not just there to harm or to serve simply yourself. And it’s going that level deeper to say you got to have domain expertise, you have to have storytelling skills, you have to be and always act in a trusted advisor sort of mode or mentality, right?

Dr. Barclay:
But then it’s also you’ve got to forge those deep relationships because unless they feel a problem and then pick up the phone and ask you to talk through it, or you already have that normal cadence built to where you can dive in together, you’re never going to be leveraging all those tools, all those skills, all that process, all that centralised horsepower toward anything that business truly needs from you. That relationship is the only way to understand what the business needs from you. So, sort of to put a bow on this point, you can deliver all the greatest product analytics, marketing, analytics, and the best concept research. But if when your C suite is ultimately meeting with their board on a quarterly basis, and they’re talking about something else, you’ve missed the boat. Your relationships aren’t as strong as they need to be.

Dr. Barclay:
And I’m not saying that insights professionals, even at an executive level, need to be in every c suite conversation or need to be in the board conversation. It’s definitely not the case because not every professional to VP and above level is in those meetings. But to have all the same context that their lieutenants have, to have all the same knowledge of what the true priorities of the organisation are, beyond just keeping the lights on and running the business. That’s what we’ve spent the most time on. We’ve spent time centralising, we spent time on tools, but we spent the most time honing those relationships and understanding. If we’re going to deliver anything, what’s the thing that’s going to actually let you rest your head on your pillow and get some z’s? Because unless we know what that is, we are not going to be heard.

Ellie:
Right? That was very eloquently put and sort of sums up the problem of the insights industry a little bit, doesn’t it? So I want to return to this point and how you ensure that some of the. I mean, obviously at Tivity Health, you talk about having done this work for years now and reaching a level where you’re seeing it translate into your services and products. But I would be intrigued to see what steps you took to bridge the gap between those insights and analytics members and get buy-in from everyone because people come from their own traditional ways of thinking and acting and so forth.

Ellie:
But before we touch upon that, I want to briefly ask about some of the products or services you can discuss that might have come out of some of the insights and analytics work you’ve done recently at Tivity Health.

Dr. Barclay:
Sure. Thanks for asking. So, of the many products we have available, the three core ones are going to be our Silversneakers product that’s available to Medicare Advantage members nationwide. We have our Bernalong plus, which is our commercial product. It’s also a fitness and wellness product, but it’s available to employers. So the 18 to 64 market. And then we have holoth living. Living is complementary and integrative medicine across things like Acuchiro PT and massage. Where I’ll spend my most time on this is with silver sneakers, because that one not only has coverage of roughly one in four Medicare enrollees across the country, but it’s also one of very few fitness plans that are available to more than 95% of all Medicare Advantage plans today.

Dr. Barclay:
And so we have, just in our own right at the moment, over 18.5 million Medicare Advantage and Medicare supplement enrollees who are eligible for silversneakers. And silversneakers at this point not only offers a lot of what I covered across fitness and wellness, whether it’s in person or virtual solutions, whether it’s in community or at home, whether it’s in the gym or solo outside of it, and it’s a lot of what we’ve built with the program. The program has been around for about 30 years, and every single month, hundreds of thousands of seniors are staying active in our network, and we’re activating millions more every year. And a lot of what our insights have helped drive for the product.

Dr. Barclay:
Before the pandemic would have been about feature sets, it would have been about what classes are people taking, what amenities are they using at the gym, what on-demand and community offerings might be good supplements around, maybe a traditional gym routine, because the whole thing is of no cost to the senior. And so it’s really just about understanding and leaning into fitness habits that were already established. But now, in the new normal, a couple of things had to change. One that had to change was their very routines changed. And it wasn’t just so gym-specific or community-specific or home-specific.

Dr. Barclay:
Physical activity in general and wellness, in general, became so much broader and so much more fluid across seasons and venues and connection points like digital versus digital, live versus digital, on-demand versus in person, that we needed to understand who our consumer was again after we thought we knew them for 27 years, and we did know them for the first 27 years, but then we had to completely gain a different and updated understanding of who they were, and not just how they consume fitness, but how they defined it. So then we could not only catch up but continue to be the harbinger of solutions that make sense.

Dr. Barclay:
So much of what the insights have built for us and provided for the business over the last just few years was defining that consumer in the new normal understanding where all those different venues and patterns of consumption were, and then understanding what are still some of the unmet needs. So looking at things like, just by way of a couple brief examples, one’s going to be Silversneakers live. Our virtual live platform for fitness programming, which you can do anywhere on basically any Internet-connected device, is something that wasn’t nearly in as much demand pre-COVID as it is today. But then it was understanding, okay, then what are the feature sets, what are the pain points, what are the obstacles, the friction to getting people to then use this thing that they told us they want? Another is the idea of burn along plus.

Dr. Barclay:
So our commercial solution, pre-Covid, was pretty focused on the gym network. But since the new normal and the tech adoption being accelerated, I think it was McKinsey that said something like ten years of tech adoption in the first ten weeks of COVID. So, going all the way back to those days and understanding that fitness became digital almost overnight. You saw, not only did you see the closure of 25% of gyms nationwide, but then the rest of the 75 went straight to I need an in-person and some sort of digital or virtual or on-demand solution for those who aren’t yet comfortable coming in now, granted new normal, now very post sort of acute phase of the pandemic, people aren’t as gun shy coming into the gyms as they were before.

Dr. Barclay:
And in fact, we’ve seen plenty of articles these days about some of the largest gym brands in the nation saying they’ve actually got membership levels above pre-Covid at this point. And they’re happy to see how many people are focusing on their health. But that’s just about creating a venue, an opportunity for them to be, well, what we’re focused then on is how do you use these tools on a personalised level, at an audience level, for the person, for the individual, against their goals, against their obstacles, their needs, their desires. That’s where so much of our insights work is honed. Where before, in essence, it would have been Persona work and we might have stopped there.

Dr. Barclay:
Now, it’s how do we take something like Personas, even from their more detailed audiences, and finish with such personalised experiences over the next year or two that literally every one of those 18.5 million members has a different silversneakers experience as a result of them being willing to provide just a little bit more data about themselves than they might have provided before the new normal?

Ellie:
Yeah, this trend toward personalised healthcare is incredibly interesting. How do you envision consumer insights contributing to the rise of this trend?

Dr. Barclay:
Well, here’s what’s interesting about that. Not only do you see demand, palpable, substantive demand for personalised experiences from every generation, but it’s also that the very levels of demand for personalisation in healthcare and other spaces now, at this moment, this very moment, older adult demand for it rivals the same level of demand as Gen Z and others. And so it’s not something that’s coming. This demand is already there, and we’re just answering the call collectively. And I would say if we take insights approach and define an insights organisation the way that we do at Tivity Health, that blends analytics and primary research to come up with something that’s not just multimethod but a little bit more holistic and creates a feedback loop, then you get to bring in the best of both worlds, from primary research and from advanced analytics.

Dr. Barclay:
You get to bring in from primary research ideas like Personas and audiences, and advanced segmentation from analytics bringing over things like AI and not even necessarily Genai and chat GPT. We’ve got enough people talking about that. But this is about AI helping make healthcare not just personal but more surgical and targeted and more couture for each consumer of it. Because it’s augmenting diagnoses, it’s augmenting the very billing and coding process, it’s augmenting scheduling. There are so many feature-rich advancements that have occurred just in the last few years. AI, reading dental x rays, these are not Sci-Fi anymore. And so if you then look at how can my understanding of the consumer provide a personalised Persona and how the AI can then support and augment the very human delivery of healthcare, understanding what that sort of one-to-one relationship can be.

Dr. Barclay:
It’s both sides of how we define the insights organisation that can then become a support structure, the scaffolding for personalised healthcare, and a version of personalised healthcare that because it now understands your goals and objectives and some of your current stumbling blocks, whether it be chronic conditions or whether it just be consumer preferences, it can actually help you stay on the wellness track longer with fewer human interventions along the way.

Ellie:
With the rise of this whole personalisation and also using AI, as you mentioned, comes the risk of how you’re handling the data, right? And the data privacy aspect, and in particular in healthcare, that’s obviously a sensitive subject. So how do you handle that activity? Health?

Dr. Barclay:
So that has honestly probably been the place of largest investment for us. It’s one thing to say, let’s go out and continue to scour the landscape for the newest analytics tools or the newest research tools, and taking advantage of things like our members, and not just older adults, but consumers at large now being willing to give you just a little bit more data than they gave you before. As long as there is that established reciprocal relationship of I give you a little bit more about me, I get a better experience in return. That’s going to bolster the consumer research part of it that’s going to bolster the understanding part of it. But the data part was harder because choosing tool sets for now, getting to do things like virtual qual, the set is out there.

Dr. Barclay:
You just have to get through them and understand and evaluate your needs. The same thing goes on the quant side, whether it’s not just as big a decision as do I use SaaS or SPSS or Alteryx or somebody else. Those questions still exist, of course, but with bigger things like moving to the cloud, digital transformation, getting off of your own data centres and getting into places that leverage some of these more, not just cloud-enabled, but places where you can spin up provisioning of your data on the fly. The benefits to productivity, the benefits to creativity and analytics, and the benefits to insights creation are huge.

Dr. Barclay:
But the risks are even bigger because you take your average CISO and you say, okay, chief information security officer, I’m going to move all my data off of the server that we are leasing, and we’re going to go put it on someone else’s box in the cloud, and it’s going to be just as safe as it was before. There’s this deep distrust among those who just don’t know and don’t have the experience and the exposure to some of these technologies to then say not just how am I going to keep that data safe, then understand in a healthcare context, HIPAA’s no joke. CMS, no joke. High trust, no joke.

Dr. Barclay:
These things are comprehensive, intrusive, expensive, and altogether necessary to secure and maintain not just patient privacy but patient trust, consumer trust in the healthcare system and with their data, that it’s not taken advantage of, that it’s not misused, that it’s not just out there to create new widgets for products to sell back to those folks. And so we’ve spent more time, I would say, doing three things on data than anything else. One was just understanding what data we ever had for so many organisations. Still; that is still their biggest stumbling block is you think you have 50 databases, you’ve got 60, you think you have 600 databases, you’ve got 5000.

Dr. Barclay:
There is no end to the value that can be extracted from just understanding how many datasets and getting down to the very cataloguing and lineage work that’s necessary to say what is my true enterprise data set. And getting it from multiple sources of truth to a single source of truth is no small feat. And it has taken completely dedicated teams with considerable investment over literally years to go from disparate data systems in an on the prem data centre to a single source of truth that’s governed by lineage cataloguing the works. And until you do that work, you don’t even have a shot at not only understanding what’s at your fingertips, and thus what needs to be protected, but also until you get to that level of centralisation and governance before you even move it anywhere.

Ellie:
That’s also how you understand those catalogued data types, which ones are Phi, and which ones are PII. And so there’s so much work to just be done with structuring, governing and centralising those datasets before any of the analytics work happens before any of the research happens, and certainly, before any digital transformation happens. And I can tell you we’ve spent quite a bit of time and quite a bit of investment centralising our insights.org upskilling our team and bringing in new tools. But the thing that we’ve spent the most time and the most investment on is the data. Because it’s not just the maximum of garbage in and garbage out. It is a single misuse, a single missed step, a single environment that any of that goes into that isn’t where it should be, unwinds the whole operation.

Dr. Barclay:
And especially in a Medicare, in a CMS regulated environment like ours, it’s the permanent black mark that you go to every sales conversation, you say, by the way, we had a breach before, we need to tell you about it now. Activity has been around, and silver Snickers has been around for 30 years, and we don’t have to make that claim because that’s not something that’s happened to us. So it’s this very purposeful evolution of centralisation of the team and creating that circular insights flow that was all crucial. But you’re absolutely right, Ellie.

Dr. Barclay:
It wasn’t until we spent the years and the investment getting the data right that we first governed catalogue lineage classifications, true governance, and into a single source of truth, where the very KPIs of the enterprise were selected at once, and the data was in a place that was trusted not only by the clients we serve but also by the members that we serve. More specifically, it wasn’t until we spent the years and the investment getting the data right that any of the other work that we’ve talked about could even be done right.

Ellie:
And what role do you think synthetic data will play in the future of healthcare, if any?

Dr. Barclay:
Here’s what I love about synthetic data. A, it can be created so much more easily now than before. Thank you, AI, for that. That’s going to save somebody a heck of a lot of time and investment. But b is I really do think that healthcare is going to become more product focused than it ever has. Been before. And it’s kind of like the same thing. You take Genai specifically, and you have multiple experts from multiple domains that have leveraged AI for longer than most consumers have. Most people who even knew what chat GPT was last November said that AI is not new, and machine learning is not new. Creating things with AI is not new. But what has been new is we’ve handed AI to the consumer to say, now it’s a product you can go use. Healthcare is getting to the same place.

Dr. Barclay:
So there’s still so much of the control today. That’s with the insurer, that’s with the hospital system, that’s with the PCP and the specialist. But as we continue to move into more AI, augmented and AI enabled, not automated, but augmented and enabled, and as we move into a more personalised, wellness-focused experience, where there are things like cost transparency and process transparency and data exchange, where the consumer is exposed, not only does this consumer get a more vested interest in their own healthcare, which is what they’re demanding, but it’s also something where healthcare becomes more productised, then all those folks who developed all that long range expertise of productising everything else under the sun come into the healthcare space and say, well, if healthcare is a product, do I have some answers for you on what we can do with this next?

Dr. Barclay:
And so that’s truly where I think the sort of the not leading edge, but we’re getting to maybe a leading edge of healthcare that says the productisation of it. Where there are product managers who are managing UX’s on healthcare, that’s something where were already behind the ball moving from sick care to healthcare, to wellness, to preventatives. The next bastion, the next chasm, is the productisation of it. To then say, well, if now this is the focus, and we’ve created tools around it, now, how do you maximise the UX, maximise the utility, maximise the lifetime value of those products you’ve now created as a result of that shift in focus, I think.

Ellie:
Right. And with that whole product focus, it brings about an interesting question: Do you think there are any risks with some of the big tech companies moving into the healthcare space or trying to move into that space? Beyond the positives, do you think there are any risks with that?

Dr. Barclay:
I think if there was any one small list of risks that are immediate, there’s still so much of how we personalise today, how we productise today. That’s a black box. And I am not going to be the first person who’s going to come on here and say, Ellie, everything has to be opened up. Everything has to be exposed. The inner workings have to be available to every consumer. There’s a balance because even something like buying a car just because I own a car doesn’t mean that I know how every piece of that engine works. But I generally know how cars work, and I generally know how to operate one. That’s not going to be the same for the output of an LLM, right?

Dr. Barclay:
We’ve had great research just published by folks over at HBS that said that there is still a very jagged frontier to what AI can even enable. There are some tasks, even among white-collar, high-value professionals, where AI sings. And there are other areas very close to them, just very close. One moving from maybe ten ideas for a product or ten ideas for ad copy, to then moving to ten ways to inspire a product team to go design around that next idea. Very close kin where AI is falling flat because we still have to remind ourselves it’s not human. It’s doing its best to replicate what we’ve said and done in the past.

Dr. Barclay:
And so much of what I think is the immediate risk is we get a new tool in our belt, and we immediately start using it without knowing how it works. And I’m not saying that everyone in the world needs to be a data scientist, a prompt engineer, or an AI engineer to use AI. I’m not going to be that guy. But what I am going to say is just understanding some of the basic building blocks of how those things come to pass, and what, knowing enough to know what they’re capable of and knowing enough to know what their limits are. That’s what’s critically important. Because it’s one thing to say, how comfortable are you at having AI augment your physician’s diagnosis versus how comfortable are you with AI just being what creates your diagnosis?

Dr. Barclay:
And those are two very different answers from consumers today. But some of those same consumers are saying, oh, if I need to go write a sales deck, I’m just letting AI do it all for me, and I’m just making sure it doesn’t say anything outlandish. And I’m publishing. Those are both critical tasks, creating value in very different spaces, that there’s somebody on the receiving end that’s going to need, that has a lot of needs that are being met and a lot of value created from those outputs. And we’re seeing them with different levels of scepticism because one impacts us personally, and one impacts our business, and it doesn’t seem to have the same level of perceived risk. And so I’m not saying to slow down, I don’t think we should.

Dr. Barclay:
But I think the very ubiquity of tools we don’t understand just means that creating ways to make it more accessible in terms of the understanding, in terms of just basic education around it, to then know what it is capable of and what you can ask it, but probably shouldn’t ask it. That’s the biggest risk. And the only other thing I’d say is for those who are already using it to augment, to really help consumers understand, to what degree is it augmenting? To what degree is it coming from the professional? To what degree is it coming from the AI? Is it confirmatory? Is it in the brainstorming with them? Obviously, if it’s not a diagnosis, but what’s the interplay? What’s the relationship for those who are already using it to augment?

Dr. Barclay:
So the person then has that informed decision because it’s very easy to say, oh yeah, this person just used AI to create a diagnosis, or this person used it to confirm the diagnosis, but confirmation, there’s different degrees of that. There are very different degrees of that. It’s the I google what temperature chicken needs to before it’s safe to eat. I’m going to trust that answer, but it’s just as easy to ask it how to build something I’ve never built. Whether a random thing that I find when I’m hiking is consumable, the level of trust is too blanket, I think.

Ellie:
Right. And with regards to the future of new products and AI and diagnosis, what role do you think healthcare professionals play in that? And also ensuring that they are receptive to the new tech.

Dr. Barclay:
Yeah, it’s so not unlike the same way that we need to continue to manage internally for our insights teams to be successful. It’s the same kind of managing up with this technology to those providers. There are so many benefits to managing up and across in an organisation when you’re in an insights team because that’s where your relationships are being established. And much in the same way that, say, pharmaceuticals spend a lot of time with doctors, not just making sure that they’re well taken care of, but make sure that they’re completely informed about the prescriptions and about what those drugs can do for their patients and what the potential side effects and interactions are. It’s not just looking it up in a book and the tool tells you which one to prescribe.

Dr. Barclay:
There are very trusting relationships in those conversations that need to be replicated with these kinds of technology where much like we can take insights to a COO and say, I can make your operation 6% more efficient with this productionised model, or I can predict with 95% accuracy what your output’s going to need to be in the next six months. These are things where you can be very clear about the value of letting us in, and it’s doing the same for AI, and it’s doing the same thing in healthcare. It’s managing up and across to say, this is what it is, this is basically how it works, this is how it’s going to benefit you. And here are some use cases where folks have seen success with it in the past. And just as important to the last part of the conversation, here are its limitations.

Dr. Barclay:
Here are the places where it’s going to continue to fall flat. And so it becomes a tool they’re comfortable pulling out of their tool belt, not something that’s seen as to replace them. Right? If we just spend a moment zooming out, that’s still the same trepidation that every white-collar professional feels at the moment that has anything to do with a domain inside a business that could be impacted by AI. Is, well, is AI coming for my job? Are the robots going to take me over? And every single person who has published a meaningful, rigorous study around AI has come back and said that augmentation for so many of those high-value positions is the way to perceive. It’s not about just replacing all humans with robots. That’s not the intent.

Dr. Barclay:
There are definitely processes inside of organisations that can and should be automated, and that just opens up that professional to go do other more high-value work. But we will see those places and businesses that can be most automated will continue to be replaced. But those jobs then get just replaced with different tasks because now that those are automated, you create other ways of creating meaningful value inside those companies. And that’s where those folks can then be deployed either to work with AI or not. And so much of this, again, is just understanding the managing up, the managing across, understanding what the capabilities are and then saying not only how does that play into capabilities in healthcare, but as many capabilities inside of any business looking to leverage value out of it.

Dr. Barclay:
Insights, organisation, whether it’s just one built on primary research, one built on advanced analytics and AI, or a combination of the two, really.

Ellie:
Right. With all that new innovation and tech coming, how do you balance that with ensuring that the solutions are still human-centric, which you talked a little bit about?

Dr. Barclay:
Yeah, that’s the part that our team is most passionate about, frankly. I mean, we spend a lot of time with execs, we spend a lot of time with industry partners. We spend a lot of time on Capitol Hill. But the part that we truly pride ourselves on and the part that we honestly believe continues to not only be a source of competitive differentiation for us but something that says, how can we know we’re doing a good job? Because that’s the thing about blending domains. When you blend a research domain with an analytics domain with an AI domain, the definition of a good job changes primary research. It’s getting to the AHA, it’s understanding, it’s unearthing the thing we didn’t know before.

Dr. Barclay:
With analytics, it’s finding the pattern, predicting the next move and doing so accurately, or appealing to a specific segment and a marketing campaign, and seeing being two x. The lift with AI, accuracy is so built in. It’s about what can be productionalised, what can be automated, and what parts of a product or a delivery or a service can be supported and augmented with it. But when you bring all that together, the good job, the litmus test of true value in an insights organisation is not just that the business will go take what you have to say and do something with it. That’s just table stakes. That’s how we get to continue to play in the game. The litmus test of success is, are you truly, accurately, empathetically representing your consumer?

Dr. Barclay:
And we’ve had our own clients tell us, we ask the question, how do we make you happy? What do we do next to make sure that you’re still happy? Right? And that’s a reductive way of putting it. But that’s basically the question. And the answer is always, you make my members happy. You make me happy. So that’s why we’ve set up virtual equal, that’s why we’ve set up omnibus, regular gen pop tracking mechanisms. That’s why we’ve set up regularly recurring pulse research. That’s why we have a whole team dedicated to advanced analytics and spinning up even more AI than we’re doing today, why this route to personalisation is not just about creating a different experience at of one, but also getting it to where it’s defined by the member, him or herself.

Dr. Barclay:
And so we’re not just saying, oh, we’re going to take a Persona and a couple of attributes we have about the member, and then we’re going to put those into our portal and give them some context-based recommendations. Our first step, even after all those capabilities have been stood up over the last number of years. Our very first step is to create a guided onboarding process that gathers that little bit more from the member directly around goals, obstacles, points of friction, needs, desires, and the whole bit. And in those 10, 15, 20 data points max that are collected, then the personalisation process begins. We don’t even start the process of personalisation without hearing from the member or herself.

Dr. Barclay:
We pride ourselves on taking that approach because it is not only helping us continue to win in our space and keep wellness at the forefront, but it also permits us to go back to our clients and say we’re doing everything we can to make your members happy, and we know that’s going to keep you happy as well.

Ellie:
Such a critical point. Keep your consumers happy, and everyone will be happy in the end. But in terms of the different members that you’ve onboarded, you mentioned you have quite a few on your program, such as the silver sneakers. How do you think the cultural and demographic factors influence their behaviours? And how do you manage that in terms of that diversity?

Dr. Barclay:
So one of the things that CMS, the government organisation that manages Medicare, is focused on, and is especially focused on now more than ever, is the idea of health equity, and it’s of ensuring everyone has equal access to these solutions. And if you’re a supplemental benefit, making sure it doesn’t matter if you’re rural, urban, suburban, doesn’t matter if you’re 65 or 90, that you have the same access to these supplemental benefits. Health equity has become central to everything we’re doing. And so what we’ve noticed and what we spent the most time in the new normal understanding about our consumers, what those differences are. And we understood, just take one brief example of COVID vaccinations.

Dr. Barclay:
So our omnibus tracking covers things ranging from fitness to nutrition to social connection, technology adoption, and mental enrichment, and we also tossed in a few flexible questions around things like COVID-19 vaccination. We asked two critical questions. One is, who are those trusted sources of information for you? And what we found in the end was it didn’t matter if we were talking about COVID vaccination later, we were asking about things like care coordination. We’ve also asked about things like technology adoption. When it comes to trusted sources of health information, the very ubiquity of health info is crazy. But their trusted sources still just come down to three their health plan, their PCP and their pharmacist. And it doesn’t matter the topic, if it has anything to do with their health, they still stick with those three.

Dr. Barclay:
Why that’s important is then when we ask about something like code vaccination, we say, okay, great. So, have you talked to your doctor, and you’re going to go get vaccinated? They say no, and we ask why. And we get very different answers based on the person’s cultural background. Right. And it’s not just a race and ethnicity play, it’s a theological understanding too. Right? People’s very belief systems are tweaking how they’re approaching their wellness. And so much of what we’re trying to do is not just make sure that those who enter Medicare Advantage Medicare supplement through disability, as well as those who age into it at 65 are receiving an equal opportunity to stay well and to approach healthy aging with as many resources and tools as we can provide.

Dr. Barclay:
But it’s also understanding those nuances like a live virtual class; what are the other nuances that we need to take into account on preferences for communication, access to broadband, and access to an in-person community that might supplement when they’re not in the live class? What we find in working with our industry partners and our clients and the Hill alike, is not only do you still have only 15% of older adults that are meeting the CDC’s recommendations for minimum physical activity, the whole 150 minutes a week, and of rigorous activity, of moderate to rigorous activity, but we also find that what’s preventing folks from being as active as they want to their issues ranging from broadband access to various facilities to just a basic understanding of even how to log on to a Zoom meeting and take a class. Right?

Dr. Barclay:
And so even though now on average, roughly 40% of seniors are still are using virtual social platforms to connect Facebook and others, but the other 60%, it’s not just because they don’t want to, it’s because some of them don’t have even sufficient broadband access to do it. So when we continue to roll out our solutions, it’s not just continuing to improve on the experience in person, it’s ensuring that our in-community experience is keeping up our virtual experiences, keeping up at-home kits are keeping up. We’re providing as many different options as humanly possible for how the person wants to stay well while making sure that we’re also tweaking for things like accessibility and tweaking for things like technology preference along the way.

Dr. Barclay:

When we deliver these solutions to this very varied group, and as the last point on this, and not only has CMS said this, but Better Medicare Alliance and Healthcare Leadership Council and Physical Activity Alliance have all mentioned flavors of this. In this place, we play the most in Medicare advantage. It’s the underserved who are the fastest growing segment of Medicare Advantage. There were a lot of stereotypes about who signs up for Medicare Advantage plan at this point. Still, we now come to know from looking at the data long enough, the trends are pointing toward the underserved, minority, rural, low income, those are who are signing up for these plans at greater rates.

Dr. Barclay:
And when these plans are managing 16 1720 supplemental benefits under a Flexcard or a basketing system, and we’re just one of those options, it’s not only making sure that we are part of a very palpable, inviting, delighting experience from day one for that person saying, yes, I’m so glad I signed up for this plan that includes silver sneakers. It’s also ensuring that all of what they need to even get started is approached and solved for. And that’s so much of what we built our omnibus tracking around into the new normal was not just to understand who that consumer is, but also understand what those obstacles still are to consuming the very solutions themselves.

Ellie:
Right. And one of the interesting points that you mentioned very early on in our conversation was the definition of wellness and what that means for people. You mentioned that meditation is now considered part of wellness. Obviously, that has come about. The topic is now less taboo after the pandemic, etcetera. But it is. Do you think that within this group of people, the elderly, that has always been an issue? It’s only now that we’re talking about it and addressing it.

Dr. Barclay:
You know, it’s a really interesting point, and we’re still uncovering it. And here’s why we’re still digging in, because you’ve got at least two factors at play. First is even among the 65 plus today, you basically have two generations playing in there. You have the silent generation, and you have baby boomers, both that are in that 65 plus. So it’s not an even 50 split. Anyone who does the demographics on Medicare and on older adults knows that it’s not an even split. And baby boomers have really come in a much bigger wave. And in fact, the second factor that gets in the way of truly understanding sort of an aggregate, what’s happening here is there are only a few more years of boomers left coming into Medicare. By 2029, the last class of baby boomers will be entering Medicare.

Dr. Barclay:
After that, it’s Gen X. Gen X is going to be entering Medicare by 2020 or 2030. And so not only do you have palpable differences in consumers between silent and baby boomers? I truly believe those differences are even more varied between baby boomers and Gen Xers who, on one end, higher-tech adoption fitness was built in from a young age. Right. These were the days of all the one-off fun fitness options like steps and ab crunchers and all those as seen on TV devices that follow. Fitness was always a part of the Gen X life, and baby boomers, to a large extent, adopted a lot of that. But what will require a shift in how we engage, not whether or not when, but how we engage with Gen X.

Ellie:
It’s a reductive statement to make, but I think it’s an important one to make anyway. Gen Xers are more in denial of being classified as old than any generation before them. Right. It’s a little bit because, and I put myself in that category, I think it kind of caught up to us quicker than we thought it was going to. And a lot of that is sort of a number of these traumatic events that we’ve experienced. Right. Boomers had the wars, and we’ve had so many other things after. But it’s. What’s more crucial to understand is Silent’s different than Boomer. Boomer are different from Gen X, even just generationally.

Dr. Barclay:
And so then to understand the subcultures inside of boomers as it shifts to Gen X and understanding where differences in belief system, differences in race ethnicity, differences in geography, even regionally in the US, change the very perception of how something like fitness should even be consumed and whether it’s something top of mind that, yes, it’s not just about, are these topics less taboo and actually more part of a person’s wellness regimen? But then how do you introduce it to a new kind of older adult that doesn’t want to be classified as an older adult in the first place and definitely does not want to be treated like an older adult?

Ellie:
It’s a very interesting point, the differences of how to connect with different generations, a whole separate conversation in itself. But I want to touch a little bit about some of the trends that we’ve seen lately. And this is probably predominantly in the weight loss aspect, but the growing popularity of medical solutions. How do you see consumer preferences shifting between medication and preventative health actions?

Dr. Barclay:
Yeah. And so much of our focus has really been on the older adults. So our answer would be skewed. Right. Because even just summarising it all as biohacking or some neighbouring concept, this just isn’t something that older adults are open to. In fact, it wasn’t until this year that there was even a need to understand that the whole category was even part of any RFP process with any one of our health plan clients. And so to now understand that it is part of the conversation, that it is in the zeitgeist, whether fortunately or unfortunately, I don’t claim here or anywhere to support or to not. But it’s rather, it’s. We’ve studied not just brand preferences, but brand and behaviour preferences among older adults.

Dr. Barclay:
And what we found is for so many of the fealties, to brands, to services, to products that older adults established, they established them well before they reached this age category. And while I don’t have a specific age cliff at when all those decisions were made, I can tell you that for so many of the fealties, they claim they were far before they reached Medicare age. And so what’s going to be interesting for organisations like mine is to understand how much influence can something like this, assisting through more medical means to influence, say, Gen Xers once they start arriving in 2030? Boomers, it might be too late to have a palpable difference in trend. It might not buck the trend on what they’re looking for in the next three or four years. Right?

Dr. Barclay:
But Gen Xers are still young enough to claim new fealties and not be quite as stuck on brands, products, and services quite to the same extent as their baby boomer neighbours are. And there will always be opportunities to change the minds of boomers. The last thing I would claim is that they’re closed minded. That’s not the point I’m making. But the point I am making is I love Jif over Skippy. That’s a decision that was made many years ago and how I choose to stay fit. Do I go to Planet Fitness? Do I go to a YMCA? Those decisions were made a long time ago, too.

Dr. Barclay:
But because boomers moving into Gen X, especially Gen Xers, were one of the first generations to say what are the tools at my disposal to meet my goals, that’s a way of thinking that was thrust upon them differently than it was during the boomers and the silents. And so I think there will be more open for medical means to enter that fitness consciousness among Xers. And so we may not see an immediate trend shift for us, but over the next few years, I would be surprised if it doesn’t arrive interesting.

Ellie:
Before we wrap up, I want to talk a little bit about the future. In terms of the different stakeholders that we talked about, the consumer, the healthcare provider, and leaders in the insight space who wish to have an impact. As we talked a little bit about earlier, starting with the researchers, what advice would you give them? You mentioned earlier on about having other business solutions in mind besides looking just at their own domain expertise, but what advice would you give them when they’re looking to have an impact in society, whether it’s in healthcare or other verticals?

Dr. Barclay:
Yep. So it’s two things. One is because they need to remember, and this was something that it took me a really long time to learn. You’re in the conversation because of your domain expertise, so don’t spend so much time convincing them you know what you’re doing. You are wasting your time. They’ve already voted you to the conversation. It’s happened. It’s not about proving yourself at that point. It’s about contributing to the collective conversation you’ve been invited to. And that gets in the way. And I see it all the time. I really do. My organisation, other organisations, a more junior analyst, and a more junior researcher spend half of their presentation talking about their method, thinking that if I get my method presentation right, they’ll take action. It’s not about believing you know what you’re doing. They already know what you’re doing.

Dr. Barclay:
You have the job; you’re part of the project. Don’t worry about it. Focus on the insight. Don’t focus on what it took you to get there. And in fact, I’m sorry, but they don’t care. They really don’t. If you know you can rely on your data, if you know it’s good data, they won’t ask you how the sausage was made. Just focus on the insight and make sure that they hear it in a way that says, what’s in it for me? I’m the business stakeholder. I asked you to the conversation. Don’t tell me the p-value; tell me what you found and do it in a way that says, here’s how I know what to go do next or think next or stop doing.

Dr. Barclay:
The other bit of advice I’d have is all the way back to what we’re talking about with relationships. So it’s not networking. And I know most who would listen to this podcast would surely shudder at the very words mentioned. It’s not networking, although that’s important if you want to climb the ladder. That’s not what I’m talking about, but relationships, true relationships. Relationships where you understand your business stakeholders needs you understand their day-to-day, you understand what foxhole they’re in and what they’re firing at and who or what they’re trying to accomplish. It’s not just share a lunch, have a friend. That’s Joe. I love Joe and Joe loves talking to me. And Joe is running a very successful marketing organisation, but he still gets 4 hours of sleep at night because X and when he needs help, he’s going to call me.

Dr. Barclay:
Because we know how to work together, we know how to speak each other’s language. I know enough about his part of the business and I know enough about our business that when I then see something in our data from our consumers that can help, he knows I’m going to give it to him in a way that’s going to help his part of the business and help his team be successful. Those relationships go beyond simply making sure that you’re mentioned by name when a need comes up. And it’s that they trust that you have their best interest first. And so I totally get that. There’s, especially right now with AI, there’s this very rabid stereotype of data scientists and advanced analytics and research professionals don’t know how to talk to humans. That it’s crazy.

Dr. Barclay:
It is ridiculous and crazy and it’s hackneyed and it needs to end. It’s not about being able to give a good presentation, it’s not being able to have, it’s not about polish, it’s not, you know what you’re doing, you can actually give a stumbling presentation. But if it has immense business benefit and they can get that from it, you don’t have to be the greatest storyteller in the world. But I will tell you, solid domain expertise, storytelling ability, and a strong business relationship together, you are unstoppable.

Dr. Barclay:
And what about for the consumer who sees this trend of personalisations and wants better products that serve them as an individual better? But they’re also a bit fearful for how their data might be used. What advice would you give them?

Dr. Barclay:
Ask questions. Never stop asking questions. And so much of our research around older adult tech adoption says, I’m not afraid of the tech, I just want the education of how to use it and what it is. So it’s, I’m not afraid of smartphones. I don’t need some flip phone with giant buttons, right? That’s not what I need. Quit treating me that way. You tell me to download your app, and I’m saying, okay, just show me how to use it and what I benefit from it. But right now, the onus is on the product provider. The onus is on the solution provider. The onus is on the business to sort of guess at what questions need to be answered next and what level of education that consumer wants from us.

Dr. Barclay:
And it’s not me as a researcher being lazy, but it’s that we’re trying our best to read your mind, but we can’t actually read minds yet. We’re still working on it. So if we can’t do that yet, will you please just ask, be sure always to ask some questions around. How does it work? How’s it going to benefit me? Why can I trust this recommendation? What do you need to know from me to give me a personalised experience? And what are you going to do with that data? And please, please do not give it to me in a two page legal about how we will protect your data. There’s a place in the world for those disclaimers. And don’t get me wrong, I love my lawyer friends and their disclaimers. They’re very necessary because there’s nothing more important than keeping these data protected.

Dr. Barclay:
There isn’t because then we lose trust in the whole system. However, there also needs to be a consumer-friendly version of the explanation of what data is being captured and where it’s going. And I will say one thing that doesn’t get a lot of questions anymore, which I’m really surprised at by consumers, is this whole idea of cookies and how cookies are not even evolving but devolving at this point and how third-party cookies are sort of on their deathbed and that whole thing. So that will change the game for who gets to see what of somebody’s behaviour anymore.

Dr. Barclay:
And we’ve done well to communicate to each other on a domain level for what’s coming, but who’s really educating the consumer on what all that means for them, that the next time they go from ReI’s homepage to checking their Yahoo and they stop getting Rei banner ads and they go, oh, that’s nice. I wonder why that stopped. That doesn’t have to be a surprise for them. Yeah. But in the interim, until business figures out how to be more, not just, I mean, human-centred design has been around long enough that we now know how to merge it with insights, work, and product design. But until our communications think the same way, not just the product itself, our education around the product is working the same way. Just please ask questions. We’ll be happy to answer them.

Ellie:
Wonderful. We started the session with you talking about joining this industry and joining the company to have an impact. So, what impact do you hope to have in the senior health and wellbeing space in the years ahead?

Dr. Barclay:
Independence. And it really does come down to independence. So, so much of our research that’s future-focused, and that’s also been we’ve replicated others have replicated us on what are the motivations around healthy ageing. What are the motivations for around starting a fitness routine at 65, which is really scary, by the way, or starting a gym membership for your very first time when you’re 72? That’s an insane thing to consider, right? So just thinking about in general, what do folks want out of healthy aging? What is the chief motivation? Right. It really only comes down to a couple of things: longevity, independence, and purpose. And as long as those three things can be supported, preserved, and extended, that’s where not only am I hoping all of this ends up, but that’s what I and my team are trying desperately to continue to contribute to as well.

Dr. Barclay:
Don’t get me wrong, the new normal with a focus on wellness and 51% saying meditation is part of the definition, our boundaries are expanding, and that’s amazing. And AI is going to help us and augment that path, and we’re all going to be smarter humans because we’ve built smarter tools to support us. All of that is amazing. But if it’s not contributing to either longevity, independence, or purpose, older adults will get nothing out of it.

Ellie:
What a fantastic objective to end with. Thank you so much for this session, Doctor Barclay. It’s been fantastic having you on our podcast.

Dr. Barclay:
The pleasure was all mine. Thanks, Ellie.

About Our Guest