Marketing Mondays Podcast – Health Information Accessibility and Marketing with Amanda Krupa

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Andreea Borcea:
Welcome to the Marketing Mondays podcast, where we explore how we can make your offerings stand out in the health and wellness space. Through conversations with thought leaders and innovators in health and wellness marketing, we’ll discuss marketing best practices, case studies, and innovative ideas to help scale your business and grow revenues with impact. I’m excited to be your host. My name is Andreea Borcea. I’m a fractional CMO and owner of the Dia Creative Marketing Agency.

Andreea Borcea:
Thanks, everyone, and welcome back to another episode of Marketing Mondays. I’m your host, Andreea Borcea, CMO of Dia Creative, a digital marketing agency that specializes in health and wellness startups, small and medium-sized businesses, and making an impact through marketing. Today, I’m super excited to introduce you to Amanda Krupa, who is the director of communications and marketing for AHIMA Foundation. Thanks for being here, Amanda.

Amanda Krupa:
Thank you so much for having me. Happy to be here.

Andreea Borcea:
Can you tell us a little bit more about the AHIMA Foundation?

Amanda Krupa:
Sure, AHIMA Foundation is the 5O1(c)(3) nonprofit foundation of AHIMA, the American Health Information Management Association, a membership organization that health information professionals can belong to. Currently, there’s about 70,000 members across the US and globally that belong to AHIMA. The foundation has a very storied history, it started in the 1960s, essentially as a library back when medical records were paper, and has really chronicled the journey through medical records and the transition to electronic health and health records. So when I started in this role in March, I was so fascinated by this history, because the job of a medical record librarian was the first job for a woman that wasn’t at the bedside in a hospital back in the twenties. So if any history buffs out there are interested in learning more about that, that’s kind of where AHIMA got its start. The foundation went into a little bit of a reinvigoration. It has this wonderful mission of health literacy for health equity and helping people access their medical records and learn what all that is about. And in 2022, the big focus is on access, because if you don’t have access, you can’t get to a place of using and understanding your health information for better health outcomes.

Andreea Borcea:
Definitely, health access has, I mean, historically speaking, right? Health access has been very much like at arm’s length, like only doctors should see the medical records and then it feels like more in the last couple of decades, people have become more empowered to understand their health, to actually dig in and have, at least get more access. Is it still a quite a bit of a struggle to, for people to get that access?

Amanda Krupa:
I think so, and the biggest hurdle for the access part is the awareness and the understanding of what your rights are as a consumer, as a patient. And we have made some wonderful infographics through the foundation on patient rights to their health information with steps on what you should be doing and what you do have access to. For example, say your parent dies and you want to access their medical record for history, or you have bills that are being sent. What are your rights as, with power of attorney and things like that? So helping everyday people in everyday situations where you might need to get those records for a different doctor, a different interoperability situation. So one of the biggest challenges, though, that we recently did a project, a couple projects actually, were specific to website accessibility and what that does for older adults, patients with various types of disabilities. If their hospital website and or patient portal is not designed accessibly to meet their needs, then they’re not able to access it, they’re not able to access the information on it and or use it. So we just put out an issue brief on this subject, and it talks about key findings from an audit of over 100 hospital websites from the US News and World Report, top hospitals, and an audit of them and the findings from that. And then also what I find most compelling is we worked with an organization called Nobility. It’s a non-profit organization that is really focused on digital inclusion to get insights from actual patients of various types of disabilities, cognitive deaf and hard of hearing, vision, all of the above. So we were very diverse in responses to understand what their experience has been when trying to access their health information and going to a hospital website. Because we all know that if you have some kind of a health issue, you’re using the system more than others. So we have wonderful stories, wonderful quotes. They’ve all been very gracious in the findings from that are also in this issue brief too. So I’m hoping that this is kind of a starting place for getting more awareness on this issue to hopefully inform decisions at the policy level and the institution level for hospitals to take on this work as part of their diversity, equity, and inclusion work, their ESG work. You know, it all starts with a small workgroup at the hospital who are involved. And there’s a lot of, I know from my years of working on websites, there’s a lot of hands involved in that, and it takes a team to do it right.

Andreea Borcea:
Definitely, the web accessibility thing is coming on people’s radar more and more. You know, a lot of the clients I work with all of a sudden are just like, we want to know about accessibility plug-ins, we want to know what accessibility, we want to know. Because I think the, it’s becoming such a current topic, and especially coming from a marketing standpoint, you know, we put all this time and effort into what we’re going to write and how we’re going to write it and what the experience is going to be, but it doesn’t matter if there’s a portion of the population that can’t even see it, right, or can’t experience it in one way or another.

Amanda Krupa:
And sure, for sure.

Andreea Borcea:
And I think from like an e-commerce perspective or like retail businesses, they’re really driven to make sure their site’s accessible because that stops sales. But hospitals, I think, ironically, might not prioritize it as much because there’s just so many other things to focus on. Is that what you’re finding?

Amanda Krupa:
I think so, we also are finding that it’s very diverse in where accessibility falls within the hospital, where they see it. By law, hospitals have someone designated as an ADA coordinator. They might not have that title. It might be 20% of their job, but they have to have an American with Disabilities Act someone there. And often that person is responsible for finding an interpreter or things of that nature. But from a digital accessibility perspective, having one person assigned with that job title really is a new thing that we’re seeing industry-wide on this scale. But I think arming someone in your organization, upskilling them to use a term that’s common right now with the skills and core competencies on web accessibility can really allow them to champion this work in addition to their other tasks. So maybe that is a health information management professional because they already have a compliance and privacy background and understand the laws and legal aspects of this, and can really champion that side of the work. Maybe it also, it needs to be your marketing, your communications people, your developers, of course. I think, you know, working in this industry, in health communications, we often see that a lot of this work is outsourced to agencies. And you’re just paying them and you’re getting back the materials, you’re getting back graphics and images and content. And then there’s somebody who it might be their role just to put it all up there. Without even thinking about accessibility and the site itself. And my co-author on this work, Jill, worked on this issue brief, it was also at CDC for quite a while, and we talked about the nature of branding. Your brand might not be consistent with accessibility guidelines and hospitals might be, you know, at a rock and a hard place with that.

Andreea Borcea:
Yeah, but I do remember studying quite a bit and we experienced this issue when even like I said, going back to like e-commerce or retail we were trying to sell to people. Once you get past a certain age, there are certain colors that are harder to see. And so you avoid yellows if you’re, if your target market’s over the age of 65, and we did that, like I said, motivated by the chance of selling. When you’re communicating this, is it a similar thing where you’re trying to go to that end user to convince them to put pressure on the system kind of the same way with like traditional e-commerce or is it more this internal fight, like working with those healthcare information professionals or senior leadership? Like where do you even start?

Amanda Krupa:
You know, I think there’s already a large patient voice advocating for this. But hospitals are already so strained for funding and money and workforce. You know, what, I think, you know, there could be, we could see a need for that position to be the chief diversity equity and inclusion officer to champion this work in their priorities. And maybe that person who has that title also is somebody with a privacy and compliance background. So it’s very diverse in healthcare as far as where your core competencies lie and how you got to the level you are, but it needs to come from within for this work because everything is so siloed and every hospital is so different. And you know, your rural hospital, I’m thinking especially, that’s why we focused on the top hospitals in this research, because if they can’t get this right with all the resources they have, what is the possibility of rural Oklahoma and rural Texas getting it right?

Andreea Borcea:
Yeah, you have to drive by the people that are well-funded, and then you’ve got a reason to say, well, let’s help out those that that can’t afford it, but how important it is, and everyone needs that kind of accessibility. When you’re working with this, is it more the website content, or are you also digging into like EHR experiences?

Amanda Krupa:
Well, there’s only so much within the control of the hospital itself. So the HIM professionals are often in the position where they’re purchasing third-party products for the hospital, such as an EHR, or they’re managing that relationship in some way. So, you know, some pressure needs to be put on the third-party vendors. Who could then do work to make their product accessible? And my guidance in marketing and comms is, if you are shopping around for any kind of product, we often, you know, if you’re an in-house role, you’re working with agencies and contractors and getting pitches from all of them, make accessibility one of the questions you use when you are vetting all of them, what does their product look like? What does their CMS look like? Any kind of work you’re doing, make sure that there is somebody on staff who knows what those core competencies are. And one organization I want to plug is the IAAP, the International Association of Accessibility Professionals. They have this wonderful credential in core competencies, and if you’re hiring for somebody to lead this work, I think that it would be better to look for somebody that has that credential because then, you know, for sure they know what they’re talking about. And I think there’s also some bias in thinking that this is only a developer’s type of job, right? It’s not because we know as healthcare marketers and communicators, we are the ones directing this work, and we have the power to then make those changes. So let’s not put all the onus on them. I think there’s a lot of inter-departmental work that can benefit from education in this area. But from a marketing perspective, especially for healthcare, I’m not sure how much you’ve heard about the price transparency laws coming about, and we’ve joked about this internally that, what is that going to look like at a hospital? Is it going to look like an e-commerce situation someday where you’re saying heart surgery, this much money, credit card?

Andreea Borcea:
That’d be incredible. That’s a whole different experience that, than anyone, but, you know, it’s an experience that customers are used to. You know, I think even if you’re booking a service like a masseuse, you’re still used to being able to go to the site and see what that costs. And even if it’s not a full e-commerce experience, although that’d be that’s hilarious, though, and then you could schedule it right there, just show up and get it done.

Amanda Krupa:
Convenience, convenience, we all want it.

Andreea Borcea:
Well, I do want to call out, though, like ADA doesn’t have to be something that’s intimidating, right? Like, I worry that, same with this price transparency, that people put this accessibility in the same bucket, like, oh, we’re going to have to think, we’re going to have to change everything and do all these things. But I think there’s so many new startups out there with technology that make your site accessible with very little effort on your part. I think you just have to be aware and make the effort to engage with them or, like you said, talk to an agency that keeps accessibility in mind.

Amanda Krupa:
But having a baseline knowledge yourself. And that’s, I mean, reading some articles really, that’s awareness of the general issue at large and how it affects people. Because often I think that if it doesn’t affect you personally or you have some sort of connection to it, you might not truly understand, you know, until you’ve seen somebody who had that vision difficulty or a hearing difficulty trying to access a website and what that actually means and looks like. We have census data showing that the population in the US is going to be trending to be extremely older. So we’re surveying all of these people that are above age 65. And what does that mean? We know, I mean, I think people come to think that this is only about disabilities, but our abilities fade with age. I mean, it’s just a matter of fact. So how are we going to meet the needs of that population years from now, and what work can we do now to set the stage for that?

Andreea Borcea:
Yeah, I already don’t like small text, so I’m getting there. I’m not even near that age group yet, so I get that. Well, how exactly did you get into this work? Like, let’s talk a little bit about how, where you started, and what made you want to go work for AHIMA Foundation.

Amanda Krupa:
Sure, well, I’ve been in Health Communications for about 15, 16 years, and I started my work after grad school. I went to Boston University and got my master’s in health communications. And then I did a year after that at the University of Chicago. I have a certificate in medical writing and editing as well. So I went and worked for some nonprofit organizations. One of them was Super Sibs, supporting siblings of children with cancer, and handled all the communications and marketing for that program. It was primarily funded by the Center for Disease Control and now is a part of Alex’s lemonade stand for childhood cancer. It’s a wonderful, I loved that work. And then I went to Pathways Awareness Foundation, which really exists to promote early recognition of delays in motor speech, all kinds of early delays that you might see in your baby so that you can get support and help early on and really, producing a lot of parent education content on milestones, and they also do some continuing medical education for providers who often don’t get this type of specialty in their curriculum, especially family medicine providers who have to know about so many things and pediatricians who maybe only do a 3 to 6-month rotation in developmental-behavioral pediatrics. So it’s a wonderful organization, loved my time there. But when I was there, then I got an opportunity to go work for the American Academy of Pediatrics. And I started in this pilot project called HealthyChildren.org back in 2011, and it is now one of the most traffic websites, it gets like 10 million page views a month. So, so proud of the work there. I was there for over eight years as the editor of that website and I could probably go on huge tangents about how proud I am of everything that is healthychildren.org and nerd out with you on AAP forever. And then I, my son was diagnosed with autism and I left and focused on him for a bit and the pandemic hit. And I said I’m not a nurse, I’m not a doctor, what can I do with the skills I have? With how many years at AAP doing vaccine communications and education and all of that? So I got an opportunity to be a consultant for the CDC on the COVID-19 Vaccine Task Force, And I was on the web content team, and I was also on the pediatric vaccine implementation team. And it was an unbelievable experience of learning, I never felt like I worked with smarter people in the world than I did during that tenure, and I will go probably go down saying that because it’s just the smartest caliber of people I’ve ever worked with, ever. And, you know, I then saw this opportunity as the response was going back into program. The CDC made some different organizational changes, and I saw this mission for this organization, health literacy for health equity. And I was like, that’s everything I’m about, I love it. Yes, … I love it, I want in, I love the mission. So that’s what led me to AHIMA, and I think this is a wonderful project. I’ve been able to spearhead this work and part of my background in working on websites forever back when web content was like a new thing in the world and websites were terrible, seeing the progression of that and the change, I’m really proud of the research we’ve been able to do in such a short time to kind of further this initiative. In the back of my hat, I’m also thinking, you know, having a son with autism, I want him to be able to someday benefit from this work and be able to be independent and have, if he uses a screen reader, is that going to be able to make sure that he can then take care of his own healthcare needs in the future? So, you know, you get a little bit mama bear on some things because you want to make sure your child can be independent and be self-sufficient and what barriers exist preventing them from doing so, and I think that this is one of them.

Andreea Borcea:
That’s a really powerful driver to be honest, like the mama bear, everything because, everything you’re doing for your own kid is something that impacts millions of other people, right? And so if that’s the driver, then that’s a great driver. I love your journey. I feel like the, every step of the way you’ve made an impact on education and getting health communication out there. Do you feel like the majority of communication has to be education for health and wellness and, or is it a bit of that marketing focus to like, how do you get people to pay attention so that they read what you’re writing and trust it as a resource?

Amanda Krupa:
Well, I think there’s a fair bit of psychology involved as any marketing 101 course will tell you, you have to appeal to everyone as people first. And if that’s a behavior change aspect, what I’m very much a fan of is storytelling in communications and marketing, because people identify with that. We see that on social media, with likes and shares and when you feel like you can connect with something that you read or you watched in a video, you’re more likely to share, because if you identify with it personally, or you’re sharing it and then retweeting it or making a comment about something that happened to you personally, I see this a lot. And then there’s a fair bit of, you know, people are also afraid of things they don’t understand. And we see that a lot with COVID, and we’ve learned a lot about misinformation and the amount of work that needs to happen to get people up to par on health literacy because there’s, you know, there isn’t laws like there are now or there still isn’t in terms of what are people getting in school, in K-12, in terms of health literacy and their ability to think critically and review content when it’s being out there and share things, because in digital that is so important for marketing, right? How your message is being shared and communicated. We often don’t have control over that once it’s out there. So it’s a challenge that we all have to face in our field as technology has evolved. And I think that there’s been a lot of creativity done with TikTok videos and younger people getting involved in advocacy. You can see, you know, a lot of the testimonials in the campaigns using actual stories of actual people. At the grassroots level, like, I’m your neighbor, I’m here and I do this and I am telling you to do it too. I also really like a strategy where, we used it at the American Academy of Pediatrics a lot, where we say, I’m a mom and a pediatrician, so I’m not talking to you as big brother, I’m talking down to you as a scientist, I’m talking to you as a mom first, because we’re all people first. And for marketing. I think that that can be replicated in a lot of different ways. And as you read content that is published in various mediums, journalism and whatnot, editorials, op-eds, you’ll often see that strategy done, as you know, as a lawyer and as whatever. And I see this in submissions I’ve gotten over the years where people do reflect in their writing back to a personal experience to help get a message across. So regardless of what your title is, I always recommend, write as a person first and write from your own experience, regardless of whatever it is you do for a living.

Andreea Borcea:
Yeah, it’s that relatability that I think a lot of people are missing. I get the sense that a lot of medical institutions go back to the business of medicine or the science of medicine, but that relatability is probably the biggest lesson they could learn if you really want to access exactly who you’re trying to reach in that sense. So along those same lines, where do you see marketing communication going in the next 5 to 10 years, and what would you advise for anyone listening on how to better get there, better prepare for the future we’re heading into?

Amanda Krupa:
Well, I will strongly say that if you want somebody, if you’re going to claim that you are an organization focused on providing equitable care, equitable content, and you have a chief diversity equity, and inclusion officer, prove it. Prove it by making your website accessible to everyone, just like you would make your steps of your front doors at your hospital. The same with where it’s going, ask your kids. My oldest is in fifth grade and I’m always fascinated at the latest and greatest on YouTube because it seems like they, all these kids want to be YouTube influencers when they grow up. So think about the role that influencers are going to play in getting your marketing and your message across. And that goes back to the storytelling aspect that we talked about already, because that’s really the trend that we are seeing, at least in reaching that younger population. Now, Facebook tends to be that thirties and forties demographic like myself. I would look on the demographics, on the traffic and it’s also how largely female as well. And we, that is consistent with a lot of the findings showing that women are the caretakers, are in their families, are the ones telling their husbands you need to go to the doctor, you haven’t been to the dentist, you haven’t done this. When’s your appointment, Dad? You know, so think about the role in your marketing to these women as they age and then reaching them younger with these messages, you know? Women in their forties are often caring for, or managing the care of a parent in their seventies. So think about the role that they play in your marketing locally. At the local level, there are so many options for geotargeting and I would really like to see that done more on social in the ads to make them more, we’re relevant. Also, voice search. We all see it. A lot of people do it now, especially kids. Is your content optimized for voice search?

Andreea Borcea:
Yeah, that’s a great call out. I think it’s something that a lot of people forget, which is funny because they probably go home and then talk to their Alexa or their Google and then totally forget that that’s actually a really great opportunity for them. That’s …

Amanda Krupa:
I also think, you know, from the, as someone who’s worked in nonprofits the majority of my career, I can also see the value that corporate has in partnering with nonprofits. So really working to establish partnerships locally, nationally, if you’re a big organization and putting that money where your mouth is and saying, hey, this is what we are passionate about, we are going to put money into this, whether it’s research, whether it’s direct services, whether it’s community-based care. I think that’s really going to move the needle in helping, you know, especially small nonprofits do good work in the communities.

Andreea Borcea:
I love that idea. I think so many corporations and larger organizations are starting to realize, yes, accessibility is important, also social responsibility. But then, like taking the effort to build out your own social responsibility department or think a better way, easier. Just find a nonprofit you believe in, partner with them, and they become that extension and they’re doing all the work, they already know what they’re doing, they’re an expert and that seems like a great, great way. I think the only other thought I came up with as you were talking is I love that you called out influencers. I’m sure everyone by default is just like, oh, an influencer is someone that dances on TikTok, and that’s not true.

Amanda Krupa:
Okay.

Andreea Borcea:
Doesn’t has to be. There’s a lot of influencers out there that are doing fantastic educational content on TikTok, on YouTube, on LinkedIn. There’s moms that are just giving out great advice and building a community of other moms that relate to their life. And that’s also a fantastic influencer to work with in these situations. … somebody just doing dances and pranks or something like there’s a lot of opportunity here.

Amanda Krupa:
I actually wrote a big piece on that topic for Care.com. I get a fair amount of journalism as well, and for different outlets. And talking specifically about TikTok and the amount of seniors that are on TikTok and following hashtags that are, like you said, providing health information. And there was a few that that are categorizing, somebody’s journey with dementia and they are a caregiver for a parent and their journey with dementia and giving tips. And some of them are humorous, some of them are just day-to-day like this is helping me and we’re playing a card game, and maybe it’s a great strategy for you too, you know? And things like that I think are really helpful, especially with everyone, you know, at home, depending on your situation, if you’re not able to get out much. Digital has been a wonderful way to build that community and share those kinds of educational resources. So using influencers, but use them, be selective, don’t put money. I think a lot of these agencies go with, you know, giving money to celebrity-type status, look for accounts that are genuine and giving you actual, credible, unsolicited health advice, care advice, wellness advice. They’re out there, you just have to find them. Don’t go for maybe what’s trendy, try to amplify somebody doing really good work.

Andreea Borcea:
Yes, that’s, I love that call out. I think that’s so important. And just like you were saying, a lot of the influencers that would probably be in this target demographic are both caring for senior parents and children. So that gives you a whole range of healthcare information and advice that you can give that they can help get the message out for you, that’s fantastic, I love that. Well, Amanda, thank you so much for joining. I’ve had an absolute pleasure. Once again, this has been Amanda Krupa of the AHIMA Foundation. How could they find out more information about AHIMA?

Amanda Krupa:
You can go to AHIMAFoundation.org and follow and like @AHIMAFoundation on LinkedIn, Twitter, and Facebook. Thank you.

Andreea Borcea:
Spoken like a true marketing professional throwing in the socials, I love it. That’s awesome. Thanks again. I have been your host, Andreea Borcea, CMO of Dia Creative. Join us again next week.

Andreea Borcea:
Thanks again for listening to Marketing Mondays. If you have any marketing questions at all, feel free to reach out to me directly at DiaCreative.com. That’s D I A Creative.com.

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Summary:

You need access to use and understand your health information for better health outcomes.

In this episode of Marketing Mondays, Andreea Borcea has Amanda Krupa, director of communications and marketing for AHIMA Foundation on the show. Hospitals and health systems don’t have website accessibility as part of their top priorities, which, in addition to a lack of awareness and understanding, makes it hard for consumers to access the information they have the right to have. Amanda explains how the increase in accessibility, diversity, equity and inclusion with the help of certified professionals is present in hospitals and health systems, especially in the teams in charge of digital content. She talks about marketing having a focus on making equitable content for better accessibility with the use of relatability and storytelling, something figures like influencers might play a role in the future.

Tune in to this episode to learn from Amanda Kruppa about health communications and marketing helping people access their health information!

About Amanda Krupa:

Amanda Krupa, MSc, is a public health communications executive, certified medical writer and editor, and digital content strategist with over fifteen years of experience at the national level. At AHIMA Foundation, she currently leads communication and research efforts to further AHIMA Foundation’s Health Literacy for Health EquityTM initiatives – including spearheading a project to improve access to electronic health information for older adults and people with disabilities and founding the Health Information History Center. During the pandemic, she served as a health communications specialist on the Centers for Disease Control and Prevention COVID-19 Emergency Response as a member of the Vaccine Task Force web content team and pediatric vaccine implementation team. She is best known for her work at the American Academy of Pediatrics where she served as the Editor of HealthyChildren.org for over eight years. Her work as a health and medical journalist has appeared in a variety of national media outlets such as Forbes Health, PBS Kids, Business Insider, and Parents magazine. As an independent consultant and advisor, her clients have ranged from national nonprofit organizations, marketing agencies, health tech start-ups, and pharmaceutical companies. She holds a Master of Science in Health Communication from Boston University and a post-graduate certificate in medical writing and editing from the University of Chicago. Her Bachelor’s is in English writing from St. Mary’s College or Notre Dame, where she also studied theater performance. She lives in the Chicago area and has three children. Follow her on Twitter @amandakrupa.

Things You’ll Learn:

  • The American Health Information Management Association Foundation is a membership organization that health information professionals can belong to. 
  • AHIMA’s mission leans towards increacing health literacy for health equity and helping people access their medical records.
  • By law, hospitals have someone designated as an American Disabilities Act coordinator.
  • Once you get past a certain age, there are certain colors that are harder to see, so avoid yellows if your target market is over the age of 65.
  • If you’re looking to hire someone for web content accessibility, professionals from the International Association of Accessibility Professionals have credentials with core competencies in the subject.
  • Create content as a person and from your own experience, using storytelling and relatability to your advantage.
  • Digital content has been a great way to build community and share educational resources.

Resources:

  • Connect and follow Amanda Krupa on LinkedIn and Twitter
  • Visit Amanda’s Website!
  • Follow AHIMA Foundation on LinkedIn, Twitter, and Facebook.
  • Visit the AHIMA Foundation Website.
  • Read Amanda’s Article on TikTok for Seniors and Caregivers here!
  • Visit the Dia Creative Website for solutions to any of your marketing needs.