Interview with Michael Stollar from Hawaii Medical Service Association

Michael Stollar is VP of marketing and communications at HMSA, Hawaii’s Blue Cross Blue Shield health insurance company. I had heard about him because of the pioneering work he and HMSA had done with online consultations for Hawaiian patients and he kindly shared his experiences for my new book. Then I learned about his most recent work, this time pioneering social media with HMSA.

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Dr. Mohammad Al-Ubaydli: Welcome to the Patients Know Best podcast. I am here with Michael today. Michael, thanks very much for joining us.

Michael Stollar: It’s a pleasure. Aloha!

Al-Ubaydli: Aloha! Michael, tell us a bit about your background.

Stollar: Sure. Well, I have been with the Hawaii Blue Cross Blue Shield plan known as HMSA, Hawaii Medical Service Association, for the last 23 years. And prior to that, I was a Peace Corps volunteer in the beautiful Kingdom of Tonga further down in the South Pacific. And I am originally from the East Coast of the States, from Boston, and I am glad to be out here in Hawaii, particularly when February rolls around.

Al-Ubaydli: Well, then at another podcast, I am going to ask you about Tonga, I am guessing you have a ton of good stories.

Stollar: That’s wonderful.

Al-Ubaydli: But today, I was very interested in the social media work that you are doing with HMSA. Tell me what you are doing there?

Stollar: Okay. Well, first of all, we are in the middle of a transformation of our entire health plan here. Recognizing the sort of looming changes coming to healthcare in the United States and in preparation for reform efforts, in just our general strategy and understanding that the system is not sustainable as it currently is, we are looking to change ourselves and realign, with all the stakeholders in the sort of the healthcare ecosystem up here, so that we can end up with a more sustainable system.

So, part of that transformation includes changing ourself and we realize that we need to — as a major player in that ecosystem, we need to be more collaborative, we need more innovation, we need more creativity. So for me, of course, it fits the bill on many of those attributes very well.

So we’ve undertaken some tactics which introduce social media as a means of changing our own culture and then reaching out and changing how we interact with all of our stakeholders.

Al-Ubaydli: Okay, so it’s interesting to me because everyone says they want to do more innovation and everyone says they want to more collaboration, but you are actually doing this. So, what are you doing with, I guess, your patients, your providers, all of these stakeholders you are working with in social media what are you doing with them?

Stollar: Okay. Well, we are at different stages with different stakeholders and included in those stakeholders are our own internal employees recognizing that we have to change and sort of figure out how to deal with all of this before we just go broad based, across the spectrum of all those stakeholders. But let me give you some ideas of the different things we are doing with the different entities.

So internally, we have begun, we have introduced blogs, wikis and forums as pilot projects and we have just had an explosion of the information sharing and collaboration and ideas; some controversial, some not, everything from management practices to how to Go Green internally, to discussions on healthcare reform, to IT policies, you name it. People now have a means to talk about it and I think we had a lot of pent-up opinion out there that really had no place to go.

So the introduction of these tools, these three tools, initially has really led to a lot of good openness and sharing and that’s something we want to reward and continue to develop because our next step will be to take blogs, wikis, and forums out live to our stakeholders and to the community in general.

So, this has sort been a preparation phase with those tools. In two weeks, we are about to introduce internally an idea generator’s application from Salesforce and that then lets people submit ideas that lets other people vote on those ideas and comment on those ideas and it provides a workflow application for management to then vet those ideas and make sure that they get addressed and for those that are valuable to be implemented and for management to feedback to people on the idea generation.

We intend to take that out in public as well, probably in the second quarter of next year. We have begun twittering.

(00:05:15)

Al-Ubaydli: Okay, but what’s your Twitter ID?

Stollar: Well, we have a number of them.

Al-Ubaydli: Okay.

Stollar: So, we have number of them based on the subject, so we have one for our senior program called Akamai Living. We have, one for our discount program called HMSA365, we have one for our ‘Island Scene’ magazine which is a health and information magazine for all of our membership. We have one for health pass which is our Health Risk Assessment program and we are slowly moving into — and we are just tracking in general what’s going out on the Twitter world. We have those accounts and we are just slowly sort of some or more active than others.

I think the ‘Island Scene’ is particularly active, since it’s publishing articles regularly. I think it has a fair number of followers or at least beginning to get those followers and have real exchanges with them.

So, we are just, I would say, in the infancy, we haven’t yet, although we do have plans to have a general sort of customer service account out there. Not where we will service people, but we will help them find the right places to come into the servicing sort of matrix we have, simply because we can’t get into the service issues all out to public because of HIPAA regulations.

Al-Ubaydli: Sure. So, this is, instead of an employee calling their phone number, for example, they would start talking to you on Twitter and getting help that way or how does that work?

Stollar: Well, it works in variety of ways. On the service side, sometimes it’s just other people having exchange about, I wasn’t able to find a doctor or I don’t understand, maybe it’s someone else’s exchange that we can then follow up on.

For instance, recently, we have a group of teachers who left us as an account and we identified some conversations they were having and when they were able to come back to us, their leadership invited us back in as an option. We were then able to Twitter to these people who were interested in those conversations and address some of their concerns, answer some of their questions and guide them to other information.

Al-Ubaydli: It’s a really interesting example. So that’s for the members, I mean, you have mentioned also all the internal tools you have for the employees. So why do they find those useful instead of the water cooler (ph) or the previous chains of command they had.

Stollar: I think, out here we call it the Coconut Wireless, and I think it’s build very much in play. I think the advantage now is that one, more people can be involved. Two is, if management or anyone for that reason wants to get out a consistent message that isn’t sort of rumor mongered or you know the old telephone tree where everything sort of changes. These tools provide a leg up on all of that in terms of consistency and reliability. We have also, just before I forget, introduced a YouTube account or we have a YouTube channel, if you will.

Al-Ubaydli: You have a channel?

Stollar: Yes.

Al-Ubaydli: Okay.

Stollar: And it’s called HMSA Now on YouTube. And we have a variety of customer service videos, we have information about HMSA, we have information from other organizations about general healthcare topics, we have all of our video advertising, we have Teen Video Award videos out there, we have lots of different information and video for that is out there. Some of it, customer service related, and some of it, general health information.

Al-Ubaydli: I am just thinking on the site, you may have actually got quite a few videos.

Stollar: Yes.

Al-Ubaydli: And so, as your employees begin using all these tools, what do you advise them?

Stollar: It’s really interesting because we are, we have a small group of employees who are very anxious and very involved to use these tools.

(00:10:00)

We have a great silent majority of people, and part of it is just our culture out here. Hawaii has a very unique culture as you might imagine. Being loud and open is not part of that culture. So for some people, it’s been a challenge to get them to open up to share opinions, and one of the things we did do as a starting point internally was we allow people to post on the blogs, just the blogs anonymously for now.

That seems to help. There is a lot of people who now post in such a way and there has been a lot of discussion actually about, is that valid, should we allow that. But right now, we figure that it’s the best way to sort of get people used to sharing their ideas and opinions. We have had some controversial topics, and it was fascinating to see how the crowd or the masses of people sort of reacted and controlled the subject.

I think some of our senior management, initially when the controversy rose, was a bit concerned. I mean, we sort of theoretically knew we would face this some day, and it popped up fairly early, and —

Al-Ubaydli: It always does.

Stollar: It always does, and it was handled beautifully by just people in general and management didn’t need to do a thing.

Al-Ubaydli: That must be interesting for management to witness but it took care of itself, I mean it’s a tool that can be used to take care of other problems in the future.

Stollar: Absolutely. There is a lot of people who support, are very supportive of what we do, and they jumped right on the issue and they sort of isolated and made arguments. We just have to sit there and watch what happen, and have faith that it would happen.

Al-Ubaydli: Are you able to share, because I don’t to ask you to discuss something that’s embarrassing to the HMSA. Are there any details you can share about that or I can move on to my next question?

Stollar: Well, let’s just say that we have folks coming from the mainland who have a very different perspective on work and relationships and how things get done.

Al-Ubaydli: Is it the 00:12:39.

Stollar: Yeah, three years in Tonga took care of that.

Al-Ubaydli: Okay.

Stollar: But, mainland folks who tend to be more brash and open in your face, and they made some commentary about the local approach to things and it really was right at the edge of where they should have been, but people jumped on it, and they address the issue.

Eventually, the individual apologized and I think came to a better understanding of how things are done here in the way to get things done here. So that worked out really well.

Al-Ubaydli: It’s very interesting. I remember here about the CIA have their wiki and they created their wiki so that any CIA employee, who is working in a different part of the world, they can kind of quickly understand the local culture. I think the big part of it was that they allowed anonymous editing.

So that people can speak and say things that would be normally embarrassing to say, but actually quite important for you to understand. Apparently, it’s tremendously useful now to keep it at all levels. Everyone finds it very useful, but precisely for that kind of group editing.

Stollar: Yeah, I can believe that. It’s really quite helpful. We’ve had less controversial issues come up when we get that same sort of editing. Another example of our cultural hesitancy to be out there and be open and then you face — we tend to have several times a year, a couple of large management meetings with our strategic or tactical planning or review. In our last one, we introduced a wall, a texting wall, where people could —

Al-Ubaydli: Oh I see, (Voice Overlap)

Stollar: Yes. So during the meeting as speakers were talking or discussions were taking place or exercises were going on, people really opened up, up on the wall which, of course, is anonymous versus — because maybe they weren’t so comfortable expressing that verbally.

(00:15:06)

So at the beginning, I mean that’s not where we want to be long-term, but it’s a beginning of people building some trust in the tools and in how I believe management is going to react to different ideas. I think there had been a more traditional, paternalistic sort of management approach that’s part of our cultural transformation, because if we can’t do it internally, how are we going to do it externally to change the healthcare system.

Al-Ubaydli: So, what have you learned from watching the employees in management use these different tools?

Stollar: Well, I think, first and foremost is what we’ve touched upon already is that you can trust in people. I think, secondly, that the number — that there is a tremendous amount of creativity and energy that if we can just sort of harness it properly, is going to just lead progress forward, and that it’s been sort of dormant or we’ve made it dormant, but it’s there. Now it’s time to unleash it and just figure out how to do that properly. I think that’s the most exciting part of all of this.

I believe that then feeds a changed mindset for people and makes us very attractive place for younger generation to come to work. That’s something we’d like to achieve as well. Ultimately, prepare us in such a way that we will be flexible and creative enough and fast enough to deal with just this grade unknown, we’re all about to enter into with healthcare.

Al-Ubaydli: Yeah, that’s a huge mandate. It’s been funny watching things ever from the UK. I was in the States after a year ago. But when you guys have debates, you guys seriously have debates. Are you ready in place watching it?

Stollar: The way our media channels now are all sort of so politically out there, it’s — I’m impressed that you called them debates not as yelling matches, although parliament is pretty interesting too.

Al-Ubaydli: (Voice Overlap) I think the parliamentarians are supposed to take pride in their politeness, but I haven’t witnessed it.

Stollar: You haven’t witnessed that, yeah.

Al-Ubaydli: I haven’t. I think, it’s just kind of obnoxious to each other. But let me ask you, I was going to ask you about when using social media, what do people worry about that they should not bet — I think, you’ve already begun answering that by management, for example, thinking they all do intervene, but actually, the problems begins to solve themselves.

Stollar: Right. I think that’s true. I think, the next — we’ll take it up to the next level of worry, if you will, as we go public. So, as you know, health plans are pretty easy targets for people. We pride ourselves on the fact that we’re a nonprofit. We pride ourselves on the fact that we have a very low, probably the lowest, if not next the lowest operating expense of any health plan in the country.

So we pride ourselves on all those things, and think we have a model that others could follow on how to do it right, but that was still a target. So when we go public, we know, and I think there is some trepidation that we are going to get hit with the usual accusations and unhappiness of certain element of people.

I think, one need to be and will be prepared to address those issues and concerns and do it in such a way that then we can move on to, hey, there are other ideas out there. People want to share ideas. They want to talk about subjects and not just be out on the attack all day. That’s the chasm we want to leap over and get to, where we really are now having meaningful exchanges.

We’re helping people solve problems, they’re helping us solve problems and it’s a real collaborative effort. Other things to be afraid of, I think, we are feeling pretty comfortable right now with social media. I think, we still have a long way to go in terms of using it to its fullest.

(00:19:59)

Particularly on Twitter, we just need to learn how to go from being a corporate entity to having a real human voice and personality on the other line or on the other end of the account, because for so many years, it was just here as a corporate response and nobody wants to deal with that. They want to deal with real humans and real ideas and real exchanges and culturally, that’s one of the things we have to continue to work at.

Al-Ubaydli: It’s interesting when you mentioned that kind of text that will inevitably come and to get public, but I’m reading about that there’s a nonprofit that was documenting on the Google Map and ever saying that your government employees are doing it. So they fill that portal here, they picked up some garbage there. And thing is people who are looking their websites, I mean they’re going to the websites to kind of document the things that weren’t being done. But actually, they come over and I think they actually — I wasn’t aware that my government was doing that. I wasn’t even aware that they were doing stuff all day, everyday.

So you kind of hear about health insurance companies always and they did not need coverage. But actually, I think that if you kept up the public, it will become transparent to people, just how much you do everyday and how much work all your employees are doing everyday.

Stollar: I think that’s a great point and we have a push on transparency and I think that if we do it well, people will see the very things you’re talking about. I think we can make the case easily and show them quantitatively, set denials are not part of our business model and that people are actually trying to help improve the health and the lives of people here and show them all the work that’s being done. So, I think you make a great point.

Al-Ubaydli: So, let’s get to question nine. I mean what should people actually be worrying about that they tend not to at the moment when they were 00:22:02 new to this?

Stollar: I guess it would strike me as you need to have managements stay in the course. If you’re going to buy into this as a strategy and not just technology for technology sake, we’d have a little bit of that and that’s been something we’ve worked hard to overcome. It’s crucial that if you dive into it, you have to really work to stay the course, you have to believe in it, you have to put the resources on it to make it successful.

It maybe difficult, especially for the financial people, to see the initial return and sometime — you have to start talking and things that are different than return in different ways. I think you have to start talking in terms of expectations, in terms of the change in society and the comfort level of people in general with the new tools and that if you don’t begin to take advantage of these tools to fulfill your strategy, you will miss an entire emerging market segment. I think that’s something to worry about. It’s — yeah, go ahead —

Al-Ubaydli: Well, I didn’t ask you at the beginning, I do apologize. But is your role in — as one of your many of roles in HMSA to actually train people how to understand these issues or are you just a captain who’s maybe been charged with using the technologies? How is the organization going to –?

Stollar: I would say, I’m a bit of both. So, our job is to make it so that people understand the issues and that the issues both with the technology and the issues we’re dealing with in healthcare, internally and externally, as well as just keep pushing a little bit on the envelope here on what we’re doing and how we’re doing it.

Al-Ubaydli: I think it’s pretty cool. Advancing, I 00:24:17 really interested in what you’re doing.

Stollar: I guess the only thing I didn’t touch on was some of the other tools we’re using, we’re helping departments here develop their own video capabilities. We’re moving into more shared meeting and streaming of events out to all our employees. So if we have a speaker come in, I mean those are applications, you mentioned some of the external stakeholders.

(00:24:52)

Having some of our trainings that we hold and some of our presentations, particularly for the physicians and being able to stream those, because it’s very hard for the physicians to get away, being able to stream those and/or capture those as whether they are video capture or PowerPoint captures or podcasts or just any other media where physicians at their convenience can go and get this information.

That’s something that we intend to move into very strongly and similarly on the employer’s side, but that often takes a lot more — that’s easy to do just during the business hours of the day. So, I think there’s a tremendous amount of application for our physicians who just can’t get to these things during regular business hours.

Al-Ubaydli: Yeah, I think they have been 25:43. So you’re actually pushing teaching materials to practicing clinicians about dealing with it, is it on how to deal with HMSA or CME (ph) products or what is it?

Stollar: Yeah, it would be two things, it would be both issues of how to deal with HMSA, so sort of the administrative issues, how to file or whatever new things are coming. But it would also be things that would relate to issues on care delivery, evidence based medicine, changes in delivery models like the patient side of medical home, all sorts of information that we can put out there to help people understand where, how things are evolving and what’s changing, at least, from our side, and putting things out for input on their side in the delivery system.

Al-Ubaydli: It’s really interesting. Michael, this has been great! Thank you very much for you time.

Stollar: It’s been a pleasure.

Full transcription provided by Tech-Synergy

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