Jennifer Colamonico
Welcome to HMA’s Vital Viewpoints on Healthcare. Concise conversations with experts that identify practical solutions to make healthcare and human services work better. I'm your host, Jennifer Colamonico, and I'm thrilled to be your guide as we explore new ideas for solving challenges that confound our uniquely American systems charged with delivering health and healthcare. Tom Cochran is a seasoned digital strategist and healthcare public relations expert, currently serving as managing director at 720 strategies, which is an HMA company.
Tom is a former Obama administration appointee. He held roles in both the white House and the Department of State, where he pioneered digital initiatives like the We the People petition Platform and Share America. He's also led digital transformations in various sectors, including media roles at Atlantic Media and Edelman Public Relations. Tom frequently speaks on digital innovation, change management, and public engagement.
Drawing on his extensive experience in both government and the private sector. In addition to his work at 720 Strategies, Tom is an adjunct professor at American University and a contributor to publications like the Harvard Business Review. So we are, this is November 2024. We are, several weeks, past the November 2024 election. And given your prior sort of political experience, I wonder if you might reflect on the communications strategy that you sort of witnessed.
You know, as you were going through this election, you know, what was your sense of what was working, what didn't work and sort of how did that play out in the end?
Tom Cochran
Sure. That's a great question. So it is interesting to look in hindsight, and it's also very easy to criticize, but also praise, those that do it well and those that do not do it well. Looking in the rearview mirror, what we do see and we do see a lot of chatter around this is that the Trump campaign and the Republicans in general, did a pretty good job of meeting the audience where they were, which was on very popular podcast, which is meaning people on social media and in fact, doing the things that made the Democrats really strong.
In 2008, in 2012, in taking that playbook and really, running with it, I think the Democrats did what, what had worked, consistently over time. But, is less and less effective, which is relying on traditional media and focusing on TV media buys, and not doing things like reaching out to immensely popular podcasts. Now, that's not to say that putting Harris on a popular podcast would not have changed the outcome, but it might have changed the ability to connect with a larger audience.
Meeting them where they are.
Jennifer Colamonico
Obviously, we could talk all day about the election, but let's kind of apply this to, you know, business. I mean, business often is in, you know, changing hearts and minds much as as political candidates are in terms of advancing ideas, advancing agendas. And certainly a lot of our audience is either influencing or at the influence of policy. Health policy.
So, you know, what do businesses kind of take away from this? It's harder to reach people through traditional means, right? That's kind of the punch line of what you say. But, how have you been applying that with your clients?
Tom Cochran
Yeah. I think it's important to stress that, it is not do one over the other. It is evaluate the entire landscape and recognize that there are many, many channels through which people gather information. One is not right and one is not wrong. They are all methods to communicate and connect with an audience. We're dealing with what we like to call in the communications world, an attention based economy.
The average attention span of an American adult is seven seconds. That's not a lot of time to pique their interest, to get them to hopefully stay a little bit longer to learn more about your product, your issue, your candidate, whatever it is, whatever you're selling, whether it's an idea or a product or a service, the only way to sell that is to have your end user or your customer pay attention to you and learn more about you.
And that is through communications, and that is through using the right channel in the mix of media. So that could be social media, that could be face to face and that could be TV and it could be radio. There's so many different opportunities, but you have to use a, a data driven approach to make sure that you're landing your message with the right person at the right time.
Jennifer Colamonico
So talk about, I guess, a little bit, how you work with clients in this space. I know you've experimented with what I think I would call nontraditional ways of reaching even decision makers, even members of Congress. So talk a little bit about how some of those nontraditional media, social media, digital media sources have, have sort of grown in influence.
Tom Cochran
Yeah, it's it's funny that we have clients and, and peers and colleagues and pundits that still see digital and social media as emerging as a new form of communication, when in fact, social media has been around for two decades, at least. Right. And so it is media. It is part of the whole rather than a separate channel through which we communicate.
And now instead of having, in the olden days, pre-internet, it was TV and radio, and print, now we just have more paths to connect with people, and we have greater ability to connect with people, but we also have far less attention to connect with. I heard a great anecdote the other day, which was the amount of information produced, on Earth on a daily basis is the equivalent of 1 billion Sunday editions of the New York Times every single day.
Now, try to wrap your head around how much information that is and that is in one 24 hour period. And then remember that the the attention span of a person is seven seconds. We're trying to cram a lot of information into a very small and shrinking window of attention. So what we try to tell our clients is, look, we're not going to be able to connect with all people at all times.
That is impossible. But our goal is to try to connect with more people a little more often, with a little bit more of your message to sort of the rising tide, will lift all boats. If if more people know what you want them to know, then hopefully we'll have an outcome that is favorable to you. And our ability to connect is based upon two things.
One is, do we have an overall strategy on how we're going to connect and more importantly, with whom we will connect? Yeah, and the tactics of it. That's the where do we go? Do we go on this podcast? Do we do geo targeted advertising campaigns? Do we do print based ads? All of those can be great ideas if applied to a good communication strategy.
Jennifer Colamonico
So is it a it's an all of the above. It's you can't not do any of it at this point. And does it have to be all of it.
Tom Cochran
We have all of them as potential channels to communicate. And the way we decide how we communicate is to have a deep understanding of the audience. And there are some people who approach communications with, the framework of this is what I want to say. And then there are other people who approach it with, this is what I want the audience to hear.
And then there's another one, which is, this is what I understand that the audience should hear. And so there's a blended way to to approach it, which is to really understand what it is that the, the end person, the the recipient of your information, how they will process the information. So what I say is very different from what you hear, because we're two different people, we interpret things in a very different manner.
Now scale that up to a thousand people, 100,000 people or 300 million people in the United States. You're playing with with so many different variables that we can't there's an art and a science that that we can push it in the right direction, but we're never going to get it completely right. We can push it in the right direction.
Jennifer Colamonico
So well, so presidential campaign, you have to do all of the above. But I think you're you're you're kind of differentiating out, you know, what the person should be hearing, what you want them to be hearing how they might be hearing it. You know, you see how that can be, I want to say manipulated, right. You see how disinformation, misinformation, right.
The fact that there are so many channels and so many ways in which people are getting bits and pieces of the information in these very small bits, as you say, it can be probably manipulated for nefarious reasons. It can be manipulated for positive reasons. Right. So, you know, the the message, it's like you're saying it's not a message that just gets pushed out to different channels.
It's different messages for different platforms, I'm assuming.
Tom Cochran
Right. Tweak the message for the channel through which it's going right. A print message is a very different message than a TV message is a very different message from audio only on radio. And radio is also different for podcasts, which is the same sort of, kind of platform and same consumption of the content, which is you're hearing something, but it's a different format.
And so you have to play with so many different ingredients to try to get the highest likelihood of a positive outcome, with an understanding that you'll never get it completely right and you'll hopefully never get it completely wrong. You want to get it more right than wrong.
Jennifer Colamonico
Thinking about the next four years. So we had four years of a Trump administration, to kind of learn from, how are you envisioning? I mean, do you think that that will be more of the same in terms of the communication style? Obviously, he did a lot of unconventional things that a president normally would do in terms of the way he used social media, etc..
Do you envision, kind of going back to what he did previously, or do you think he'll communicate in completely different ways? Kind of given where we are today.
Tom Cochran
Yeah. Well, if he it's been eight years, roughly since he first took office. And so eight years in the lifespan of the internet. And technology is essentially a century. It's a long time, the landscape has changed considerably. There are more channels, there's more noise. And if we go back to the to the anecdote of a billion Sunday versions of the new York Times on a daily basis, that's eight years of that.
We have a different landscape. People also tune different channels out there, able to filter, hopefully. But people are also overwhelmed by the amount of information. And I, I recall living in DC in the early Trump years, the volume of information that was coming out, from Twitter and social media was overwhelming. And also not healthy, because the brain is not built to process that amount of information in such a whiplash manner, where the speed of government and the speed of internet are two very different things.
But when something as big as the government is led by an individual who speaks at the speed of the internet, it can be very, discombobulating, a very challenging to process when everyone is also dealing with their lives, commuting to work and dealing with children and families. And so I don't know the answer. I don't have a crystal ball.
I can I can look to past performance as an indication of what would happen in the future. But we don't know you.
Jennifer Colamonico
You remind me, and, you know, we've been obviously lots of people trying to figure out what's going to change. What is he going to do, how, you know, what types of policies is he going to, put forward? And particularly our healthcare clients obviously have, a lot of interest in understanding that. But you're reminding me the first administration on the speed of the internet versus the speed of government.
It seems like there were a lot of things that were announced that actually maybe never happened. But in a lot of people's minds, they happened because he said that they were going to do it. And I think that's really interesting in terms of managing a policy narrative or, you know, having people kind of follow the follow the breadcrumbs, do to the end.
Like, you know, did we actually change this policy? Did he actually deliver on what he said because so many people digested it initially and then kind of moved on to the next thing? Government is slow. So how does the speed of media, help people really stay aware, I guess, of what's actually happening versus what somebody says they want to do.
Tom Cochran
Right? Well, operating at the speed of the internet is not inherently bad for the government. But it is important to differentiate between, what's a norm? What's a tradition, what's a law, what has been done historically just because it's always been done one way doesn't mean it's the right way to do it. And just because we have access to new technology that makes things, cooler, faster, better, stronger also doesn't mean that's the right thing to do.
I think it is okay to experiment with new tools and channels and platforms to communicate, but, not at the cost of disrupting, what is a massive machine that runs the United States of America, right? It has to work and it has to it has to not fail. And so we have to have systems in place to prevent erratic sharing of information that may not be factual, but we should also embrace the ability to speak, in a faster manner using the internet.
I think it's there's a net positive provided it is used appropriately.
Jennifer Colamonico
Well, appropriately is an interesting conversation, right. There have been lots of discussion around limits on social media, particularly around children, and they haven't, gotten very far. Right. So it is exactly that balance of embracing the transparency that comes along with it. And yet not, you know, putting a boot on the neck of government, you know, do you envision there being successful restraints on social media, on media in the way that it's been evolving?
Tom Cochran
Yeah. You know, as soon as I said the word appropriate, I think I wanted to retract that because one person's appropriate is not the other person's appropriate. It is important to collectively agree on what is appropriate and not appropriate with an understanding that some people are not going to agree with that. But generally it has to be something that is useful for the largest number of people.
I think grounded in fact, that that's the thing that I hope everyone can agree with, which is it is really important to be grounded in fact and not opinion, or subjective assessments of situations or circumstances, because when we blur the lines between fact and fiction, that's where we get into a really difficult, civic situation where we are now unable to agree or disagree because we have different facts.
If we can have the same facts in the same baseline, then we can agree or disagree vehemently, but still are grounded in the same truths.
Jennifer Colamonico
Do you think that's why they haven't been able to? I mean, there hasn't been common agreement, right on. What is acceptable? What is the facts? I mean, it doesn't it doesn't seem like there has been universal agreement or even majority agreement. As to those basic pieces, I don't know. I don't see that happening anytime soon, but maybe in pessimistic.
Tom Cochran
I don't know. You know, there is a very big difference between misinformation and disinformation, right? One is intent. Intent to mislead is is different disinformation. You're you're you're seeding the information landscape with something you know is wrong in the hopes that you alter or influence outcomes. Misinformation is you're sharing something that you think is right or your assume is right, and other people pick it up, but it's actually wrong.
They both have negative consequences and negative outcomes. But one, it comes from a place of being nefarious. One comes from a place of a variety of things. It's an accident moving too fast. Not fact checking. And so there's an element that the media plays or had played for a very long time, which is the media was the filter through which we we would interpret information and facts, and we would assume, generally speaking, that what's coming out of the media was what's true.
Now, if you are tribal and I believe this media outlet and you believe that media outlet, and we're having different filtering mechanisms on the information, that's a very dangerous place to be, which is we're not consuming the same information and therefore we're not agreeing on the same baseline information. And so it's hard to have a conversation about policy, local communities, national communities, international events.
Jennifer Colamonico
Well, and and we've trusted media to package that for us. So you go back to the, you know, the billions of of New York Times, we can't process that information on ourselves. None of us have time in the day to get all the facts on our own. Right. That's what media has done, is to kind of package and present that.
And there was a trust we trusted that they would package and present it for a whole variety of reasons. That's been challenged. Right? Whether it's the tribal media, whether it's the budget cuts for local media, I mean, there's all sorts of reasons why media is a less trusted, less central source to how we consume information. But what takes its place and I kind of want to talk about I know it's a it's an area that you have thought a lot about and are thinking a lot about.
And it's attempting er it's attempting solution. Right. How do I digest this 50 page report. Oh, run it through. You know ChatGPT give me the highlights. Right. So, is that of course, that's a little dangerous. So how are you thinking about AI in this realm of how we're processing information, and is it getting us closer to facts or further away?
Tom Cochran
Yeah, it's only dangerous if we assume that everything coming out of it is fact based. The onus is on us as consumers of information to have a little bit of, fact checking capabilities. Now, with an understanding that we don't have the cognitive capabilities to fact check every bit of information that's coming at us all the time, but we should have the ability to read something, just be like, wait, that doesn't sound right.
And then check it or read it and say, that sounds plausible. That sounds realistic. There has to be a human element where there's a responsible party on the individual. It's not fair to say you have to fact check everything all the time. That's just impossible. But we've gotten to the point where media did the fact checking for us for a really long time, and generally it was very good, and we believed it.
And then we went into the world of social media, where we assumed that the framework was the same, that what I see online is factual. And actually this starts with the birth of the internet, right? If I see it online, it's real. Well not really, you should still fact check it and you don't know the source, right?
We all rely on platforms like Wikipedia, which is a really excellent platform at providing guidance on where to find information. It is not the authoritative source, but it is a good source where you can get the highlights of something, and it references where it got the information and it's very important to go and just double check if there's something, where truth is critical, you should you should verify the truth.
You should absolutely verify the truth. So this is a long way of saying if you have a 50 page or 50,000 page document, that is a government report, you don't have time to read that. And that's okay because everybody's busy. And if there's a tool that could extract topics of relevance from that, and you can read it and you can generally say that seems reasonable, that doesn't seem reasonable, but it's not supposed to be, 100% fact based.
Just assume that what comes out is, is accurate.
Jennifer Colamonico
How? Well, a couple questions. First of all, you know, when you think about that ability to even gut check yourself and say, you know, is that true? I mean, what guides people to that? Right? Is it is it critical thinking skills that are taught in elementary school? Is it some sort of framework? I know there's kind of the real time fact check that's starting to show up in a couple of, like, you know, in various social media.
Do people have that innate ability anymore? And if not, what are the the tools that can be brought to bear, you know, how do you know when you should doubt something? I mean, then it becomes a little bit of an existential question at some point, right?
Tom Cochran
Right. You know, we're parents of children, and I look at my children and they should be taught to process information with an understanding of it. Look, they're really young, but not yet. But at some point, grow up and have critical thinking abilities to not believe 100% of the things that they hear, but also don't have the the conspiracy hat on where everyone is lying to you at all times.
That would be a terrible place to live, but to have the critical thinking abilities to know through experi perience and wisdom, from reading, from reading some of the classics to reading history books, to reading contemporary, news articles, to to have a picture of what is real, or what could be real or what could not be real, and using that critical thinking ability and apply that to information as it comes in.
Again, back to the we don't have cognitive abilities to fact check every single piece of information that came in, but we should have the critical thinking ability to know when to question something and then just double check it and verify it.
Jennifer Colamonico
We hope I certainly yeah, let's go back up now to this idea of, you know, businesses communicating with policymakers because this is the backdrop, right? This is all the backdrop about how all of us are consuming information and how things have changed. You know, when we think about influencing hearts and mind changing hearts and minds, whether it's, members of Congress, whether it's decision makers on a particular committee or an agency or, to state, what are, you know, what are the things that you think are most important for our clients to understand, about this kind of new world order of communication that can help them sort of be more effective at what they're trying to accomplish.
Tom Cochran
There's a signal noise problem, which is there's so much noise and figuring out a way to make your signal, make your message connect with the audience that you want to connect with is really hard. And you need, experts in the communications world to be able to do that. But there's also something that is of of utmost value and in fact, probably of more value than it than it has ever been, which is a human human connection, having relationships, having the ability to connect and find common ground with people that you're communicating with.
It is the longest lasting solution, which is a relationship can last 50 years, and you can have the ability to call someone up and ask them to do something or ask for advice, figuring out a way to not lose that human connection among the abundance of information that we're drowning in on a day to day basis, I think it is way more important today than it ever has been.
And I'm a techno optimist. I think technology's great, but it is not the solution. It is a tool that we can use that allows us to communicate at scale, but it doesn't replace, the things that we have used for thousands of years, which is, a conversation.
Jennifer Colamonico
If you had a magic wand and you could wield it to help people understand, how to best leverage communication tools in this day and age. How would you wield that wand?
Tom Cochran
How would I wield that one? Well, I think it depends on what we're trying to communicate. Right? If it's if it's selling a product versus selling an idea versus, pushing societal change, I think the common ingredient is people. And recognizing that technology is not the solution. It's an enabler of good communications strategy. It's an enabler of an understanding of what the message is or what the message should be, but also it is an enabler of connecting the recipient of information with the sender of information, in the hopes that the information is passed from point A to point B, and consumed and synthesized at point B to trigger whatever action we want them to take.
In the in the world of politics, its vote for this candidate in the world of selling products. It is by my product. So communication is definitely an art form that is infused with data and science. But it is far from a science.
Jennifer Colamonico
Is there anything in particular when you think about, you know, if you're advising clients that are going from a Biden administration to a Trump administration? You know, in terms of techniques, tools, you know, is it the same game plan? But, you know, different, audiences? I mean, is there any anything from a communications strategy perspective that you think, given everything you've heard about in the campaign and what folks are coming in thinking about, any advice that you would give folks on how to really maximize their communication during this time of transition?
Tom Cochran
Yeah, I think pause. Understand the landscape. It is a wildly different landscape for many reasons. We understand. Right. But also don't make assumptions and don't make negative assumptions. Let's hopefully try to assume best intentions, recognizing that that we're on different sides of, of the field. Or maybe we have different policy views, but ultimately we all live in the same space together, whether it's, the entire country, a single state or a small community and figuring out a way to connect together to move the move the ball forward an inch in the right direction.
Ultimately, it's a it's a game of influence, and it's a game of communications that drives that influence. And communications really starts by listening and understanding rather than talking and broadcasting.
Jennifer Colamonico
Just thinking about this idea of, you know, mixing, the digital with the human interaction. And I know there's always a lot of fear in healthcare around, you know, how AI is going to be used between doctors and patients. And, is it going to disrupt the doctor patient relationship? And I just wonder, I've always felt like it's an enabler.
But I guess in that framework, you know, how do you think about AI in, in kind of improving health and engaging with patients? You know, when is the the handshake and the look you in the eye is important versus all of the great things that I could digest and, and help understand.
Tom Cochran
I would respond to that with a question of how are we already disrupted for the negative, the healthcare experience, the patient experience using technology? Let me give you an example. If I go into one doctor and, the doctor or the physician or the nurse practitioner or whoever it is is typing away at a computer asking me questions about my health and vitals without looking me in the eye.
Is that a personal experience, or is that a very robotic, systemic, or system driven experience? Or the alternative is we can still use technology. And what if we had AI transcribing the conversation, and the doctor can look you in the eye and say things like, how are you feeling today, Tom, please explain your symptoms. And the doctor, the physician doesn't have to take notes.
A physician is not a note taker. A physician is someone who should diagnose health challenges with an individual. Right. And they do that through conversation, not by typing on a keyboard. So I use this example specifically because my wife had that experience at the doctor the other day, which was the doctor said, do you mind if I use AI to take notes?
Because that allows me to be more present. And I think that is a great example of using technology for good. It is certainly not perfect, and it certainly makes some people feel uncomfortable, but if the doctor can look you in the eye and ask you questions, then that technology has allowed us to be connected as humans. 1 to 1 again, and liberated us from the shackles of, of of technology.
Jennifer Colamonico
So we're at we're we're coming back around. We're fixing the mistakes of early technology and separating us more.
Tom Cochran
I hope so, I think we're going to make more mistakes. That's what humans do, right? Well, sure. But hopefully you learn from that mistake and of course, correct. And you try to make things a little bit better. I am optimistic that the goal is never to make things worse for people. The goal is to make things better.
We don't always agree on what is better, but this is a case where I think we get many people can get on board with this being a better experience from a frontline healthcare experience.
Jennifer Colamonico
So maybe connecting back to where we started, which was, you know, politics and campaigns, it seems like, the course correction there is, is needed. You know, social media and the way in which people are observing information seems to have pulled us apart more. And you know what you're talking about about it, of course, correcting and enabling that human connection, it seems to be kind of maybe what is needed to heal the political rifts as well.
I don't know, is that do you see evidence of that happening?
Tom Cochran
I think it's a great analysis. I think it's very hard to fix. I think there needs to be an attempt to acknowledge the pervasive tribalism that digital and social media has created, these micro echo chambers where you think that everyone agrees with you because that's the bubble you're in, and then you realize, actually, that's not the world, and that's very upsetting.
But then you also other different groups and you look down on them for having different views, as opposed to being curious about their views and trying to understand those views. It is very easy to dismiss someone and their alternative opinions because they're not your opinions. It's very hard to ask them questions, to try to understand them. And we should figure out a way to do the harder thing, which is connect as humans and ask those questions.
Jennifer Colamonico
So knowing all that, you know now, is there anything you would have done differently, thinking back to when you created these digital platforms for, you know, in the early Obama years and, and the stuff that you did in government is there is there anything that you would do differently about how we've created these platforms? And given what you know now about kind of those downsides?
Tom Cochran
I think, well, there's an argument to be made where maybe we're not meant to be connected to all people at all times, using any device, always, that is cognitive overload. And maybe that's a bad thing. I think Ta-Nehisi Coates is the one who says that the best thing he loves is his books. I just want books.
I don't need internet. Internet is a useful tool, but books. That's the best way to gather information. I think it's also, naive to think that we'll go backwards in time when it comes to technology, but there has to be some acknowledgment and reckoning that the human brain is not meant to process this amount of information at this pace, and it is detrimental to our health in order to operate like that.
And so I don't have a solution for this. I think we should all agree, hopefully, that that is one of the challenges as a society and a planet. We should figure out a way to solve that, and then maybe we can make things a little bit better for for our children.
Jennifer Colamonico
Yeah. Our children there. I don't know about you, but it's there. They don't like to read books anymore because they've got the world at their fingertips. So it is interesting to think about we're going to be having to solve this problem for quite a while as this next generation that came of age on devices and having access to all the information in the world makes their way through.
Tom Cochran
Yeah.
Jennifer Colamonico
Any other advice that you'd give people that are, trying to understand the power of, of digital communication in a world where human interaction still matters.
Tom Cochran
Don't lose sight of the fact that human interaction matters. Digital communication is great. It's a great tool. It's an opportunity to connect with a lot of people. But it is not a handshake. It's not a hug. It's not a hello. It's it's an email in your inbox. It is an opportunity to connect, but never lose sight of the fact that, shaking someone's hand has a lot of value.
And in fact, it has way, way more value. In a very remote or digital world, it has a very high value because sort of in the old, laws of supply and demand. Right. If the supply of personal meetings is really low, meaning we have fewer of them than the value of that one meeting is really high.
So take advantage of that meeting and take advantage of that conversation.
Jennifer Colamonico
This episode of Vital Viewpoints on Healthcare is sponsored by HMA Information Services. HMAIS is a subscription based service that provides state level data on publicly sponsored programs like Medicaid from the latest managed care enrollment, market share, and financial performance data to up to date RFP calendars and state by state overviews, HMAIS has all the information you'll need to power your initiatives to success.
This podcast was produced by myself, Jennifer Colamonico along with Tiffany McKenzie in collaboration with our guests. The content is the property of Health Management Associates.
