Based on research by Vikas Mittal

• Most hospital outreach still relies on untailored – that is, untargeted – communications.
• Rice Business Professor Vikas Mittal shows that tailored, personalized health care marketing works better to convince at-risk patients to get screening for liver cancer.
• Patients of different ages, genders and health statuses respond differently to the same intervention and also to different interventions, meaning outreach shouldn’t be one size fits all.

Amazon is famous for targeted marketing that approaches customers based on their unique needs. Like other successful businesses, such as Netflix, the company taps into machine learning, which uses customer data to understand their behavior.

Hospitals and medical centers rely on marketing too, investing heavily in direct-to-patient outreach to urge at-risk people to get regular screenings. Johns Hopkins Hospital’s cancer center, for example, uses emails, letters, seminars and community events to encourage patients to get screened for potential cancer. The high cost of cancer treatment makes this effort worth it: research shows regular screenings help with early detection, leading to more cost-effective treatments and better prognoses. 

But hospitals can – and must – improve their outcomes much more, by melding this essential outreach with individually tailored communications based on machine-learning insights.

In an award-winning paper, Rice Business Professor Vikas Mittal and colleagues developed new algorithms indicating that targeted, personalized outreach can increase screenings among at-risk patients. “Outreach marketing” –  including sending informational letters and talking to patients about potential barriers to screening – was indeed a powerful motivator for patients to get screened, ultimately lowering health care costs for patient and hospital. But patients with different characteristics, Mittal’s team found, responded differently to marketing interventions. When it came to marketing campaigns for cancer screening prevention, one-size-fits-all outreach efforts were neither effective nor economical. Personalized marketing works better for preventing cancer.

To conduct their research, the researchers randomly divided 1,800 patients at UT Southwestern Medical System at risk for hepatocellular carcinoma – the most common type of primary liver cancer – into three groups – usual care, outreach alone, and patient navigation, which includes help such as follow-up calls, motivational messages and assistance spotting specific barriers. They followed each group to see if patients scheduled an MRI or CT scan within six months, from 6-12 months and from 12-18 months. 

The first group was asked to receive a screening during their doctors’ visits and wasn’t contacted after that. The second group received a one-page letter in the mail, then staff called patients who didn’t schedule a screening. The third group receiving patient navigation got the same treatment as the second group supplemented with phone calls designed to identify potential barriers, which they used to give customized motivational messages encourage coming in for a screening.

The researchers used patient data from medical records, including patients’ age, gender, ethnicity, income, commute time, health status, how often they received healthcare services, whether or not they had insurance and how populated their neighborhoods were.

Following traditional methods, Mittal’s team found that the patients who got a letter and call were 10-20% more likely to complete a screening, while those who got the customized motivational messages were 13-24% more likely to schedule their screening. But this is where traditional medical research stops, without asking a crucial question: Within each group, such as those of the 600 patients receiving patient navigation, could screening rates differ based on patients’ individual characteristics? 

In past research, everyone receiving the same stimulus is presumed to respond the same way. There was no statistical technique to separately estimate the responsiveness of patients with different characteristics. Mittal’s team solved this problem by using a machine learning technique called causal forests.

By using "causal forests" to quantify how each of the three marketing approaches could be applied to different patients, Mittal’s team found, improved returns on the traditional approach by a remarkable 74-96% – or by $1.6 million to $2 million. 

Using traditional methods, physicians would have concluded that every patient should get patient navigation because it was a more intensive marketing approach. The causal forest method showed otherwise: there are small groups of patients with unique characteristics who respond best to specific types of overtures. Minority women in good health who had insurance, visited the doctor often and lived close to clinics in more populated neighborhoods responded especially well to all three types of outreach interventions. Younger patients with long commutes who live in neighborhoods with more public insurance coverage embraced the second type of intervention, outreach alone. And older patients in higher-income neighborhoods favored the patient-navigation approach.

The stakes for common marketing practices like “AB testing” could not be higher. In AB testing, marketers run randomized experiments such as showing ads to some people and not to others. If those seeing an ad, on average, buy more, the conclusion is to blanket the market with ads. But AB testing ignores the fundamental idea that customers exposed to an ad might buy differently in response to an ad based on their individual characteristics. In fact, research shows, many customers seeing a non-tailored ad will buy less than those not seeing an ad. 

Personalized marketing can uncover these differences and substantially increase the return on marketing investments in many settings such as retail and ecommerce, services marketing, business-to-business marketing and brand management. Healthcare companies should consider dedicating more resources to machine learning, which can power data-driven patient-centric outreach programs. Because individual health is a civic good, policy makers and organizations need to support these personalized outreach programs. 

As for patients themselves, giving detailed personal data to a doctor or receiving highly personalized, unsolicited phone calls legitimately can seem like an invasion of privacy. But Mittal’s research shows, it measurably has the potential to save your life.  

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Vikas Mittal is the J. Hugh Liedtke Professor of Marketing at the Jones Graduate School of Business.

To learn more, please see: Chen, Y.C., Lee, J.Y., Sridhar, S., Mittal, V., McCallister, K., & Singal, A.G. (2020). Improving Cancer Outreach Effectiveness Through Targeting and Economic Assessments: Insights from a Randomized Field Experiment, Journal of Marketing, 84(3), 1-27. https://doi.org/10.1177/0022242920913025.

A mobile app to help prevent veteran suicide is one of the products created by three student startups that claimed the top prizes at this year’s edition of Rice University’s H. Albert Napier Rice Launch Challenge (NRLC).

The first-place winner, rutd: resources united. technology driven., created a platform to deliver mental health resources to veterans – with more than 14,000 resources available. It includes secure chat and document functions to provide support with significantly reduced response time.

The competition featured eight Rice-affiliated startups pitching their businesses to a panel of judges for a shot at equity-free seed funding. Named after Rice professor and entrepreneurship program founder H. Albert Napier, the NRLC is presented by the university’s Liu Idea Lab for Innovation and Entrepreneurship (Lilie).
 

“With the biggest and most diverse field of competitors in the history of the competition, it shows that at Rice and Lilie, you don’t have to choose between being a student and working on your startup. We empower you to do both,” said Kyle Judah, executive director of Lilie. “These founders took advantage of all our resources and opportunities — which is why they had million-dollar partnerships and tens of thousands of users at competition time.”

More than 400 members of the Rice community and Houston’s entrepreneurial ecosystem watched the virtual championships on April 22 as teams delivered five-minute pitches followed by five minutes of questions from judges. This year’s judges included Rice alumni Claire Shorall ’10 (CEO and co-founder of Topknot), Sunit Patel ’85 (chief financial officer, Ibotta), Monica Pal ’84 (founding partner, How Women Invest), Chris Staffel ’17 (managing director, GOOSE Capital) and Brad Husick ’86 (CEO and founder, IdeaSense).

The top three teams that earned a share of $65,000 are:

• rutd: resources united. technology driven. — first place, $27,500: rutd is an enterprise software and mobile application solution connecting veterans and resources, in a single click, to end veteran suicide.
• Green Room — second place, $20,000: Green Room is building tools to power the local live music industry, starting by simplifying payments and tax compliance.
• A440 — third place, $15,000, and the Norman Dresden Leebron Audience Choice Award winner, $2,500: A440 is bringing the creator economy to classical music, helping a centuries-old art form find new life in the modern era.

All competitors received personalized mentoring with experienced entrepreneurs, investors and subject matter experts from across Houston and Rice’s alumni community. They also received coaching on how to deliver pitches as well as help from  the Lilie team refining their ventures and accelerating their progress.

This year’s NRLC was sponsored by Mercury Fund and T-Minus Solutions, with continuing support from the Napier family and the Liu Family Foundation.

To learn more, visit https://lilie.link/nrlc or Lilie’s website, entrepreneurship.rice.edu.

Read through our interview with Rice MAcc alum Sean Kim (Class of 2020) and discover how he used the MAcc to transition from a high school teacher to a career in business.

Tell us a little bit about your background and where you work now.

I am a former high school science teacher. I earned my undergraduate degree from Rice back in 2014 with dual degrees in Ecology & Evolutionary Biology and Spanish. After graduation, I spent the better part of the next five years teaching the gamut of high school science classes: biology, chemistry, physics, and environmental science, plus one semester of middle school math. I taught in rural eastern Washington State and also back home in Houston.

I now work for PwC in Los Angeles and moved to L.A. around Christmas time last year after starting remote. I work in PwC’s asset & wealth management practice under its financial services arm.

What made you interested in pursuing a graduate accounting degree?

Prior to the MAcc, I had never taken a business course in my life! That all changed after having a phone call with Dr. Lansford, the MAcc Director. That was the catalyst for an 18-month long journey into the business world which continues today.

I had known about the MAcc through a close friend of mine (Jane Ren, MAcc Class of 2018), so it was kind of always in the back of my mind. But it wasn't until my last year of teaching, when I wasn't quite sure what my next step would be, that I remembered the MAcc program and thought to myself - why not give this a chance?

I followed up the phone call with an in-person meeting with Dr. Lansford and Danielle Riley, Assistant Director of the MAcc, and soon thereafter was registered for my first ever accounting course. My last semester of teaching was a busy one, as I juggled full-time teaching with financial accounting homework sets on the weekends. But I really enjoyed my intro class, and the following summer I found myself taking six more business classes (MAcc prerequisite requirements), as my MAcc journey took off full-steam. It was a whirlwind to say the least, but if I had to I would do it all over again.

Why did you choose the Rice MAcc?

The one-year timeline of the program was ideal for me at the stage of life I was in. I could commit to a one-year program for a career pivot.

It was also the future career opportunities that would be available after completing the program that attracted me. At that time, I didn’t know if I wanted to go into audit, tax, or advisory services, but it seemed clear that whatever path you chose after the MAcc, there would be plentiful opportunities available across the business landscape. The MAcc really did change my life.

What were some of your favorite moments from your time as a MAcc student?

Some of my favorite memories stem from the various social opportunities provided through the MAcc and our Social Committee to help build a sense of community for our cohort in one short year. Valhalla (graduate bar on-campus) Thursdays, group workouts at the Rice Recreation Center, group yoga sessions at Black Swan, Top Golf, Christmas party in the Village, and Hopdoddy happy hours – just to name a few!

All of the courses in the MAcc program were great, but one that stands out to me was MACC 512 – Financial Statement Analysis & Valuation, taught by Dr. Lansford himself. The course involved taking key concepts and ideas learned throughout the program (e.g., ratio analysis, profitability analysis, and equity valuation) and applying them to real-world case studies. The learning experience was very hands-on, practical, and teamwork-based – much like my job today!

What advice do you have for prospective students?

Work hard! If you are planning to make a career change, it is not going to be easy, but like most things in life that are truly worthwhile, I think all of the hard work and effort will pay itself off in the end.

Learn as much as possible, and take advantage of every opportunity – one year goes by quick. Soak up as much as you can from the courses that you take, the internships you pursue, the interactions you have with potential future employers, and of course, your community at Rice.

What do you like most about your job so far?

This will probably sound cliché, but I do love that I learn something new every day. So far, I have mostly worked with real estate clients, and I have learned about things I had never heard of or had minimal prior exposure to (e.g., gross-up provisions, triple net leases, and fund accounting). I am constantly learning, and I am constantly challenged by the work.

With a firm as large as PwC, there is almost no limit to the professional development opportunities and resources available to you. In our financial services practice, we have something called infinite learning day – a full workday set aside each quarter for “digital upskilling” your technical proficiency with different software tools, leadership development, and cross-team collaboration. Within my first few months of the firm, I even had the chance to be a featured guest on a podcast available across the entire firm to share my experience on what it is like to start at PwC in a virtual environment.

Does the Rice MAcc program sound like something you’d like to pursue? Reach out to us! 

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What does a hospital do when it runs out of surgical gowns? Ordinarily, order more surgical gowns. But nothing was ordinary in New York during the spring of 2020, when a surge in coronavirus cases made personal protective equipment nearly impossible to find.

As president of SUNY Downstate Health Sciences University, a teaching hospital in Brooklyn, New York, Wayne Riley oversees nearly 5,000 employees serving a population of over 2.3 million people in one of the most diverse communities in the country. When the coronavirus pandemic hit New York, it hit Brooklyn disproportionately hard, taxing the medical center like never before. Like most hospitals, SUNY Downstate had long embraced the principal of “just in time” inventory, keeping virtually no stockpiles of medication, equipment or supplies. And when protocols changed overnight, requiring everyone in the hospital to wear masks and surgical gowns — not just surgeons and ICU staff — they started burning through PPE at an unprecedented rate. By early April, they only had enough gowns to get them through another 36 hours, and no prospect of resupplying. So Dr. Riley got creative. He checked with his maintenance staff and found that they had plenty of garbage bags.

Those became Plan B.

“We never did run out of gowns, but we got dangerously close,” he says.
 

“We probably use 500 to 600 gowns a day in normal times, but then everyone had to wear gowns and we went to 7,000 gowns a day. You can see how fast that erodes your just-in-time inventory.”

Riley, who has an MBA from Rice Business along with a medical degree from the Morehouse School of Medicine, a Master of Public Health degree from Tulane University and a BA in anthropology from Yale University, had to adapt quickly in a crisis that brought new challenges daily.

“Every day there was a supply chain issue. It was like Whack-a-Mole. I might need 10,000 swabs today; tomorrow I need 30,000 gowns. Then we run out of masks, then it was gloves, then it was drugs — we needed medication to sedate patients to put them on a ventilator,” he says. “I had never heard the concept of supply chain management until I went to business school at Rice, and during COVID I kept thinking back to those discussions. This was the problem we were dealing with in New York City: The supply chains we were relying on for all of our needs — gowns, syringes, pharmaceuticals — got disrupted within weeks.” 

For the entire healthcare industry, the normal rules of operation no longer applied. Medical centers that had been fierce competitors suddenly embraced a new role as allies in a humanitarian crisis that spared none of them. One Friday night, the head of a nearby hospital called Riley, desperate for help. “They said, ‘We’re down to our last 5 cans of oxygen. We have 200 patients on ventilators. Can you spare any until Monday morning?’ ” Riley recalls. Oxygen, luckily, was one thing he did have. He sent it over.

“Everybody knew this was different. This wasn’t capturing market share or trying to rise in the rankings — this was trying to save lives,” he says.

To keep his staff safe and ensure the highest level of care for their patients, Riley dove into advocacy and negotiation, wrangling new sources of PPE wherever he could. “My management training tells me you have to roll up your sleeves and manage by walking around,” he says. “Leadership is a contact sport, and by showing that I’m willing to jockey for masks and swabs, that I’m making the calls and that I’m passionate about making sure our staff has PPE, it gives people confidence and support.”

Riley’s students and staff needed the support, especially as a second crisis gripped the country over the summer following the death of George Floyd, an unarmed Black man, at the hands of white police officers in Minneapolis, along with numerous other Black victims of police violence nationwide.

“In the Black and brown community around the country, we’ve had a twin pandemic. You have the disproportionately high incidence of COVID-19, and high mortality from it. Then you have superimposed on that the social justice movement in response to the murders of Ahmaud Arbery, Breonna Taylor and George Floyd,” he says. “We’ve had to deal with both. It’s really caused a soul-searching in all institutions, including the medical profession: What have we done in the past that may have contributed to this?”

That’s not a rhetorical question. In the healthcare field especially, the effects of institutional racism still reverberate — including a deep mistrust for vaccines among the Black and brown community, Riley says. “It goes back to the days of slavery, when they tested new treatments on slaves to find out if they were safe for their owners, up to the Tuskegee Study that lasted through the 1970s. That parade of horribles did happen, but this pandemic is wiping out people young and old, people in the prime of their life, and I will be the first to take a vaccine on the front steps of my hospital to show my community that it’s safe.”

Vaccination will stop only the first part of this twin pandemic, of course. Riley will keep battling the second long after COVID stops spreading. Of his many board memberships, perhaps the most notable is with the New York Academy of Medicine, where he is the first Black board chair in the organization’s 173-year history. Its mission is to alleviate healthcare disparities of the kind that made Brooklyn one of the epicenters of COVID mortality in the U.S.

“If nothing else, this pandemic has elevated the awareness of healthcare disparities in this country. Why do African-Americans have hypertension at a rate of three to four times the rest of the population, as well as higher rates of obesity and diabetes — which happen to be the three top preexisting conditions that this pandemic has targeted like a laser beam? My hope, when we get to the other side of COVID, is that we have a very fulsome discussion of how we address these disparities. It’s not healthy for our country to have a large segment of the population whose lives are cut short and who get sicker at a much greater rate. We may not ever be able to eliminate health disparities entirely, but we can lessen their impact with an all-hands on deck approach. Healthcare institutions, the government and the private sector all have a big role to play.”