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Everyone is talking about one to one communications, but few have developed a workable system for doing it. It was hard enough for a small store owner in the past to keep track of the lives and purchasing habits of 300 customers. But most of them were able to do it. How do we, today, keep up with the lives and purchasing habits of several hundred thousand customers? That is the challenge of database marketing.

One company that is making a good stab at it is MicroMass Communications in Raleigh, NC. They were recently awarded an International Award of Excellence from the Medical Marketing Association for their Committed Quitters (CQ) program. The CQ program is a two-way communication program for smokers who have purchased Nicorette nicotine gum or Nicoderm CQ patches, and enrolled in a personalized 12 week support program, run by MicroMass.

When the smoker buys a Nicorette starter kit at a drug store, he finds a Committed Quitters program outline inside the package, with an 800 number to call to enroll. In the call, he is asked 27 personal questions about his smoking habits, his lifestyle, and his goals in the program. There are 63 possible data responses which are entered into the MicroMass data record on each participant. Right after the call, the smoker receives a Free Committed Quitters stop smoking plan which has been personalized to his needs, based on the questions he answered in the phone call. He receives a 12 week calendar addressing barriers, motivations, high risk situations and coping strategies. The next week he gets a personalized newsletter explaining high-risk situations and providing social support, plus a reminder to buy his first Nicorette?refill. A week later, he gets a reinforcing postcard. Some program members elect to receive their reminders and materials by email.

Meanwhile, the former smoker is chewing away or applying patches and trying to keep from dreaming about a cigarette. If he feels the need, he can call an 800 number where a trained anti-smoking counselor will listen and provide helpful advice. In the sixth week, he will receive a tri-fold mailer with additional advice on how to cope with his problems, plus a reminder to begin tapering off. If the program is working, he should be able to do less chewing and patching, and still stay smoke free. Week nine brings a congratulations packet and, at the end of the treatment program, he receives an award packet.

How effective is the Nicorette?system? Dr. Saul Shiffman of the University of Pittsburgh reported on a study of 3,807 smokers who were randomized into three groups, all of whom got Nicorette nicotine gum:

those who got no outside assistance,
those who got the standard Committed Quitters program, and
those that got the "enhanced" CQ program with a phone call from a counselor.

More than 75% of those smokers who received no assistance were back smoking again after 28 days. But only 64% of those who received the personalized CQ program had resumed smoking. The CQ contact program boosted the success rate by 50%. "The study demonstrates the potential for low-cost, tailored printed materials to have a significant impact on cessation, even among smokers who are already receiving nicotine medication and basic written behavioral advice." The study also showed that the personal phone call was not worth the extra expense, since those called had virtually the same success rate as those receiving the direct mail program alone. This may be a significant finding: perhaps people don’t like to get personal phone calls about their health maintenance programs, and money spent on such efforts might be wasted.

Anyone can buy Nicoderm or Nicorette at a drug store. But in addition, SmithKline Beecham, manufacturers of the products, has signed up more than 200 companies and HMOs who want to help their employees and patients to quit smoking. Several hundreds of thousands of individuals enrolled in the program, in addition, of course, to hundreds of thousands more who bought the products, but failed to enroll.

Based on the success with this personalized communication program, Steve Sloate, Vice President of MicroMass, announced the launch of a new personalized patient contact project with the American Heart Association. The program will begin in September 1998. It will address individuals who have three treatable conditions:

High levels of cholesterol
Hypertension
Stroke

For these patients, there will be a one year curriculum. Several thousand companies will ultimately participate in the program by sponsoring their employees. In addition to direct mail and telephone contact, the American Heart program will use a customized Website and email. Those using the Website will be assigned a personal pin number and password to assure total privacy. In addition to the heart patient, the corporate sponsors, and the patient’s HMO, in some cases, the patient’s physicians are going to be included in the data loop. They will all receive reports on the patient’s progress, and will play a role in helping the patient to overcome his health problems. Unlike the Nicoderm program, the American Heart program is open only to people sponsored by an employer. Private citizens cannot enroll in the program as it is presently planned.

To kick off the heart program, the employee provides basic data by calling an 800 number, or by entering the data on the Heart Association Website. This data is converted and entered into the employee’s database record. The HMO contributes medical records, and is given the resulting profile. Once in the program, participants receive four quarterly newsletters, plus six reminders in the mail. During the year’s program each patient will receive six phone calls from live operators who call to set evaluation dates. The program is entirely confidential. The patient’s behavior and success rate is tracked. After the first year, the American Heart Association will publish the results of the experimental behavioral modification program research findings.

If this program is as successful as the Nicoderm program seems to be, it could represent a complete new breakthrough in patient care. The research findings could contrast the economic difference between the direct mail and telephone follow-up costs, and the costs of patient visits, and subsequent hospital stays for those with similar symptoms but not enrolled in such a program. If it works well, it will represent a whole new use for direct mail, telemarketing and the internet which could grow to be quite substantial in the years ahead.