Outcome Health Description of Methodology

Date Effective: October 1, 2019

This document describes the office and provider qualification and validation process, campaign scoping, contracting, ad serving, campaign management, reporting methodologies and the systems and data used for advertising campaigns on Outcome Health’s technology platform.

Overview
Outcome Health is a healthcare innovation company reinventing the point of care to facilitate better outcomes for patients, their loved ones, and healthcare professionals. Through partnerships with nonprofit organizations, health advocacy groups, leading content creators and brand sponsors, Outcome Health makes critical moments more impactful by bringing relevant content into the physician’s office, where health is top of mind. Our BPA-certified digital network includes over 131,000 devices in more than 37,200 physician offices and health systems across the country, serving impactful content when it’s most needed. Current products include Waiting Room TVs (WRTV), Exam Room Tablets (ERT), Exam Room Wallboards (WB), Infusion Room Tablets (IRT), Patient Wi-Fi, and Waiting Room Posters.

Ad Types and Placement
Outcome Health clients have several ad placement options across our devices. The ad types include videos, IAB standard and interactive banners, and other creative content, including large digital displays and printed posters. Outcome Health works with clients to deploy ad creative in placements that are approved to run on our network. Advertisers can also access some ad inventory through programmatic channels.

Video ad creatives should consider that clinics are busy environments and sound may not always be audible.  Open captions are recommended, and have the additional benefit of increased accessibility for patients who may be hearing impaired.

Below are specific types of ads available on the Outcome Health platform.

1) Autoplay video ads
2) Full-screen image ads
3) Standard banner ads
4) In-stream banner ads
5) In-stream video ads
6) Custom executions

Technical Specifications:
Outcome Health supports a variety of custom and certain IAB standard ad formats. For additional information contact CSM@outcomehealth.com

Compatibility:
Outcome Health executes an internal QA process against all third party creative assets that are provided to ensure their compatibility with all devices that they are targeted to on the Outcome Health network.

Content Requirements
Outcome Health content requirements must meet minimum standards based on the following technical and quality criteria:

Quality Measures:

  • Broadcast Production Quality
  • Medical/Factual Accuracy
  • Sources/credits (when applicable)
  • Duration specifications/limitations

Technical Requirements:

  • Important Safety Information (ISI), Prescribing Information, and Medication Guide – (ISI, when applicable)

Brochure Distribution
Outcome Health recognizes the requirement of some customers’ to have brochures at point of care to support patient’s needs for information around direct to consumer advertising. 

When contracted, Outcome Health will only distribute brochures to physician offices who have not opted out to receive them. The offices that do receive brochures will receive an accompanying letter with instructions to display the brochures to support the Waiting Room TV campaign running in their offices.  Brochure placement is subject to layout of the office and Outcome Health cannot guarantee uniformity or compliance across offices.

Office & Provider Verification
To ensure accuracy across the data associated with healthcare provider locations, including address information and National Provider Identifiers (“NPI”), Outcome Health currently engages in a multi-step verification process which may include but not be limited to third-party data sources and primary research.

Campaign Effectiveness & Measurement
Targeting
When performing an HCP list-match, the standard practice is for the Outcome Health team to match based on commonly available NPI.

The client-provided NPI list, as of the date of contract, will be used to target the program unless Outcome Health and client mutually agree to revised contracted data sources. The Outcome Health provider database is subject to change and regular optimization efforts will take into account Outcome Health database shifts, like movement of HCPs/offices, and adjust the campaign accordingly to meet contracted targeting requirements.

Campaign Measurement
Outcome Health uses test and control analyses to measure the impact of our clients’ ad campaigns. A third-party analytics firm executes statistical studies. These studies measure how much HCP prescription writing habits change following campaign exposure, controlling for any known influences.

Ad Effectiveness
Ad effectiveness is an online market research study used to understand recall of advertisements on the Outcome Health network and measure the effectiveness of the campaign, including impact on viewers’ purchase and recommendation intent.

Third-party Review and Verification
As the first company in the point-of-care industry to earn BPA Worldwide’s platform certification in August 2017, we are uniquely positioned to lead the industry in defining and delivering independent third-party validation and verification that meets the IAB measurement guidelines and BPA Worldwide measurement rules. BPA has direct access to Outcome Health systems to pull granular impression-level data for campaign auditing directly. The platform is independently reviewed every quarter by BPA and any modifications or enhancements to Outcome Health’s systems during that time period are certified.

Outcome Health’s independent certification of its health intelligence platform in accordance with the BPA Worldwide rules for audience qualification and Interactive Advertising Bureau (IAB) guidelines for impression measurement from BPA’s iCompli division. Outcome Health is also leading the point-of-care industry in providing audited results of marketing campaigns through third-party audits that ensure complete transparency and accuracy in a timely way.

Ad Measurement Metrics
All reported ad display events are device initiated. Ad display events are not counted until they are received by the server in accordance with current Interactive Advertising Bureau (“IAB”) standards for ad measurement (available at https://www.iab.com/).  We measure each campaign, across our digital devices, for our brand clients based on ads served. This is the number of instances an ad appeared on a screen; this can be autoplay or interaction driven.

Audience Estimates and Demographics: Outcome Health collaborates with Nielsen, a leading third-party global marketing research firm to receive independent media measurement and audience estimates for our products. The data set includes:

  • How long patients and caregivers spend in waiting, exam and infusion rooms
  • Awareness of Outcome Health Products 
  • Patient demographics

Third-party Ad Tags
Outcome Health permits but does not guarantee the performance of third-party ad tags on the company’s touchscreen devices. The connectivity constraints of a Digital Out of Home network preclude the usage of the following tools for rendering campaign performance data accurately:

  • 1×1 pixel impression tags
  • Click trackers

We believe in full transparency and providing partners with all possible tools for campaign verification. For this reason, we offer monthly delivery reports and BPA audits as an alternative. Should customers wish to embed third-party tracking functionality in their advertising properties,  they are permitted to do so with understood limitations.

Data Logging
Each action completed on an Outcome Health device generates a logging event that is processed through Outcome Health’s data processing infrastructure. If the device is connected to the Internet, the logging event is immediately sent to the third-party event tracking system’s data server via a call to the third-party event tracking system application programming interface (“API”). For devices that are not connected to the Internet, the logging events are stored on the device. Once an offline device regains Internet connectivity, the local buffer is flushed, and all locally stored events are sent to the data server via the third-party event tracking system API call. Additional device metadata is imported into the Outcome Health data lake via a daily bulk import. Event data is then aggregated and stored according to the data schema in the Outcome Health data lake. Every month, data is archived from the queryable bucket in the data lake to compressed, cold data storage; the two recent years of data are kept readily queryable.

Known Limitations
Outcome Health is aware of the following limitations in its systems and processes:

  • For Waiting Room TVs (WRTV), Exam Room Wallboards (WB), Exam Room Tablets (ERT) and Infusion Room Tablets (IRT), events are stored in the device’s local buffer and  transmitted to remote OH servers. Should the device not have internet connectivity for an extended period, events are stored locally until the device runs out of storage.
  • Tablets are muted when there is no interaction with the device to accommodate clinicians’ ability to perform patient exams, Outcome Health cannot guarantee that devices are not muted when ads are playing.
  • Online device counts can fluctuate due to provider network connectivity and availability of power to the device.
  • Outcome Health’s device network is built to run effectively in the absence of consistent internet connectivity. Assets that are hosted remotely (not locally stored on the device) are not guaranteed to be accessible at any point in time, contingent on internet connectivity.

Network Integrity
All content is administered by Outcome Health and all devices are managed by Outcome Health. Outcome Health applies list, or parameter-based, filtering and activity-based filtering.

There are two primary methods of flagging invalid impressions:

  • Time Check: Events are processed through a time check. Each device has a specific clinic-hours configuration that defines when the device should be online or offline within that clinic. Outcome Health cross-validates events against this configuration, and any events outside the window are flagged as unqualified events.
  • Activity Frequency Check:  Events are processed to ensure that there are not duplicate events that are delivered within the exact millisecond of device activity. All duplicate events that exceed this threshold are flagged as unqualified events and deduplicated as part of the Outcome Health data processing logic.

Additionally, Outcome Health has developed a proprietary Anomaly Detection application to proactively monitor network integrity on an ongoing basis. The Anomaly Detection application scans all impression metrics logged by devices on a daily basis and alerts operational teams of unexpected aggregate variations in impression levels.

Product Release Quality Assurance
Outcome Health validates the functionality of the software that runs on its network devices (those with screens that are involved in the serving and rendering of advertising campaigns) through a rigorous process of quality assurance which leverages manual and automated testing to compare intended product requirements against the actual behavior of the application to validate functionality.

Once software versions are deployed to the devices in the field (via remote installation),  Outcome Health maintains processes to evaluate event data, generated by the software, to identify anomalous or erroneous trends in event data which could indicate an issue with the devices.

Issue Resolution and Make-good Procedures
If Outcome Health identifies or becomes aware of issues impacting the performance of client campaigns, it initiates a formal review process to determine the root cause and identify potential solutions. Decisions to provide make-goods or other remedy are made on a case-by-case basis and in discussions with clients and or their agencies. In the event a make-good is offered, clients and/or agencies are notified.