The Grove’s Rachel Smith and Kaiser Permanente recently created a graphic recording movie about ALL-PHASE, Kaiser’s simple yet effective protocol to prevent heart attacks and strokes in diabetics age 55+. This video is now being used for patient education at 85 participating community clinics nationwide.



Project Background

Diabetics are two to four times more likely to have a heart attack or stroke. Yet many high-risk patients are not receiving preventive treatment because the commonly used protocol is too complicated for patients to start and maintain.

Now a simple and affordable alternative known as ALL-PHASE makes it easy to lower the risks. “A-L-L” represents three pills taken daily at the same time to prevent blood clots, reduce blood pressure, and lower blood cholesterol. “P-H-A-S-E” stands for “Preventing Heart Attacks and Strokes Everyday.”

Over a ten-year period, Kaiser used the ALL-PHASE protocol in-house with 70,000 at-risk patients. The results: a remarkable 60% reduction in the predicted rate of heart attacks and strokes.

Early Communications

With the treatment’s effectiveness established, the next step was to get the word out to people who might benefit. As part of a broader commitment to improve access to health care, the Kaiser team launched an initiative with dozens of community clinics to make the protocol available to uninsured and underserved at-risk patients.

The clinics soon reported difficulties as they tried to educate patients about the protocol. Facing huge resource challenges, they did not have enough staff to explain the program one-on-one. Written materials were prepared, but language and literacy barriers limited their effectiveness.

Developing the Video

Given these factors, the Kaiser team decided to “go visual.” They engaged The Grove to create a patient education video that summarized the benefits of ALL-PHASE and the science behind it.

Coralie Chan, national program manager of ALL-PHASE, was Kaiser’s point person and integrative voice in scripting the video. Many drafts were circulated and innumerable inputs gathered to fine-tune and shorten the script. As it neared completion, several physicians tested a beta version with patients.

Once the script was ready, Rachel completed the graphic recording movie. Narration was provided by the program’s clinical expert, Dr. Jim Dudl, Diabetes Lead for Kaiser Permanente’s Care Management Institute.

Rachel explains, “We had to adjust the imagery as we went along, because it needed to be scrupulously realistic. For example, we couldn’t draw a generic pill, because people would get it in their heads that the pill looks that way. It wasn’t just about creating an image that looked good artistically; it also had to look like the real pill. Throughout the video, we needed to create imagery that patients would identify with.”

Using the Video in Clinics

Have you ever felt overwhelmed by information from your doctor as you try to absorb it all on the spot? Most of us can recall such conversations that never got around to addressing our core concerns. In contrast, when people take five minutes beforehand to view an informational video, the basics are already covered. This frees the health care provider to address action steps. “How can we support your engagement with this program? Do you have any specific concerns we can address?”

Many facilities play the video in patient waiting rooms. Or if the necessary equipment is available, patients can watch it in their exam rooms. This gives them something to do besides staring at a blank wall. Then the doctor can follow up. “Did you have a chance to review the video? Do you have any questions?” Addressing the patient’s specific concerns is a much more effective use of health care providers’ time.

Coralie explains, “This communication strategy speaks to varied learning styles. Some people are visual learners, while others are auditory learners. Also, some people want to have something they can review at home. People can watch the video again on YouTube to reinforce the information or share it with loved ones.”

Starting the Conversation

Kaiser continues to offer the ALL-PHASE protocol to its own patients while also supporting its use in the community clinics. Currently nearly 100,000 community clinic patients are using the treatment protocol nationwide.

Coralie Chan concludes: “The ALL-PHASE video has been great for us. It certainly fulfilled our expectations, and it has been very well received.” She says that it all boils down to adult learning. “People learn differently as adults. The video facilitates continued learning and engagement because it jump-starts a real conversation, not a one-way street of information sharing.”