Evidence-Based Digital Health Content Development and Sourcing Policy for StayWell or Krames CHL
StayWell and Krames commitment
Our commitment is to provide clients and their end users with accurate, timely, and understandable digital health content. We focus on diseases, conditions, tests, and procedures. Our goal is to promote understanding and management of health conditions and wellness. StayWell and Krames are dedicated to developing health communication solutions that are evidence-based, easy to understand and behavioral-change focused.
Our health content is developed using clinicians whose expertise falls in the content area under development. We aim to develop content consistent with evidence-based medicine and nationally accepted guidelines and standards of practice. StayWell and Krames research methods, include, but are not limited to, reviewing journal articles, practice guidelines, and subscription databases; consulting with medical experts; and attending health care association meetings and conferences with both practitioners and end-users of our products.
Digital health content
StayWell and Krames define health content as content that focuses on diseases, conditions, tests, treatments, and procedures. This type of content is URAC-accredited and cannot be edited by the website receiving the licensed health content. Our health content has two medical reviews. Health content will enter the medical review process every 24 months. Our health content enters its “first” medical review two (2) months prior to the expiration of the last review date and the medical review process - two medical reviews, a QA process (clinician review), an editorial review, and translation - may take up to six months to complete. Dates of medical reviews are tracked and stored in StayWell/Krames Content Management System (CMS). Certain diseases and conditions that have ongoing medical research and frequent updates to treatment guidelines are medically reviewed more often to remain current with standards of care.
Please note: Content can be hosted by StayWell/Krames servers, hosted on the client’s servers, or delivered via Web services or manual syndication. Revision of licensed health content is permitted with a specific administrative tool obtained by clients to meet their needs, but if revision to licensed health content occurs, the content will not be considered URAC-accredited.
One medical review by a medical or clinical expert will occur in the specialty area(s) - of nutrition, wellness, and health promotion - and with specialized content that focuses on nonclinical or less clinically specific information about a specific disease, condition, test, medical treatment, or procedure. Our Digital Content Team sets the medical review schedule, based on the health topics or conditions under review. Our Quality Oversight Committee receives a quarterly report on the medical review process of digital health content, as well as clinical updates made to accommodate new medical practices and knowledge.
Our self-management or interactive tools, such as calculators, condition-related risk assessments, and quizzes relating to specific health topics - smoking, weight loss, exercise, immunizations and screenings, pregnancy, stress, depression, and substance and alcohol use - are considered health content. This is also true of our multimedia content and animations. Our animations and interactive tools are medically accurate in content, visual representations, and data interaction. Standards and requirements that direct the creation of health content also guide the development process in multimedia content and self-management tools.
Throughout the process of the creation of multimedia content and self-management/interactive tools, there are several different script/content reviews by our Digital Content Team. During production, the Digital Content Team reviews many visual beta versions of any product developed by the graphic artists, animators, and programmers. During each step of the process, our Digital Content Team has multiple opportunities to ensure medical accuracy of the final product. All interactive multimedia content undergoes user testing by the staff and other consumer users.
Great importance is placed on visuals. Our award-winning art is used to:
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Bridge learning barriers - Visuals speak across languages and literacy levels;
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Convey key messages - Images reinforce key content; and
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Tie content and audience together - Offer real-life examples and solutions.
Digital health content development and medical review process
Our health content is developed for a range of reading levels, from 5th to 9th grades, depending on the audience and topic requirements. In general, our target reading level is between 5th and 8th grades. Reading level is measured with commonly used readability scales (Flesch-Kincaid, FK Reading Ease, and Gunning-Fog). Going beyond readability, StayWell and Krames also focus on health literacy. We create content using the Centers for Medicare and Medicaid Services (CMS) Toolkit and the Plain Language and Training Resources offered by the National Institutes of Health. Multimedia content facilitates a low-literacy reading level with medical illustrations and a diverse selection of multimedia products.
The medical review process for health content is conducted through a content management system (CMS). The application allows (for) electronic editing, sourcing, and recording (to occur) during electronic medical reviews of digital health content. The CMS serves as a mechanism to track and save revisions, sources, updates, and edits made to digital health content, as well as store dates, authors, medical reviewers, and editors during the medical review process for digital health content.
The medical review process for digital health content includes, but not limited to, the following steps:
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Health content is sourced by the author(s) and medical reviewers when developed, updated, or revised. Our writers use only evidence-based information.
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Health content, including interactive or self-management tools and multimedia content, has two medical reviews.
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Health content will enter the medical review process every 24 months. Health content enters its “first” medical review two (2) months prior to the expiration of the last review date and the medical review process - two medical reviews, a QA process (clinician review), an editorial review, and translation - may take up to six months to complete. Dates of medical reviews are tracked and stored in StayWell or Krames CMS. Certain diseases and conditions that have ongoing medical research and frequent updates to treatment guidelines are medically reviewed more often to remain current with standards of care.
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Content is updated immediately when significant new medical knowledge or change(s) in medical guidelines occur, and when content errors (not spelling or grammar) that could impact the health or well-being of an end-user, are identified.
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Two medical reviews are performed on health content. At least one of the medical reviewers is an expert or specialist in the area pertaining to the disease, condition or topic under review.
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Experts or specialists in the area pertaining to the disease, condition, or topic under review usually consist of clinicians, advanced practice registered nurses (APRN), or physician assistants (PA).
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Editorial reviews occur after the two medical reviews are completed to assess the reading and literacy levels of the health content; to correct misspellings or errors in grammar; and to maintain StayWell/Krames writing and style guides for digital content.
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StayWell or Krames digital health content - whether existing and being updated or new - is intelligently indexed and mapped to MeSH (Medical Subject Headings) concepts as a common keyword scheme. MeSH is an industry-standard vocabulary maintained by the National Library of Medicine.
For additional information on our editorial processes, please review our Editorial Policy.
Medical reviewers and health content developers
We employ a highly skilled team of medical authors, editors, and reviewers. Most reviewers are independent contractors and clinicians – e.g. medical doctors, doctors of osteopathy, dentists, psychiatrists, dietitians, pharmacists, social workers, physical therapists, advanced practiced registered nurses, or physician assistants – and have numerous years of professional experience. In addition, each medical writer has many years of experience in writing patient education materials for hospitals, health systems, private organizations, and professional organizations.
Our medical reviewers - licensed clinically-experienced health care providers - are charged to assure that the content is evidence-based and that recommendations made on a particular topic are consistent across all content on that topic. To ensure accurate and accessible content, we have an in-house team of:
For background information on our medical reviewers, authors and editors, please see our policy for Digital Health Content Reviewers.
Practice guidelines we follow
In developing, medically reviewing, and updating digital health content, we monitor a substantial number of associations and organizations that publish healthcare guidelines. All guidelines are vetted, and those directly applicable to StayWell and Krames digital health content are taken into consideration and utilized for product development and maintenance.
See below for the list of guidelines currently monitored and distributed to our editorial staff and clinicians.
1. Academy of Breastfeeding Medicine
2. Academy of Nutrition and Dietetics
3. Advisory Committee on Immunization Practices
4. Agency for Healthcare Research and Quality
5. Alzheimer’s Association
6. American Academy of Allergy, Asthma & Immunology
7. American Academy of Audiology
8. American Academy of Child and Adolescent Psychiatry
9. American Academy of Dermatology
10. American Academy of Emergency Medicine
11. American Academy of Facial Plastic and Reconstructive Surgery
12. American Academy of Family Physicians
13. American Academy of General Dentistry
14. American Academy of Neurology
15. American Academy of Ophthalmology
16. American Academy of Orthopaedic Surgeons
17. American Academy of Otolaryngic Allergy
18. American Academy of Otolaryngology Head and Neck Surgery
19. American Academy of Pain Medicine
20. American Academy of Pediatric Dentistry
21. American Academy of Pediatrics
22. American Academy of Physical Medicine and Rehabilitation
23. American Academy of Sleep Medicine
24. American Association for Respiratory Care
25. American Association for Thoracic Surgery
26. American Association of Cardiovascular and Pulmonary Rehabilitation
27. American Association of Clinical Endocrinologists
28. American Association of Diabetes Educators
29. American Association of Endontists
30. American Association of Neurologic Surgeons
31. American Association of Neuroscience Nurses
32. American Association of Oral and Maxillofacial Surgeons
33. American Association of Orthodontists
34. American Association of Orthopaedic Surgeons
35. American Association of Pediatric Ophthalmology and Strabismus
36. American Cancer Society
37. American Chronic Pain Association
38. American College of Allergy, Asthma & Immunology
39. American College of Cardiology
40. American College of Chest Physicians
41. American College of Clinical Pharmacy
42. American College of Critical Care Medicine
43. American College of Echocardiography
44. American College of Emergency Physicians
45. American College of Endocrinology
46. American College of Foot and Ankle Surgeons
47. American College of Gastroenterology
48. American College of Obstetricians and Gynecologists
49. American College of Physicians
50. American College of Preventive Medicine
51. American College of Prosthodontists
52. American College of Radiology
53. American College of Rheumatology
54. American College of Sports Medicine
55. American College of Surgeons
56. American Congress of Obstetricians and Gynecologists
57. American Dental Association
58. American Diabetes Association
59. American Epilepsy Society
60. American Gastroenterological Association
61. American Geriatric Society
62. American Head and Neck Society
63. American Heart Association
64. American Institute of Ultrasound in Medicine
65. American Laryngological, Rhinological and Otological Society
66. American Lung Association
67. American Lung Foundation
68. American Medical Association
69. American Occupational Therapy Association Inc
70. American Optometric Association
71. American Osteopathic Association
72. American Pain Society
73. American Physical Therapy Association
74. American Podiatric Medical Association
75. American Psychiatric Association
76. American Psychological Association
77. American Rhinologic Society
78. American Society for Colposcopy and Cervical Pathology
79. American Society for Gastrointestinal Endoscopy
80. American Society for Metabolic and Bariatric Surgery
81. American Society for Parenteral and Enteral Nutrition
82. American Society for Pediatric Gastroenterology, Hepatology, and Nutrition
83. American Society of Anesthesiologists
84. American Society of Cataract and Refractive Surgery
85. American Society of Clinical Oncology
86. American Society of Colon and Rectal Surgeons
87. American Society of Echocardiography
88. American Society of Hematology
89. American Society of Interventional Pain Physicians
90. American Society of Nephrology
91. American Society of Neuroradiology
92. American Society of Nuclear Cardiology
93. American Society of Pediatric Otolaryngology (ASPO)
94. American Society of Plastic Surgeons
95. American Society of Reproductive Medicine
96. American Society of Temporomandibular Joint Surgeons (ASTMJS)
97. American Stroke Association
98. American Thoracic Society
99. American Thyroid Association
100. American Urological Association
101. American Venous Forum
102. Association of Women’s Health, Obstetric and Neonatal Nurses
103. Asthma and Allergy Foundation of America
104. Brain Trauma Foundation
105. British Association of Dermatologists
106. British Menopause Society
107. British Society for Rheumatology
108. British Society of Gastroenterology
109. British Thoracic Society
110. Canadian Academy of Sports Medicine
111. Canadian Association of Oral and Maxillofacial Surgeons
112. Canadian Association of Radiologists
113. Canadian Cardiovascular Society
114. Canadian Diabetes Association
115. Canadian Headache Society
116. Canadian Heart Rhythm Society
117. Canadian Interventional Radiology Association
118. Canadian Medical Association
119. Canadian Paediatric Society
120. Canadian Pain Society
121. Canadian Task Force on Preventive Health Care
122. Centers for Disease Control and Prevention
123. Centers for Medicare & Medicaid Services
124. Concussion in Sport Group
125. Department of Defense
126. Department of Health and Human Services
127. Department of Justice
128. Department of Veterans Affairs
129. Emergency Nurses Association
130. Endocrine Society
131. Environmental Protection Agency
132. Eye Surgery Education Council
133. Food and Drug Administration
134. GINA: Global Initiative for Asthma
135. Global Initiative for Chronic Obstructive Lung Disease
136. Heart Rhythm Society
137. Infectious Diseases Society of America
138. Institute of Medicine
139. Joint Commission
140. Joint Council of Allergy Asthma and Immunology
141. Multi Society Task Force on Colorectal Cancer
142. National Academy of Family Physicians
143. National Association for Sport and Physical Education
144. National Asthma Education and Prevention Program
145. National Cancer institute
146. National Cholesterol Education Program
147. National Heart, Lung, and Blood Institute
148. National Institute for Health and Clinical Excellence (NICE)
149. National Institute of Allergy and Infectious Diseases
150. National Institute of Diabetes and Digestive and Kidney Diseases
151. National Institute of Mental Health
152. National Institute on Aging
153. National Institute on Alcohol Abuse and Alcoholism
154. National Institute on Drug Abuse
155. National Institutes of Health
156. National Kidney Foundation
157. National Lipid Association
158. National Osteoporosis Foundation
159. National Stroke Foundation
160. North American Menopause Society
161. North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
162. Obesity Society
163. Oncology Nursing Society
164. Pediatric Infectious Diseases Society
165. Preventive Services Task Force
166. Royal College of Obstetricians and Gynaecologists
167. Royal College of Radiologists
168. Society for Vascular Surgery
169. Society of American Gastrointestinal and Endoscopic Surgeons
170. Society of Cardiovascular Anesthesiologists
171. Society of Critical Care Medicine
172. Society of Interventional Radiology
173. Society of Obstetricians and Gynaecologists of Canada
174. Society of Thoracic Surgeons
175. Substance Abuse and Mental Health Services Administration
176. US Public Health Service
177. USDA
178. Veterans Health Administration
179. World Health Organization WHO
180. World Heart Federation
181. Wound, Ostomy and Continence Nurses Society
Questions about our policies and general inquiries
Please email us at [email protected] or call 877-330-3796 and select Option #1 for additional information about STAYWELL and KRAMES.
We respond to clients within 24 hours on business days.
Reviewed and Approved by the Quality Oversight Committee: Q4 2022
Revised: March 2024