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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:

  • Bridge learning barriers - Visuals speak across languages and literacy levels;

  • Convey key messages - Images reinforce key content; and

  • 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:

  • Health content is sourced by the author(s) and medical reviewers when developed, updated, or revised. Our writers use only evidence-based information. 

  • Health content, including interactive or self-management tools and multimedia content, has two medical reviews. 

  • 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.  

  • 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.

  • 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.

  • 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).

  • 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.

  • 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:

  • Clinicians with advanced degrees

  • Project manager

  • Medical writers

  • Certified medical illustrators

  • Medical editors

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 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

Date Last Reviewed: 10/19/2022
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