Dan Piekarz

What Healthcare Systems Can Do to Engage Patients in Chronic Conditions Management

By Daniel Piekarz, Head of Healthcare and Life Sciences Practice at DataArt

I recently watched a TED talk with Joe Gebbia, a designer and co-founder of Airbnb. He told the audience a story of how Airbnb grew by designing for trust. Indeed, in the world where more and more of our interactions happen through user interfaces, reality lends itself to design. If a start up can grow into a billion-dollar company by designing for trust, could we then reach better patient health outcomes by designing for patient engagement?

The battle for consumers’ attention happens on their devices and success is driven by customization, convenience, frictionless interactions, intuitive interfaces, relevant content and focus on the user experience.

While patient engagement is becoming a popular concept, its application in real life has been quite superficial. It is often associated with Meaningful Use Stage 2 requirements and patient portals, most of which provide no more than minimal, dry functionality. Currently, healthcare systems are starting to realize the necessity of shifting towards customer-centric services and the value of embracing technological advancements in the area of UI/UX design to better engage with patients. A good example is the Ochsner Health System in New Orleans, which launched the O Bar, an in-person center, which recommends and teaches patients to use more than 300 health apps (including nutrition tracking, fitness, expectant mothers’ education and chronic conditions management).

The Healthcare Practice at DataArt is focused on creating research-based customer personas and providing customer-centric solutions and immersive user experiences to the healthcare industry. Earlier this summer our healthcare team took part in InnovateNYP, a Pediatric App Challenge of the New York-Presbyterian Hospital. In two weeks our team designed an award-winning prototype of a complete patient engagement solution for pediatric patients with diabetes and their families. The prototype can be customized to any other clinical state and consists of two interconnected applications: one for the child and one for the parents.

The child’s application is gamified by an animated interactive squirrel. The squirrel leads the child through daily schedules, rewards for compliance, suggests personalized educational content, captures statistics about the child’s condition such as digital glucometer readings and reports it to the parent application. It helps the children along the recovery process by reminding them of the scheduled actions and keeping them on track with the treatment plan.

The education section includes short movies, aligned with the child’s medication plan and is available in different languages. Once a new video is available, the squirrel encourages the child to watch it and gives a star reward, which can be used in the entertainment section. With the app, it is easy to track carbs intake for each and every meal. The child simply chooses a type of food and an approximate portion size, and gets instant feedback from the character of how healthy the food is.

Not only is the child involved in making decisions about their health, but so is the family. The child and the parent apps are interconnected and all data captured on the child’s device is sent to and available for analysis on the parent’s device, allowing the parent to monitor the child’s condition and progress through a history of vital indicators (including carbs intake and glucometer readings). The parent’s dashboard contains the same schedule as the child’s for taking medication and checking blood sugar levels, as well as scheduled doctor visits, reminding parents of the upcoming activities and helping to reduce the number of risk factors.

The parent app also provides educational content on diabetes and its management, recommendations for the child’s daily routine, diet and activity, including explanatory videos and articles. Parents can read the doctor profiles, write and read reviews and check schedule for availability. Solutions like Care Companion can help families adapt to new life-changing conditions and improve children’s health and quality of life through self-education.

The Care Companion is one example of a good recipe for patient engagement. The ingredients that make it successful include: thorough research into patients’ needs, development of patient personas, highly customized services, engaging interface design and relevant content. Solutions like this offer an important avenue for healthcare systems to engage patients in their own health.

Let’s assume for a moment that patient portals were designed by the same principles. Patients could track their health trends historically based on chosen indicators, get analytics from connected devices and insights into how their lifestyle affects those important health indicators, while getting data-driven recommendations for improved health outcomes.

What if portals would educate patients about their particular conditions and treatment options, allow them to pick and compare doctors that specialize in their conditions and give feedback on their services? What if these portals were not isolated interfaces but smart omni-channel systems, connected to all our devices, calendars, to do lists, relentless in reminding us to adhere to our health strategy, pushing relevant information to our attention at the right time, helping to manage chronic conditions and prevent them?

The technology for it is already here and legislation is catching up.

Meaningful Use Stage 3 will open up health records for use by external APIs (Application Program Interfaces), allowing third party technology companies to offer their services and apps to patients based on their unique health records. This will inevitably lead to competition between technology companies to become the provider of the universal patient portal- a convenient API-based marketplace for medical care and other health-related services. It will be nothing new to us, we take marketplaces for granted in other industries; when we intend to travel, we go to online travel marketplaces like Expedia or Travelocity where all flights and hotels can be conveniently compared and purchased.

In a similar way, we will turn to a global healthcare system to compare and purchase most convenient healthcare services to us, based on various service qualities (i.e. location, cost, doctor characteristics, user reviews, popularity index), as well as our specific health records. The system will also collect and analyze our use patterns, interests, purchase behavior and other preferences to further customize services and bring the healthcare industry one step closer to becoming customer-centric.

Millennials: What can the Healthcare system learn from Millennials?

By Dan Piekarz, Vice President of Business Development, Life Sciences at DataArt

While the aging boomer generation will bring healthcare costs to new highs, it is the Millennial generation that will likely show us new ways to deal with those increasing costs, through their unique relationship with technology. The Millennials have now come into their own, and according to the Census Bureau, the Millennials are over 75 million strong in 2015 and will eclipse the boomers to become the largest generation of Americans.  Industries that want to remain relevant need to understand this generation as they are a primary economic force expected to be spending $200 billion annually in the next two years.

Some may ask, “What does this have to do with healthcare, aren’t we talking about kids?’  Well, the Millennials are currently ages 15-35. The oldest are now getting married and having children – and their unique traits will define what successful patient engagement looks like in the future.  So what is it about the millennials that make them different? A recent White House report noted that millennials are the most technically savvy, ethnically diverse, highly educated and socially connected generation the USA has ever seen.

Unfortunately the millennials high degree of college education is a double edged sword. While lifetime earnings for college graduates is much higher than non-graduates, the high cost of college combined with the ‘great recession’ has led to one of the poorest generations for the US and created one of the toughest consumer groups ever. Money is a very limited resource for Millennials and they expect the highest value possible for their money. According to a PNC study Millennials expect their healthcare to be delivered quickly. This ‘drive through’ generation prefer retail clinics and acute care clinics when possible, with only 61% of Millennials noting they actually visited a primary care physician.   When choosing healthcare they follow the same ritual as when purchasing any important product or service. They check online reviews, tweets and ask their friends when shopping for the right healthcare provider, and one out of five surveyed by PNC listed unexpected/surprise bills (such as those associated with surprise healthcare costs) as a major issue.

According to world-renowned game designer Jane McGonigal, a 21-year-old spent the same amount of time between 5th to 12th grade learning as they did gaming. This generation has been molded by the immersive technology of videos games and they expect a similar immersive experience when dealing with service providers. If we want Millennial patients who are more engaged in their healthcare we need to look at examples from industries that have been able to effectively grab the attention of the Millennial generation.

This focus on gamification and immersive experience was behind the creation of a concept application called KidPro demonstrated at the recent DIA convention. KidPro is a fully gamified electronic patient recorded outcomes system built for children ages six to ten. Since ePRO systems and electronic Patient Diaries are not usable by children, attendees had incredibly positive feedback on KidPro, which has the potential to help the Millennials raise children who see healthcare as fun and engaging. The Millennial generation is still young enough where more immersive healthcare engagement focused on education and prevention can greatly reduce healthcare spending per capita as that generation ages with healthier habits.

Guy “Kry0” Costantini, Director of Community at mobile game powerhouse, Kabam (publisher of Marvel: Contest of Champions) and veteran of PC gaming giant Riot Games has had a unique career spanning both the video game and healthcare technology industries. Guy’s expertise is in helping companies identify ways to keep customers thinking about products through social connections both in and out of game. During a recent conversation with Guy he said, “Not tapping into peoples’ social connections leaves a lot of value on the table. Every person can be a powerful advocate or detractor of your products and of your decisions. You have to be part of the conversation people are already having about you in their social circles, you have to speak to them colloquially, in a way they are used to conversing among each other. You need compelling content, designed to entertain, engage and create shareable moments. When you leverage the connections and channels that people are already on, they will force multiply your message and you create loyalty”. This approach is the path to full customer engagement in all B2C industries including healthcare.

Social media is also changing the way all patients interact with healthcare providers. Healthcare companies will need to leverage a range of applications to keep Millennial patients engaged, such as new apps currently in development that help healthcare and life sciences analytics experts understand how their company and products are trending in social media while looking at publically available competitive information. Companies can then better understand and compare the dependencies between educational, marketing and sales efforts with the trends on social media, which makes managing their eReputation much easier. When a consumer mentions a company or product on the web, it’s in that company’s best interest to know about it and respond. Social media has become a communication hub where we get our news, talk to our friends and look to engage with the companies we care about. And social media is poised to have a larger impact on many industries, such as pharmaceuticals. It’s only a matter of time before the FDA requires pharma companies to monitor social media for reports of adverse events or effects to their drugs. Many pharma companies are currently not monitoring social media and ignoring this inevitable change.

The Millennial generation expects healthcare providers and other companies to engage with them and to know who they are via technology and face-to-face interaction.  In an age where I can go to any Jiffy Lube in the USA and they will be able to bring up all the specifications for my car and any service I had previously, the idea that this type of nationwide system is unavailable for healthcare is absurd.  Millennials expect technology to work, be simple, connected, mobile and extensive in its feature set, a complete system.  The ideal patient engagement system would follow this prescription:  A mobile platform that provides patients with the ability to manage their medical records, prescriptions and doctor visits, make payments, message their doctor, and of course have virtual doctor visits.  This is not a mere wish list – it is what the Millennials have come to expect from any modern service provider, a fully immersive engagement model.  The patient portals available today look like websites from the late 90s in comparison to what is expected.  The portal used by my primary care physician is less than impressive, and provides me with very little functionality.  It is sad that my local coffee shop has a more feature rich mobile app than my healthcare network.

Immersive engagement, good service, fair prices and cost transparency are expected from the Millennials, and healthcare providers do not want to be on the bad side of this generation. Millennials are a social juggernaut with technological powers like the world has never seen. Within seconds of bad services, they will immortalize it across social media. Millennials have thousands of friends, followers and connections in their electronic network ready to shred the reputation of any organization that does not treat them well, or make engagement simple. All age groups seem to be aware that medical care is too expensive and unpredictable, but as the Millennials start to use healthcare more and more, their force and focus on technology, especially mobile platforms, will make these kinds of changes to our healthcare system inevitable.