During the 9th Annual Partners’ Connected Health Symposium, several speakers shared examples about how consumers are taking responsibility for their health by using online and mobile tools. Given the changes in health reform, Providers and Payers welcome patients taking on a more active role in both monitoring and managing their health.

 1. Trackers for Self Management: 

Susannah Fox presented findings from the latest research by the Pew Internet Project and the California HealthCare Foundation which focused on self-tracking. One interesting insight is the segment of adults who track a “health indicator or symptom”; “62% of adults living with two or more chronic conditions is self- tracking”.

The research also revealed that only one third of all self trackers shared this information with someone and half of those shared with a clinician and the other half with a member of the family, group or a friend.

2.  PHR with Mobile Capture of Observations of Daily Living (ODL):

Patricia Flatley Brennan, Professor, School of Nursing, University of Wisconsin, discussed the insights that can be gained by “listening in the moment”.  Patricia provided an overview of the Project HealthDesign’s five projects for this second round. I was particularly interested as she described how these projects capture the “words of the patient” about their observations of daily living.

Imagine the tremendous value in sharing the patient’s words not only to help the clinician communicate in a way that resonates with the patient but also to discuss the observation data patterns and their impact on the patient’s live.

After the conference, I reviewed the projects on the Project HealthDesign website to get a better understanding about the tools that were being used by patients. Several projects entail having the person enter the observations into their mobile phone; symptoms for Asthma, pain and energy levels for Crohn’s disease, caregiver stress for high risk babies and moods for Obesity. For the project focused on elders, I was interested to see sensors being used to collect information to monitor their cognitive decline.  

3. Online Patient Communities

Right from the beginning, I knew this panel was designed to be provocative- “Online Patient Communities are an effective way to Deliver Care”. Alex Drane, moderator and CVO at Eliza explained the panel's focus on peer to peer patient communities without clinicians. 

Shouldn’t this panel really have been titled “Online Patient Communities are an effective way to ‘support’ care”? So much has been written about the strong value that patients receive sharing their experiences.

Taking patient communities to the next level, it would be interesting to consider how one type of patient community differs from another.  Is there the same intensity of involvement for different types of conditions? Do patients participant in them mostly when they are diagnosed or do they stay on to give back? Are patients using the tracking tools and sharing with others in the community? Are there examples where clinicians are successfully participating in these patient communities?

Opportunities to Empower Patients with Data & Tools

Healthcare organizations have any opportunity to provide data and tools as resources to support consumer health management. Here are some areas that I am closely watching.

Connecting the Data Dots on Health: As a patient gathers information from the various tracking tools, how can this information be combined with other data about him to provide a more comprehensive picture to guide their collaborative care decisions? As Joseph Coughlin, Director MIT Age Lab asked during his Symposium keynote “Data, data everywhere but where are the drops of actionable knowledge?”

Interjecting Data into the Discussion: When can the patient discuss this information with their care team and get the needed guidance for behavior change? How can this information be incorporated in to a coaching session as the patient discusses the management of her chronic condition? During an intervention, how can this information support the decision discussion?

Measuring the Impact of the Tools: Each organization will need to think about measuring the elements that make the tool actionable. During her keynote on “e” is for Engagement, Susannah Fox shared a few key measures that they captured for the self trackers including the percent that said their data collection “affected a health decision”,  led them to “ask a doctor new question or seek a second opinion” and “changed their overall approach to health”. 

As organizations continue to evolve their business models and approaches, these data and tools become more important because they effectively engage patients in their own health. In recent discussions with leading organizations, I have heard about their increasing investments in connecting data and tools to bring more insight to the patient to better manage their health with the support of their care team. What is your organization doing to provide truly engaging online and mobile resources for your patients?

World Congress Leadership Summit on Mobile Health, July 25-27th in Boston

Over the past three years, I have participated in this interesting event by running a workshop or panel.

Health Plans are finding new ways to bring value to consumers by empowering them with tools and guidance to manage their health while on the go.

At many conferences, health plans present their newest mobile application or texting campaign to engage consumers.

UnitedHealth Group announced their latest move at the recent Consumer Electronics Show to integrate several mobile health applications into their OptumizeMe solution, through partnerships with CareSpeak Communications, FitNow and FitBit. UnitedHealth is integrating content and tools to bring new capabilities to both consumers and caregivers.

Through the CareSpeak Communications’ partnership, consumers sign up to receive two-way texts to help them manage their medication and condition. UnitedHealth delivers CareSpeak’s personalized messaging to provide relevant content to each consumer segment ( e.g. asthma, diabetes, cancer, etc). A patient with diabetes opts in to receive customized education and reminder messages and can give a caregiver permission to monitor her health. The patient’s clinician is also kept in the loop with medication and condition management data to discuss during patient interactions. Patients are further engaged by receiving text based educational quizzes and viewing online reporting showing their effectiveness in managing their medication and condition over time.

With the integration of FitNow’s Lose It! mobile app, consumers can better manage their weight through fitness and food tracking tools, educational nutrition information, motivational reminders and social peer support.

From the FitBit integration, consumers automatically track their physical activity instead of having to key it in. Since this activity data is no longer self reported, UnitedHealth Group can use validated information to drive their rewards program. The FitBit app also tracks the consumer’s sleeping behavior for a more complete view of their health.

Integration Delivers Insight

UnitedHealth Group has invested in this set of mobile technologies to capture and connect multiple sources of data for a holistic view covering the consumer’s physical activity, dietary behavior, medication adherence, biometric and mood information.

“With these partnerships in place, we are connecting all the pieces of data across our platform for a common view for the consumer to self manage and share with their coach while creating a personalized experience”, explains Nick Martin, VP Innovation and R&D, UnitedHealth Group.

This supports the trend for “integrated end to end health to care solutions” where technology connects with care management platforms and programs, as noted by IDC Health Insights’ analyst Janice Young.

Coach/CareGiver & Consumer Collaboration

Nick Martin describes how the OptumizeMe application is being used by the consumer with their coach.  “Let’s say you are trying to lose weight. Your coach can push messages to your mobile which are educational and supportive. And if you give your coach permission, she can see your tracked physical activity”.  Think about how much more motivated and accountable the consumer will feel when her coach is monitoring and responding to her daily progress.  On the health side, the asthma patient can give access to her caregiver to monitor and address medication compliance issues. Her caregiver can also send encouraging and educational messages between visits.

UnitedHealth’s partnerships deliver new capabilities to their OptumizeMe mobile app giving consumers a new way to remain in close contact with their coach and to self manage with the social support from caregivers. With the power of the personalized information pushed and pulled from the consumer’s mobile phone, UnitedHealth Group can successfully generate both stronger consumer engagement and better health outcomes.

CareFirst BCBS Medical Home SDM Tool

Over two years ago, I led a panel on patient decision support tools for a large interested crowd in Boston, despite the very snowy day.

Since then, I have noticed a few key changes. Physicians are now prescribing information to patients, using the EMR to send emails with links to health resources. And innovative health plans are playing a role in bringing shared decision making tools to engage and empower their members. Health Plans have a big cost saving incentive when these tools educate their members about less invasive and less expensive options.

3 Key Engagement Drivers With Shared Decision Making Tools

While evaluating technologies for my panel on “Evolving Web & Mobile Tools to Engage Consumers in the Shared Decision Process”, I identified how three key drivers of consumer engagement are being utilized:

1. Education

These tools show the consumer what the treatment entails and share patient stories which tell them what to expect.  This education reduces anxiety by putting the consumer in control to understand their health issues and presenting options to address them.

2. Evaluation

Shared Decision Making tools are ideally designed for “preference sensitive conditions” where there are multiple clinical options (For information about target conditions, see the recent report on the Dartmouth Atlas Project which was developed with The Foundation for Informed Medical Decision Making). The most effective tools offer alternatives, capture preferences and guide the consumer through the process while documenting their decisions. This helps set expectations for their experience and supports the discussion with their doctor or care coach. 

3. Collaboration

As the patient and clinician/coach review the SDM summary document together, they can discuss questions, concerns and comments to make the best decision.

Health Plans Leverage Shared Decision Tools

During the panel, health plans described using Shared Decision Making tools to engage members in two key areas:

• Medical Home

Panelist Zev Lavon, PHD, Director Solution Architecture, CareFirst BCBS emphasized “the story of the patient is not their last doc visit or lab test”.  CareFirst launched their Primary Care Medical Home initiative across a panel of physicians deploying communication tools to push information to patients to support the management of their chronic conditions.

•   Wellness Coaching

According to Mark L. Robitaille, MBA, Head of Care Management Support & Engagement, Aetna puts these tools into the hands of their health coaches to send emails with resources links to members or use the tools to look up information for the members without internet access.

Independent Health panelist, James J. Mis, MBA, Communications Manager, Health Care Services, described their interactive voice response campaign to inform members about viewing a shared decision making video (from Emmi Solutions) selected for their specific health interest.

Emerging Mobile SDM Tools 

With a high penetration of smart phones and strong usage across minorities, health care organizations are realizing the tremendous opportunity to deploy mobile applications to engage consumers. To date, most health mobile health applications have been focused on wellness with educational information and tracking.

Panelist Changrong Ji, Senior Solutions Architect, CareFirst BCBS described the opportunity for mobile shared decision making tools. In the future, she envisions that sensors will capture the context of the consumer’s daily life, database analytics will identify patterns and machine learning will be used to help identify relevant mobile messages to send back to the consumer.

Healthwise’s View on Patient Response

During the Shared Decision Making Summit, the chairperson, Don Kemper, Healthwise’s CEO discussed the opportunity for shared decision making tools to give a “voice to the patient”.  After the physician prescribes health information, the tool gathers patient’s preferences to document them in the medical record. I strongly agree with Don as he explains “there is no better way to engage the patient than to assure them that their voice will be heard in treatment and care plan decisions”.

Shared Decision Making Tools for Your Consumers

What are you doing to bring Shared Decision Making Tools to your consumers to motivate engagement in their health and wellness?  I can help guide you through the process of identifing, evaluating and piloting these technologies to deliver better outcomes and a better experience for your consumers. 

At the recent World Congress mHealth Summit, I led a panel called “Personalizing the Mobile Experience to Drive Consumer Engagement”.

Why is mobile so important and why does it need to be incorporated into all consumer health & wellness engagement strategies?

Pew Research’s May report found that “83% of US adults have a cell phone, and 42% of them own a smart phone”.  As mobile phone ownership grows so does the consumers’ expectations about using this device to plan, manage and monitor their personal lives. Consumer- driven companies across financial services, retail, media and entertainment are designing creative ways to engage the consumer through a valuable mobile experience.

Within healthcare, mobile is a cost effective and efficient way to not only generate but also sustain consumer engagement.

Here are several strategic considerations that I presented while introducing the panel topic.

1. Segmentation & Customization. Once a company moves beyond enabling mobile access for all target users, they must think carefully about the varying needs and mobile usage profiles of their different consumer segments. Consider consumer segments which have high mobile technology usage.

Pew Research found that over 87% of minorities such as African Americans and Hispanics have mobile phones and they are more likely than whites to send/receive text messages, use the internet on their mobile phones and have smart phones. What about a mobile texting program educating them about their health condition or motivating them to engage in preventative care?

Frequent business travelers stay connected to their company, customers and family through their mobile phones and tablets. A recent Columbia University study showed the association of business travel and cardiovascular disease. According to the study, this may be caused by their poor diet, lack of exercise and sleep as well as stress. Imagine how mobile can be used to help these travelers manage their health issues and make better decisions while on the road.

Over 75% of teens have a mobile phone and more than half are texting every day based on Pew research. Can you send mobile messages to teens to educate them about staying fit or informing them about ways to manage their diabetes? There is also opportunity on the mobile apps front.  I recently participated on a project envisioning mobile solutions to support the mental health of (college) students to avoid depression.

How is Highmark approaching segmentation? Highmark utilizes Forrester’s Technograph Segmentation to prioritize their mobile initiatives. Panelist Lisa Fitting, Director Client Engagement mentioned that when Highmark conducted segmentation research across their member base, two key segments emerged-- “Connectors who use their mobile phone for work and are productivity- oriented” and “Communicators who regularly use SMS” and often use other digital communications. Highmark is using this insight to define mobile initiatives based on these preferences. They also plan to come out with mobile applications targeting specific needs such as “fitness, weight management, diabetes, medication”.

2. Multi-Channel Experience. As consumers move about their daily life, they move from channel to channel. Teens put down their mobile phones when they pull out their laptop computers. When they are through interacting via their computer, it is important that their next mobile interaction reflect their latest online activities.

Humana conducts user experience research to better understand how different types of users interact with their Humana Fit application through their mobile phones and computers. Panelist Tony Tomazic, Director of Consumer Innovation at Humana explains “we understand the strengths of mobile. Through research, we have learned how consumers want to use their mobile phone for tracking and communications regarding personal health and fitness (e.g. saving episodes of activity, receiving reminders and alerts), whereas consumers prefer to use their computers to manage more complex and visual planning of their goals and gather information from their other external devices.”

3. Personalization in Context. While carrying their mobile devices, consumers can use them to receive reminders, review educational messages, track information (e.g. mood, pain levels, fitness and nutrition) as well as search for information to make decisions while on the go.

"Healthline brings both personalization and contextualization to the consumer", explains panelist Ryan Tarzy, VP Business Development. “Aetna members view search results that are both contextual to the issue they are researching (e.g. diabetes), but also personalized based upon their personal health record, location, and covered benefits”.

As you develop your mobile health and wellness strategy, think about the needs of your various consumer segments and their mobile technology profiles. Consider their multi-channel experience of which mobile is only a part. And determine how you can design a mobile strategy which brings new value to the consumer through personalization within the context of their current health, plan coverage and location.

Have you read the Seven Mobile Health Engagers?