Joseph Kvedar, M.D.
In his keynote address at the iHT2 Health IT Summit in Boston, Joseph Kvedar, M.D. gave attendees an overlook of specific strategies and tactics that healthcare provider organizations can use to leverage the addictive nature of mobile devices.
The summit is sponsored by the Institute for Health Technology Transformation, or iHT2, which since December 2013 has been in partnership with Healthcare Informatics through its parent company, the Vendome Group LLC.
Dr. Kvedar is the director of the Center for Connected Health, a division of Partners Healthcare in Boston, which focuses on non-traditional medical interventions through the use of connected devices. While smartphones, tablets, and other devices have reached an overall critical mass in terms of adoption and addictive use, he notes that this "always on, always connected" phenomenon hasn't been taken advantage of in healthcare delivery.
"At the Center, our bottom line goal is to integrate care into people's day-to-day lives. That rolls right off the tongue, but in an environment where we're so used to care only being delivered when we visit the doctor, this is counter-cultural," Kvedar said to the attendees.
Since the Center specializes in creating interventions with the use of these devices, as has been highlighted in previous Healthcare Informatics
articles on mobile health (mHealth)
and patient-generated health data (PGHD),
Kvedar is able to illustrate successes and failures in this burgeoning area. Using the successes and failures from those interventions, he outlined three strategies and three tactics that can be used to make healthcare addictive through the use of mobile devices.
His three strategies were as followed:
Make it about life: This strategy, Kvedar said, is about creating messages on mobile devices that are compelling and engaging. It's about drawing patients in, making them want to participate in their healthcare, rather than isolating them.
His example was an intervention they did at the Center, where they had text messages sent to pregnant patients on relevant prenatal care information. The messages, based on their due date, would remind the pregnant women that they had an ultrasound appointment or told them when they should feel the baby kick. Of those who received the messages, the Center found that 74 percent said it helped them take better care of themselves and 85 percent said it made them feel more supported by their obstetrics (OB) clinical team.
Make it personal: In a similar vein, Kvedar recommended using different data sets to motivate patient behavior through the use of personalized messages. In the case of the Center, they used patient survey information, their pedometers, and global positioning systems (GPS) that can determine the local weather to create personalized, motivational text messages for patients twice-per-day.
In this intervention, Kvedar said that on the whole, the entire population opened the messages 80 percent of the time. This engagement, he said, meant better outcomes. The HbA1c (hemoglobin) levels of patients involved in the project dropped .62, which is better than what it drops in a good controlled drug trial.
"This intervention is better than a drug," Kvedar said.
Reinforce social connections: Having patients get support from social groups is another area of opportunity. In the example for this strategy, Kvedar talked about the Center's Connect 2 My Act project, which brings together asthmatic teens with each other through private Facebook groups.
Using the social network was therapeutic for these teens, he said, and that in this case, the social intervention was better than the medical intervention. Of the teens who were in the Facebook group, 80 percent took the asthma control test, which is a measure of health in this area, compared to 20 percent of teens with asthma that normally take it.
Continuing on, Kvedar then delved into the specific tactics that providers could use to make healthcare addictive on connected devices. Those tactics were as followed:
Employ subliminal messaging: Kvedar recommended fronting important messages with compelling, relevant information. As an example, he talked of a program where weather reports were sent to phones with messages on sunscreen adherence.
Use unpredictable rewards: While this isn't really going on in healthcare, Kvedar said there was a "can't miss" factor with smartphones in other sectors that got people to check their phones because they didn't want miss out on something important.
Use the sentinel effect: This is what happens, for example, when patients are monitored on dashboards that track various health measures. When something is out of the ordinary or the patient is non compliant in some way, they get a phone call from their clinician. In other words, they know they are being watched. "What really matters, patients tell us, is that the clinician is calling them out," Kvedar said, adding that the Center is working on automating this "effect."