Helping Patients Learn Healthy Habits

Building for lasting behavior change with a patient-centric, research-driven approach to health innovation

What if we told you we could improve health outcomes for more than 50% of patients and save the US healthcare system up to $289bn a year?

That’s the average cost of nonadherence to prescribed medications, or in layman’s terms, not taking your meds. Fixing this epidemic could not only save billions of dollars but, with around 125,000 deaths a year in the US due to failure to follow doctor’s orders, it could save thousands of lives too.

Better lifestyle decisions can solve many of our personal health problems; eating healthily, regular exercise, taking your pills, are all positive behaviors that contribute to better health, and disease resistance. Many health companies are looking to technology to help us build these habits; for example, ‘smart’ pillboxes that uses reminders, alerts and progress tracking.

Unfortunately, positive behavior change takes more than an electronic prod. Recent research showed no noticeable improvement in nonadherence when using a wireless pillbox.

For Daniel Weng, founder of Tricella, the maker of a smart pillbox, technology alone can’t fix our biggest health problems. “A smart pillbox isn’t enough. Too many companies forget that it’s humans, not technology, that leads to better outcomes. While technology empowers people to make better decisions, it’s not the solution unto itself,” he says.

Consequently, Tricella pillboxes go beyond basic reminder technology to inject the element of social support. Weng designed his pillbox to connect patients and caregivers; an accompanying app with simple call-to-action response buttons reduces the friction of responding to non-adherence and driving the engagement of caregivers to patients.

In short, health technology must help patients build sustainable healthy habits – if it doesn’t, it fails.

Baby steps
Changing patient behavior is increasingly at the heart of healthcare, but no one finds change easy. Many of us make new year’s resolutions but 80% have failed by the second week of February.

This failure isn’t our fault, says Sean Young PhD, Director of the UCLA Center for Behavior Change, because we set ourselves up to fail by trying to change too much too quickly. When change proves too hard, we lose motivation and revert back to bad habits.

In his bestselling book, Stick With It: A Scientifically Proven Process for Changing Your Life For Good, Young suggests a better strategy – taking tiny steps towards greater change. He also underlines the need for community and for change that holds the patient’s interest. His goal? To make change easy.

When designing health technology, the Fogg Behavior Model provides a blueprint for effective behavior change. It facilitates behavior change by optimizing three key elements of the patient’s journey; ability, motivation, and triggers.

Don’t assume your users already have the education, resources or time to achieve the target behavior. Often this isn’t the case. When mapping out motivational experiences, consider both technology-based ability and the patient’s knowledge of the health problem.

A frictionless design flow is critical. A patient-centric approach ensures design never prevents a user performing a desired action or adopting the target behavior. Map out the user journey from first access to adopting the new habit. This makes sure every direction has a clear and easy-to-follow path to completion.

Education is vital in health technology; for users to adopt a new behavior, they must understand their illness and the benefits of change. Key to successful health technology is understanding your users’ needs, emotions and challenges at every stage in their patient journey, then delivering the right educational content at the right moment.

7 Cups of Tea, an on-demand emotional health service, takes a thoughtful approach to providing educational content. The step-by-step My Growth Path drip-feeds advice for a happier life, helping users to quickly engage with the platform. Content series, such as Mind Over Mood, and ‘single paths’, such as Anxiety: Overcoming Worry, allow users to delve into topics of interest.

Ongoing user research should inform both the design of a health technology and a content strategy.

When designing and building the Together in Heart Failure platform, a Novartis-funded online community for those impacted by heart failure, multiple research sessions revealed patients’ pain points and needs. These included:

• Patients want to access support throughout the day
• They struggle to consume complex information supplied by healthcare professionals
• They crave a safe space where they could share and connect with others.

Together in Heart Failure – an always-accessible, mobile-first platform – addressed these challenges and allows patients to receive digestible educational content at their moments of need. A user-tested approach to design created a welcoming aesthetic and high engagement rate.

An effective health technology should motivate patients to take the next step towards better health. Again, user research should inform your approach; identify the support and inspiration your patients need, and when they need it, to ensure their motivation remains high throughout the journey.

With Together in Heart Failure, audience research revealed that users felt most motivated when content was tailored to their position in the patient journey. Building on this insight, the platform allows users to personalize the content they see by following specific topics and contributors.

This means that recently diagnosed patients can choose to see motivational messages that help them come to terms with their diagnosis, while patients at a more-progressed stage can consume content that inspires them to improve diet and exercise.

Another example of leveraging patient motivation is Pfizer’s Hemocraft, an online platform that uses gamification to help young people with hemophilia better manage their disease. Players embark on a virtual adventure where they learn to self-treat their condition. This innovative approach to health technology seeks to truly build for the target audience – making the process a game, rather than a chore.

If we’re to create health innovation that empowers patients to adopt healthy habits, we need to take a research-driven, patient-centric approach to technology design. When we build for lasting behavior change rather than short-term results, health technology truly has the power to help save lives.

Steve Peretz is Director of Health Innovation and Meg Donchak is Product Manager at Beyond, a global design and technology ideas company.