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Moving Mobile Health Past The Hype

POST WRITTEN BY
Howard Steinberg
This article is more than 9 years old.

Imagine if the iPod could only play Frank Sinatra songs, or if the latest iPhone version was a not-so-smart-phone with just text, email and a weather app. It's not just the existence of mobile computers we call smart phones that has changed our lives in profound ways, but the content delivered by them. It's also why the “mobile health” or “wearable technology” movement is dramatically over-hyped.

The belief that new technology like body monitoring and data tracking is the key to a healthier and happier world ignores the huge role that content plays in converting data and analytics into emotion that engages people in new health behaviors by humanizing our experience with technology. It’s one thing to get fitness fanatics who already take care of themselves to adopt cool new devices. It’s an entirely different challenge to attack major health issues like diabetes among large populations historically resistant to engaging in their own care.

Ultimately what will successfully complete the virtuous cycle back to the user is not simply data. Nor is it a text, a call, a reminder or a lecture upon the next visit to a physician who is now armed with yet more data.  We need personalized, compelling and imaginative content that makes the user want to engage in self-care.  People aren’t moved to action by “data dumps,” but by emotion and narrative.

Mobile health devices could become a biological information superhighway that transfer data from our bodies or brains to the cloud for analysis and action, so long as the right content returns to the user to complete the cycle.  Here is a prescription for success.

1. Overcome Innovator Arrogance. Only in the rarified air of Silicon Valley, where revolutionary trends, rebellious billionaires and the fastest-growing companies are created, would a movement emerge apparently tone deaf to the audience it most needs to serve. The current fascination with making disease management quantitative has less to do with mass population health need and more to do with the often narrow perspective of technology “innovators” who (1) believe that data is the answer to every problem and (2) build things for who and what they know, which tends not to be the mass population of chronic disease sufferers. Aging Americans have little access or interest in a quantified life, but rather are just trying to have a normalized life.

2. Get Beyond a Self-Selected Consumer Base. There are multiple markets and consumers to serve for this new generation of mobile health tools, but so far adoption is from those raising their hands. Whether it’s activity trackers like Fitbit or a new family of interactive glucose monitors for people with diabetes, users opting in early aren’t the ultimate target. Most consumers aren’t even asking for this gadgetry. Despite the over 100,000 health and fitness apps now available, the number of Americans using technology to track their health has not changed since 2010, according to the Pew Internet & American Life Project.  And when asked, “What would you like to do more of with your smartphone?” only 12 percent of consumers told a recent Zogby survey they would like to “monitor their health.”

3. Serve Patients, Not Their Proxies. Crossing the divide from cool consumer devices to integrated healthcare tools for the chronically health-disengaged requires penetrating the powerful forces that pay for it (employers, insurers and government) or entrenched providers that deliver the service (physicians and hospital systems). These consumer proxies are focused on the macro and thus love data and the potential efficiencies and cost savings it can deliver, fueling interest from start-ups but not necessarily from the ultimate user who lives in the micro and may not care much about this data collecting gadgetry – even if their doctors and insurers do. Commercialization is a great deal more challenging as innovators bump up against embedded and siloed systems not prone to quickly adopt or integrate new paradigms and where consumers tend be treated like they’re not in the room. We must put products in front of patients they will actually want to use, not the ones its proxies want them to use.

4. Recognize That Medical Problems Have Tough Behavioral Roots. Diabetes consumes almost 25% of total healthcare system spending and is growing at epidemic rates. By 2050 a third of Americans will be challenged by diabetes which requires strict adherence to diet, exercise, medication and more. The onus always falls to the patient, which is why it is so critical for new digital health solutions to be “humanized” to attract the panoply of potential users. Start-ups like Telcare and Livongo claim they can make diabetes management better or easier with a “connected” blood glucose meter that sends data all over the place – your doctor, your insurer, your caregiver and so on, but it still depends on a base level of compliance by the patient.

This is fine for the young, intensely self-managed, tech savvy Type 1 patient or parents of kids with diabetes, who are motivated and open to leveraging this kind of technology and may even have a physician with the time and interest in using the data. But unfortunately, the vast majority of the devastation and cost of diabetes is concentrated in higher-risk groups who are less informed or resistant to behavior change, and managed by a harried primary care doctor inside a fossilized system. 65% of people with diabetes are over 50 and almost 60% don’t even test their blood sugar at all. These folks don’t look or act like “quantified selfers”.

5. Think Like Marketers and Storytellers. Fundamentally these chronic “lifestyle diseases” such as diabetes, obesity and hypertension are behaviorally driven. Digital health must shift to a more consumer-centric mentality to achieve user relevancy and embrace the very real psychosocial and emotional challenges that limit self-care behaviors.  Numerous studies refer to the "narrative" as a more effective way to get individuals to do what you want them to do, no longer clinging to outdated strategies of authorities lecturing overwhelmed patients with data and facts.  Current data-driven algorithms that use basic information like blood sugar readings, medication, food intake or heart rate as inputs could come to life if enveloped by compelling branding, content and storytelling to command attention and sustain behavior change regardless of age, ethnicity, disease progression or tech-savviness.

Integrating the biological with the behavioral is as much a creative process as it is an engineering or clinical challenge. Doctors and engineers must collaborate with behaviorists, content creators and marketers to pioneer new ways to engage not just with data, but with emotion.  Even in a HIPAA-dominated world with appropriate sensitivity around data security, knowing more about each user by not just monitoring physiological variables, but assessing subtle psychosocial and behavioral influences as well, can facilitate delivery of a more personally tailored, relevant, involving and even entertaining experience.

For example, a diabetes management system enabled with individual “likes” could deliver videos from Oprah encouraging me to test my blood sugar for the sake of my grandchildren, instead of a generic text reminder to test my blood sugar. Which one do you think would resonate with an Oprah fan and sustain some behavior change? This is where the content creators – storytellers, filmmakers, game developers and advertisers – can play a major role in product development by integrating the narrative elements that attract the disengaged into their story because it is personal, involving, compelling and real.

We now have a pipeline of hardware and the highway; we just need the content for digital health to start changing the game for a mass population compromised by chronic lifestyle diseases like diabetes.

Howard Steinberg is an entrepreneur who has lived with type 1 diabetes since age 10. In 2004, he formed dLife, a multi-media DTC platform to engage this burgeoning population in better 24/7 self-care. He remains active as an investor and advisor from his perch at the Westport Innovation HUB, a co-working center for entrepreneurs and investors that he founded in 2013.