Leveraging Digital Technology to Increase Engagement in Population Health Programs

BioIQ: Let’s start with the basics. How do you define engagement and specifically, how do you define it through the lens of population health?

Dr. Reynolds: In broad terms, engagement is about taking action, leveraging personal effort toward a shared goal and engaging in interactions that foster a sense of community.

In the context of population health, the Population Health Alliance defines engagement as, “When an individual performs sustained actions toward achieving optimal health and well-being.” For instance, a person living with diabetes could be considered engaged when they actively participate and collaborate in their treatment plan, expend effort learning as much as they can about their condition and practice routine self-management. Instead of healthcare being something that happens to you, it’s something you control. In short, it’s about shifting from being a passive recipient to an active participant in one’s health.

BioIQ: From the implementation of the Affordable Care Act to new FDA regulations to evolving technology, the healthcare landscape has changed drastically in the past decade. How have these changes impacted the way organizations must think about engaging their members?

Dr. Reynolds: Healthcare has evolved beyond the paternalistic service delivery model (“the doctor is always right”) to one that is consumer-focused. Individuals are bearing more of the burden for healthcare costs and have a greater responsibility for managing their own health.  This is a natural transition as healthcare service reimbursement has moved from fee-for-service to outcomes-based models. This change has encouraged significant innovation and pushed providers to think not only about the time spent during each appointment, but also what happens between visits. When providers are rewarded for better outcomes within their populations, there is an incentive for them to provide healthy lifestyle interventions, self-management, condition care, clinical decision support, treatment plan transparency and collaboration, and useful educational tools.

Furthermore, consumers are increasingly interested in obtaining the best value and outcomes for the dollars they spend on healthcare services. For many years, there was no visibility into the cost of services or why they were even needed. With costs shifting to consumers who now have more “skin in the game,” they are empowered to demand better quality and the best value for their money.

There is clear evidence that engagement in health leads to better outcomes, both clinically and (to some degree) financially. Providers who recognize this are leading the charge to include better tools, models of care and innovative technologies to boost patient engagement.

BioIQ: Organizations increasingly depend on technology to engage their populations, and utilizing poorly designed tools can be costly. Why is understanding the perception of these tools and delivering a great user experience key to successful engagement?

Dr. Reynolds: It’s pretty simple: If the tool isn’t used, it won’t be effective. Developing, integrating and deploying technology to support population health can be an expensive and time-consuming process. With resources at a premium, organizations must carefully consider the expected use for these tools, who will be using them and whether they are adding complexity rather than convenience to the expected engagement behavior. If the proposed technology doesn’t meet a defined consumer need, it will result in low participation or a lack of sustained engagement.

It’s also critical to understand your population. Certain socioeconomic and demographic strata access and use technology in different ways, so program designers should consider these differences when deploying technology.

Finally, even the best technology will fail if the user experience is poor. Today’s consumers have little patience for technology that falls short of its expected use, is confusing or generates frustration, rather than joy when interacting with it.

BioIQ: What are some of the benefits to an employer or health plan of having a member population engaged in its wellness program?

Dr. Reynolds: There is plenty of evidence that supports positive outcomes for engagement in population health and worksite well-being programs. Consider the following examples of engagement outcomes.

• Increased preventive behaviors like making healthy food choices, exercising regularly and self-monitoring compliance
• Better outcomes across diverse groups, such as BMI, A1C and blood pressure
• Decreased health costs for organizations
• Better service for healthcare consumers
• Increased employee productivity

If organizations can engage their populations and create a culture of health, they will see many other improvements as well.

BioIQ: You’ve mentioned a culture of health before. What is it and what role do digital tools play?

Dr. Reynolds: In short, a culture of health is created when an organization or a population views health as a core value. In this setting, people participate in individual and group activities that encourage wellness, while organizations support these activities through highly visible leadership and policies that promote healthy behaviors. Once developed, this culture provides a social influence and supportive environment for people to engage in healthy actions. It becomes routine for employees to use walking workstations around the office, take the stairs instead of the elevator or select healthier lunch options.

Organizations with an established culture of health have a healthier, happier, more engaged workforce, which ultimately leads to better individual outcomes as well as financial ones for the business.

Digital tools are a key component of a culture of health. Recent research from the National Business Group on Health suggests that organizations with an established culture of health tend to use technology for engagement in their programs more than those that do not. Consider the differences in engagement when the following tools are used: online competitions (50 percent versus 25 percent), activity tracking (40 percent versus 18 percent), social networking (39 percent versus 10 percent), game-like features (37 percent versus 13 percent), mobile messaging (29 percent versus 9 percent), and mobile apps (27 percent versus 7 percent).

In part two of our exclusive interview, Dr. Reynolds shares how organizations can measure digital engagement in wellness programs, best practices for building a digital strategy and more.