Originally published in the August 2016 issue of Population Health News
The solution to meeting the healthcare triple aim of simultaneously improving patient experiences, improving patient outcomes and reducing healthcare costs will likely be as complex as the challenge itself. It will require integration and collaboration across the entire healthcare ecosystem to succeed. Although a monumental task, creating healthy patient behaviors stands to have a huge impact on every dimension:
- Improve patient care experiences. Better health reduces the need for care and makes preventive care visits more pleasant for doctor and patient. When change is needed, well-designed intervention strategies with built-in support mechanisms lay a solid foundation for patients to feel they can succeed, while motivating them to start their behavior change journey.
- Improve patient outcomes. The transformation to value-based payment, which bases reimbursement for service on quality and clinical effectiveness of care provided, will drive providers, hospitals and health systems to increase their collective stake in helping keep patients healthy. In addition, high-deductible health plans are becoming more prevalent, which relies on patient self-care and self-management. Health and wellness programs that teach and
support healthy behaviors are critical.
- Reduce healthcare costs. Dave Chase, a senior executive in healthcare and digital health at Cascadia Capital, estimates that the combined economic impact of changing patient behavior for just six key health influences (obesity, tobacco use, drug and alcohol use, sleep and sexual activity) could save up to half a trillion dollars in the United States alone.*
Healthcare providers play an integral role in driving change as one-on-one interactions between doctors and patients can be especially effective but are limited by patient numbers and scheduling possibilities. Whether educating patients on the need for change or helping them find the motivation to begin creating new habits, learning materials have the power to engage in a meaningful way. Hospitals, health systems and even insurance companies and employers have a much larger megaphone for broad communication across populations digitally. Finding a better way to define populations and target messages accordingly is crucial to success.
Empathize with an audience
Start by knowing an audience and how it relates
to both health information and technology. This knowledge is crucial to designing better behavior change solutions that engage audiences and move them along a path to new and healthier habits.
An increased level of understanding leads to better predictions of user behavior and if it is possible to predict behavior, it is possible to influence it. Digital platforms offer significant opportunities for facilitating change as they pervade every aspect of everyday life and have the benefit of following patients out of a clinical setting into the real world. Scalability, flexibility and reach make digital tools a logical investment for reaching patients, and recent trends in health-related platform adoption reinforces the available market.
Human-centered design focuses on an empathic approach to designing solutions. Empathy is the human element that goes beyond just defining a target audience to also understanding its perspective—the lens through which a group interprets the world. The result is the ability to connect on a human level and extend that connection to deeper engagement.
By analyzing various perspectives represented in an audience, an organization can subset a larger audience into groups based on their likely behaviors to target interactions more effectively. For example, some consumers are more likely to look for health information online as a primary source, while others are more apt to ask a medical professional or other trusted person. Based on those behavioral parameters, it’s a logical assumption that reaching the first group will require search engine optimization and social media strategies. To engage the second group, outreach through intermediaries such as community health workers is more likely to yield results.
The very concept behind population health creates a unique opportunity for applying behavior change strategies. When trying to define large and diverse audiences, traditional segmentation creates too many variables for a manageable data set. Using empathic indicators, such as needs, challenges, habits and influences, to segment audiences creates an actionable data set based on typical and likely behaviors. Cross-referencing that information with available data through population health adds considerable dimension to an audience profile and allows for another level of tailored messaging.
Build influence through engaging relationships
Effective behavior change initiatives require concerted, comprehensive strategies to succeed. A key part relies on the level of engagement with an audience, in this case patients or healthcare consumers. Behavior interventions seek to change the relationship someone has with an existing habit. Relationships yield influence, and the relationship a person has with a particular habit must be replaced to establish a new one.
Engagement is the basis for any successful behavior change strategy because it builds and strengthens all relationships. It allows an organization to amplify its influence on an audience because as engagement increases, so does influence.
Well-designed behavior change strategies lead patients along an engagement pathway that builds a relationship and influence along the way. The engagement pathway lies between where an audience starts and desired outcomes for them. There are two journey maps that will aid in designing engagement strategies. First, the ideal journey from point A to point B maps the steps necessary to achieve a desired outcome. It’s a good place to start, but a patient rarely experiences an ideal journey for many reasons, not the least of which is the huge differences between people. Secondly, mapping a different typical journey’s experiences and examining the deviations patients take from an ideal journey allow providers to integrate tactics that prevent abandonment or help patients get back on track.
A considerable amount of work and scientific research have explored how to move patients along a behavior change journey. At the highest level, the keys to affecting lasting behavior change are engaging the audience’s head through awareness and education, the heart through emotional connection and desire and finally the body through action to deepen engagement and extend influence with an audience.
Those three levels of interaction—the head, the heart and the body—set the guidelines for effective engagement through content development. Keeping in mind where an audience is in its journey, an organization should educate, connect or call consumers to action. Moving too fast can cause an audience to revert on its journey or abandon progress altogether.
Engage on consumers’ terms
Detailed audience profiles, along with ideal and typical journey maps, provide a great deal of information about what information an audience needs and when to help it succeed on its behavior change journey. Digital analytics provide details to determine the best content formats and platforms for engaging an audience, as well as data for customizing engagements and personalizing experiences to increase efficacy.
EMPATHIZE > BUILD INFLUENCE > ENGAGE > AMPLIFY INFLUENCE
For example, tracking what content is accessed on what devices throughout the day and what types are most popular allows developers to create content users desire, as well as establish publishing cycles that capitalize on when users are most likely to consume it. Analytics are a powerful tool, and the information that can be tracked is becoming more detailed and more accurate. A harder task is creating a culture of developing content based on data-driven decisions. Not getting emotionally attached to content and being willing to throw out the status quo to experiment and embrace the direction an audience prefers can be difficult at first, but the risk of letting audiences’ needs lead pays off in engagement.
Taking the concept of customized experiences to the next level, flexible open content models allow users to create their own adventure as they navigate. In an on-demand world, audiences have become accustomed to exploring content on their own terms—when, where and how they want. Health information should allow users to scan bite-sized chunks of information quickly to see what’s available and to dive deeper for more information as desired. For those looking for more scientific, in-depth material, they can continue to explore further.
Getting an audience to act is just the tip of the behavior change iceberg. Continuing to connect and reinforcing successes helps keep patients on track for the long term, moving them beyond acting to maintaining. When patients successfully change an action to a new habit, they can become the most powerful advocates for helping others start their own journey or get back on track. Successful patients personify the benefits of healthier behaviors and evangelize the need for change to others. Their success stories make excellent content as audiences connect with and trust content more readily when they see themselves and their lives reflected in it. Success stories from everyday people holds up a mirror for audiences.
Patient behavior change is a critical part of any population health effort, and developing effective content that encourages, influences and supports behavior change is a powerful tool for health providers. The key is to balance an organization’s goals with an audience’s needs, and make a population audience feel as if it is a priority. The more content resonates, the more effective it will be and the bigger the ripple effect based on loyalty and advocacy.
* Chase D. “Report: The Future Health Ecosystem Today Provides Look Into Healthcare’s Future.” Forbes. Feb. 3, 2016.