For the last two years, we at Wellsmith have been working to get patients to engage in their Care Plans. We have, by providing them a personalized digital care plan, made following their doctors’ requests: simple, memorable and actionable. In a continuous program of a year, we have been able to get a majority of the people on the platform doing a majority of things we need them to do, a majority of the time.

So, after all this time and engagement, what have we learned about consumers, their healthcare and digital technology? Here are the philosophies behind 7 engagement habits we’ve designed in to the Wellsmith platform:

  1. Consumer don’t want to solve your problems; they want to solve their own

When businesses go digital, a common issue is trying to get consumers to solve their business problems. The best example here might be newspapers. Newspapers saw a huge drop in advertising revenue and loss of subscriptions from online competition. They also saw a huge increase in the number of people wanting to read their content online. Their answer was to charge people to read the paper online, backfilling the loss in revenue. It didn’t work, and a recent article noted 69 news sites where paywalls were dropped or eliminated.

One of the biggest reasons newspaper\s’ paywall strategy failed is that they were not solving the consumer’s problem. The news sites were trying to solve their own problem of loss in revenue. The consumer wanted convenience, mobility and the ability to read content anywhere and anytime but they do not necessarily want to pay for it. In cases where there is high brand loyalty, like with the storied Wall Street Journal, the consumers will pay.  But when there is an abundance of choice, they will not.

The same problem exists in healthcare where 98% of digital health startups fail. Whose problem are you trying to solve?

Lesson: People don’t want your digital life, they want their own– solve their problem first.

  1. If you have to train a consumer on your app, they are not going to use it

If you make it too hard to do, a consumer will not do it. Take the example of Google’s Wave. Wave was supposed to be the ultimate communication tool, but it failed and was shut down in 2012. The biggest challenge for Wave was managing the expectations that couldn’t possibly be met, with a product that was too hard to use.

Now compare Wave to YouTube. Few people need a video showing them how to use YouTube because its interface is intuitive. It does what you expect it to in a way you expect it to. Too often people build digital interfaces that mirror their existing systems. It is pretty unlikely that any consumer interface looks like your existing systems. You can find other examples of apps with intuitive interfaces here.

In healthcare, users are typically highly trained and licensed professionals. They have a language which they share and complex systems they are trained on. Additionally, they have lots of attorneys telling them what they can and cannot say. All of these elements make it nearly impossible for consumers to use or understand healthcare-designed systems.

Lesson: KISS – Keep It Simple.

  1. Consumers respond to how something occurs to them (not to you)

The book The 3 Laws Of Performance makes the case that we respond to something, 100% of the time, based on how it occurs to us. If it occurs to us as hard and we don’t like hard things, we will avoid it. If it occurs to use as of no value, then we probably will not do it, and so on. At Wellsmith we know that consumers are willing to do things, like track their health vitals, if it occurs to them as easy and frictionless.

Some physicians repeatedly told us that we would not be able to get Wellsmith participants to track their blood sugar levels every day. The reasons they gave for this ranged from people are too busy to just too lazy. That’s because, in a non-digital setting, consumers were being asked to remember to take their glucose reading, remember to write it down in a booklet or chart, and remember to bring that data in for every visit. By integrating their Glucometer (the device that measures their blood glucose) into an easy to use the app, Wellsmith removed that resistance. The consumer only has to do one task, take the measurement, not three, because the other two are automatically completed. As a result, a majority of consumers on the Wellsmith app, monitor the things we need them to, a majority of the time.

Lesson: Consumers will change their habits if you remove resistance.

  1. Things we choose have more value than things we are given

A diner in the US can be an intimidating place because there tends to be an abundance of choices. When we are eating breakfast there with fellow Brits, I tend to say to them, “Don’t look at the menu, what would you like for breakfast?”

If you want to understand more about choice, I would recommend the TED video called “On the Art of Choosing.” One of the many lessons from this video is that people often are more committed to choices they make rather than things that are chosen for them. In other words, we are more likely to stick with something we choose rather than something we are given.

A diner menu has so much choice that making a decision can be hard. This is what some have called the ‘tyranny of choice.’ If we remember that consumers also want simplicity, then too much choice just adds complexity.  And if something occurs to them as complex, most will avoid it (see Lesson 2).

Lesson: Consumers want to be able to choose, but from a small menu of things.

  1. Consumers need to feel in the loop to stay in the loop

In an attempt to make patients happy, healthcare providers have responded with 24×7 helplines and guaranteed short response times. This works well when we visit or call; it’s not the same in a digital world. When we use Facebook messenger, WhatsApp or even text, it’s nice to get an instant response but not vital to us. Sometimes a digital conversation can happen over hours or days.

Consumers want the same from their digital health apps. They want to know that when they interact, there is someone or something hearing them and responding. One of the reasons for the failure of so many health apps on smartphones is that while they do a good job of tracking health actions, there is little or no feedback or response. There are no insights into what the information consumers provide means to them.

Lesson: You need to value the consumer input and return it with a response they can use and value (but this doesn’t mean they expect 24 x 7 phone support).

  1. Consumers need to trust to share

I still hear people tell others not to use Apple Maps unless they want to drive off a bridge, even though those stories are over 6 years old now. Some people will never be able to trust Apple Maps again and establish a habit to use Google or Waze.

Trust is clearly an even greater concern when it comes to health. A Black Book survey in 2017 showed that 57% percent of consumers who had experience with either a hospital, physician or ancillary provider’s technology said that they were skeptical of the potential benefits to certain technologies. Data hacking and a perceived lack of privacy were the top reasons why patients were hesitant to utilize new technology. So, while healthcare professionals believe the value of sharing your health data may outweigh the privacy risk, most consumers still do not.

Lesson: Adoption of digital solutions will be gated by who refers you and who you trust.

  1. Consumers like accountability

No one likes a ‘nagger’. Yet, as American writer Paul Fleischman once said, “when people nag us, we instantly resist, but when the facts force us in that same direction, we instantly adapt.” We see this at Wellsmith.

Participants using Wellsmith tell us that one of the things they most like is that someone is holding them accountable for the health actions they have committed to take. It can also help that this accountability comes from someone other than your doctor or a family member. We have found that when we see people starting to miss their ‘to-dos,’ our first approach is just a gentle and empathetic nudge from a health coach or nurse. Often people will get back on track, without even responding to our nudge. For others, we need to talk to them and understand what is causing them problems.

Lesson: We don’t mind being held accountable to our commitments, but take care in how we are reminded.