How will we know when digital health, or even just a small element of it, is a success?
It won’t be when a certain number of devices are shipped. It’s not when we arrive at an appointed date in time. It won’t be when the industry reaches a specific value.
It will be when people just call it ‘health’.
This will be a time when we don’t even bat an eyelid as the surgeon straps on a virtual reality headset to make that first cut; or question a chatbot triaging our symptoms and dispensing pills personalised for our individual biochemistry. We won’t even notice the ‘digital’ element of it, much like we don’t say we send ‘digital messages’ or play ‘digital music’ anymore.
We need to remove the ‘digital’ from ‘digital health’. This was the resounding challenge at Digital Health World Congress 2017, laid down by the first keynote, Alistair Stuart, Project Director, Clinical Innovation & Digital Platforms at GSK to a varied gathering of big pharma, start-ups, academics, and everyone in between.
The way to do this is behavioural change, and this idea was the red thread running through many – and arguably the most engaging – presentations, such as those from Liva Healthcare and Echo. Those discussing its importance are far out in front of competitors and colleagues relying on the fact they use machine learning. This is now table stakes.
Focus on behaviour change elevates the Digital Health conversation beyond interface design, flavours of machine learning, or monthly active users. Doing so naturally addresses all these areas whilst keeping the end user front of mind. And if we’re not keeping the user front of mind, why address health challenges with technology in the first place?
The term ‘user’ and not ‘consumer’ is intentional, because healthcare professionals are a big piece of the digital health puzzle. One of the most telling moments at the event was when a speaker asked of the room, Who has had a doctor prescribe an app or digital solution as part of their treatment? One person out of a few hundred proudly raised their hand.
Numerous principles can be employed to enact change. At the risk of over-simplifying entire libraries of research and study, we can apply some of the following principles of behaviour economics:
- Availability– the ease of recalling an association. Here we might look to challenge the association of an existing method (painful blood glucose monitors; or complex reporting systems for healthcare professionals) with a new process (non-invasive contact lenses, such as those concepts developed by Google; or interoperable record systems) to demonstrate end user benefit
- Anchoring– arriving at a decision via the first piece of information offered. Subscription-based models can benefit here by guiding people toward a longer-term commitments (eg. Proposing a monthly charge before outlining a three or six month subscription.) Just ensure that you hold up your end of the bargain for the duration of the relationship
- People like me– we respond to those we can relate to. Whilst not strictly health, a great example of this was in my homeland when Australian boxer Danny Green spoke out against single-punch assaults – what came to be known a ‘coward’s punch’
- Social proof– we recognise and are more likely to replicate action from people like us. User reviews or endorsements are a simple method here, encouraging others to try your product or service
- Commitment– public declarations mean we’re more likely to uphold or continue behaviour. Health has a great tradition here, from Red Nose day to Movember. The challenge in the digital age is ensuring the declaration isn’t as fleeting as a social post, but there are great examples of how awareness is applied to the digital age, such as the ice-bucket challenge for ALS
- Reciprocity– as social animals the convention of ‘returning the favour‘ is a very powerful motivator for action. In digital health this could be gamification of care, such as earning points for medicine adherence
- Scarcity– fear of missing out. Limiting products or services, either by availability or price will not play well in the health space. However success in a specific area or market can be used successfully to drive demand in another during expansion phases
- Authority – we look for people to help us make the right choice. Healthcare professionals will continue to play a role here, but the method and manner in which they engage will need to evolve to reflect the preferences of today’s end users
This is just scratching the surface. But focus on even the smallest elements of behaviour change will bring us into a world of health that is enabled by technology quicker than we know – and possibly before we even notice it happened.