Presenter: David Ahn, UCLA Endocrinology @AnhCall
My clinical career and the iPhone were very intertwined, and I’ve been very interested in the use of mobile technology in medicine.
Medicine versus Business
- They’re very different; polar opposites in many ways (both have their pros and cons).
- Business-led ideas in medical hardware are often not what they’re promised to be (over promise & under deliver), i.e. Scanadu, Theranos: Hubris in disruption.
- Medicine-led ideas: clinical utility over the user experience (“everything but the sink” approach), no clear business model: hubris in being a domain expert.
Achilles Heel of Digital Health: Engagement
- Poor user engagement
- Preaching to the choir
- What happens after 30 days?
- Do they actually lead to behavior change
- Passive measurement alone is not the solution
How Do We Engage & Motivate Users?
- Habit-forming psychology
- Variable rewards, i.e. slot machines
- Loss of reward > Hope of earning reward; expiring offers
Apps that Do a Good Job with Engagement
- GymPact: “get paid to work out,” commitment-based, negative & positive reinforcement, effort-dependent, not result-dependent
- Prevent by Omada Health: 16 week online course structured around the DPP (I think this one is based on solid medial principles); health coach via phone, text, private message; social motivation (teamed with 12-18 random people); technology tools provided include a wireless scale and pedometer.
Hipster / Hacker / Hustler
- UX, Engineer/dev, marketing/business
- In health startups you also need the healer!
Diabetes
- 29.1 million in US have it
- Hundreds of millions are spent on it
- Managing it: monitoring glucose, diet, physical activity, exercise
Blood Sugar
- “What gets measured gets managed”
- Regularly checking sugar is proven to help improve diabetes control
- Traditional: use glucose logbooks (a vital tool)
- Every device has it’s own proprietary plug/cable
Patient’s Perspective
- Information overload
- I don’t want to feel bad
- Forgetfulness
- Inconvenience
- I don’t gain anything from it
- Insurance restrictions
How to Change Perspective?
- Scare tactics
- Education
- Gamification
- Rewards/Incentives
- Punishments
- Social pressure
What Works for Me
- “Pact App for Diabetes?
- Commitment based
- Negative and positive reinforcement
- Effort-dependent, not result-dependent
Streak-Based System
This approach helps to build a healthy habit
- Commit
- Build streaks
- Learn and earn
Trends and habits are reflected via graphs
App has been successful so far!
v1.8 New for “Code for the Mission”
- Dashboard for viewing/sharing glucose reports
- Viewable on an y mobile or desktop browser
- Notes field
How are we doing on User Engagement?
- 10% log in every day
- Longest user streak: 164 days
- Thousands of users have logged 50k sugar readings
David then gave a demo of the app