Health inSite: #PokemonGO and Health

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Intro

I know there are a TON of articles and posts that have surfaced in these 6 days since PokemonGO was released in the United States. The sheer volume of discussion around this just-short-of-a-phenomenon app is certainly surprising in many ways, though another very popular app that just recently was eclipsed in downloads, Tinder, also got a ton of press at the beginning – mostly for the questionable intentions of its users. In this case, you might be able to make a case for the questionable intent of the creators, but I’ll stay away from either of those as the crux of this post and use it as a jumping off point for what I see as valuable technology for the future of health intervention.

What is PokemonGO

pokemongo3

From NianticLabs.com

Loosely based on “Ingress,” PokemonGO is a marriage between Google spin-off Niantic and Nintendo’s Pokemon company. Both companies have, on their own, somewhat of a cult following at this point. While the platform that enabled Pokemon to flourish, Nintendo, has wider reception, both at this point, are not particularly popular on their own. I was actually never a big fan of either. There may have been Pokemon Pogs when I was growing up, but aside from that, I’m not intimately familiar with either. But this combination of geolocation technology and fantasy are not new at all. In fact, if you check out ARGNet, you will find a number of times when games have moved beyond their stated fantasy world and brought them into the real world. Even Cards Against Humanity’s 12 Days of Holiday Bullshit involved very real things IRL (In Real Life) that helped to solve a massive puzzle by contributing members.

But why is it so dang popular!?!

Simply put: it’s fun to play. In Jane McGonigal’s book Reality is Broken and in her TED talk Gaming can make a better world, she covers why gaming can be so much fun and how it can be used for more than just checking out from reality. For those that don’t know what makes a game, there are 4 rules for game-making:

  1. It has to be fun
  2. There are rules
  3. There has to be feedback
  4. It has to be voluntary

And PokemonGO handles these splendidly. If you are able to suspend seriousness and simply play the game, you get the cute characters of Pokemon as if they are in your own world. And then you have to interact with them. There are rules and while you don’t necessarily know them as a newbie, you pick them up rather quickly because there is a lot of feedback as you fail. And voluntary? At over 50Mb to download, significant battery management, dedication of time to the task, and a VERY serious draw on device memory, you’re making a conscious decision to volunteer your time to the goal “gotta catch ’em all.”

How does it work?

Relying on Niantic’s successful incorporation of layering fantasy graphics on Google’s mapping technology, your movement within the real world is translated to the world of PokemonGO. With real world locations acting as stops, real world walking moving you toward Pokemon, and real world feedback as you navigate around obstacles to find these critters, the technology is immersive while being a bit of a “screen suck.” You swipe and click the screen throughout the game to engage different activities (preferably once you’ve stopped moving!) and try to level up through the game.

A word on design

Despite the fact that there are no real instructions on how to use the game, it is incredibly easy to use and intuit as to the next thing you need to do in the game. In the case that you get jammed up, you can always talk to a friend about what they have experienced. And that conversation results in extended conversations about what you’ve seen, done, and enjoyed; even sharing what your highs and lows have been.

Laying the fantasy world on top of the real world allows for the interaction between real and false worlds to transcend the experience of the individual. While it is not necessarily a new technology, it certainly hasn’t been used to this level across a population of people. Look no further than the people walking around parks to see how pervasive this game has become.

Security

Besides the clear security issues that one might expect with an app that logs one’s location, we’ve seen articles that highlight a number of, sometimes false, security concerns that may or not may reveal private details about someone. For example, Instagram’s geotagging feature might reveal that the user is nowhere near home; meanwhile, there have been users that have been vandalized by their Uber driver because they were recently driven to the airport.

While there is only one clear security issue derived by the PokemonGO app, other than the iOS opening that created access to Niantic for the complete control of the users’ Google account (which was quickly remedied within the first five days of operation) PokemonGO does not have the hallmarks of issues, inherent to the app, that many others have had. The one condition to this that I would offer is the use of Lures at Pokestops, which allow for control over the fantasy world for other players as well. This is intended to allow you to attract Pokemon and potentially meet other people, but as you can imagine, that might cause a problem if someone wanted to maliciously use that tech to lure users more than Pokemon. You can’t see other users. You can’t lure those users (unless it’s discovered that incense works beyond the user – which, as of yet, it hasn’t). And until you can hack the database, which, as far as I, know never happened with Niantic, the users are relatively safe.

Health hazard or opportunity

So what are the real opportunities or hazards for this app. Truth is that we’ll likely see more and more stories about the extreme situations like a robbing in O’Fallon, IL that used the technology to target individuals (disproved in this case but could have been a Lure) and a young woman finding a dead body near a stream near her home. But truth is that this has created an engaged population, regardless of age, that is regularly walking through areas that they don’t regularly. And is that bad? We live in a country that is SO LARGE that we don’t inhabit more than 90% of the mass, and yet we have SO many opportunities for exploration for a nation of explorers.

Maybe it is. There are maybe some places that we don’t go and that’s okay. But for the large majority of people playing this game, it seems that it runs through the normal course of daily activity, or just slightly more.

What can it potentially do?

Gamification

Without going too deep into what the values of using gamification are here (feel free to read more here), it is certainly becoming more commonplace to bring this theory into regular technology for deeper interaction with users. The reason that gamification can be such a powerful tool in the capture of behavior change is that it seemingly separates the activity’s goal from the activity’s work by creating an intervening level of excitement with the user. This is done by initiating what is known in psychology as Flow.

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From Gamasutra.com, link below

Flow is the state where the skill meets the difficulty that the user is presented with in a maximally optimal position to engage.

Augmented Reality

One of the best arguments for, and against, augmented reality that I’ve seen is nicely packaged in the form of this short film:

While there are many opportunities that augmented reality potentially brings to the table with regard to the mundane (paying your tab at a restaurant, preparing food, even exercising like PokemonGO has been credited with) there are also potential dangers to these augmentations. With regard to PokemonGO in its current version there’s certainly no actual human interface except through the handheld device. While it can influence behavior by incenting the user to do one thing or another, it cannot override human decisionmaking. Yet.

But let’s set aside the potential for danger for a moment to consider how immersive PokemonGO has become for its users and how another user interface might have a significantly decreased reliance on the “phone” to play the game might actually allow for it to become more of a background activity, rather than what one is actively doing. In PokemonGO, the user is staring at a screen trying to find where the leaves are moving and that’s partly because of the limited amount of time most devices can actively “play” the game. But if, say with a device like Google Glass, you could be hunting Pokemon all day long? What if, rather than having to seek out Pokemon in a thirty minute “hunt,” you were hunting all day? Tracking steps all day to incubate eggs? Regularly checking into PokeStops and learning about those locations?

There are certainly risks, and those need to be mitigated. But there’s definitely a lot more opportunity too.

Teams

When you are strong enough to actually do battle at a gym, you pick one of three teams to join. These have their own internal meanings to the game and once you’ve joined a team, you can rely on those other team members for support in controlling gyms and help with training your Pokemon.

One thing that is currently lacking in this first version of the game is the ability to bring in one’s pre-existing social network. Because you must log into the game with your Gmail account or a Pokemon.com account, the audience is potentially limited when it comes to mining the available social network data that might be available with, say, a Facebook login. Then you could invite your friends to join your team in the search for Pokemon. You could actually provide each other with tactical and strategic support in quests as well as provide emotional and physical support in reaching goals. Our social networks are significant in our health decisions, and forcing users into only having the option of the three team options in the game – which are highly contrived and not very useful on their own, so far as I can tell – there are additional opportunities for increasing the effectiveness of the platform for health behavior generation.

Socio-environmental disturbance

One thing that is for sure: there are a lot of people I’ve watched over the past few days playing this game. Will it last? I’m not sure. But watching two people who are running around a park together while staring at their phone certainly acts as a pattern interrupt for me. I’ve watched as someone stared at their phone and walked around corners, and down streets, trying to engage the PokemonGO world largely oblivious to their surroundings except for what is represented on the screen. And when you see someone doing that, it definitely has a similar impact to the way that we all responded when Bluetooth headsets and wireless earphones became popular for holding mobile phone calls in the public.

Yes, it’s a pattern interrupt. And yes, it was extremely annoying when phone calls made it out into the general public, seemingly creating dialogue that only existed in the speaker’s head. But that has become so normalized now, I can’t imagine there won’t be a possibility of a similar normalization of that activity. And once normal, adoption will likely go up, not down.

Why is this important?

BmsB9w6 - ImgurThese are not the Pokemon you seek

While the PokemonGO craze has blown away the expectations of the game-makers, and frankly any Ingress user is probably also doing the, “I was geocaching before it was cool” thing right now, this does start a discussion about how we can better leverage the technology that is already available to us to change our behaviors in small, although ultimately significant, ways.

Just the beginning…

…but an important one. Critical events like this are rare in helping to shape how we want our world to look. Each of us has the capacity to impact the way that we want to engage with our communities and our technology. What do you want your world to look like? Or, more precisely, what do you want which of your worlds to look like?

To our health,

Ryan Lucas
To stay ahead on topics related to this, follow me on Twitter @dz45tr

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Health inSite: The Sharing Economy in HealthIT

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This is a draft of Part III in a three-part series on the current, and potential future, of healthcare delivery economic models. The full series will be available on xchangehealth.wordpress.com in the next week. A quick synopsis of parts I and II are extracted as an introduction.

Intro

I was recently invited to participate in a Storyvine for Stride (on twitter). While reading through the questions that had been prepared, I was thinking about the way in which Stride is poised (intentionally) to disrupt our current healthcare delivery model by bringing together stakeholders from startups and the institutional healthcare system.

As a company that’s been around for 35 years, MINES & Associates is certainly in that latter category in many respects; however, one of the reasons that I have decided to make MINES my home is that, as a company, we have embraced technology as a tool to reach our organization mantra: to “save lives, and influence the course of human events.”

There may be a shift to consumer-directed healthcare in the very near future. One of the opportunities (or threats, depending on your viewpoint) of consumer-directed healthcare may be the collapsing of the system within which the decisions in healthcare are made at an administrative level. As a fellow Health 2.0 Denver/Boulder chapter member of mine, Sumanth, mentioned while on a panel regarding open-innovation models in healthcare, ‘We have a sickcare system, we’re working toward a healthcare system, but I’m interested in a health system.’ When we begin empowering people by giving them purchasing power, we also saddle them with the responsibility of that decision and we need systems in place to make those decisions reasonable.

Is 4PHealth going away?

If you’re not familiar with my concept of 4PHealth, check out my earlier blog post for details (secretly hoping I can stop linking to this post at some point!) but the long and short of it is that there are four P’s in the healthcare system: payer, patient, provider, and the patient’s peers. Truthfully, there’s actually a fifth P that was not originally contemplated in that post but comes to light when you consider a consumer-directed healthcare model: purchaser.

For most people in the US, the purchaser is an employer. But now that is shifting as organizations are actually sending their employees to the health insurance exchange. Increasingly, I expect this to grow; and that’s a good thing. When the purchaser and the patient are the same, there is a shift in the financial onus for having a particular benefit plan; which means we need more informed consumers (patient-purchasers). But it also creates an opportunity for further collapsing of our very-tiered silo. If the consumer could then also become the payer, we could very well see a one-to-one relationship between the provider and the consumer (patient-purchaser-payer).

Part III: The sharing economy

What does the sharing economy have to do with the consumer-directed healthcare system? First, let’s look at what is at the core of purchasing: economic offering.

Levels of economic offering

In their book The Experience Economy (I did a post on this too, forever ago!), Joe Pine and James Gilmore explain the value pyramid.

From Pine and Gilmore’s “The Experience Economy”

As products increase in differentiation (customization), a higher asking price for that product can generally be realized. In this way, value to the consumer comes in the ability to match the need with the offering and in healthcare, this means enabling smart, simple decisions.

In a consumer-directed healthcare system, shifting healthcare transactions to goods, rather than experience, and focusing the overall healthcare purchasing and maintenance up to that of an experience will be critical to success. Again, an awareness of this intentional effort to differentiate based on total experience. This can be done when the exchange, for example, becomes broker, maintenance organization (think HMO), and coordinator of one’s health record (not an Electronic Health Record as we know them, but a coordinator of the health profile mentioned earlier).

For such a situation to work, the exchange then will need to either build out, or partner with organizations with experience in guiding human behavior, to successfully engage those patient-consumers in maintaining their profile as well as actively pursuing greater levels of health.

Examples that work

The sharing economy is also making significant changes to the way that we engage as consumers. This economic shift allows for individuals to make transactions with little to no broker (for example, a bank) in order to make purchases. Most of the sharing economy relies heavily on technology to enable people to come together. A chart of examples is below:

Organization Primary offering Industry disrupted Innovation Description
Uber/Lyft Car service Taxis By allowing individuals to directly contact a driver, users interact with an app that can manage their payment and reservation.
AirBnB Housing Hotels Users submit their social network credentials as “proof of trust” for user-to-user reservations of rooms
Car-2-Go and many others Cars Every car company Cars placed around the city, can be “rented” for one-direction travel.
Bitcoin and other cryptocurrencies Currency Banks Distributed, “proof-of-work” based cryptocurrency which allows for peer-to-peer exchange of value.
Kiva Microfinance Lending companies Individuals can register their needs for financing and other members of the Kiva network can make those loans direct to the borrower without a traditional lender.
GoFundMe and other crowd-sourced finance platforms Project Funding Investors Individuals can create a project page with donation-level rewards for contributing to the financing of a project or product.

Considering these examples, I believe that there may be some interesting opportunities for alternative funding and insurance when it comes to healthcare. Consider this: what would it look like if traditional insurers were no longer the primary location to insure oneself. In the current healthcare system, some groups (usually smaller companies with less leverage than bigger companies) might choose to pool their collective employees into what’s called a captive insurance group.

What if a similar model were to be contemplated where individuals were to select a captive group of similar patients, almost self-selecting to become a part of a patient-centered medical home model. Exchanges could do the same with their patient population by segmenting those patients into population groups.

Now, what if those groups could be funded by individuals wanting to bet on the success or failure of those groups. This allows for more direct funding for investors and patients that could result in dividends for the patients and investors when benchmarks are achieved or maintained. What other possibilities for alternate funding models might still be out there to be explored?

The core of the sharing economy

Trust

At the very core of the sharing economy is a redistribution of trust networks. By decentralizing trust models from institutional to peer-to-peer, the sharing economy refocuses and reinforces a community around the exchange of goods and services by moving brokerage to a fluid, and seemingly direct brokerage for those exchanges.

Supply/Demand

The other side of this change to the sharing economy is supply and demand monitoring and connection. Uber has the ability to simplify the exchange of need for transportation with the supply of excess time (and access to a vehicle) on the part of the driver all while it is in the process of cutting out the institutional (and very infrastructure heavy) taxicab industry.

What that means for institutional healthcare

So WHAT DOES this mean for institutional healthcare? Great question! It could mean realignment around roles within the healthcare system. It could mean small market-share loss if the idea doesn’t take off easily. It could mean more competitive models. I’m interested to hear your thoughts.

Questions for Health IT

#HITsm T1: Is a sharing economy model realistic for the healthcare industry, in whole or in part? Where? How?

#HITsm T2: What should a sharing economy model prepare for with the current status of #HealthIT and #Healthcare?

#HITsm T3: If a sharing economy model were to come about, who wins and who loses in #HealthIT and #healthcare generally?

#HITsm T4: What other technology models are out there that #HealthIT can borrow from to enable those changes?

#HITsm T5: Any other thoughts on #healthcare economic models and how #healthIT can help?

Health inSite: Salutogenesis

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We are a cool species, engaging with our world in a very different way than any other species of which we know.  We shape our world physically, mentally, and socially to suit myriad fantasies, individually and collectively.  This results in a shifting landscape of reality in which we, as Daniel Kahneman points out in his final chapters of Thinking Fast and Slow, are subject to our cognitive biases that may have positive or negative sway in any given situation.  The key to best engage with that reality on a day to day basis is to recognize these imperfections in our cognitive wiring in a reflective way.

In those final chapters, Kahneman points to a need to recognize, that as remembering beings, our memory often fails us.  It’s subject to outside influence and shortcuts on our own behalf.  Taken together, this means that there is an opportunity for each to shift our remembering self towards a different understanding of an event than our experiencing self, the one that’s actually present during an event.  This is because our memory is subject to duration neglect and a product of our episodic memory – we are prone to ignore duration as opposed to intensity.  If we were to have a true recording of events, we might not remember correctly that vacation taken last year, when it rained for the first three days, but the last day was so gorgeous (and all of our pictures were from that day) that we may remember it more fondly than we experienced it.

What effect does this have on adherence?  Quite a lot actually, and this is where perception has a great opportunity to hop into the world of Behavioral Health and Substance Abuse treatment.  Simply by altering the treatment protocols to take into account this remembering self, it is possible to focus on the peak-end rule.  The peak-end rule says that when we are remembering an event, we more heavily weight the experience of the most painful or pleasurable event (peak) and the last thing (end) that occurred in a timeline.  If a treatment protocol were to decrease the peak of a particular episode and include a positive, context-provoking end to the episode, the remembering self will have a different memory as it progresses towards more positive outcomes.

There is another major implication of this very important understanding of the remembering self vs. the experiencing self and it is related to a concept called Salutogenesis (basically “from health”). Salutogenesis is a concept coined by Aaron Antonovsky, a Medical Sociologist, as a counter to our current health model, which has a pathogenic slant to it.  I would venture that our health system is as much a product of our two selves as potentially influenced by a change in the approach.  Our duration neglect and base-rate neglect lead us to an imperfect memory of the picture of health that we have for ourselves.  This leads us to looking at healthcare as episodic – we go to the doctor in a self-encapsulated event, we get ill, we deal with symptoms.  These are all pathogenic experiences of our overall wellbeing.  If we had a tool that helped our experiencing self more accurately engage with our health reality, that we are always to some level healthy and to some level ill, duration neglect would be mitigated, increasing our ability to engage with our health as if in two realms, time and space, rather than simply in a given moment in time.

So what does a salutogenic framework look like?  Mindfulness, resilience, focus on daily health-promoting activities that increase our ability to get healthier, rather than fend off illness.  Of course, a fee-for-service model doesn’t bode well with this concept, so unless you’re enrolled in a highly visionary health promotion healthcare system, you’re probably on your own – for now.  If so, here are some resources we’ve seen that might be helpful for you to consider when you begin working towards your healthiest self:

SuperBetter.com – This site allows you to engage in a number of different challenge “packs” to help increase your emotional, social, mental, and physical resilience.  You can even invite your friends to help you complete these challenges!

FitBit – not simply a pedometer, this device will help track your sleeping patterns, too, giving you the opportunity to analyze some of your base-rate metrics and progress in your fitness.

Various apps and websites – there are literally thousands of apps out there now for tracking everything from heart-rate to nutrition to fitness to mental resilience to even sobriety (check out sober24, an online community for alcoholics in recovery!).  Keep in mind that when you are looking at these programs, you are more likely to be successful if you are doing it with someone else.  And if you invite someone else to participate, they are as likely to make you healthier as you are to make them healthier!

Your EAP – while most people think of their EAP (Employee Assistance Program) as something they use when things are bad, keep in mind that MINES has many programs that may help you no matter what level of health you’re at – including career coaching, financial coaching for learning to save, and more.  You don’t have to be in pain to give us a call; we’re here whenever you want to talk.

To our health,

Ryan Lucas
Marketing

Health inSite: Bring Your Own Health

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Blended, not segmented

In an increasingly interconnected world, the rift between the person and the role within the workplace is diminishing.  Again, highlighting a moment from our presentation at the EAPA 2011 Conference back in October, we provided a brief demonstration of the change that is coming with the introduction of smart technology that is cheap, intuitive, and pervasive.  We added many of the ingredients of our everyday lives – personal photos, TPS reports, business cards, a beer (non-alcoholic, of course), and some others – to a blender.  After pureeing the ingredients, we had the mish mash of our lives in a soupy representation of its non-segmentation.  Slowly, but surely, we continue to blur the lines between our personal and professional lives.  The generation entering the workplace today, as well as the mavens that have been productively using social media over the past decade, are contending with very significant issues when it comes to their personal versus professional circles.

Which is perfectly fine for them as, characteristically, they are less concerned about the space between work and personal that has existed in previous generations.

But it does bring up a new combined reality wherein the interconnectedness of all things plays a new role, e.g., less applying for jobs and more networking with previous co-workers and current friends.  This is a powerful change in the culture of hiring as we can rely more on data points that are trusted, rather than on the various axes we might consider from an interview.

We’ll have chips, you bring the dip

This is further aided by the number of devices (and the consolidators like cloud computing and apps) on which we can maintain a seamless online life.  Our ability to share, connect, and compute through these various devices has led to a revolution for some workplaces.  We’ve gone from intentional VPN connections on desktops into the workplace, to push-based access to email on our phones.

Enter BYOD.

Now we have the opportunity for individual employees to Bring Your Own Device (BYOD).  Gone are the days where individuals carry two phones, or a personal phone and a work laptop.  A new tide is rising where an employee can use their personal device to connect to work.  This has obvious implications associated with it.  In my last blog, I walked through some of the changes in the landscape regarding social media in the workplace and its potential for the leaking of PCI (a play on Private Health Information, Private Corporate Information).  Imagine the concerns regarding that PCI on a device that can literally be left on a street corner!  Consider data from Lookout Security (a mobile app that tracks lost phones) alone: 9 million lost phones in 2011.  By the way, if you have employees using mobile devices for work purposes, either company owned or personally owned, you should have a solution like Lookout or iOS’s Find my iPhone in place.  It’s just another thing to add to the technology section of your HR manual.

We can access statistics and reports from virtually anywhere with a WiFi or data signal, and we can do it on the same devices as our social media and personal activities.  This means increased efficiency for some, and others less so as there are more distractions on the same device; however, it also means being less tied down to a workstation.  Enabling employees to function in their role fluidly and dynamically means a potential for faster response rates and less commuting or booting (as in booting up a computer) time.  So long as you are not also operating in System 1 by multi-tasking.

What does this have to do with health?

I’m so glad you asked.  The mobile revolution has another impact on our lives: the ability for our physical wellbeing to be more social and integrated with our daily activities.  For an employer, this can mean increased health outcomes to decrease premiums as awareness of one’s health can increase attention to keeping oneself healthier.  Integrated with Social Media, this also allows for real time feedback from our social network, encouraging and assisting in the process of growing our health.  And since we spend 1/3 of our week working, ignoring this time because it’s “work time” is simply the wrong way to go about creating a healthier workforce.  Population health strategies necessitate an integrated approach to health – and even more so when you are self-insured!

If that’s not interesting enough, using both hardware and software, new tracking of the quantified self enables a feedback system that helps provide data to be reviewed by System 2, resulting in increased awareness of our current health status.  Knowing your heart-rate through events, in real time, allows for biofeedback-based solutions to situations.  Literally translated, our at-the-moment health can enable greater productivity at work – whether that’s at a coffee shop, your home, or at the office.  As these pieces of technology become cheaper and more precise, BYOD might one day allow for the inclusion of health devices for work too.

To our health,

Ryan
Marketing

Health inSite: Social Media Access at Work

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Let’s take a moment to discuss the great ‘Social Media at Work’ debate.  You’re familiar, I’m sure, with this concept.  It starts with a question like this:

“Why would we allow our employees to spend ‘work time’ doing things other than work?”

or another popular alternative,

“Do we want to allow employees to engage in social networking where they could release PCI (a play on PHI in the health world, Protected Health Information: Private Corporate Information).”

or the myriad other great arguments for canning social media in the workplace.

In 2011, MINES had the great honor of presenting at the EAPA International Conference on Wellness Programs where we posited an alternative to traditional wellness programs that relied on the value of social media with employees as a means to increasing adoption, bolstering adherence through social relationships, and positioning health as a social venture where people are spending increasing amounts of their free (and yes, even work) time engaging in health.  The core of most Wellness programs is similar to that of traditional EAP; a sort of ‘we’re there when you need us’ or ‘wait-and-see’ approach.  Wellness programs, however, often incentivize participation through monetary carrots or sticks.  This is a one-to-one approach to health.  Those of you that get to play with relational databases, however, recognize that there are many ways to connect entities (data, people, sites, etc.).

Social Media has the ability to act in a many-to-many way; that is, connecting me to my friend, and my friend’s friend, and all of us to an expert (be it a website, user, resource, or anything else) to engage on a topic.  This is an extremely powerful tool that is starting to be leveraged by a handful of companies – similar to the group therapy model where part of treatment is engaging with other individuals that are currently in treatment, rather than solely with the doc, therapist, CAC, or sponsor.

At the conclusion of our presentation, an attendee posed the following question during the Q and A:

“My company doesn’t allow access to Social Media at work, what recommendation do you have for a company that wants to consider leveraging Social Media but its’ employees don’t have access to it.”

The answer from our CEO went something like

“At MINES, we’ve created a culture wherein every employee is expected to do their best.  I trust that my employees are doing just that and see that they do their best every day and until I see different results, I trust my employees to not abuse the system.”

Let me take a quick moment to highlight this infographic from the University of Melbourne (et. al.) which highlights some of the points on this subject.  Restricting Social Media at Work has many great arguments on its side; potentially lethal viruses, decreased bandwidth (the tech kind, not the personal productivity kind), and even legal concerns regarding PCI.  Productivity is a really common go-to, however, and the others are extremely valid.  Further, I don’t have good arguments against them (besides increasing your company’s bandwidth, installing good anti-virus software, and educating your employees on safe browsing habits), so let’s talk about the increased productivity experienced by those with unfettered access to Social Media.  Could these quotes be right?

“Short and unobtrusive breaks, such as a quick surf of the Internet, enables the mind to rest itself, leading to a higher total net concentration for a days’ work, and as a result, increased productivity.”

That’s pretty interesting and kind of common sense when you think about it.  Looking to an interview with the guru of productivity, Tim Ferriss, on LifeHack is the argument that we should…

“Take frequent breaks and strive to constantly eliminate instead of organize.”

So, despite all of the many reasons to not allow employees onto these Social Media sites, here we see the interplay of increasing productivity by taking breaks, and Social Media as an opportunity to boost creativity and rest the mind.  It’s certainly interesting.

Keep in mind; we’re not suggesting that every company, organization, or government entity allow unfettered access to social media sites.  We recognize that many of the groups that we work with each day have significant and valid arguments to be made as to why they do not allow access from a workstation provided by their IT department; but most arguments are worthy of reexamination as new information becomes available and the growing trend in BYOD (Bring Your Own Device) will have significant consequences as well when it comes to the Social Media, or WILB (Workplace Internet Leisure Browsing), debates – a topic we’ll tackle in the next iteration of Health inSite.

To Our Health,

Ryan
Marketing

Health inSite: Transformations as the Future of Healthcare

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Have you read the book The Experience Economy?  To explain it very quickly (and not do true justice to the ideas proposed in the book), there are various levels of economic offering that warrant different valuations, and thereby ability to generate revenue.  The levels of development discussed in the book are elegantly displayed in the graph below by Pine and Gilmore (the authors of the book):

This progression has expanded over time with new levels being added as the market strives for differentiation.  Many of the examples brought up are clear and concise, such as Starbucks as a purveyor of coffee (a commodity) that really charges the market at the level of a Service.  Pine and Gilmore stop at the level of Service in their description of Starbucks, but I would readily argue that they reach towards the level of experience.  Starbucks actually refers to this in their training materials as creating “The Third Place;” it’s not your work, or your home, it’s that other place where you can unwind a little bit.  Even though the customer isn’t actually brewing their own coffee, as is a hallmark of many experiences, they are engaging with the sounds and smells of the coffee shop in a very intentional way.

The book spends a great deal of time discussing offerings that are on the level of Experience but certainly takes a moment to tip its hat toward Transformations, a burgeoning new market offering.  Transformations are marked by the engagement of the customer in a way that enables that person to learn or grow, exactly to Transform, themselves in a way that is truly valuable to the customer.  It includes giving the customer the skills and motivation to make changes that will both provide some immediate value but also cascade down into further value down the road.

In healthcare, this understanding of the market is significant and valuable.  As we, as an industry, discuss Accountable Care Organizations, capitated care models, and participatory medicine, it’s important for us to keep in mind where value is derived in the typical marketplace.  Healthcare, while arguably different in many ways from other industries by its virtual necessity in every citizen’s timeline, still must compete under the same rules as many other industries.  Many times, in healthcare, we present ourselves on the level of Service – that is that we are doing something for someone, for a fee.  As we look at these new systems, it is time for us to consider what the future of healthcare delivery will require under a population health model of delivery.

Eschewing the fee-for-service model opens up the possibility for the healthcare industry to reconsider offering the long-term value of teaching individuals how to keep themselves healthy, at least in terms of the 80% of healthcare costs that are mediated by behavior.   This decreases the time and services that must be provided creating new forms of cost savings.  As we move further up the economic offering ladder, it will become more necessary to move our industry into the Transformation realm.  In fact, there is no other industry more suited to it.

To our health,

Ryan
Marketing

Health inSite: Halo Effects and Link Influence

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In a recent article published by NPR, Gain Together, Lose Together: The Weight-Loss ‘Halo’ Effect, two studies were mentioned that suggest that our social networks have a significant effect on our overall health and well-being.  Since weight is oftentimes affected through behaviors (exercise, diet, smoking, drinking, etc.), those with whom we engage in those behaviors have a direct impact on the outcome.  It’s pretty simple when you think about it, but certainly, easy enough to miss.  We do know that your friends’ friends make you fat.

However, the article highlights another very interesting second-node response to those receiving treatment for obesity. While there may have been behavioral changes that were enacted by family members (first degree of separation) as they complied with the treatment plan for the patient’s (first-node) benefit, the article suggests that there may have been another influence on the weight of the patients’ family members – additional education.

This does add a new layer of influence that might create additional change.  If you are engaged in the treatment, even just on the education level, what possible changes might that make to your cognitive approach to the subject.  Said differently, even if your behaviors aren’t initially, directly adhering to the treatment plan, is it possible that through continuous education on the subject, you might potentially change your behaviors simply through thought pattern change? We do know in psychology that simply logging what you eat will result in weight loss. Where your mind goes, the energy goes.

Of course, the way Psychology views the Halo Effect – a cognitive bias that involves one trait influencing others in one’s judgment of another person or object – a little different than what is described in the study – but it would be interesting to see if perception of success of the patient had an influence on the outcomes of the family members.  In other words, if there were a Halo Effect regarding the overall interpretation of the composite qualities of the patient by the family members adhering and discovering success with a treatment plan, if that in turn could create the opportunity for a cognitive reframe of self-perception – a sort of, “they are doing it and maybe I could/should too.”

If anyone knows of an interesting article or study that has delved into the topic, we would love for you to share it.

To our health,

Ryan
Marketing