Last week, I attended Mass Technology Leadership Council’s event on the Emerging Technologies for the Silver Tsunami: Aging in Place through the use of Integrated Technology.  The room was packed with interested stakeholders from HIT technology companies, hospitals, home health agencies and senior living communities.

This is one of several events across the country focused on opportunities that will be brought in with the new waves of seniors.

Beginning in 2011, the oldest of the 78 million baby boomers will turn 65 years old. According to the Stanford Center on Longevity, the "number of older people (age 65 and over) will double over the next 30 years, from 40 million to 80 million, and the percentage of older people in the population will increase from 13% to 20%".

Given the size of this new segment of seniors, their education, affluence and comfort with technology, they will have a powerful impact on healthcare delivery, health plans and aging services.

Riding the Waves:

Leveraging my extensive consulting experience and knowledge about elder care technologies, I have defined five requirements for HIT solutions to meet the needs of seniors, families, caregivers and  the care team.

1. Extending Solutions for Care Management

“I want my mom’s doctor to know what is really happening when she is away from his office”.

Through acquisition and partnerships, companies are combining their “point solutions” to bring new capabilities to seniors and their care circle. HIT suppliers are also proactively seeking ways to tie their solutions into the EMR and Health Information Exchange to bring needed insight to the clinician and support the  medical home care team.

2. Expanding Solutions across the Care Continuum

“I do not want to have to purchase, learn and manage all different technologies as my father ages.”

There is an opportunity for health information technology firms to design their solutions with a set of capabilities that can be turned on as the senior requires the support. Considering the burden of the adult children and caregivers, the solution for this market will meet the needs of seniors across the care continuum; preventative, acute, chronic and long-term.

3. Guiding Care Decisions

“We are all taking turns caring for my father and we are exhausted since his health is deteriorating each day.”

Most of us have access to calendars and communication  technologies which we can use for personal reasons. The problem is that we do not know what to expect each day and find ourselves reacting instead of planning for the care of our loved one. When we have a few minutes, we call our friend who just went through this with her mom. Think about how social networking can be leveraged to help families anticipate, plan and make the best decisions with the guidance of experts and other experienced caregivers.

4. Supporting Service Delivery

“I need to know what our caregivers are observing and be alerted when mom needs additional care.”

Whether they are busy raising their own families or living in another state, adult children struggle to care for their elder loved ones. Professional caregivers including home health workers can use technology to record observations of daily living and engage in shared decision making with the family.

5. Supporting Self -Management

“My dad needs to be able to manage this diabetes on a daily basis”.

With the shortage of health care professionals, older consumers need to take care of their chronic conditions and understand how to make changes when they run into many different situations common to their condition. Technology can serve as an enabler by reminding the senior to take medications and perform certain behaviors, tracking these activities, educating them what to do when these activities are missed, monitoring their vitals  and alerting caregivers when problems arise.

Getting Ready for the Silver Tsunami:

As you define/refine your own product strategy for the senior market, think carefully about the steps you will take. The senior market is made up of many different “sub-segments". It is important to identify and understand how these sub-segments differ in their needs, behaviors, technology usage and preferences. This research will provide the insight to guide your product development to meet the requirements of your target audience(s). 

How can you prepare for the Silver Tsunami? Learn more.

We see it every day and everywhere. Consumers are engaged with their mobile phones at restaurants, at the gym, by the pool, in parked cars and in the hallway outside of the doctor’s office. They have a strong need to stay connected and use every free moment to review and respond to messages as well as access online information through their mobile phones.

Over the past 6 months, I have heard health care providers, health plans, health care technology companies and employers express strong interest in reaching, engaging and influencing consumers through mobile health applications. Although mobile committees have been formed, most are in the beginning stages of identifying and prioritizing the applications that they will develop and deliver to consumers.

Seven Mobile Health Engagers:

Here are seven key capabilities that companies will want to build into their mobile health applications:

1. Guiding-  Sending personalized alerts and reminders for motivating specific actions such as taking medications, testing blood sugar levels or participating in healthy behaviors (e.g. lunch time walk with co-workers).

Consumer perspective: What do I need to do to meet my health needs and goals?

2. Educating- Providing access to a customized set of health information, pushing informational tips based on needs, interests and profile and testing health information knowledge.

Consumer perspective: How can you make learning about my health fun, personalized and easy to understand?

3. Encouraging- Delivering support messages from my social network, clinician and health coach.

Consumer perspective: How can you support me in reaching my health goals at the right time?

4. Consulting- Enabling access to a live discussion with my clinician, health coach or mother’s caregiver.

Consumer perspective: How can you connect me with experts for real time communication and collaboration?

5. Monitoring- Capturing and viewing information about my mood, pain levels, symptoms, activity levels, diet and sleep.

Consumer perspective: How can you help me aggregate and organize all of my health information so that I can see patterns to experience “aha moments”?

6. Deciding-  Accessing a decision support tool about my treatment options or viewing my PHR with links to relevant and "in context" content.

Consumer perspective: How can I make better decisions by combining my own information with trusted expert sources and accessing this wherever I am?

7. Managing- Delivering customized messages to help me effectively plan and respond to our health care needs.

Consumer perspective: How can I change from being reactive to becoming proactive about my health and the health of my family?

Generating Your Mobile Health Momentum…

How can you define and design these mobile applications to be most valuable to your target consumers?  Unlike many of the mini-applications that consumers can buy in online stores, you have an opportunity to connect these capabilities such as “monitoring” and “deciding” so that consumers can not only track their activity but also make decisions with the patterns of data that emerge.  

Think about how you can use “personalization” with your mobile health applications to motivate consumers to stay engaged in their health. How can you help consumers use their mobile phone to communicate and collaborate with their support network and caregivers for better health outcomes?

How far along are you with your mobile health strategies? Have you selected your priority consumer segments? Have you conducted research to deeply understand their needs, mobile behaviors and attitudes? Have you conceptualized, defined and validated a solution for each segment? Are you ready to pilot the solution with the target segment? Have you defined your measurements for success?

With experience and industry knowledge in the mobile health space, how I can help you move your mobile initiatives forward?

Read more about my mobile health technology expertise.

During my Healthcare Unbound Panel on “New Models in Social Media”, Kendra Markle from the Stanford Persuasive Technology Lab shared interesting examples of students designing their own social media interventions.  

While co-creating with a consumer segment, you can design applications they value which leverage their relationships with their own social network and influence both personal and group behaviors.

Our Interview:

Sherri (Stepping Stone Partners): Tell me about how students define their own interventions. For example with SPF Stalker, what is the goal and how did students participate in this innovation process?

Kendra (Standford Persuasive Technology Lab):This project was created by some ingenious students as part of a class on habit formation taught by BJ Fogg, Director of the Stanford Persuasive Technology Lab. The project goal was to use technology to motivate people to wear sunscreen every day.

Students came up with this great idea to photoshop pictures of SFP chapstick into photos of famous people and photos they took of each other as a humorous way to remind each other about wearing SPF chapstick. By tagging their friends in the photos posted to Facebook, each friend gets an irresistible email from Facebook saying "you've been tagged! Click this link to see the photo".  The response rates for click throughs on Facebook tagging emails is unbelievably high.

Sherri: What are the comments that students have shared about SPF Stalker? Why do they want to use it with their friends?

Kendra: This intervention was designed to be funny, which made the photos memorable enough to share with friends, thereby recruiting even more people into the intervention without them realizing it. We call this a stealth tactic - when people start engaging in healthier behavior without being explicitly told they're participating in a "health" app.

Sherri:  What is the goal for the Healthy Check-ins project that you presented?

Kendra: The healthy check- ins project is also a stealth project, that's just our internal name for it. Our goal for the healthy check ins project is to combine the element of checking in with target health behaviors such as taking the stairs instead of the elevator, eating less meat or biking to work instead of driving. By checking in, many people feel some validation of their behavior, or feel they get credit for doing it by reporting it. We combined this urge with the fun of unrealistically awesome achievements from the game world to produce an experience that rewards you with virtual goods and powers that help you in the game world for indulging in the urge to check in your real behaviors. The motivation you feel to level up in the game layer can be translated into motivation to complete healthy behaviors just so that you can check them in.

Sherri: How do students feel the Healthy Check-ins will help them and their friends become more healthy (e.g. what is the value that students see?)   

Kendra: So far, the students are excited about this project because it's something that they think they would use and could picture themselves getting a little addicted to. Since college aged kids want to do everything with their friends, we're working on making this intervention a social experience, one that requires use of both reciprocity and vengeance to advance. These are two behaviors that are believed to have evolved to encourage us to cooperate with each other. Cooperation is a very strong intrinsic motivator, as is competition, especially when both are used together.

Sherri: Since “location based services” (Foursquare like) are so popular, how have the students envisioned the connection between this capability and healthy locations for check-ins?

Kendra: We've expanded beyond location check ins to behavior check ins. Why is everyone feeling limited to location check ins? GPS technology provide convenient proof of presence at a location that can translate into monetary value but there are many other things that can be easily proved when using a mobile phone. It just takes some creativity. Students have come up with a whole bunch of target behaviors and creative ways to prove they're engaging in them, all while in stealth mode so the user never feels like they're supposed to be "getting healthy" while using the app. 

Over the weekend I had dinner with close friends who told me about their teenage daughter and her sleepover with few girl friends. “All three of the girls had their cell phones lined up and plugged in a charging side by side on the night table”.  Even when they are sleeping, teens keep their cell phones close by.  While awake, these “digital natives” are continuously connected which provides opportunities for reaching and engaging teens in their health. 

Strong Statistics on Teen Mobile Usage

In Pew’s latest study of 12- 17 years old teens, there are interesting insights about teen's use of mobile technologies:

- Teens Have Mobile Phones. “Three-quarters (75%) of teens now have a cell phone”.

- Teens Texting for Connection. “Fully 72% of all teens – or 88% of teen cell phone users — are text-messages. That is a sharp rise from the 51% of teens who were texters in 2006.” 

- Teens Texting Daily. Each day, 54% of teens text compared with 25% using social networking sites.

- Girls Texting Much More. Teenage girls tend to send and receive more texts each day, 80 compared with 30 for boys.

- Minority Teens Use Mobile for Internet Access. “44% of black teens and 35% of Hispanic teens use their cell phones to go online, compared with 21% of white teens”.

Influencing the Health of Mobile Teens

Organizations have been researching and piloting programs to learn how to impact the teen’s health behaviors for better outcomes.

After a successful pilot, the Murdoch Children’s Research Institute (MCRI) with the Telstra Foundation rolled out a program for teens (and young adults) that uses mobile to monitor their mental health including stress levels, coping strategies, dietary and fitness factors.

The NY Times reports that Mount Sinai Hospital has researched and learned that sending text messages to young liver transplant patients can improve their medication adherence and “avoid life-threatening complications”.

Partner’s Center for Connected Health recently ran a pilot with pregnant teens with the goal of using mobile for outreach. OB Case management sent SMS text messages about proper pre-natal care and regiments. These messages were educational and prompted the teens to take an action such as attend an office visit. “We learned that the texting strengthened the relationship- 83% reported feeling more supported by the health center case manager”, explains Alex Pelletier, Team Lead, Program and Product Development at Partners. More about this pilot from Alex on my upcoming World Congress panel, Generating Mobile Engagement Through Consumer Segmentation, Crowd Sourcing and Personalization. 

Future Mobile Teen Projects:

The Robert Wood Johnson Foundation recently granted $2.4M to mobile health project including one from the San Francisco State University – San Francisco, California targeting teens from low-income backgrounds who experience much higher rates of obesity. To help these teens manage their obesity and depression, the University will evaluate the capturing of observations of daily living (ODLs) through smart phones and sharing of the data with their care team for planning and care management.

Teens are dealing with many different health issues while on the go managing their busy lives. Their health concerns span their physical and mental health which may include juvenile diabetes, obesity, asthma, sexual health problems and even autism.

How is your organization targeting this segment of “digital natives” around health? How are you leveraging mobile technologies to reach, influence and impact them to have healthier bodies and minds?

World Congress Leadership Summit on Mobile Health, July 29th & 30th, Boston

Healthcare organizations are taking advantage of the consumer’s strong demand for smart phones and mobile health apps. They are piloting new health initiatives through SMS (text), Mobile Web and Mobile Applications and learning about the opportunities and barriers to accelerate adoption and usage.

Industry leaders understand the need to tailor their mobile offerings to specific consumer segments and to personalize the experience to sustain engagement.

During our session, you will learn how our panelists are utilizing mobile to enable care access and compliance, deliver health education as well as  influence and track health behaviors.  They will show examples of their mobile health initiatives and share insights they’ve gained from segmentation, personalization and crowd sourcing. The panelists will also offer their vision for mobile health opportunities in the near future.

You will gain a unique perspective from companies on this panel which are bringing mobile health offerings to consumers directly as well as through the healthcare delivery and health plan channels. As you will see, each business channel has its own sources of value to engage the consumer.

Facilitator:

Sherri Dorfman, MBA, CEO, Consumer eHealth Engagement Specialist, Stepping Stone Partners

Panelists:

• Bud Flagstad, Vice President, Strategic Initiatives, UnitedHealth Group
• Julie Kling, Mobile Strategy Group, Humana
• Tim Kieschnick, Director, User Experience Internet Services Group, Kaiser Permanente
• Alexandra Pelletier, Team Lead, Program and Product Development, Center for Connected Health, Partners HealthCare System
• Benjamin Rubin, CTO and Co-Founder, Zeo Inc.