Business of Well-being

Successful Engagement Programs Require New-er Age Approach

With the 2012 presidential election season in full swing, there is certainly a lot of talk about healthcare reform and what may or may not hinge on the election's outcome. However, I can confidently say that there is one industry trend that will continue regardless of the election's outcome - that is the industry's shift from a fee-for-service system to an outcomes-based reimbursement model.

And this shift is forcing healthcare organizations, including health plans, pharmaceutical companies, and device manufacturers, to realize that 1 organizations need a program that engages patients beyond the traditional therapy and treats both the physical and emotional state, as well as, fit their lifestyle and 2 patients need to play an active role in their own healthcare in order to see improved health outcomes.

These organizations, yours likely among them, are now looking at different, innovative ways to empower patients to take control of their own healthcare. A recently released survey on diabetes from the National eHealth Collaborative (NeHC), illustrates that consumer engagement programs are gaining ground when it comes to priorities for healthcare organizations.

Survey findings cited that 53 percent of respondents ranked engagement among consumers - health plan members, patients, product users, etc. - as high or very high among their organization's priorities. Healthcare organizations are realizing that it's not enough for patients with chronic conditions, like diabetes, to visit the doctor once a year or even several times each year.

Patients need to be engaged in self-management 24/7 in order to fully understand how their behavior affects their overall health; to effectively realize the benefits of therapies provided by their health system; and to responsibly take ownership for their health. I wholeheartedly support the goal to engage patients in their own health; after all, individual patient behavior impacts health to a far greater extent than healthcare services.

One widely quoted estimate published in the New England Journal presents data that behavior patterns account for 40 percent of premature death, an impact four times greater than premature death due to poor or inadequate healthcare services. The survey from the NeHC mentioned above shows that engagement programs, which go beyond the typical therapy and address a patient's emotional well-being and lifestyle, are outperforming the more traditional therapy-centric approaches.


Today's new focus on patient engagement and improved outcomes presents challenges for healthcare organizations in determining which strategies to leverage for successful engagement and behavior change. First, and simply, let's face it - behavior change is difficult. Often times patients need to change habits they've had for the majority of their lives, and that's never easy.

All at once they are asked to make changes in their lifestyle; deal with the emotional issues and challenges of a disease; and overcome isolation and disclosure issues. There are successes and relapses; starts and stops that can take a toll on the overall success of embracing and accomplishing long-term behavioral change.

Also, health organizations need to generate awareness among members and drive enrollment across their population of diabetes patients. Even if a successful behavior change program can be implemented, it won't improve population outcomes if a significant number of patients don't sign up. From the organization's point of view, it is not enough to change one individual's behavior; we must change the behavior of enough individuals to impact population health.


To meet both challenges, engagement programs must be just that - engaging. They must find a way to deliver interesting, relevant, and timely information in a way that is not only educational, but also entertaining. It must be flexible and take into consideration that each patient is engaged and entertained in different ways, and that they prefer their engagement through different channels - from print to digital e-health tools.

How do you accomplish such a tall order? A multichannel, multimedia approach. The information must first be delivered in a medium that patients are comfortable with, such as TV, print, digital, and mobile, and ideally in multiple mediums, giving them a choice. When information is presented in a way that fits easily into patients' lives, it improves program adoptability and engenders greater behavior change and better outcomes.

In other words, when disruption is minimal, adoption is high. Taking a lesson from marketing, we should endeavor to fit the program into individuals' habit streams. Second, patients want to be entertained. When they are entertained, they are more engaged. It goes back to the age-old solution of storytelling.

Digital platforms enable storytelling in multimedia formats such as video, articles, and interactive content, including dynamic question and answers, polls and quizzes. We have found that video content, whether accessed online, through mobile phones, or directly on the television, powerfully connects with patients and helps to put the behavior change in accessible context. What lends to the success of these formats is that the delivery methods are entertaining and exciting.

They offer more than a single-medium delivery model where the information comes across as flat. Third, the invitation to engage must come from a trusted source - someone or an entity with whom they have familiarity and historically positive experiences. If organizations find this challenge difficult to overcome, they should consider partnering with organizations that already have an established, trusted relationship with their consumers.

Enabling behavior change is about building a relationship, one where the patient views your information, and most importantly your intent as aligned and consistent with what is best for them. Trusted entities leverage that trust to build deeper more impactful relationships from the first program sign-up through to ongoing and sustained change.

Lastly, personalized content is best consumed when integrated in a program that aims to engage a patient over time and delivers that content based on the patient's progression through therapy adoption and disease maintenance. The key here is to not let behavior tracking and its accompanying feedback loops become the intervention, but rather to put in place proper methods for measurement and feedback that integrate with the broader engagement solution.

Programs should look to incorporate behavior tracking as part of a deeper self-care intervention. For example, a program that helps a user understand the importance of goal setting, then helps them to set goals, track progress and review their progress in light of barriers to success, will result in improved behavior change.

Additionally, the ability to measure and track results - not only for the patient but for the program administrators as well - is vital to the long-term success of a program.


With each new development in technology and each organization that announces its no-fail, innovative program, we see that the future is about technology and our ability to empower and engage patients to create positive behavior change in a holistic way.

It's about understanding the patient; establishing a more intimate relationship with them; and rethinking the way we speak to, collaborate with, and educate them. It's about evolving antiquated strategies into ones that adapt to new methods in communication.

Finally, it's about fully understanding basic human needs and coupling them with traditional therapy and new technologies, including mobile, social, digital, and beyond.


i. National eHealth Collaborative, Consumer Engagement with Health Information Technology Survey, 2012 July 24

ii. Schroeder, Steven We Can Do Better Improving the Health of the American People New England Journal of Medicine 2007: 357:1221-8

About the Author

Adam Kaufman, Ph.D. is General Manager of Healthcare Solutions at dLife. As a pioneer of technology and media solutions, Kaufman has directly led the development, rollout and evaluation of behavior change solutions currently used by dozens of healthcare organizations that touch tens of thousands of patients daily. He can be followed on Twitter @adambkaufman or reached by email at or telephone at (203) 221-3442.

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