It’s 7 pm and the phone rings. You know exactly who it is–your health coach. The last time you spoke, you told them the best time to call you was after dinner. But tonight, you’re behind on a work project and the kids need help with their homework. Talking to your health coach has dropped to the bottom of the priority list, prompting a brief, hurried exchange that does little towards achieving its goal: improving your health. In reality, tonight is no different from most nights and underscores a decades-long problem underlying the way we’ve approached wellness.
While the healthcare industry has grappled with how best to engage individuals in leading healthier lifestyles, the health of our nation has continued to deteriorate. According to the Gallup-Share care Well-Being Index, in 2016 the obesity rate among U.S. adults climbed to a new high of 28.4 percent, representing an increase of over 6 million people since 2008. And, the prevalence of chronic diseases–diabetes, heart disease, depression, to name just a few–continue to increase at alarming rates. The disconnect between what we know about good health and our actual health status as a nation has never been more apparent.
Twenty years ago, the wellness industry made bold assertions that they were going to significantly improve the health of employee populations through worksite wellness programs. Led by Dee Edington, staff at the University of Michigan Health Management Research Center performed ground-breaking research showing and quantifying the link between specific health risks and healthcare costs. However, current evidence shows that for the most part, the industry over promised and under-delivered, leaving employers disappointed in low engagement and employees frustrated with programs that don’t meet their individual needs or expectations. With respect to direct medical cost, few programs and typically those which, address holistic well-being yield even break-even ROI.
The wellness industry did not set out to deceive employers. Armed with the knowledge that the risk factors impacting health were lack of physical activity and sleep, poor nutrition, smoking, and stress, leaders and researchers set out to change behavior in these areas. However, even with good intentions, wellness vendors significantly underestimated the difficulty of changing or mitigating lifestyle behaviors, especially when our environment undermines our intentions.
"Data, used effectively and responsively, promises to revolutionize wellness"
Today, we know that most of the content spoon-fed to us by wellness vendors, incentives for or education on the positives and negatives of eating properly, exercising, and getting enough sleep is based on scientific research but ultimately does little to change lifestyle factors. As BJ Fogg, the Director of the Persuasive Tech Lab at Stanford University, notes, “We shouldn’t believe that providing information leads to action—-we humans aren’t so rational.”
For health to improve, personalized information must be served up to individuals when they need it and how they want it. The medical claims and biometric data we historically used to identify risks and model behavior is insufficient to identify or address these issues and particularly useless to modify activity in real-time.
Fortunately, we now have access to vast quantities of heterogeneous data that often tell us more about individuals’ behaviors and preferences than they know about themselves. Our most ubiquitous piece of technology, the smartphone, has become our greatest health improvement ally. We can measure sleep, track daily activity, and monitor stress levels by analyzing fractal patterns within the voice–all through the smartphone, without the use of additional wearable technology.
However, accessing such data is only the first step in optimizing this wealth of information and insight. A successful big data strategy must include:
• Evidence-based behavioral economics and a focus on holistic well-being
• Ubiquitous technology
• A fully-integrated, intelligent platform
• Linkage to physicians and providers
In combination, this system can deliver nudges and touch points that will lead to lifelong healthy habits and sustained behavior change.
This brings us full circle to the health coach. Individuals with the poorest health status are typically those who don’t prioritize their health and even the most engaging apps are unlikely to catch and retain their attention. Combining high-tech (digital apps) with high-touch (live coaching) is a proven, effective strategy for sustained behavior change. Supported by data and powerful algorithms, both mediums can serve up consistent, effective responses in a manner that is personalized to the individual’s current emotional state. Data, used effectively and responsively, promises to revolutionize wellness. It’s about time.