How fine-tuning technology and redesigning care delivery can improve patient engagement

Doctor patient
Technology can improve patient engagement, but only if it is fine-tuned to account for nuanced patient behaviors.

Healthcare providers and digital health companies are searching desperately for ways to get patients more engaged in their care. Doing so may require some radical changes to care delivery.

As smartphones and mobile devices have become more ingrained in everyday life, many view technology as the key to patient engagement. But industry leaders also caution against a plug-and-play approach that fails to account for a wide range of unique variables that impact patient behaviors.

Design and usability are the primary drivers of behavior change, said Sean Duffy, co-founder and CEO of Omada Health during an event hosted by NEJM Catalyst. Companies and organizations that use analytics to identify trends and pinpoint models of success will be able to fine-tune tools to build engagement and ultimately improve patient outcomes.

“It’s about fine-tuning and personalization and this, I think, is spawning an incredible, incredible wave of potential in the way we work to improve the health of the country,” he said.

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Omada is among several tech-based companies targeting diabetes care with empirical success. The digital health company has partnered with health systems and incorporated digital therapeutics to help patients lose weight and reduce the risk of diabetes.

Duffy explained the scientific rigor behind the company’s approach, noting that the company went through a “thousand-page checklist” and talked with hundreds of patients about how they interact with certain tools in order to perfect the program so that it could work for a range of patients while also accounting for the ingrained systemic processes on the provider side.

“You almost turn it into a pill,” he said. “[You] turn it into something the medical system could ingest.”

Fine-tuning that approach also means changing the way the health system thinks about patients. Stacey Chang, executive director of the Design Institute for Health in at the University of Texas Dell Medical School in Austin, pointed out that although physicians are often at the center of current healthcare delivery models, patients often have strikingly different priorities. Aligning patient motivations with system priorities is a first step in redesigning care models that revolve around the patient.

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In a blog post for NEJM Catalyst, Kevin Volpp, M.D., director for the Center for Health Incentives and Behavioral  Economics and vice chairman for health policy at the University of Pennsylvania, noted that physicians are rarely trained to help patients change their behaviors, but a tech-based system could help solve the “5,000 hours problem” that plagues the industry—the time that patients spend on their own, away from the watchful eye of a provider.

Mobile apps and virtual technology could fill those gaps, he said, but only if it can account for the nuances of each individual.  

“Each patient would essentially get a different intervention customized to his or her own life and preferences, as revealed in his or her own experience or in the experiences of others,” he wrote. “Much of this would be automated by technology that learns from the successes and failures of each individual and gets progressively smarter and better at customizing.”