Want to create an effective health app? Engage patients with storytelling

Mobile apps remain a red-hot topic in heathcare. But the breathlessness around them has begun to abate a bit, and hospital CIOs are starting to evaluate the apps they've created and some of the most popular apps their facility's physicians are using.

I recently read about an exciting new concept to add to that analysis--storytelling. A blog post at Co.Design, written by design consultant Stuart Karten, lays out some core ideas for building a patient-driven narrative into your apps, one that not only engages patients, but actually changes behaviors and improves health.

So far, that's proven to be no easy task. Research from earlier this year shows app stickiness is pretty flat, with 29 percent of users doffing an app after the first use, and 75 percent of users abandoning them after the tenth use. One of the key downfalls of many apps, according to users, is relevancy to their lives, or--to use Karten's parlance--an app's story.

Storytelling can up that relevancy quotient by clearly identifying the following for patients:

Conflict: Like any good story, healthcare apps should have a core conflict or quest, whether its competing against the game itself or against other users, or fighting to get the highest score. An app needs some conflict that patients can work to resolve. Karten points out an example of a game in which 40 top executives at a global company were given points for physical activity, and for taking a placebo pill.

"The result was dramatic change in behavior," Karten writes. "During the three days the game lasted, not one participant missed a pill ingestion. One busy executive rearranged his schedule to walk 17 miles over the course of a weekend; another walked out of a meeting to take a jog."

Characters: No one wants to go on a quest alone. Successful apps will build in supporting players and characters to accompany the patient, and provide motivation when morale is flagging. Karten points to MyQuit Coach, a mobile app that tracks the users' smoking habits and changes, and includes an online support network online.

"It boasts a 90 percent success rate, thanks in large part to the interaction between participants," Karten says. He adds that online support, while virtual, can provide "intense relationships that people form with one another in these purpose-driven communities, where a vast majority of successful users said they received continuous positive feedback when they needed it."

Setting: Another key to creating sticky apps may be developing an "immersive" experience, much in the way an engrossing story can absorb the reader's attention for hours. Include sounds, colors and even tactile sensations like vibration, to cement the positive experiences of your app in your patients' minds.

Resolution: Patients need multiple points at which they can overcome the inherent conflict of your app, feel a sense of accomplishment, and tie up loose ends. In the narrative world, it's called a denouement, and it's designed to let the reader down gently after the climactic scenes of the plot. To keep patients engaged, they need to experience resolution on multiple levels, including real-world rewards (coupons, redeemable points, etc.), as well as virtual kudos such as blue-ribbons, comments from other users and online atta-boys.

So as you're developing your apps for patients--and ostensibly using gaming and other design concepts to get patients involved and motivated--consider whether you're allowing the patient to participate in a story, or just a static collection of data. The former will surely engage your patients better than the latter. - Sara