The Institute of Medicine says healthcare should take lessons from other industries, and the founders California digital health startup HealthCrowd think that’s a great idea.
They’ve built a mobile messaging program to help health plans keep their customers engaged in their health based on behavior change techniques used in the advertising industry.
“Advertisers are the masters of persuasion; they make us do things we don’t even know we want to do,” said HealthCrowd co-founder and CEO Neng Bing Doh. “I thought, if only we can use the same techniques that advertisers do so well and take them over to healthcare to get people to take better care of themselves.”
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While her idea was brushed off by many people she approached, it resonated with an ER physician and former chief health strategist at Intel by the name of Bern Shen, who became a co-founder.
What they came up with was a two-way text messaging service with multiple use cases, from reminding patients to show up for an appointment or re-start a prescription, to helping people with chronic diseases like diabetes and cardiac disease remain engaged in their care, to sending follow-up information to patients after an appointment with a care provider.
Just six weeks after it was officially formed in May of 2011, HealthCrowd launched its first product with a paid customer – a text messaging cardiac rehabilitation program with 80 participants. Doh said she and her team wanted to find out at what rate people responded to text messages in a healthcare setting, and whether text messages motivated people to action.
What they found was that almost all responses happened within a day, and participants continued to demonstrate a 40 percent to 45 percent response rate six to nine months after starting the program. And as for whether patients were motivated to action, she said the average number of rehabilitation sessions the institution’s cardiac patients attended increased from 15 to 25 after six months of using the program.
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The key for HealthCrowd is talking in the language of the people receiving the messages, which are crafted based on what research has shown works – and doesn’t work – with certain populations.
“We’re focused on optimizing the message,” Doh said, addressing the numerous other text message-based services in existence. “The worst thing you can do is do the same thing over and over and expect different results.”
For example, a current study being conducted with Johns Hopkins is looking for ways to use the program to encourage teenagers to show up for an annual well-care visit with a physician. It’s looking at things like, does a plain text message work, or will it be more effective if it includes a smiley face or a special ringtone or audio clip?
“We have to take it up a notch; we have to do multimedia messaging,” Doh said. “We have to be relevant at every single level – age, political, religious, etc.”
Then there’s the issue of a business model. HealthCrowd works with payers but has turned its focus particularly to Medicaid plans.
Doh explained that most health insurers have Medicaid divisions, but these customers are often the hardest to reach by mail or phone. However, as many as 80 percent of them have cell phones and send text messages.
More than half a million new Americans are covered under Medicaid as a result of President Obama’s health law (although the future growth of Medicaid is up in the air, as the presidential candidates have opposing views on the program). Thus, plans are looking for new ways to improve their performance and Healthcare Effectiveness Data and Information Set scores. HealthCrowd is one of a growing number of startups aiming at increasingly competitive health payers.
Doh said three new customers will launch HealthCrowd programs this month, and a prominent non-profit organization and eight other health plans will launch by the end of the year.
[Photo from Flickr user Summer Skyes 11]
