Can personal health data motivate behavioral change? It depends.

By: admin | May 16, 2013        

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Dave Dickinson HeadshotBy Dave Dickinson, Former CEO, Zeo

After leading Zeo for the last 5 years, I’d like to share some of the key lessons we learned as an early pioneer within the digital healthcare movement. This post includes lessons learned for those who share our mission of improving the health and wellness of mankind by leveraging the awesome power of technology. Hopefully, some thoughts will engage new ways of thinking and serve to help guide other healthcare innovators to keep carrying the flag forward.

One of the critical questions within the connected healthcare movement is whether or not personal health data will actually catalyze and then incentivize lasting behavioral change and better wellness. Will any kind of data serve to motivate behavioral change? Does it matter if we see our data on a smartphone versus a laptop screen? Do all people respond in the same way? Early on, we realized that our ability to transcend our customer base, from highly-engaged, “quantified self” early adopters to the mainstream world of the “frustrated sleepers”, would require far more than just the raw data itself. It turns out that the gift wrapping matters as much as the present inside.

Moving from Quantified Self early adopters to the Mainstream Motivated Self will not be easy, but here are some clues that may help:

All data is not created equal. Some of the health data that various sensors are generating is simply not that provocative or intrinsically motivating. The more intuitively obvious the data is, the lower the consumer engagement will be. Within sleep, we realized that simplistic sleep/wake data is simply not very motivating and will relegate this health metric to the back seat of behavioral change. However, when you are able to help consumers discover a new health unknown, such as the amount and vital roles of their REM, Deep and Light sleep, this new level of shock and awe may provide a better catalyst to engage the mainstream. This is akin to a cholesterol test where the underlying HDL (“good”) and LDL (“bad”) data may be more motivating to encourage statin compliance than just the overall number alone (because I may be more scared). The level of data granularity, and then the scales that are used to convey what is high, low and average, are very important considerations to not only catalyze interest but then to also provide enough statistical significance for the critical positive reinforcement rewards that will be needed later to sustain the changed behavior. Scales of 1-10? Unlikely to motivate change. How about 1-100? Obvious, and better, but don’t assume that this should always be the default. It depends.

Relate the data to something else I care about NOW. Unfortunately, consumers are not motivated enough to take action when the resulting benefits are longer-term or too scary, like the prospect of getting a terrible illness one day in the future. This is one of the greatest challenges of preventative healthcare; however, other ideas may be able to help here. For example, we found that comparing your personal sleep data to others your own age was far more motivating. Most people do not want to age before their time and well understand what being older than your age may imply as it relates to their performance, sex appeal, career development, closeness to the prospect of dementia and more. The cosmetic industry is a very big business, and Real Age built a business model around this powerful consumer insight.

Make your advice as personalized as possible. Knowing about what is best for “people like me” is a good start, but the consumer now has far higher expectations of what is possible with technology. They want a personalized self-assessment that is quickly followed up with far more “prescriptive” advice. This is still relatively new ground for the connected healthcare movement, as the marriage of personal sensors and powerful mobile apps is still in its infancy. I think we ain’t seen nothing yet when it comes to personalization. When we get there, I think we should expect better outcomes than we have now.

The presentation of the data matters. Quantified Selfers revel in being able to demonstrate their data correlations, share their cause & effect discoveries and review new, insightful hypotheses. I know because I am one of them. We are anecdotally discovering some amazing things, but alas, this is not the average consumer. Over the last five years, I have attended many connected health conferences. Unfortunately, I rarely see presentations from behavioral psychologists or, as important, designers and artists who can fire our emotions with the power of their visuals. Some data charts and graphs simply have no chance to capture our fear or to engage our competitiveness. Some data, like trend analysis, is not best displayed on a small smartphone screen, yet another challenge within connected healthcare as we move faster toward mobile viewing versus watching our health wins and losses on bigger screens at home. GE seems to know a lot about data visualization, and there may be some more lessons from their work (read more about it here).

Motivating behavioral change through data visualization can be very powerful, but it is more of an art than a science. We will need far more artists, user interface experts and psychologists to help make our data work harder to motivate better health. Yes, it will take a village of talent, but I believe a far more creatively diverse one than most technology-based innovators may feel comfortable residing within.

  • Frank Katarow

    Dear Dave,

    Thank you so much for sharing what you have learned. So many times we
    only hear about great successes. The experiences that did not meet
    expectations are rarely shared and only benefit the future of those who were
    directly involved. Your experience can now benefit many of us now
    fighting the good fight. Fantastic article.

    Frank Katarow

    VP Product Dev,Mfg and Regulatory

    Sleepmed,Incs

  • http://twitter.com/ceo4rent Dave Dickinson

    Frank,
    Thanks for the positive feedback. The connected healthcare movement is a long journey that we all walk together, with each of us taking in important insights that can lead to the greater good. I will try to share more lessons going forward.
    Best,
    Dave

  • http://eric.jain.name/ Eric Jain

    I’m betting that what most people want is not more motivational visualizations, but guidance on what to do next in order to reach their goals (or just stay healthy).

    Example: Do I need to lose weight? If yes, what is the most appropriate diet, given my genetics and general environment? What do I need to do to track progress? It better not be time-consuming; remind me! How soon do I know if the diet is working for me, or if I should I try another approach?

    Even for a dedicated self-tracker, it can be a lot of effort to figure out how to set up an experiment, how to chose intermediate goals, and how to evaluate progress. What gadgets do I need? How much data do I need to collect? How do I know if there is a statistically significant difference?


    Eric Jain
    zenobase.com — What do you want to track today?

  • Diana Long

    Dave,

    Great consumer insights. Great overlay to Simon Sinek’s TED Talk about crossing the chasm to mass market success. Consumers only care about our “WHAT” if it motivates them to “Do Something for Themselves” – what they believe in! I’m impressed how you/your company were willing to change your behavior e.g. “relegate it to the backseat” – another critical lesson for us all.

    Diana Long

    CEO/5 Minutes of Fun

  • Li Shang

    Thanks, Dave! Great article! Data monetization, as the potential home run, is the challenge every domain expert trying to figure out. Great learning experience from Zeo. Thank you so much for sharing!

    Li

  • Pingback: Take positive lessons from Zeo failure | mobihealthnews

  • Eduardo Briceño

    Thanks Dave for sharing what you have learned! Great role model for
    helping one another move our society forward. And I loved Zeo – thank you for showing the way of what personalized data can be.
    One thing: it’d have been nice to email the Zeo customers to let them know you were shutting down! We would have taken screenshots of our charts / cause & effects / etc. Now the information/insights seem to be gone forever. If there’s a way to bring the website back up so we can extract our personalized knowledge in screenshots or whatever form, we’d really appreciate it! (I learned you were shutting down when one day there was no website). Thanks again for everything you did and are doing!

  • http://www.beaugunderson.com/ Beau Gunderson

    I’m astonished that anyone would listen to Dave’s advice given that Zeo was shut down without so much as an email to its customers notifying them of the fact (which would have allowed them advance notice to download the data they had generated). The myzeo.com site went dark last week with no warning and now shows the GoDaddy parked domain page.

    Zeo also didn’t notify their customers of the asset sale currently underway, which I’m guessing contains the personal data of all of their users given this clause from the privacy policy:

    “Business Transfers: As we develop our business, we might sell or buy businesses or assets. In the event of a corporate sale, merger, reorganization, dissolution or similar event, Personal Data may be part of the transferred assets.”

    What a train wreck.

  • Kyra Hagan

    Dear Dave, I agree completely. That being said, I am struggling to grow the team of behavior experts I’m seeking to build @medseek. Do you have any tips on how to recruit consumer behavior/health behavior psychologists in the IT space?

  • philip mann

    Amen! IMHO Mr. Dickinson and Co. have chosen to ignore the most important rule of any business model, don’t run rough shod over your customers. I’ve been burned twice since both my wife and I were users of the product. I won’t forget these folks; they’ve taught me some valuable lessons and in the process hurt everyone in the business.

  • George

    Current laboratory tests were designed to monitor disease. The motivation you seek needs to take place in clients without disease, when they have developing abnormal biochemistry. The Personal Preventive Profile uses data of your personal biochemistry to determine your personal health trend profile. Data provided by licensed clinical laboratories is used to track your progress using laboratory data from you and for you; not data linked to some “normal reference range”. In those with a degenerative disease, like cancer, you can monitor your intervention effectiveness and continue to change interventions till you find the one that works for you.

    When consumers have access to the Personal Preventive Profile, a shift can take place toward a consumer centric model whose focus is personal health with the resultant reduction in the population’s disease burden..
    Nationally new cancer cases represent about one half of one percent of the population – that equals over 1.5 million new cases of cancer in 2013. If it takes 10 years or more for most cancers to progress from a latent state to disease, we have over 15,000,000 people in some stage of biochemical abnormality that is not identifiable as cancer. For these people the medical community waits for the abnormality to progress to a disease state.
    In 2010, there were about 12.5 million smokers between 30 and 50 years of age in the US. How many have developing biochemistry abnormalities with no warning signs? Would you want a personal baseline determined so any abnormal biochemical changes could be identified?

  • Ricardo Vasquez

    I agree with you Beau.

    Dickinson, you did a great disservice to your customers by shutting down your company the way you did. You are evidently one more of these white greedy selfish CEOs that only care about themselves.

    How is it possible you couldn’t make the software available to customers maybe via a download or CD. No notice whatsoever, no email, nothing.

    And wherever you create a profile like in LinkedIn, you fail to disclose you were the CEO of Zeo for many years. Why? Are trying to hide how badly you messed up this company? You can say all you want, I assure you that if it was Jack Welch running the company, it would have succeeded. This was your ship and you sank it, without telling anyone the time to abandon the boat was nearing.

  • TheJeebus

    What a shitty way to shut down a company. You will forever be on my list of people not to buy things from again.

    You had everyones’ emails and yet, nothing was sent out. The website just went dead and all the data’s lost.

    Please remain unemployed forever.

  • Matt

    I agree with Beau and Ricardo! What a horrible way to shutdown a company! I never found out anything until the sync stopped working because the site was gone! At that point it’s too late.

    Now the iPhone app has been pulled from the app store. I feel horrible for anybody unfortunate enough to purchase the product from Amazon (or other retailer). They are completely screwed because you can’t get the iPhone app anymore. It’s just a worthless headband.

    You just burned all your loyal customers! I can’t understand why any company would ever be stupid enough to hire you.

    If you want to help people, don’t give advice on how to run a company. I wouldn’t trust anything you have to say. Instead, write a book about “How to drive a company into the ground!” with your personal experience. The only think we can learn from you is what NOT TO DO!

  • Brother ben

    People, it’s called an injunction. He was forced to sell the company and can only give clues by NOT including certain facts, publicly. His statements at the sale spoke volumes. There’s a big push for microphone based sleep technologies, not beta wave detection. They helped certain developers to step into military projects.