Maria Resurreccion

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	In the day and age of instant communication and direct to consumer capabilities, why is member/patient engagement still an ongoing dilemma? At recent count, 

 health- and wellness-related apps on iOS, of which the top 10 far outweigh all the others combined in terms of downloads and perceived value.

	Every week another company socializes their latest wellness program for losing weight, increasing steps per day or disrupting sitting behind a desk to move around, and yet studies show that six months into using the new app, the utilization diminishes dramatically, as does the accompanying gadgets such as wearable bracelets. Are employers, health insurance companies or individual users/patients in the best position to add the most value for healthcare apps? Or perhaps is there much more to the picture?

	On one hand, there are the employers who want to increase productivity, promote a work/life balance and retain employees with interesting benefits that are different than competitors. Then, you have the healthcare insurance companies that continue to drive toward consumerism, patient centricity and becoming a more digital business with a "top-of-wallet" approach for engaging users. As for the individual, there is a desire not to enter the same information repeatedly, have to link to multiple doctors and facilities, and the "need for the want." Individuals, to modify behavior, must be intrinsically motivated or have enough extrinsic motivation to want to change and engage in their own health or manage a chronic condition; there must be something inspiring that encourages them to have the "readiness to change."

	So, the question is who should own the app? The employer, the healthcare insurer or individual users/patients? How do we bridge the gap to effectively reach consumers? 

	As an employer, employee wellness has many documented advantages, including fewer sick days, higher productivity levels and a more positive outlook of work. These benefits show an obvious rationale for organizations to own the app, yet in this day, more than half the population travels or telecommutes, and loyalty to an employer is at an all-time low.

So, how do organizations ensure the employee base responds to an employer app?

	Enable employees to use the app for as much as possible, from time reporting, training and pay review to social, employee-only communities (e.g., bartering, vacation planning, informal FAQ, posting of benefits, etc.). By creating an all-inclusive community, the wellness program becomes a benefit of the app, but not the only reason to visit, which will increase the stickiness factor and keep employees using it.

	The most successful results for employee wellness engagement come from building in-house clinics, but for remote workers, email and conference calls are the primary communication needs. With mobile and telehealth technology easily available, employers should have a virtual clinic option. Video chatting with a nurse or PA will provide a high-touch option that local employees may be slow to adopt but will soon crave, and will have a high likelihood of adoption to remote workers, quickly shifting to proactive advice rather than reactive treatment.

Conversely, how can healthcare insurers provide more meaningful interactions between users/patients and the app to create longer-term success?

	Since the financial aspect of healthcare is a constant concern for many employees, a single app with benefits, notices of coverage, and prescription information, as well as the ability to talk, text or chat with a care manager who has access to each users' records and HSA information, would be a valued app that serves as a one stop shop. A true full-service app would enable the user to interact across platforms to identify treatment, schedule a visit, complete paperwork and even have medications and products sent directly to their home.

	Using an app, an insurer can identify groups with similar needs, pains and treatment patterns to help connect users. When users have a mutually shared goal, wellness programs are more likely to succeed. In addition, the insurer could facilitate the creation and execution of a plan for each group, regardless if the goal is wellness or simply information exchange. This approach has the ability to generate relevance and enjoyment for users.

Finally, if a user/patient has access to a more "centralized" app that enables them to own the information, would it be valuable enough for a consumer to develop a more lasting relationship with the app? 

	Users/patients are tired of answering the same questions over and over again for providers of health plans, as well as hospitals and other care organizations. Yet as consumers, we know the importance of providing accurate information so we receive the best care.

	Having the freedom to control your own medical records at your fingertips, and having the ability to share the information, can remove the hassle of making a formal request multiple times since the consumer owns the information and can keep track of it. This should empower the individual to make better choices about their health.

	Without engagement, wellness programs will not succeed. Apps must create a "convenient way" to reach the user and make users/patients want to have health at their fingertips. Fewer barriers to consuming the value means more people will receive that value and come back repeatedly.

	It is more evident who should own the app when looking at how to add the most value to the most important stakeholder in the equation: the users/patients.

	What if healthcare insurers devised healthcare programs for employers that included real-time feeds of meaningful benefit information for them to provide to their employees via their chosen application? Or better, what if the information was made directly available to the employees to choose the exact app they wanted to use to store the information? 

	A "consumer-owned" app would stay with the individual regardless of their employment status or the health insurance they have during a particular year. Perhaps the app automatically supports multiple insurances as our population ages and payers such as Medicare become the primary insurance for users/patients. A critical component however is how we get to an end state and with the current ecosystem of payers, providers, employers and users, the healthcare insurance companies have the most to gain in shifting to a more customer-friendly coordination of care approach, similar to retail and banking disruptors who encourage longer times on the phone to help cross-sell, care managers are in a unique position to engage, educate, and develop meaningful relationships to facilitate acute episodes, manage chronic care, and promote healthy lifestyles.

	It is not "who owns the app?" that is the most important question, but more about how we transform the value that healthcare insurance companies and employers provide to enable the consumers to take charge of their own health.

Adam Nelson leads the Healthcare and Life Sciences Solution Offerings group at 

. The group's focus is productizing service capabilities to bring predictable and relevant industry solutions and benefits to its clients. 

NTT DATA's Healthcare and Life Sciences industry

is skilled in healthcare and clinical informatics and provides performance management and clinical operations consulting with 

NTT DATA's Healthcare and Life Sciences Solution Offering and Business Consulting Group

Articles

There are more than 165,000 health- and wellness-related apps for iOS, but overall engagement remains low outside the top 10. To best benefit users, who should be responsible for health and wellness apps-employers, healthcare insurers or individual consumers? It depends.

Maria Resurreccion

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Who should own healthcare apps?