I’ve been thinking a lot recently about the distinctions between web/mobile health engagement solutions that have been designed to delight and engage consumers vs. those that have been developed primarily to deliver value to a healthcare stakeholder other than the consumer – typically an employer, health plan or provider – but in order to do so successfully must engender a change in user (employee, member, patient) behavior along the way.

Direct to consumer health engagement solutions presumably focus entirely on delivering some kind of value to the user – to help them do something they either want or need to do. That could mean helping them to track their blood pressure, access a social network that encourages them to lose weight, or save money by better managing their healthcare spending. These solutions are most often monetized through ads or (freemium) subscriptions, so achieving large numbers of engaged users is a critical business objective. Typically, the user base is comprised of individuals who are early technology adopters and either already engaged in their health, or keen to be more so.

On the other hand, solutions whose revenue model stems from a healthcare stakeholder other than the user serve two masters. Their paying customer is an entity that has a vested interest (often a financial one) in fostering some kind of behavior change among its members/employees/patients. These solutions’ user base is (obviously) comprised of the individuals that this stakeholder wishes to influence.

In the latter case, these particular individuals do not necessary want or (in their opinion) need to change their behavior in the way that their sponsoring entity desires. Though they (almost always) sign up for the solution voluntarily, they may have been conditioned or nudged to do so in any number of ways (cultural, financial, etc.). And they are almost definitely not paying for the solution. Moreover, the type of individuals that a sponsor really wants to engage (usually because they incur the highest costs) are probably the least likely to (voluntarily) engage with such a health solution.

Finally, these solutions are judged by their paying institutions on (typically subjective) value – cost savings, ROI, etc. User experience and engagement are understood to be prerequisites of value – if nobody likes the product and nobody is using the product, it is unlikely to engender meaningful behavior change. But they are viewed as means to an end, rather than ends in and of themselves (and they have historically been treated as such). And engagement is rarely achieved to the extent that sponsor and vendor would like.

Due to the very distinct parameters that surround each of these solution types – from their revenue source to their user base composition and everything in between – it is not surprising that they are at least somewhat divergent in their nature and purpose. However, there are valuable lessons that each solution type might learn from the other - and noteworthy examples of vendors who have applied them successfully. Given the momentum toward consumerism in healthcare, I predict a continued convergence of the two. Techniques used by consumer facing web/mobile solutions that have successfully engaged early adopters will be increasingly - and more effectively - transferred to settings where a sponsoring stakeholder has the opportunity to provide additional nudges and incentives to encourage those less likely to engage. This creates an opportunity to do better at engaging many of the individuals who are most in need and stand to benefit the most from increased engagement in their health and care.

I’ll come back to this topic with more specific examples over time.