Richard McAleavy considers what autonomous cars can teach digital healthcare about building engagement
Digital healthcare is “entering the self-service era” according to Sarah Wilkinson, chief executive of NHS Digital, speaking recently ahead of the launch of the NHS App which is now being rolled out in England. Yet while I am excited about digital healthcare, I am also quite worried. As both creators and potential users of digital healthcare, I’m not sure we’re quite there yet.
For a start, one survey revealed that over half the population – some 57% – remains sceptical about digital healthcare. Furthermore, only a small number of digital apps achieve significant engagement – a late 2017 report by IQVIA found that just 41 apps account for nearly half of all digital health downloads.
With the average healthcare app currently costing around £325,000 to develop, a cynic might challenge the logic of this investment – at a time when healthcare budgets are under greater financial pressure than ever, people aren’t really engaging. But given the patient benefits digital healthcare can deliver, rather than question its value we should instead focus on how we can all work effectively to get people better engaged.
So, how can we engage? We can draw some important lessons relevant to digital healthcare from what’s happening in the world of autonomous driving.
Looked at rationally, autonomous cars seem a great idea: saving time, reducing fuel consumption, benefiting the environment and boosting safety – with 90% of road accidents caused by human error, one estimate suggests they have the potential to save more than a million lives each year.
Leaving aside the fact that fully driverless tech is still at the testing stage, partially automated cars are already available. So why aren’t we all driving one? Regulatory and infrastructure issues accepted, the answer is that humans don’t always make rational decisions and our multitude of experiences and biases influence the choices we make.
Trust is one potential obstacle to the autonomous driving revolution. Fear is another – fear of the unknown, fear amongst those who drive for a living of having their livelihood taken away, and fear for those who love to drive of losing something enjoyable.
An effective response has been to present autonomous technology not as a replacement for a driver, but as an enhancement to the driving experience and to make accessing the technology as simple as possible. For example, virtual assistant and voice technologies are being used to provide a naturalistic connection between human and machine to seamlessly bridge the gap between self-driving and autonomous modes.
In the same way, creators and developers of digital healthcare apps need to step back from the rational benefits of their products in order to better understand, engage with and address the emotional experiences and biases of humans – not just patients’, but the creators’ own. In this regard, we propose three biases that we may recognise in ourselves.
The first is ‘Pied Piper Belief’ – an assumption that digital healthcare is something everyone will automatically buy into. In fact, while many say it’s great, dig deeper and you will find that often those who could (and should) be the biggest advocates have deep concerns.
Take healthcare professionals, for example. Talk to this group and you will find they are worried about how their role will be impacted – I’ve had several nurses express concerns that they’re being expected to support digital health solutions but aren’t being supported themselves, and pharmacists questioning how they should respond to referrals from digital apps like Fitbit. Pharmaceutical field forces, meanwhile, are anxious that digital healthcare is progressing to an end point where their roles will no longer be required.
The answer to effectively overcoming this is to be more proactive – go out and find out what our audiences truly believe, and then work to bring them onside to better harness them as supporters and advocates.
The second bias is ‘Intuitive Interface Assumption’ – a belief that because we are comfortable interacting with technology, everyone else will be. The elderly population is likely to have most to gain with the least understanding of how new technologies work, but this is not just an age issue: one person’s idea of a great user interface isn’t necessarily the same as another’s.
To address this, the aim should be to minimise and simplify interfaces and design natural, frictionless interactions between the user and the technology. Developments in artificial intelligence (AI), including natural language processing (NLP) and conversational interfaces (CI) are providing the opportunity to develop solutions that are easier to operate than ever before, and for a wide range of audiences.
However, we do still need to think about how we can educate and improve digital literacy for both users and stakeholders, particularly in the transition period while technology matures.
Our final bias is ‘Digital World Myth’ – an over-emphasis on digital that underplays the power and importance of physical experience and interaction.
I’ve often heard the phrase ‘it’s a digital world’ from clients and colleagues as they plough headlong into developing the next revolutionary digital healthcare solution. But shouldn’t we be developing patient-centric and channel-agnostic solutions, solutions that make a difference with real people in the physical world?
In fact, live events and experiences can be an antidote to digital overload. Google, the epitome of a digital business, has been investing in Google Garages to bring its products and services to the high street; its programmes are creating awareness, educating and building trust with customers. The question we must ask ourselves is: how do we harness both digital and the real world to work holistically around patients’ needs?
To drive uptake of digital healthcare, we must change behaviour. To change this behaviour and sustain it, we must build engagement between people and the digital healthcare solutions we create.
We believe that this can only be achieved by effectively addressing the three pillars on which successful engagement is built: environment, content and emotion. This means we must consider not only the tactile, physical environment of where and how our solutions are used, but how patients first hear about and access the solutions, as well as where and who they go to for support and guidance.
We must work hard to create authentic, engaging content that people can believe in, understand and get behind; utilising media formats and technologies that are not just the latest thing but right for the audience.
And we must connect on an emotional (not just rational) level with our audiences and stakeholders – while this could be as heartfelt as communicating the impact of disease progression to family, friends and carers, it could be equally light-hearted and fun by adding elements of gamification or humour.
If we can achieve all three, we stand the best chance of achieving the goal of any digital healthcare solution – improving patient outcomes.
The message here is simple: while it is critical to overcome the users’ biases preventing adoption of digital health solutions, it’s equally important to recognise and overcome the biases of other stakeholders and advocates, particularly those who may also be anxious or disengaged.
We need to remember we’re all only human, we all have biases that drive our behaviour, and that includes us – as creators and developers, too.
Richard McAleavy is client engagement director at The Creative Engagement Group (TCEG).