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Aetna Scores with Interactive Patient Engagement Game

 |  By gshaw@healthleadersmedia.com  
   November 15, 2011

I would have finished writing this column much earlier if I hadn't gone online to do a little first-hand research  and clicked on an online personal wellness game created by Hartford, CT-based health insurer Aetna in partnership with Seattle-based social media company Mindbloom.

I have to admit I spent a little bit longer on the site than I probably should have been during work hours.

Then again, that's the whole idea.  

The platform takes advantage of the science behind social gaming and blends technology, art, and behavioral psychology to engage users in achieving personal health and wellness goals, according to the two companies.

"I'm very passionate about personal development," Mindbloom co-founder Chris Hewett said in an interview. "I'm a big believer in small steps every day and the key is every day. So how do you get someone to change their life one small step at a time? It's about engagement. The idea was to tap into game elements, inspirational content, and social to make this a very powerful way for people to grow the life they want."

The site relies in part on gamification to increase and sustain engagement. Each user has his or her own tree with leaves that represent different areas of life, including health, finances, and spirituality.

Users keep the tree healthy by scheduling and performing tasks. So, for example, one of my goals is to drink more water. When I meet that goal I'll earn sunshine and water to keep my tree healthy. If I don't, my tree will wither and die.

I can add inspirational quotes, personal photos, and music. And I can invite friends to join and share my progress on the site or via other social media sites such as Facebook.

When you set goals, accomplish tasks, and perform other actions, your tree produces seeds that can be used to send a little burst of rain to a friend (200 seeds per shower) or to upload 50 additional images (1,000 seeds per upgrade), for example. 

Getting patients engaged in managing their own health is a growing priority in the industry. The trick is how to accomplish that. Some suggest that the only way to get patients to do anything is to gives them incentives or disincentives, from virtual raindrops and sunshine or cold hard cash to higher health insurance deductibles for those who fail to improve their health.

"We support the use of financial incentives today for engagement," said Dan Brostek, Aetna's head of member and consumer engagement. "There's this big discussion around real versus virtual rewards and which one works or if it's a hybrid that will work. I'm a believer that the financial and tangible rewards will get people there and get them to participate initially. But if you want sustained engagement around true behavior change it has to be intrinsic. And that's where emotional rewards come in—things you can't touch but you can feel."

"This, really, to me is about creating a vision of why I want to be healthy. It's not about getting a five-dollar discount at some local sandwich shop because I met my health goals today. It's about 'I want to be healthy because I want to be with my kids,'" Hewett said.

"The financial, the tangibles will get people there. It's a good way to market and communicate the capability of the experience. But then to keep them there, which is what we're all after, it's got to be more emotional in nature," Brostek said.

And fun.

"We did a ton of quantitative and qualitative research and what came back was [that users] want fun, easy, rewarding, and social. It's going to be critical for us that the next layer takes into account the new features and functionality and then what we can start to incorporate into the user experience moving forward  across those different distribution channels," Brostek said.

"We want this thing to be part of people's lives. Because you're going to invest a lot into it—putting your images and you music and your quotes and your journal entries. And it really is touching on all aspects of your life," Hewett said. "It's got to be focused on outcomes, behavior change, and it's got to be cool and interesting and engaging and leverage some of the consumerism trends right now for it to work."

Initial numbers suggest the companies are meeting the goal of sustained engagement: 15,000 beta testers visited the site an average of 3.5 times a week and spent about 15 minutes on the site. In all, they scheduled 1.3 million daily intentions or tasks (such as drinking more water) and 75% of those tasks were completed. The average user stayed on the site for about 16 weeks after he or she first registered.

Aetna is pleased with those stats and recently released a suite of new features it hopes will keep users around even longer. One of them is custom content. Aetna can populate its customers' sites with articles about certain health topics, for example. Large employers, hospitals and health systems, or other sponsor organizations can also offer content such as articles and videos for their target audiences. 

"We're thinking about it as a wellness [program] that could be distributed through our large B2B relationships. But at the same time we're also thinking about it as a consumer-oriented platform. Because that's how we started this concept inside Aetna before we ever partnered with MindBloom. It was all about creating a consumer oriented experience," Brostek said.

"The interesting thing with solutions like this, interactive health [and] broader well-being solutions, is there's a fine line between individuals as users and what they want from the experience and what a sponsor or carrier may want or even healthcare professionals. How do you walk that fine line so they don't feel like they're in their insurance company's back yard or their employer's back yard? They actually feel like they're in a very immersive, safe environment where they can share to the extent that they want to share with colleagues, friends, family," Brostek said.

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