Can personalized and actionable feedback get you to put down that doughnut and go for a walk?

By Doug Beaudoin, vice chairman, US Life Sciences & Health Care leader, Deloitte LLP

I have three kids under the age of 12. As a parent, I pay close attention to their well-being. I limit their screen-time and get them to bed at a reasonable hour (usually). I make sure they eat well-balanced meals and have access to healthy snacks. I also try to sign them up for sports teams and camps to make sure they stay active. Unlike my kids, no one is constantly monitoring the choices I make that could affect my health. I know I don’t get enough sleep. When I’m on the road, I tend to skip the gym more often than I’d like.

We have been writing extensively about our vision for health in the year 2040 when we expect always-on sensors, multi-omics profiling, and highly personalized health data will empower individuals to take steps to improve their health condition or prevent illness in the first place.

And speaking of taking steps…nearly 600 of my Deloitte colleagues recently completed a 36-week randomized clinical study that looked into the impact wearable devices can have on physical activity. Researchers from the Perelman School of Medicine at the University of Pennsylvania concluded that wearable activity trackers paired with an element of gamification are much more effective at boosting activity levels than wearable devices alone. Even 12 weeks after the study concluded, the participants who had a fitness tracker paired with competitive gamification were far more physically active than the control group that used a fitness tracker alone. The results of this study were published yesterday in the September 9 issue of the American Medical Association’s Internal Medicine publication.

Another recent article (this one in the journal Nature Medicine), backs up our thesis that patients will become more engaged in their health as they gain insight into the preclinical conditions that impact their well-being. In this study, participants who were at risk for developing diabetes were evaluated over a period of up to eight years. Tests included profiling of the genome and gut microbes, and participants used wearable devices to continuously monitor their glucose levels. Regular feedback related to their health prompted a majority of participants to alter their diets and to exercise more frequently. Participants said their wearable devices kept them accountable for exercising and made them more aware of the need for occasional walking breaks.

We are heartened by the results of these studies, which challenge the orthodoxies about human behavior. Twenty years from now, or maybe much sooner, a smart wearable device might continually track activity as well as blood-sugar levels, electrolytes, and hydration.

Immediate feedback can change behaviors

To effectively change behaviors, health data provided to consumers should be highly personalized, immediate, measurable, and actionable. Here are two more examples of how feedback is being used today to change behaviors, and what it might look like in the future:

Facial-image scans: Last year, Walgreens teamed up with the Skin Cancer Foundation to encourage consumers to be more proactive in protecting their skin. Participants were invited to receive a high-tech facial scan that shows sub-surface sun damage that has occurred over years. The imager system provides visual proof of a potential health risk. An estimated one out of five people will develop skin cancer by the age of 70.

• In the future of health, such devices might be imbedded in our bathroom mirrors to illustrate the importance of sunscreen before we head out of the house.

Pictorial warning labels: Graphic photos on the front and back of cigarette packs have been highly effective at getting people to quit or to smoke less, according to a 2016 study.² Researchers in Australia, Canada, and the United Kingdom looked at changes to smoking rates after pictures were added to cigarette packages. In the eight years since Canada added pictures, for example, smoking prevalence has fallen between 12 and 20 percent.

• In the future of health, a wearable device might tell a person what is taking place in their lungs immediately after a cigarette.

Are stakeholders ready to change?

At a personal level, most everyone who works in the health care industry understands that helping consumers make better health choices can improve their well-being and reduce long-term care costs. But the antibodies that exist within many organizations can be highly effective in maintaining the status quo of engaging with people only after they become sick. There is also a fair amount of skepticism among stakeholders that patient/consumer behavior can be changed. But there is a growing body of evidence that highly personalized, immediate, measurable, and actionable data can be effective in changing behaviors.

We all know we should eat more dark-green leafy vegetables, avoid saturated fats and sugary drinks, and we need to exercise regularly. Most people understand that some of the choices they make today could have a negative impact on their health in the future. However, many of us will still reach for a doughnut instead of a piece of fruit if given the choice. Rather than doubling down on existing products and services, health care and life sciences stakeholders should consider investing in diagnostic and visualization technologies that encourage consumers to make healthier choices.

^{Endnotes
1. A longitudinal big data approach for precision health, Nature Medicine, May 2019 VOL 25 792-804
2. Graphic Pictures on Cigarette Packs Would Significantly Reduce Smoking Death Rate, Georgetown University Medical Center, November 3, 2016}

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