The hierarchy of health and its impact on patient engagement through design

Patient engagement is on everyone’s mind these days, or at least it should be.

The buzzword of choice in 2017, research and discussion has proven that patient engagement will be just as important this year as patient’s needs continue to evolve, and more eHealth applications come to market in an effort to improve upon patient outcomes.

These eHealth mobile applications aim to equip patients with the tools to take control of and proactively manage their health. Still, patient engagement remains a sought-after holy grail for most organizations. To create an application that helps people live their lives, rather than manage their condition, one must focus on the user’s context and understand where people fall within the “Hierarchy of Health,” a model for what people are thinking, doing, and feeling at each level of wellbeing. Doing so will not only engage the user to ensure long-term use, but also affect long-term positive behavioral change.

A Unique Model for User Context

Of course, our users are not patients 100% of the time. Today’s “patient” should really be thought of as healthcare consumer — one that may also be a patient from time to time. This atypical way of thinking about patients, going beyond the usual requirements, will forge a much deeper connection and an understanding of their emotional, cognitive, and behavioral needs as they move though the healthcare system and within the stages of the “Hierarchy of Health,”— super health, healthy, homeostasis (not sick), and unhealthy.

For Example:

During the homeostasis stage, the individual isn’t sick, but isn’t exactly healthy either. This person could be going about his daily life while dealing with an issue that he is trying to keep hidden from his peers — a mental health issue, perhaps — due to the stigma often associated with such a condition. When designing an application to appeal to this particular group, it’s critical that it be easily accessible and portable, while providing a highly-personalized experience, which may include targeted messages and interventions that require the user to interact with the app on a regular basis or direct access to a clinician.

For an individual in the unhealthy stage, the design might look quite different. At this stage, the targeted users are in full “patient mode,” however they still may want to live their lives without the constant reminder of being sick. This means, application designers must make it a point to limit interactions, and when they do occur to keep them brief and to the point. For unhealthy users, patient engagement is often higher when required usage is minimal.

In many instances, of course, one’s target user may be more broad and spread across several stages of the hierarchy of health, or the individual may move fluidly from one to the next. In these cases, the application must be designed so that it may change and adapt to the evolving needs and context of its users.

The Impact of Increased Patient Engagement

With competition at an all-time high in healthcare, and more eHealth mobile applications coming to market every day, patient engagement is the key to standing apart from your competition and surviving in a saturated market. In fact, BCC Research expects that global revenues for m-health will reach $21.5 billion in 2018, though few will be fully adopted by their uses. Above that, equipping patients with the tools necessary to become more invested in their health will ultimately lead to better health outcomes, reduced healthcare costs, and overall improved patient satisfaction. While the business implications are significant, the ultimate winners here are the patients.

Lorraine Chapman is senior director, healthcare, for Macadamian, a company that designs and develops digital experiences to improve healthcare.

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