Data-driven Health Behavior Change and mHealth

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Data-driven Health Behavior Change and mHealthM. Courtney Hughes, PhD

mHealth ConferenceChicago, IL March 30-31, 2011

1IntroductionApproach Health helps companies:Drive behavior changeIncorporate evidence-based research and industry best practicesLower medical costs & increase productivityDemonstrate ROI

Background:Experience with health IT companies, health plans, PBMs, program vendorsPublished studies in health behavior change, workplace health PhD, University of Washington; MS, University of Michigan; BBA, University of Notre Dame

22The Time Has Never Been Better3ChallengesOpportunitiesRising healthcare costs75% due to unhealthy, modifiable behaviorsEngaging membersUbiquitous mobile devices

Strong interest in improving health behaviorsCost-effective customizationReadily available data

Effective communication algorithms3Capturing PopulationMore patient data is available than ever before.EMR, PHRPharma ClaimsSurvey(HRA, QoL)Medical ClaimsmDevices(Events, ODLs)Lab Values 4

4Health Behavior: Medication Adherence30-50% patients are nonadherent with medicationMedication nonadherence costs our nation over $100B / yearMobile devices can help improve adherence

55Identification & TargetingCurrent poor adherers missed refills, no med response, missed apptsIndividuals at risk for future poor adherencepsych problems, side effects, asymptomatic disease, cost, treatment complexityPrioritize participants within target groups

6Preventable disease, deathChronicCostlyDependent6Tailored Message for High-Impact77Optimizing Delivery8Target Optimal RecipientTiming should be immediateStartMed timesDays12431238Example 1: Diabetes Patients 9Multiple meds: 1 message or several?Time of day: weekday vs. weekends

Source: CareSpeak Communications

9Example 2: MI Patient Text, Day 1:Heart attack patients may benefit from taking a beta blocker like Atenolol. These drugs assist in the healing process and help prevent another heart attack.

Optional Reminder Text, Daily:Please remember to take your Atenolol today.

Call, Day 6: How do you feel about taking Atenolol?

Text, Day 28:Congratulations on refilling your Atenolol. You are helping yourself stay healthy and prevent another heart attack.

1010Where to Focus for Greatest Impact11*Cost information from Medical Expenditure Panel Survey, 2008

11Behavior Change Cost Impact BehaviorPrevalence Rate Annual Cost / Afflicted IndividualCostReferencePopulation Medical CostsMedication Nonadherence30.0%$1500Med Care, 2005Allergy, 2007$4.5MObesity38.91700JOEM, 20106.6MSmoking19.6*2432CDC, 20074.8M*Hughes et al., Am J Health Prom, 2010**Conservative estimate based on articles in Health Psych, 2011, Am J Prev Med 2009, J Am Coll Health 2008

Population: 10,00012Smoking prevalence drops 5% to 18.6** --> Population savings = $243,200 12Whats Next?Determining optimal level of interactivityPatient or provider initiation?Activity feedback 13

Source: Halo Monitoring, DePaul

Healthy Behaviors. Healthy Returns. Contact:14