In my work I often try out health apps that are designed to ‘engage’, support or even treat patients in specific therapeutic domains. Now while I’m totally committed to the digital transformation of healthcare and believe it does and will benefit patients, I have to be honest that most apps I try out just don’t convince. In fact, most are irritating, disingenuous and utterly superfluous.
In the movie “Don’t look up”, astronomer Kate Dibiasky repurposes her diet app to time the destruction of the planet. At the end, we see the app with its hollow “Congrats!” message floating amidst the debris (see the featured pic above – source Netflix “Don’t look up”). Beautiful symbolism.
Let me try to explain my feelings on this.
Most health apps try to do a combination of the following:
- Teach me something (e.g. about my disease, or how to exercise or meditate)
- Provide personal(ised) data or insight about myself (e.g. wearable sensor data or interpretation of such data, self-report data or interpretation thereof)
- Change my behaviour, attitudes, thoughts or mood in some way (e.g. take my meds, do exercise, reduce stress, feel better about myself)
At their worst, health apps do the education part via dry text or woody videos of white coated bad actors, provide personal data I entered myself without any extra insight, and try to change my behaviour with an overly simplistic, cringeworthy, bot-driven application of Cognitive Behavioural Therapy (CBT) principles. Yes, CBT is well studied and can be effective in treating some conditions or encouraging behaviour change, BUT my sense is that the ‘CBT’ moniker is too often abused to give health apps a scientific veneer.
The best apps do a much better job educating me with engaging content – although even here I still think the better health apps are still way off the benchmark of educational pure plays like Masterclass and Duolingo. We can do so much better.
The best apps also provide personal(ised) information that is truly new, insightful and even magical. For example, ResApp Health from Australia (just announced acquisition by Pfizer for A$100 million) uses machine learning to analyse the sound of my coughs and breathing to help detect Covid-19 and other respiratory diseases including pneumonia, asthma, bronchitis and chronic obstructive pulmonary disease, or COPD. That’s useful.
The toughest challenge, however, is behaviour change. While CBT, or habit-forming and addiction principles more generally, can be effective (those addicted to Duolingo will understand), they can also be downright irritating and decidedly undelightful. Does that mindless avalanche of gushy, chatty reminders and fake rewards really create something meaningful in your life? How good do you really feel about your collection of badges? It may work for a while, but I’m convinced that real, enduring behaviour change is achieved by combining highly engaging educational content with useful personalised insights and a judicious use of reminders and meaningful rewards.
That’s also why I’m a fan of hybrid approaches where humans are brought back in the picture, as coaches, doctors or peers (indeed, “digital-only healthcare is so 2020”). But also, crucially, as creators of the apps themselves. I think (and hope) that the future of medical apps is not platform based, crunching out formulaic apps based on common principles, modules and routines, but ‘studio’ based, where app creators produce unique and captivating works of art that win people’s hearts through creative storytelling and top notch production value.
What would a medical app or hybrid care service look like if it was as engaging as your favourite Netflix series? Where the digital character (your guardian angel) is not some childish and clearly automated bot, but a human expression that you grow to love and admire (like your favourite characters in your favourite series), where the story telling can move you emotionally in any direction, deeply, and astonish you with its aesthetic appeal. I’d like to see Ricky Gervais pulling the strings of my health app, not the ghost of BF Skinner.
So what do you think? Am I being too pessimistic or have I got my finger on the wound? My worry is that if we don’t fix this problem, if we don’t “level up”, then we’ll soon hit a deep and lengthy Trough of Disillusionment marked by investor and user disinterest.
I’m convinced that it is possible to create the health or medical app we’ve all been waiting for. The one that will win an Oscar or Golden Globe. That’s why Koen Kas and I are delving deeper in this topic to create a new keynote presentation and workshop: Delighting Digital Health: it’s time to level up. The goal: to show you a way forward, to provide an inspiring mix of ideas, insights and methods that will help you radically raise the bar for the entire industry.
