Cigna folds GoYou into digital health coaching program Cigna Health Matters

Cigna has developed a digital health coaching program, called Cigna Health Matters, that offers mobile tools, social media engagement, gamification, and web-based incentives. The program is available for Cigna’s 14 million US members on employer health plans.

“Cigna Health Matters integrates the latest insights and practices of the sociology of engagement, motivation and rewarding behavior change with the latest in health tools and technology,” Cigna Vice President of Product Develompent Eric Herbek said in a statement. “By combining clinical insights, health coaches, digital tools, measurement and reward engines, we have our customers’ backs to help them get on the right path, and stay on it, for better health for themselves and their families.” 

The program begins with a gamified online health assessment. After completing the assessment and answering questions about the user’s BMI, cholesterol and blood pressure, members are given a Health Matters Score. From there, as users work on improving their health, their score changes. The score also helps Cigna coaches and clinicians target the members that need the most help improving their health.

Cigna has also curated a health and wellness app store. The store has compiled the “most popular and effective health improvement apps”. Once members have downloaded health apps, they can link those apps to their Cigna Health Matters dashboard and receive various incentives or rewards, depending on their plan.

Some of the features of Cigna Health Matters are similar to those mentioned as part of an initiative that Cigna announced last year: Cigna GoYou. A Cigna spokesperson told MobiHealthNews in an email that GoYou has been folded into Health Matters and renamed.

“The GoYou Marketplace – the curated health/wellness/fitness app store — is a part of the Health Matters ecosystem. We have simply named it ‘Apps & Activities’, which in our user testing was found to be a more easily understood name,” they wrote.

Cigna began working with another company called SocialWellth, as it developed GoYou, and that partnership continues for Health Matters, a Cigna spokesperson confirmed to MobiHealthNews. As we wrote last year: Members will be able to download apps recommended to them based on their Cigna profile, some of which will be marked with an “mWellth certification.”

As part of this announcement, Cigna also released a survey of 1,847 consumers on their health and wellness habits. Cigna found that 83 percent of respondents are taking steps to improve their health and of this group just 22 percent are using some kind of an online tool to do so.

In May, Cigna partnered with Samsung to launch a feature on Samsung’s S Health app called Coach by Cigna, which will launch exclusively on the Galaxy S5. The platform is being launched in 36 countries and 26 languages. The software, which Cigna describes as a “digital health guidance system,” will incorporate health information collected either manually through the smartphone or via sensors in the Galaxy Gear or Gear Fit. It will use that information to generate a personal health coaching regimen for users.

http://mobihealthnews.com/37345/cigna-folds-goyou-into-digital-health-coaching-program-cigna-health-matters/

Game changer: Patients of doctors who played online game had better control of blood pressure

Boston, MA – Primary care providers who engaged in an online game to solve clinical cases about hypertension management improved blood pressure control of their patients in a shorter amount of time compared to non-gamers, according to a new study by researchers at Brigham and Women's Hospital (BWH) and the Veterans Affairs Boston Healthcare System.

The study was published May 20, 2014 in Circulation: Cardiovascular Quality and Outcomes.

"This study is the first to show that an online educational game among medical professionals can improve the health measures of their patients," said Alexander Turchin, MD, MS, director of Informatics Research, BWH Division of Endocrinology, co-lead study author.

Leveraging spaced education, a learning concept in which students may significantly increase knowledge retention if information is presented and reinforced over spaced intervals of time, researchers found that primary care clinicians who participated in an online spaced-education game developed by B. Price Kerfoot, MD, EdM, staff surgeon, Veterans Affairs Boston Healthcare System, lead study author, improved their knowledge of managing high blood pressure and generated a modest but significant decrease in the time it took for their patients with high blood pressure to reach their blood pressure target.

A two-arm, randomized trial was conducted during the course of a little over a year among primary care clinicians at eight Veterans Affairs hospitals in the Northeast United States. Clinicians were randomized to either a group that received educational content about lowering blood pressure in the form of an online game vs. a group who received identical content via a static online posting. One hundred eleven clinicians enrolled in the study. Of those enrolled, 48 completed the trivia game while 47 completed the readings of the online posting.

Educational content consisted of 32 validated clinical cases followed by multiple-choice questions with explanations on hypertension management. Those in the online game group were e-mailed one question every three days. Questions were re-sent in 12 or 24 days if answered incorrectly or correctly, respectively. A question was retired when clinicians answered it correctly twice consecutively. The game would post clinician scores to foster competition.

Primary outcome measured was time to reach blood pressure target (less than 140/90 mm Hg). In multivariable analysis of 17,866 hypertensive periods among 14,336 patients, the researchers observed a modest decrease in the time to achieve target blood pressure values in patients treated by clinicians in the online game group.

Researchers found that patients of clinicians playing the game lowered their blood pressure to their target level in 142 days compared to 148 days for those whose clinicians read an online posting.

The number of clinicians who had to participate in the game to achieve target blood pressure in one more patient was 0.43 (i.e., for every four clinicians who participated in the game, approximately 10 more patients achieved target blood pressure).

According to the researchers, anyone can enroll in the spaced-education game for free at Qstream (http://qstream.com/vabpgame), a start-up company launched by Harvard to develop and disseminate the spaced-education methodology outside of its firewalls.

"Based on our findings, educational games may be effective tools to engage health professionals, boost learning, optimize practice patterns, and improve patient outcomes," said Turchin. "We hope that future studies continue to focus on figuring out how to most effectively integrate games into the education of health professionals for the benefit of their patients."

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This research was supported by the Research Career Development Award Program and research grant from the Veterans Affairs Health Services Research and Development Service, the American Urologic Association Foundation, Astellas Pharma US Inc., Wyeth Inc., and the National Institutes of Health (K24 DK63214, R01 HL77234).

Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 3.5 million annual patient visits, is the largest birthing center in Massachusetts and employs nearly 15,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 1,000 physician-investigators and renowned biomedical scientists and faculty supported by nearly $650 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH continually pushes the boundaries of medicine, including building on its legacy in transplantation by performing a partial face transplant in 2009 and the nation's first full face transplant in 2011. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information, resources and to follow us on social media, please visit BWH's online newsroom.

Virtual reality games may improve stroke recovery

Virtual reality games that challenge balance may speed recovery after a stroke, a new study suggests.

The exercises appear to be a relatively inexpensive way to improve people’s ability to balance and walk following a stroke, Dr. Hillel Finestone, the study’s senior author, told Reuters Health.

  

Finestone directs Stroke Rehabilitation Research at Elisabeth Bruyere Hospital in Ottawa, Ontario, Canada. His small study found that stroke rehabilitation patients who played virtual reality games while on their feet could walk a little farther and maneuver a little faster than patients who sat through the exercises.

“We showed that people do improve,” Finestone said. “We saw improvements in balance. It’s not the be-all, end-all, but we see a good potential.”

For their study, the researchers randomly divided 59 patients who had recently suffered a stroke into two groups.

With the help of therapists, people in both groups participated in a series of 10 to 12 virtual reality gaming sessions lasting 20 minutes each over three weeks.

One group stood to play the games and the other sat. Games included soccer goaltending and snowboarding and were designed so that people standing needed to shift their weight by leaning and reaching to succeed.

The mobility of participants in both groups improved, but the standing participants saw larger gains. Following the therapy, people in the sitting group added 70 feet to the distance they could walk in two minutes, while the standing players added 111 feet, on average, the authors found.

Finestone said that difference could mean a recovering stroke patient being able to walk from his or her living room into the kitchen.

Standing virtual reality participants also shaved more time off a standard test of mobility that requires a participant to get up out of a chair, walk to a line on the floor and then return to the chair.

But Dr. Kara Flavin, from the Stanford School of Medicine in California, told Reuters Health the study didn’t convince her that investing in a virtual reality program would pay off in significant improvements for stroke patients.

“I definitely would want to see more data before I would incorporate it into my practice,” said the physical medicine and rehabilitation specialist, who wasn’t involved in the new research. “If I brought this study to the hospital administration, they wouldn’t be jumping to buy it for me.”

More than 795,000 Americans have a stroke each year, and nearly 130,000 of them die, according to the Centers for Disease Control and Prevention. Stroke is a leading cause of serious long-term disability, and survivors often battle paralysis, speech problems and confusion.

Once just toys for kids and teenagers, videogames have been incorporated into a variety of physical rehabilitation programs. Prior studies found virtual reality exercises improved recovery among people with traumatic brain injury and adolescents with cerebral palsy, the authors of the current study write in Stroke.

A 2011 Canadian review on virtual reality technology hinted that it might help stroke patients recover (see Reuters Health story of May 4, 2011 here: reut.rs/1nDzk5D).

Finestone and his team hypothesized that patients who stood and participated in the intensive virtual reality exercise program would recover movement faster than patients who sat through the exercises.

“We did show some improvement, and it was safe and feasible,” Finestone said. “It’s giving people hope that we can do this.”

Stroke patients might be able to play videogames at home, but they would need to be specially designed to help them recover, he said.

“We’re hoping we can put this into communities,” Finestone said. “We need to organize it and package it properly.”

SOURCE: bit.ly/1fB9TtF Stroke, online April 24, 2014.

Empirically Driven Consumer Engagement: The Power is in the Simplicity!

Necessity breeds solutions. mHealth Games, is a perfect example of how creative efforts to solve a problem can generate powerful solutions that work. Picture perfect innovation. Cost effective tools developed by and for those on the front lines. Disruption of the greatest kind.

In August of 2013, I was given an opportunity to design and implement an ICD-10 training program for a large managed care organization in Miami. This is not as easy as it may sound. Most coders, including myself, have been doing it for so long that we think in code. The idea of having to retrain our brains as well as our providers was almost an unimaginable task. Knowing this I quickly realized the one variable that would ensure success was the ability to create content that would engage everyone. But how?

This particular organization spanned 4 states and 3 time zones. Efficiency was critical. The ability to monitor and measure the amount of engagement on a daily or hourly basis would provide the intelligence that I needed to modify, adjust and improve the content. I knew what I needed to succeed, but could I execute?

Creative content is what activates consumers to engage over and over. It is what keeps them coming back. I am not an IT person. I have no technical training at all, other than that which was required to graduate. How was I going to pull this off? I could hire a company who specializes in IT or even e-learning, but would that accomplish my goal? No, although experts in their field, they lacked the experiences of a coder, and that was what I knew I could capture my audience with.

So we started experimenting with tools to engage. The first one took over two weeks. I took the top 200 ICD-9 codes and mapped them backwards and forwards to the corresponding ICD-10-CM codes. I added specific conventions to each mapping and added tips for clinical documentation. I thought I had knocked it out of the park. I sent the final project out and waited for feedback. I kept waiting and waiting, until I finally realized that even as great as the tool was, it wasn’t applicable to what we were doing today.

So, I came up with a better idea and requested the top 20 codes from each of their providers. With this new information I was able to create a personalized training program for each provider. Surely, they would be interested in learning about the codes they use on daily basis and how to mitigate any impact to their revenue. But again, I was wrong. This still wasn’t able to truly engage at the level I needed to succeed.

At this point, I was desperate for a better way and turned to Google to research alternative methods. I spent at least 200 hours reading about technology and how it is being used in distance education. What I found was amazing! Really smart people had created amazing tools that would allow me to work with technology. That was a defining moment! A change in paradigm had occurred. I was no longer dependent upon others to close the gap between what I wanted to create and what I was capable of creating.

This is where the fun begins. I had found the tools and now it was time to really start creating engagement. Had I of known the complexity of trying to learn new software, design games and teach ICD-10 -  I may not have taken the challenge. This is actually much harder than it sounds, but the results were well worth the time, talent and energy!

The learning curve was steep and fast. I can not tell you how many times I considered quitting, but then I would look at the results and I knew this had the potential to change everything! Why? Because these games are not just games. They are published using the xAPI or “experience API”. This means that we now are able to learn as much about our learners as they are learning from us!

Consider, the power of one game and the insight of data it could provide. The traditional tracking methods of pass/fail have now been replaced by the ability to visualize when a learner has both interacted with the concepts and mastered them. Thus creating an individual path to success!

These are the tools of the future! They create the foundation for the new learning health care system, but most of all they provide high value at little cost. We already know that games activate consumer engagement, but the time to market and cost of production complicated the process and reduced the return on investment.

Over the last few weeks, I have spent hours upon hours discussing the potential impact on consumer engagement and the potential value of taking mHealth Games to the next level. I have listened to stakeholders from every end of the ecosystem describe their version of how, why, and what this expansion could look like. Opportunities that I never thought possible have been discussed with people who can actually make them happen. But what if we choose to grow organically, where we continue to have to the freedom to create, deliver, modify and improve? After all we have just begun.

The single greatest take-away from this week was how every conversation of “growth” had the same plan, “By partnering with us, we will be able to bring in engineers and you won’t have to design games anymore!” But doesn’t that defeat the entire purpose of this journey?

  

Kameron Gifford

mHealth Games

The Next Generation of Healthcare: Games and E-Learning – high value, low cost!

Games drive engagement through consumer activation. We know this! They are a fantastic way to challenge learners and keep them engaged and interacting with the content at hand.

So, how do we improve on something that is already awesome? We embed it in a learning ecosystem that drives improvement through partnerships with all stakeholders. This new learning environment sets the stage for providers, patients and caregivers to connect and communicate - anytime, anywhere, any place and on any device.

As we move towards a healthcare system that reimburses for value instead of volume we will need tools that can capture this next generation of care.  We will need to automate the processes of education and learning much like the electronic claims we send today. All of this data will then need to be interpreted to understand and truly visualize the path to wellness. That feedback will allow us to refine the process and continually work to improve the delivery of care.

But what if we can already do this through fun, engaging, and cost effective e-learning games? I believe we can! With the help of new technology, such as the xAPI, we can now track and measure all those things that were so hard to track before.

These short games below can capture up to 32 data points vs. the traditional check boxes, and take days to get to market instead of months. Imagine the possibilities. 

Click on a game below to launch.  Bird Hunt is a flash game, so you will need a flash browser. The Olympic Mountain Summit game is not. 

Fred was just diagnosed with type 2 diabetes and now he is afraid to enjoy the things he used to. This game combines his love of hunting with diabetes education. 

Johnny Three-Scoops and Earl Strong-Fit will not only be fighting for their individual victories tonight, but the fate of their entire teams may lie in the outcome of this single event. With only 3 events left, and this being the only event in which their respective teams have a real contender, this could decide the gold.

Can you help TEAM HEALTH reach the top first by correctly answering the questions?



For more fun, FREE Games visit our website: www.mhealthgames.com

The serious business of gamification

If you’re interested in changing behaviour in your workplace, helping employees or customers to develop new skills, or spurring innovation, you may want to consider the approach known as gamification. If that scares you – given that the word is ugly and sounds as if you would just be encouraging staff to play video games – Brian Burke, a vice-president at technology research firm Gartner Inc., says you should relax.

Gamification is actually not about playing games. Games are about entertainment. Gamification is serious stuff, using game mechanics such as badges and awards to digitally engage and motivate people to achieve their goals.

“It’s not entertainment. It’s motivation,” Mr. Burke said in an interview.

He points to the Boy Scouts, which has long used badges to motivate youngsters, and Weight Watchers, which uses a points system and social encouragement to nudge dieters. Both are examples of gamification from the days before the term was even coined. “It provides them with the encouragement, motivation, and clear path to achieve a goal,” he said.

Mr. Burke stresses that when using gamification, it is vital that the emphasis not be on organizational goals but on motivating people to achieve their own goals. When those personal objectives are aligned with the organizational goals, you can hit the gamification jackpot.

Behavioural change is the most common use for gamification. It comes in handy because new habits must be created to change behaviour, and gamification can excite us to adopt those practices.

In his book Gamify, Mr. Burke notes that Spanish bank BBVA used gamification to encourage customers to use its online services. The BBVA Game, which has 80,000 users, rewards players for completing challenges that educate them about Web banking, encouraging them to use the service. Points are awarded, which can lead to prizes. It has led to a 5-per-cent increase in BBVA’s Web-banking users, who spend 60 per cent more time on the site. Because online banking can be easier than going to a branch, the game is aligned with customers’ needs. But it’s also aligned with BBVA’s needs, because it reduces costs.

Samsung Electronics focused on customers with its social loyalty program, dubbed Samsung Nation. Customers are rewarded with points, levels and badges for watching product videos or commenting on Samsung products. The program has doubled the number of items placed in online shopping carts.

A key to success for behavioural change is to increase complexity over time. The BBVA Game starts by encouraging customers to watch instructional videos and then try simple operations such as checking an account balance. As users become more confident with the help of coaching, they move to more complex tasks such as paying bills.

Gamification can also help people to build their skills. Learning new skills often requires a repetitive process of lectures and practice, which gamification can handle. Or if the skill is best learned in an experiential way – such as being presented with a problem to solve – gamification can provide a vehicle for collaboration with others.

There have long been games that can teach new skills, such as Where in the World is Carmen Sandiego? (a series of video and computer games and TV shows designed to stimulate kids’ interest in geography, cultures and history). But Mr. Burke says those are games first, and skill-builders second. Gamification puts the skill-building first.

U.S. organizations such as Capital BlueCross are using it to educate members on the complexities of health care. The U.S. Department of Health and Human Services applied a gamified solution to educate health-care practitioners on best practices about privacy and security.

A key element of design is to create theory-practice loops. Players are provided with instruction, a challenge, and feedback on their efforts. “Gamification breaks the learning process into small, achievable steps and provides constant feedback and encouragement throughout the process,” Mr. Burke writes in his book.

To spur innovation, gamification can encourage people to submit innovative ideas, evaluate proposals and then collaborate to refine the idea into reality. Quirky, a crowdsourcing product-development company that has more than 6,000 inventors as members and has launched more than 400 new products since 2009, uses gamification in this way.

Mr. Burke says the process can be captivating. During his research he found himself hooked as he submitted a name for an anti-theft rucksack – one of 1,400 possible choices – and watched his suggestion bounce up and down in the Quirky rankings.

While he is an enthusiast, Mr. Burke warns that the biggest challenge facing companies is to understand the limitations as well as the opportunities of gamification. “A lot of organizations are pursuing opportunities that are unlikely to be successful with gamification,” he said. Faced with a problem, they throw some points at it and hope a solution will materialize. But you need to figure out how a point system might work, how to employ collaboration, and whether what you are designing can hold for the long term as well as short term.

But if you get it right, he believes you can harness the power of game design to great benefit for your organization.

Harvey Schachter is a Battersea, Ont.-based writer specializing in management issues. He writes Monday Morning Manager and management book reviews for the print edition of Report on Business and an online work-life column Balance. E-mail Harvey Schachter

http://www.theglobeandmail.com/report-on-business/careers/management/the-serious-business-of-gamification/article18020562/

Join Dr. D. and Natalie for ICD-10-CM SHOOT OUT

Score a goal for QUALITY with Dr. D and Natalie in ICD-10-CM SHOOT OUT!!!


This game covers chapters 18-21 of ICD-10-CM..

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