Putting Fun into Health & Wellness | with Nick Martin from UnitedHealth Group [Transcript]

by Joe Sherwood on May 17, 2013

Link to podcast episode: Putting Fun into Health & Wellness | with Nick Martin from UnitedHealth Group

Jesse Lahey: Welcome to the show, Game Changers.  This is the show for CEOs, HR Executives and other business leaders to learn about internal gamification.  Over the course of this series, you will hear examples and pitfalls, discover how to assess when it’s an appropriate strategy and learn to evaluate gamification partners and game design ideas.

I am Jesse Lahey, and in this episode we’re featuring our second interview with a gamification solution provider.  Nick Martin is Vice President of Innovation, Research and Development for UnitedHealth Group.  Nick and his team have been exploring ways to infuse video games and gaming elements into health and wellness activities for employees and their families.

Nick, welcome to “Game Changer.”

Nick Martin: Thanks, glad to be here.

Jesse: Can you tell me the history behind UnitedHealth Group and your experience with gamification?

Nick: Well, Jesse, I think it was probably about 2010 when we started to take a look at how gaming could be applied to healthcare to make it work better.

We started that by delivering a mobile application to the marketplace called OptimizeMe.  That tool was launched in the market as I’ve said in 2010.  It was geared towards making a fun, collaborative, kind of a competitive-like, health and fitness challenge application for smart phones.  But we’re actually a launch partner with Microsoft on the Windows Phone 7 Platform, and then we surely thereafter rolled it out on the iPhone and Android platform.

So, we’re really kind of excited about how we can take and apply game-related advances towards the health and well-being of individuals and now we’re doing that in both UnitedHealthcare, as well as our Optum book of businesses touching over 70 million Americans every day.

Jesse: Wow! That is something.  Nick, what is your personal history about how you came to be involved with gamification?

Nick: Jesse, as you mentioned in the introduction, I’m part of the Innovation Research and Development team here as part of the UnitedHealth Group.  We’ve long time had an interest in how we can take and look at gaming as an industry, and how we can help individuals, and so we actually created a gaming program that’s part of our Innovation Research and Development team that is comprised of a couple of different categories.

One of those being game play and how we might actually take a game and make it fun and we did that.  As part of that, as I mentioned OptimizeMe earlier, we’ve also done some partnerships with Konami to take the Dance Dance Revolution classroom edition technology and put it in classes in the Joint Committee Program to help kids combat obesity, to get them active and is part of the activities for kids program.  It actually gets their body mass index down, get them burning calories but make it fun and engaging for them.

As a team, we’ve been very engaged in how we might apply this type of technology to get people moving.

Jesse: That’s interesting.  My own kids were really interested in Dance Dance Revolution.  In our family, we have the same insight, I guess, that wow, this could be something that would be a long term, fun way to encourage them to get more exercise.

Nick: It’s really interesting, imagine those kids.  Obviously gaming applies across all walks of life, but in particular to the kids [inaudible 00:04:06].  Parents, in fact in some surveys that I’ve recently seen, 40% of parents play computer games with their kids and 59% of those do that actually monthly.

So, parents are really looking for ways of taking video gaming concepts and making it healthy for kids.  Fifty-two percent of them say video games are a positive part of their child’s life.  As it turns out, parents actually like to play with their kids and as long as you can do it and make it healthy and make them active and engaging, I think it’s a tremendous opportunity to help the healthcare system.

Jesse: Well, it is interesting.  With my own kids, I’m not nearly so quick to sit down and play a video game with them, but when I do they are just super excited, which I guess I can remember when my parents would play different games with me when I was a kid even if it wasn’t video games.

That’s a need aspect of engagement.  Before we go too further, gamification is somewhat still a buzz word in the relatively early stages.  What sort of definition would you apply for gamification right now?

Nick: You know, I’m glad you asked that question Jesse.  Before I go on to how we look at gamification, what I would like to just quickly point out is when we took a look at our gaming program as a whole, we broke it down into three very distinct categories.  I mentioned one at the beginning around game play, getting people actively engaged in playing a game.

The second category is the one you’re asking me about right now which is gamification and that’s defined as making something that’s historically been quite boring or difficult to making it more engaging and immersive by adding game mechanics and game psychology to the effort.

Then the third thing that we look at is game technology, is there ways to take game technology and adapting it to existing products and services out there to make healthcare work better?  For example, the Microsoft Kinect platform, can we take that Kinect device in the Kinect platform as a whole and look at maybe serving patients in need around physical therapy in a remote sense or enabling them to do training exercises remotely in new and interactive ways and helping them treat conditions, or chronic conditions, or disease, or even helping them work out in a more effective manner by doing the exercises properly.

Jesse: That is fascinating.  Now, can you just tell me a little more about the difference between number one and number two in the list that you just shared?

Nick: Gamification, you could gamify something by just making it a little bit more interesting, but game play is actually engaging.  A game psychology and gamification together are applying on top of something that’s historically been quite boring, but it doesn’t necessarily have to be a game in itself.  For example, it could be a badge or reward or things to that nature, whereas game play is actually physically playing a game, either online or actively engaging in a game in physical activity, as well.

Jesse: Okay.  So, as a way of example, the Dance Dance Revolution.

Nick: That is both.

Jesse: That would be both.  But you’re taking a real game and figuring out how do we use that for a business purpose in terms of engaging employees and their families, engaging healthcare consumers as opposed to just playing a video game for the sake of the game.

Nick: Absolutely.

Jesse: Then, gamification might be taking something that is more boring, let’s say, we’re just trying to encourage exercise in general and how do we think of the creative ways to make a game out of that or at least insert some elements to make it more fun.

Nick: Let me give an example of maybe educating a consumer by putting gamification on top of an enrollment activity so that the enroller in the healthcare system has a better understanding of their benefits and the design and the programs that are available to them by applying some gamification concepts on top of that to have them seek out maybe in a scavenger hunt type of methodology to find the different areas on a screen and then be educated about their wellness program or their disease management program or the biometric screenings that could be part of that benefit, for example.

Jesse: What are some examples of specific applications that UnitedHealth Group is offering to the market right now?  What do you already have out there for employers to take advantage of?

Nick: So, as I mentioned earlier, you know, one of the first things we put out there was our OptimizeMe program.  It is available on smart phones.  We’ve also applied some gamification techniques to some enrollment activities on a scavenger hunt-type methodology.  We’ve also, as I mentioned earlier, the Dance Dance Revolution program that we have out on the market place for kids in a number of different schools right now, as well.

So, we also do some customized solutions for employers that are providing healthcare to their employees that meet the needs for their specific book of business, as well.

Jesse: Okay.  Do you have any case studies or data that you can share with us about how effective these offerings have been so far?

Nick: Yes, our programs kind of really run the gamut of applicability across the different books of business.  So, it’s kind of difficult to put specific numbers around return on each one of the efforts that we have on the marketplace.  What we do know is that our programs have encouraged greater health engagement.  They have improved some of the outcomes on the health of individuals out there.  So putting an actual number on the ROI of each one is really a difficult thing to pin down.

Jesse: Okay.  How long does an implantation take?  Let’s say the enrolment application for example; how far ahead of the enrolment period does an employer need to make a decision whether to implement that?

Nick: Yes, many of our efforts are already free in the market today and available for our members, as well as, all of America is some cases, the OptimizeMe, for example.  So, from an implementation perspective, that could be done in minutes, if you will, from the communication.  It’s all on the communication to the end groups of individuals to notify them about it to help get them engage in that or it could take longer than that.

For example, in the scavenger hunt capability that I mentioned earlier, that is for pre and post enrollment for an individual.  So what we want to do is customize what the benefit structures look like for that employer and ensure that we have the right descriptions for that individual, so that when they’re going through pre-enrolment, they can make the right decision about the plan that they want to select and then once they have enrolled we have the right information around what benefit structures they currently have and educating them on those benefits, as well.

So it kind of depends on how deep you want to go, how engaged you want to get the individuals under which components of our gaming initiatives you want to put place.

Another example of that that I just throw out there for Jesse is our baby box initiative, which we have with our Medicaid book of business, which is gamifying the process of pregnancy or expecting mothers to get them to engage in their healthcare check-ups along the way, to do their three month and six month check up, and make sure that their baby is healthy so that they don’t have a premature labor.

Jesse: So you mentioned that, that’s available for Medicaid.  Is that something that a large employer or even a small employer would be able to implement?

Nick: We’re looking at how we might apply that to employers right now as we speak.  We don’t have it out on the market for the employers today, but we have to make sure that we baked in the right incentive based programs around that for those employer groups.  So, we have to work really close with those employers to make sure that we’re fitting the needs for their benefit structures.

Jesse: Yes, that makes sense.  Can you tell us a little more about OptimizeMe?  I think that you mentioned that, that’s a smart phone app.  Is that somehow tied in with Fit Pit?

Nick: You know, it is.  We do have the Fit Pit integration tied in, Jesse, so let me back up.  OptimizeMe is a platform that’s around health challenges, fitness challenges.  So it’s all about taking mobile technology, social technology, and then some gamification on top of that, as well.  So what you can do is you can enroll on a challenge maybe it’s the, you know, walk so many steps a day, for example.

Then you can track your progress around that and you can do that by your hand entering the data in or as you mentioned integration with devices like the Fit Pit or you’re data can get synched in there if you authorize that to occur so your steps will get synched right on the OptimizeMe application.

But then, you can actually challenge other individuals.  You can make your challenge public.  You can make it semi-private or you can make it private individual and bring your social network in from a support perspective and get individuals to encourage you, maybe even give you a little bit of a hard time to try to motivate you to achieve your goals.

We’ve gamified that a little bit by applying a whole badges system around that as well and rewards, so you can set up a reward for the winner of that contest between you and your social network, as well as achieving badges along the way whether it’s the newbie badge or whatever the badge might be.  A virtual badge is a reward that you get for accomplishing different tasks.

Jesse: Are there any options for an employer to make that a specific company benefit or program?

Nick: There absolutely is, Jesse.  We have a couple of things that we have in our second generation OptimizeMe product.  First is, we’re actually stretching out and helping individuals manage their diseases and chronic conditions to the application of making it private between them and the health of wellness coach.  So they have that ability for an employer that they can have that disease and condition management program type OptimizeMe.  The second is the ability for employers to launch employer specific challenges, as well.

Jesse: Optimize Me is available to anybody, but are there any advantages if you have, you know, your healthcare as your healthcare provider or OptumHealth?

Nick: The ability to do chronic disease and condition management is something that you have to be a customer of UnitedHealthcare Optum, but it’s available to all of North America if you just want to compete in the challenge with another individual, and then if you want an employer’s specific challenge you can tie that down so that only your employees are able to enroll in that challenge.

Jesse: Yes, that interesting.  So, how would that work on the disease management side?   I’m assuming your health coach might have access to your specific claims data maybe but then they can also see how you are doing on your exercise?

Nick: So, imagine a diabetes-related individual, Jesse, where they need to be checking their blood glucose on an early regular basis, as well as, managing their weight so you can take your blood glucose data and be able to push that into the OptimizeMe app, as well as, your weight data into the app, so your health coach or a wellness coordinator can help you manage through your disease by being able to get ready access to that data from those two data points.

But lastly, also to be able to send private messages to you through to a secured platform, as well as, to be able to send mobile friendly article and information to you that can help better manage your needs, as well.

Jesse: Now if I were a participant in that would I need to be worried about my employer having any of that information or is it really just the health coach?  Is that pretty well walled off from my employer?

Nick: Security is of the utmost importance to us here at UnitedHealth Group, Jesse, and we definitely manage that very, very tightly and securely.  We do those coaching programs not only through Optimize Me but through Portal Solutions, as well.  We take it to the level of HIPAA and PHI.  It’s something that’s most serious for us that your bank account information is probably more at risk than your health information with us.

Jesse: Just a quick pause from this interview with Nick Martin to tell listeners about a game we’re playing to have some fun throughout the series.  First, thanks to the generosity of the UnitedHealth Group.  We are giving away a free Wii version of DDR.

To enter to win, leave a comment on our show notes sharing the first video game you ever remember playing.  You can find the show notes for this episode at EngagingLeader.com/GC3.  We’ll pick a winner at random from the first 50 comments we receive.

Our clue for the “Game Changer” series prize is the letter O as in octopus.  There will be other tasks and clues and each of the first 14 episodes in the “Game Changer” series, as well as, in “Engaging Leader” podcast episode 38 featuring Kevin Werbach.  From those 15 clues if you can be the first person to guess the secret phrase, you will a $100 gift card from Amazon and everyone who guesses it correctly will be honored on our “Game Changer” genius board.

Do you have a sense, Nick for how OptimizeMe or any of these other programs might compare with other solutions available in the marketplace and what’s unique about your program?

Nick: You know, I do have a sense of it but I don’t have a full appreciation for specific solutions that I don’t personally have access to through competitors if you will.  What I can tell you is that the OptimizeMe application and coaching platforms, one of the things that would differentiate us is our integration.  We have that integration not only just with that health and wellness related data, but as you mentioned claims-related data.

All of your health and wellness information can be exchanged in a secured environment helping you, as well as your wellness coordinator or coach better manage you in advance, if you will.  It’s not just targeted it’s specific to one finite area.  So it’s the overall integration I think that helps differentiate us.

Jesse: What are some of the objections or concerns you hear that might get in the way of an employer implementing a gamification solution like this?

Nick: I’d say overall, our responses are very positive.  It’s been not only just positive in general but our employers have been extremely positive, members have been positive, even some of the government agencies that we’re working with have been very positive.  That’s why they can see the impact that gaming and gamification can have on people and their health.

Schools, for example, the Dance Dance Revolution classroom edition; schools are ecstatic about adding this to their existing, you know, physical education curriculum.  They love it.  They’re seeing the whole value proposition of injecting into what they currently offer. That all said, if you mention security as an important part to us, we’re also really sensitive to ensuring that if you’re treating someone with a chronic condition or a very serious illness, that may not be a fun experience in gamifying that experience might not be the right approach.  So, we’re very sensitive to when and where we leverage gamification, and then what individuals would like to have as a gamified process.  But we know that there are a lot of places in the healthcare world and sphere of influence where we can make a huge impact on the end individual and prevent chronic condition, in the first place.

Jesse: Are there any prerequisites that an organization should have in order to implement any of these programs?

Nick: Desire.  Desire to make an impact on Americans and their health.  As I mentioned some of our gaming initiatives are already available in the market place today and some of them are even free for use and they’re going to help all of America.  I don’t think there’s necessarily a prerequisite other than the desire to really help make the healthcare system work better.

Jesse: How about computer access or smart phones?  Do you have any rules of thumb for whether an employer has enough access to that kind of technology or has it gotten pretty well ubiquitous?

Nick: I don’t think I can quote any specific penetration range of computers, tablets, and phones right now.  I just wasn’t prepared to do that, Jesse, but I think most of your listeners, if you will, would know that a large portion of America has computer access, as well as, a huge portion has smart phone and cellular phone access, as well.

As we mentioned earlier, the things even like the Dance Dance Revolution classroom edition for example,  on those kids that, that’s a tool that’s sitting in their physical education area and so they’ll have access engaging in that without access to a computer, as well.

Jesse: Now you mentioned that several of these are available free of charge.  Which ones are going to have a cost associated with those, and can you give a sense for what kind of range that an employer would be looking at?

Nick: It really depends on that engagement model that the employer is looking to obtain with their membership-based.  We do customize our approach not only in gaming but in our benefits and in all of our offerings with an employer to ensure that we’re reaching the most individuals who have been their employee base, as well as the dependents of spouses that are engaged in that group, as well.

So, each one of our employers is going to have a different approach as you mentioned, whether it’s access to the tools or resources or is it the demographics of the individual or the geographic location of that employer.  It’s all going to dictate how we address and design a program to help that employer be healthier.

Jesse: So take something like OptimizeMe where they are a UnitedHealthcare client, is that something that’s available free or is there an additional member cost for that?

Nick: Yes, there’s a free of charge application to engage in challenges and help the challenges for them.  Certainly, we want to do is we approach an employer, as we would want to look at the demographics of their population and find out how healthy they are, and where programs and services, such as a diabetes program or congestive heart failure program or whatever it might be, might be beneficial for them and have a return investment to actually apply to their population.

Jesse: So in that case it might be one of those disease management programs that would have a cost associated to it?

Nick: It could very well, if it makes sense to that employer.

Jesse: Are those cost typically per member per month sort of costs?

Nick: They could be a per subscriber per month cost, again it depends on the particular disease management program and the employee base, as well.

Jesse: Okay.  What about like DDR, you mentioned that, that’s available in schools, is that being implemented in any employers, as well?

Nick: We aren’t in the employers phase just yet, Jesse.  As I mentioned, we’ve kind of been testing it in our school systems today.  We have it in four different schools across the US.  I think you could see it sometime in the future where tools such as that or maybe more adult-focused types of games might hit the employers best.

Jesse: Okay.  Then, the employer enrolment and post-enrolment with the scavenger hunt and everything, how widespread is that?  Is that available right now to employers across the country?

Nick: It is and again, we do customize it for the employers to make sense.  We’re in a couple of different areas around the country today.  We do see fairly good engagement rates on understanding their benefits when individuals do get out there and get to it.  We do have some other tools that are maybe a little bit broader spread that help individuals on the education side of things but not maybe as customized for the employer thing is like our Victorious Patient online game that helps educate consumers on the aspects of healthcare cost estimation; taking the right provider, the right price, the right procedure, and the right place for example the four P’s.

That is available widespread across the country.  It’s available on our MyUHC.com website for people to get access to, so that they can be educated on making the right decisions around healthcare and having transparency on what the cost are for them as an individual.

Jesse: That’s interesting.  How long has that been available?

Nick: The Victorious Patient online game for education has been available for about the last 8 to 12 months.  MyHealthcare Cost Estimator tool has been a tool that we’ve had for a number of years and has continued to be refined.

In fact, I think you’ll note in some of our press releases we have brought a level of clarity to your healthcare cost estimation with our tool that actually takes and looks at the contract at rate with that specific provider and that specific place and gives you an exact cost of that procedure and episode of care, if you will, that you’re looking at, specific to where the physician is going to give the service and that specific physician, and your benefit structure.  That, as I’ve said has been available for a number of years, but we’ll continue to enhance that and offer a level of clarity to healthcare consumers over the last 12 months.

Jesse: Nick, how can someone find out more or take the next step with UnitedHealth Group?

Nick: Certainly, I think great spot to start would be our UnitedHealth Group website and on that you will find links off to our UnitedHealthcare book of business, as well as our Optum book of business, as well as some of our innovations that we have as part of the UnitedHealth Group as a whole.  I think that’s probably the best place to start.  That said, I would also encourage like the large employers and small employers of businesses alike to speak with their broker or consultant about partnering opportunities with UnitedHealthcare, as well.

Jesse: Nick Martin is Vice President of Innovation, Research and Development for UnitedHealthcare Group.  Nick thanks for joining us today.

Nick: Jesse, it has been a pleasure being here.  I really appreciate the opportunity.

Link to podcast episode: Putting Fun into Health & Wellness | with Nick Martin from UnitedHealth Group

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