Speaking of patient engagement …

I'll be delivering a general session on patient engagement (and the role of marketing and communication) tomorrow morning at the New England Society for Healthcare Communication's Spring 2014 Conference in Mystic, Conn.

Here are several teasers:

Eat right, check. Exercise, check. Sleep? Not so much.

Your routine says a lot about you — and your health.

Good health is about eating right, getting plenty of exercise and being as active as you can. It's also about getting enough sleep.

Do you?

I don't.

But I'm trying.

I think I've mastered the eat right/exercise more game (see how I used gamification to lose 70 pounds). I track calories in/calories out every day. Three years on, it's no longer a chore — it's just what I do.

Now it's time to try and win the sleep game.

I've been using the Jawbone UP for several months to try and get a handle on my sleep patterns. Every night, my UP band quantifies my sleep — deep versus light sleep, how quickly I fell asleep, how long I was in bed and how many times I awoke during the night. It shows me my average over the last seven days (usually not a pretty sight!).

Jawbone also sends me a weekly report. My most recent report tells me one thing very clearly: Go to sleep earlier!

I'll know I'm winning when I reach that eight hour goal more than I don't.

I have a lot of work (er, sleep) to do!

Here's a look at my reports for the last two weeks: 

My Jawbone UP report for the week ending October 20, 2013.

My Jawbone UP report for the week ending October 20, 2013.

My Jawbone UP report for the week ending October 13, 2013.

My Jawbone UP report for the week ending October 13, 2013.

RUN! Zombies are chasing you!

Your mission is to help the planet avoid a zombie apocalypse.

That's the motivation in Zombies, Run! 2, an app for iPhone and Android that challenges you to reach your goals through "Zombie Chase" interval training. 

In Zombies, Run! 2, you are inserted in a gripping storyline where you must achieve your fitness goals to move the story forward. Here you'll trade the usual encouraging and inspirational messages (like "you can do it" and "you really rocked today") for zombie-related messages ("they're right on your tail; don't look back!" and "they spotted you — run!").

This app is another example of "gamification" — using game theory and tactics to incent people and improve engagement. A proliferation of apps and devices now help connect you to your health — from tracking activity and sleep to counting calories and nutritional breakdown of food.

If you fear zombies — and it will make you run faster, further and more often — this is the fitness app for you.


Achieving better health through gamification (a personal journey)

Almost three years ago, I decided to take control of my health: Lose weight, eat right, be healthy.

Success! I'm down 70 pounds, off all medications and eat vegetables I previously couldn't pronounce.

I did it the old-fashioned way (with some present-day help!) — I now eat less, exercise more, watch my diet and get more sleep.

Was it easy? No way. Worth it? Oh, yeah!

Americans spend more than $60 billion each year on dieting and 50 percent of Americans say they are actively trying something to lose or maintain their weight. The average person makes four attempts a year to lose weight — with 95 percent failing and gaining the weight back within five years.

With so many people failing, what was my secret?

Gamification and technology.

A number of iPhone apps helped me achieve my health goals.

A number of iPhone apps helped me achieve my health goals.

Studies have shown that it takes 21 days to create a new habit or break a bad habit. But most people have a hard time sticking with something for three weeks.

That's where technology comes in, powered by the concept of "gamification" — using game theory and tactics to incent people and improve engagement. A proliferation of apps and devices now helps connect you to your health — from tracking your activity and sleep to counting calories and the nutritional breakdown of what you eat.

My secret was Lose It!, an iPhone app that allows me to track calories and exercise. Lose It! made a “game” out of my health — my challenge was to always have a "green" day (good!) and never have a "red" day (bad!). And I was rewarded regularly with achievement badges (think Boy Scout merit badges) congratulating me on my incremental achievements (I have earned 43 with four to go!).

Nike+ GPS watch

Nike+ GPS watch

And it got better. Lose It! doesn't work alone — it's part of a bigger and burgeoning health data ecosystem. The app ties in with my Nike+ running app and my Nike+ GPS watch that I wear while running to automatically add those miles and "positve calories" to my log. It also ties in with my Jawbone UP, which tracks my all-day movement and my sleep.

Together, these apps and devices give me a sharper picture of my overall health and suggest ways to maintain or improve. And there are social functions I can share with my family and friends so they can continue to encourage me.

Gamification has long been successful outside of health care to incent users to make purchasing decisions — buy more, get discounts, gain an elite status level or join a premium club.

Jawbone UP

Jawbone UP

Now health care is harnessing gamification for patient engagement. Apps like Lose It! and devices like the Jawbone UP, Nike+ FuelBand and FitBit do it at the individual level — you are largely "playing" against yourself and your own goals.

But gamification's real power may be at the community level — bringing together groups of people, through the power of technology, social media and support groups, to make tangible health changes. A great example is NBC's "Biggest Loser" show, which has encouraged many communities to "lose weight together" (see what they are doing in Fall River, Mass.!).

As we move squarely toward preventive care, gamification at the community level can support greater engagement and encouragement. You are no longer in this alone — the group is counting on your contribution to achieve a collective goal.

Gamification challenges, encourages and supports its users. They become winners — and so does their community and your health system.

And, returning to my own story, here's a bonus secret: A 15-plus minute walk after dinner — every night and in addition to your regular exercise regimen — will do splendid things for your metabolism!

 This post originally appeared on EngagingPatients.org, a blog dedicated to advancing patient and family-centered care. I am a member of the Engaging Patients Advisory Board and write for the blog.