In 2012, Tom Chamberlain, PharmD, founded EdLogics, our gamified health education platform. Recently he shared how he first got the idea from working with patients, and the results so far.
Right. As a PharmD and an entrepreneur, I’ve been involved in starting and growing a number of companies, all of them focused on healthcare education and improving the utilization of healthcare services. My primary objective has always been to improve clinical outcomes and reduce healthcare costs for consumers and payors of healthcare services.
I was fortunate to have had the opportunity to manage my own patients during my doctor of pharmacy program and residency training. Having firsthand experience treating patients with chronic conditions like diabetes, high blood pressure, and COPD, I knew the challenges of educating and engaging patients in the self-management of their conditions. Traditional educational strategies such as pamphlets and printouts weren’t effective in teaching patients what they needed to know to improve their conditions.
For people with diabetes, testing blood sugar is a routine part of managing their condition. If you’re injecting insulin or using a pump, you may have to test several times a day. Without accurate blood sugar tests, you might not get the right amount of insulin at the right times.
If you can’t measure your blood sugar, you can’t control it. And if you can’t control your blood sugar, you raise your risk of amputations, heart attacks, blindness, erectile dysfunction, and many other problems. One immediate risk is diabetic ketoacidosis, which comes on quickly and can be fatal. Even if you survive, your ER trip will cost thousands of dollars. And it all can be avoided with appropriate education.
Many patients seem to understand how to check their blood sugar once someone shows them. But it was clear to me that most of my patients had forgotten what they’d learned by their next visit. They still weren’t retaining the information needed to manage their diabetes.
This happened over and over again – and similar scenarios occurred with a number of patients with various chronic conditions. I realized we’d never be able to help our patients if we couldn’t find a better way to teach them what to do.
Yes, but a lot of people aren’t familiar with the term. Here’s one definition:
“Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.”
Or to put it more simply:
“Health literacy means you can find and understand the information you need to make good decisions about your health.”
Low health literacy is now recognized as a critical barrier to effective and efficient healthcare. It’s an enormous problem, and the consequences are far-reaching. For instance, did you know that compared to patients with adequate health literacy, patients with low health literacy have:
In fact, the cost of low health literacy in the US is somewhere between $106 billion and $238 billion per year. It’s unreal!
If we want to improve health outcomes and lower healthcare costs, we need a way to reach consumers – a way that works for them long term.
Since I started working in the healthcare industry, the concept of health literacy has matured into an academic discipline. Institutions like Vanderbilt University have devoted teams of talented experts and researchers—like Russell Rothman, MD, MPP, arguably one of the top health literacy experts in the world—to help healthcare providers, employers, payors, and the public understand the implications of low health literacy—and develop effective solutions to address this major healthcare issue.
At EdLogics, we’ve teamed up with many leading academic medical centers and Centers of Excellence (CoE), as well as industry thought leaders like Dr. Rothman and former US Secretary of Health and Human Services Governor Tommy Thompson, to identify specific ways to improve health literacy.
The first step is to make learning fun and engaging. To do this, we employ and work with experienced clinicians, developers, designers, and gamification experts to create stimulating, engaging games that educate users on important health topics, from diabetes to the Zika virus, all developed with the low health literate user in mind.
To keep users coming back, we’ve developed innovative gamification and unique incentive strategies where users earn rewards by playing games and completing educational activities.
Employers can purchase a customized version of the platform, enabling employees and their families to play, learn, and win. And the cost is minimal: roughly $20 a year per family.
I’m very proud of our platform. It’s a product that educates consumers about chronic diseases, common medical conditions, general health, well-being, medications, and how to navigate the healthcare system. We’ve heard inspiring testimonials from employers and employees, and we have impressive statistics on knowledge improvement and consumer engagement. In fact, 100% of users improve their knowledge of a given condition after completing our learning activities, and 79% of users say they will change their behavior based on what they learned.
We’re continuously making enhancements, all with a focus on improving consumer engagement. That’s the key to being able to influence positive behavior change and deliver the most important, lifesaving knowledge. Not to mention the opportunity to reduce pain and suffering – both physical and financial.
A version of this article was originally published on2/22/2017.
ou can’t control many of the factors that contribute to high healthcare costs: expensive drugs, the cost of providers, rising insurance premiums. So, what can you do?
Improve health literacy, the ability to understand and act on health information.
Watch health literacy expert Russell Rothman, MD, MPP of Vanderbilt University and gamification guru Brian Primack, MD, PhD, then of the University of Pittsburgh (now at University of Oregon), outline problems with existing health education programs and describe real-life solutions.
Watch the entire webinar recording below.
Here's the skinny:
EdLogics wants to improve low health literacy through education.
It’s not about avoiding medical care. It’s about getting the right care at the right time.
We want to empower people to make real changes in their day-to-day habits, so they can stay healthy and keep their families healthy, too.
We want to educate people to prevent sickness before it starts, to show them what to do and where to get care when they do get sick, and help them become well-informed, proactive healthcare consumers.
Ultimately, EdLogics wants to improve health outcomes, reduce the number of claims, and lower costs. For everyone.
“In the US, 1 in 3 Americans can’t follow directions on a drug label. And I have to say, even with a medical degree, I sometimes get a prescription for one of my kids or something and I have to look at it pretty carefully with that small print and the code that it’s in. So it’s not surprising that it’s a challenge for many different people.”
“When someone, for example, just has an ankle sprain — if they can access and follow good information that they have — then they very well might be the kind of person who will say, ‘You know, I don’t need to go the emergency room. I can wait.’
A couple days later, they’ve already improved with ice, elevation and rest — all things that are free.
Whereas another person who is having more difficulty understanding or accessing information might decide to go to the ER for the same condition, and the second they get through the ER door, already they’ve racked up very high costs. They’ve put themselves at risk for getting some kind of a hospital-acquired infection or some additional problem.
Even though this is one small example, when we start quoting issues like ‘90 million Americans have poor health literacy, and this costs an extra $150-200 a year,’ you can see how these numbers add up.”
Knowing what to do to prevent chronic disease, how to take medications, and where to go when you’re sick — and acting on that knowledge — can have a huge impact on both personal health and the number of costly healthcare claims.
✅ Improved knowledge of health issues
✅ Improved behaviors
✅ Improved outcomes for:
“Even after you take into account a patient’s education level, their income, their insurance, and a host of other factors, we find that their literacy level is an independent predictor of how they do with their health.”
Of course, health education programs trying to raise people’s health literacy already exist.
But are they actually making a difference?
Pamphlets: Often don’t make it from the doctor’s office to the car.
Health websites: Too high-literacy, not personalized, and not always trustworthy.
Doctor visits: Patients may misunderstand, forget instructions, or feel too embarrassed to ask questions.
“And, unfortunately — and I say this as a primary care physician [laughing] — but there’s also a lot of variation in how well doctors communicate with their patients and their families. If you ask most clinicians we would, of course, tell you that we’re excellent communicators, and our patients all nod their heads and seem to understand everything that we say to them. … Some studies suggest patients only recall about 20% of what’s said to them by the time they get home.
So we like to think we’re all good communicators as clinicians, but a lot of us struggle — using a lot of jargon that might be hard for patients to understand, maybe speaking at too high of a literacy level without enough plain language, and giving people too much information to try to take in during one single visit. We often don’t assess patient understanding before they leave.”
Poorly designed games: Many focus on the wrong goal.
“So there would be hamburgers and pieces of pizza, and you are supposed to shoot those, but the salad you are supposed to let live. You can probably imagine the next step, which was that they studied this and they found that being exposed to this game and playing this game a lot didn’t actually make people change their diet in any way.
It’s just a caution that even though sometimes gamification is really valuable, if the game is poorly designed, that’s just not a magic quick fix.”
It’s one thing to learn more health facts. It’s another thing to change your daily habits — the one thing that has more of an effect on health than any other single factor.
“The question is: Can we take principles of gamification and game based learning — the interactivity, the unique incentives — and can we use that to leverage for positive change? And what we have found is that, especially in the area of health literacy, there is a lot that we can do.”
“What we really need to think about more is how to link people to other social support mechanisms to help them with their health. We have lots of studies now that really demonstrate that patients who have strong social support do much better with their health. There’s actually an epidemic of loneliness going on in a lot of countries.
And even when people are with their family, they may not have social support for disease that they’re dealing with.
So it can be really helpful to help a patient or employee and their family link to community resources — maybe to disease-specific organizations if they have a certain disease, or to a community organization that provides peer support. Or we can help them gain access to exercise or healthy food. Even to help them with getting additional support from their own family.”
“Health literacy is a major problem in the United States. We have at least 90 million Americans with only basic or below basic literacy skills. Even patients with good literacy skills can struggle to navigate what’s become a very complex healthcare system when trying to take care of their health or the health of their family.
We have found that by addressing health literacy issues, we can improve care for patients with low literacy. Studies have suggested that using good forms of health communication and addressing health literacy can even improve knowledge and behavior for people with high health literacy. So improving how we educate and communicate can be of great value to everyone.”
“There are so many challenges here. If it were easy, we wouldn’t have 90 million Americans with low health literacy. But I think that it’s important to end on a positive note and say that we really are moving the needle. There have been studies that show that using the kind of principles that we talked about today really do help and change people’s lives. I think that that is what we need to hold up as we move forward.”
A version of this article was first published 10/12/2018.
n estimated 80% of large US employers offer wellness programs for their employees. In fact, wellness programs are often touted as key employee benefits.
But new research questions if wellness programs actually do reduce health care costs. Research published in the Journal of the American Medical Association was jointly conducted by Harvard and the University of Chicago.
The researchers randomly offered different wellness programs at various work sites and then tracked the results. Specifically, they offered new wellness programs at randomly selected locations of BJ’s Wholesale Clubs. Those results were compared to existing programs at other locations to identify any changes in individual behavior as well as any changes in the corporate culture.
The results showed some demonstrated behavior changes ... but little effect on other outcomes.
Behavior changes recorded at sites offering Wellness Programs:
Outcomes showing no significant impacts included:
Researchers noted that the field of studying wellness programs is still relatively new. Others have commented that 18 months might not be enough time to effectively measure the success/impact of wellness programs. Might it not take decades?
One of the coauthors of the study, Zirui Song, MD, PhD, assistant professor of health care policy and medicine at Harvard Medical School’s Blavatnik Institute, stated her summary.
As we grow to understand how best to encourage healthy behavior, it may be that workplace wellness programs will play an important role in improving health and lowering the cost of health care. ... For now, however, we should remain cautious about our expectations from such interventions. Rigorous research to measure the effects of such programs can help make sure we’re spending society’s health and wellness dollars in the most effective way.
One missing variable is the role that education plays. Would behavior change absent of an increase in health literacy even be sustainable? Conversely, if employees better understand their personal health — how to properly use an asthma inhaler, for example – would behavior change persist longer?
We’ll be fielding these questions to several health literacy experts so check back for their responses.
A version of this article was originally published 4/19/2019.