I have been a Fitbit user for a few years now. Every time I need to lose some weight (yes, for me it is cyclic) I put on my Fitbit Charge, pull out my Fitbit Aria ‘smart scales’ and log in to the My FitnessPal app to track my calorie intake. Combining these with the Endomondo app to track exercises like weight lifting and running, I can pretty much lose half a kilo of weight consistently every week.
Having visited some of our customers who are building telemedicine solutions or running telemedicine-related projects, I can’t help compare their experiences to the experience I have had with Fitbit. Here are my findings:
Finding #1 – It is not (only) about the data, it is about the perception of the service. Much as Apple revolutionised the music industry with the iPod/iPhone connected to a marketplace (iTunes) and brought out a full service, the success of a telemedicine project is also about the completeness of the service, the perceptions of the customer, ease of use and the perceived value of that service.
Finding #2 – Speed of innovation and being sexy – Even if Fitbit might call this ‘time to market’, it is all about being perceived as a market leader and having the best service. Even if they have a great offering expanding into nutrition, weight loss and personal coaching, they are still humble enough to open the data to other apps offering overlapping and competing apps and portals. This allows for choice and integration and flexibility. Users like that.
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In a typical telemedicine project, meanwhile, we have a lot of discussions about Continua, certification, interoperability and so forth. These processes are creating friction for innovation and tend to slow down innovation and the “currentness” of the offering: we are basically losing time. So while we are busy discussing how to exchange data, Fitbit, with no certification process to speak of, ships a new product.
Finding #3 – User experience – Fitbit has a dedicated App, allows for other apps to consume their data to build other value added services, you have web pages with dashboards and reporting and you can share your progress with your friends and family. In a typical telemedicine project, we need to be stricter on security and consent – and this drives us into a slower cycle of innovation. We are also dependent on the quality of the national portal or hospital portal where you can log in to see your details – if at all. There is a fundamental problem here in the way we handle data as opposed to the way commercial actors can get away with handling data with the consent of the consumer.
Finding #4 – Motivation and engagement – I understand that there is a huge difference in motivation between a fitness / wellness application and handling a medical condition. When it comes to motivation to do something, you can always choose the carrot and the stick and typically the best results come from when you use both. So how does this relate to Fitbit? Well, they are typically driven by carrot motivation. You want something nice and sexy, the nicest fitness tracker and you wear it on your wrist (which is less precise than wearing it on your belt), because you then look like someone who takes care of themselves. From the telemedicine angle, we typically push these devices to the patients “because of your medical condition” i.e. ‘stick motivation’. Fundamentally this would need to shift, making it popular to fix your body for all types of issues – not just being overweight.
Finding #5 – Social and gamification – Fitbit uses a lot of social media connections: for example, inviting your friends to compete, challenges and badges as rewards to motivate you to take those extra steps to reach 10,000 in a day. I know these work for parts of the user group. Peer pressure is external pressure you choose yourself in this instance. Imagine if you could compete with your friends over glucose levels or getting badges for taking the pills according to schedule – “5-days-in-a-row pill-taking badge” and maybe graphs showing how consistent you are.
Finding #6 – The extended ecosystem and integrations – Connectivity is all the rage for healthcare and ditto for Fitbit. However, being a hub of information takes some responsibility and Fitbit has published their APIs for anybody to develop apps or web applications to connect and consume the data (given the consent of the consumer, of course). This is handled easily with providing the username and password to the connected services typically. In healthcare and for telemedicine this is almost unheard of. What if people could get access to the data? I believe we could leave that to the patient to qualify who will have access to what part of their healthcare data. After all, the data should be owned by the patient and as such is the property of the patient and can be distributed to anyone.
Finding #7 – Making people want to pay! – To be able to define a service where the customer/patient are willing to pay the full price for the device and in addition subscribe to more advanced features in the app and portal, means you are able to understand the value for the customer/patient. So the trick is in seeing the value from the customer/patient side and not only from the clinical side. So what can we learn from Fitbit in this regard? Well, their premium service includes things like a digital trainer, benchmarking, a premium icon, 100 images in your pictures stream etc. The digital trainer is where they push exercises and full workouts to you depending on your progress and level. The benchmarking is perhaps the most valuable where you are given insight into how you are doing in your demographic. The other two mentioned are more social media stuff such as allowing you to publish more pictures and having a more advanced icon showing that you are a paying subscriber to the premium – an indication of status.
So, in summary, I think there are a lot of things we can take back when planning our next generation telemedicine approaches. I think the biggest thing is to see the value of the solution for the patient outside the clinical environment. If we can succeed there, we will have a more mature and sophisticated offering.
Date:April 19, 2016