Gamification Boosts Employee Health Behavior, Blue Shield Argues

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A major West Coast health plan has jumped on the social gaming/networking trend in fitness and wellness applications. Blue Shield of California is already offering one such program to its employees and will soon provide two more. The company is also trying to sell its employer customers on the idea that this approach can help engage workers in their own health care.

Blue Shield launched Wellvolution, a wellness initiative for its own employees, in 2009. This program had some impact, but the company eventually realized that it could do even better, Bryce Williams, director of Wellvolution, told InformationHealth Healthcare.

Recent research had shown the power of social connectedness in improving health outcomes, and mobile health apps were suddenly catching on among consumers.

"So it made sense to take the technology that people were already using and comfortable with and migrate that to a health platform that included social media and social gaming," Williams explained.

Blue Shield's first move was to try an application called Shape Up Shield that focuses on increasing physical activity.

"This is an eight-week-long, social-media-fueled challenge that uses an online platform to let employees form teams, post comments in forums, set team and personal fitness goals, and give virtual 'high fives' for encouragement," a Blue Shield spokesman said. "In 2011, over 1,800 Shape Up Shield participants walked, hiked and ran 600 million steps," about 300,000 miles.

One of Blue Shield's new programs, The Daily Challenge from MeYou Health, is similar to Shape Up Shield, in that it uses social media, including Facebook, to make wellness fun. But instead of confining itself to physical exercise, it gives participants a series of individually tailored Daily Challenges, Williams noted. The Daily Challenge is "a simple activity that improves your wellbeing." That might be physical, emotional, or mental, he said. (The MeYou website says, "the Daily Challenge promotes everyday wellbeing by encouraging the small actions and fostering the social ties that drive meaningful change.") MeYou's program features the hallmarks of social gaming, such as points, badges, status, and progression.

Another application, Healthrageous, uses mobile devices to get patients involved in wellness and chronic disease care. Based on personal data collected on these devices, Healthrageous advises and supports patients in meeting their health goals. The program also includes a social media element: participants can compete and share their experiences online.

What makes Healthrageous different from the other online wellness programs, Williams said, is that its coaching "is related to what I've done rather than to some generic recommendation about exercising more or changing health behavior. That enables us to tie our actions to almost immediate feedback."

Including the impact of Shape Up Shield, Wellvolution has had an impressive track record. In the past three years, Williams said, 80 percent of Blue Shield employees have participated in at least one of its wellness programs. During that period, there has been a 50 percent drop in smoking prevalence and a similar increase in regular physical activity among employees. The incidence of hypertension has fallen by two-thirds, and disability claims are down among participating workers, but not others.

One reason for the high participation rate is the incentives offered to employees. Wellness program participants are paying $3 million a year less in their share of insurance premiums, and they're getting a total of 2,500 "health days" off from work. The company has also benefited by cutting annual health cost growth for its employees from double to single digits.

Now that it has shown the effectiveness of the social networking approach, Blue Shield is starting to offer its customers Healthrageous. They may buy the program either as a standalone product or as part of the company's Blue Groove consumer-driven plan, which already includes some wellness and care management aspects. Eventually, Williams noted, Blue Shield may also sell Shape Up Shield and the Daily Challenge to California employers.

"Doing wellness is hard work," noted Williams. "It's hard to eat less, exercise more, and give up addictive habits like smoking. But there's no reason it can't be social and fun, too. And once it becomes relevant to people's everyday experience and becomes less of a chore, and less about willpower and abstinence, that's when engagement rates start to rise."

The 2012 InformationWeek Healthcare IT Priorities Survey finds that grabbing federal incentive dollars and meeting pay-for-performance mandates are the top issues facing IT execs. Find out more in the new, all-digital Time To Deliver issue of InformationWeek Healthcare. (Free registration required.) This article was originally published on April 18, 2012 on http://www.informationweek.com

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