Traditional Triage vs. Choice: Put the Person Back into the Personalization to Get Better Results in Health and Wellness

At some point along the way, we decided that best practice wellness program design is using health claims and health risk data to triage our populations into high, medium and low risk buckets. We took the riskiest, and costliest, employees and tried to get them to talk to a nurse or coach, and offered everyone else low-cost resources like newsletters and web portals.

It’s logical. It’s budget-prudent. But here’s the problem: We left the consumer out of the process. We’ve long known that no one method will work for every individual, that no two individuals change in quite the same way, and that people have greater buy-in and commitment when they make a choice.

We also know that many consumers already know the right things to do to change their health for the better—they just don’t do them. It’s less about gaps in knowledge than it is about creating a more successful strategy to help people change their health behaviors. We’ve found choice to be a powerful part of that strategy.

The Case for Consumer Choice

Consumer-driven approaches that use choice architecture are revolutionizing how we construct and offer health benefits. Why not make choice architecture a core element of your wellness program design?

At RedBrick we began using that approach several years ago. Rather than slotting risk groups into intervention topics and methods, we use data to create a personal HealthMap where you pick your destination from among three or so recommended areas of focus (for example, nutrition, stress, or managing your condition), and then how you’d like to engage (for example, digital coaching, self-tracking, or working with a live coach). We always make sure we offer a bounded set of relevant choices.

We recently did a large-scale analysis of our participants, and it turns out that choice works. Not only did we get better engagement than traditional programs, we got similar results out of each intervention type. Those who tracked improved, those who chose digital coaching improved, as did our live coaching participants. And they improved at almost identical rates. These improvements weren’t just self-reported—they were objectively measured: We saw clinically meaningful reductions in blood pressure, cholesterol, and BMI.

Similarly, we found that those with chronic health conditions did better when given a choice. Over 80% of those with conditions wanted to start their wellness journey with a lifestyle topic. We let them—and when we did, we ended up doing three times as much condition-specific coaching since our model addresses the whole person, not just a singular risk or condition.

The moral of the story: Start where the person is – not where the algorithm says the person needs to be.

Become a Choice Architect

As an employer, how you arrange things for your employees can transform the way they respond. Even something as simple as offering healthy cafeteria options before the unhealthy will change what people select. Choice architecture presents a whole new way for wellness program participants—those with chronic conditions and those without—to move the needle. You can overcome inaction if you:

  • Offer guided, relevant choices. While one person might be motivated to change dietary habits to lose weight, another might be seeking to boost energy or set an example for their kids. Intrinsic motivations matter, and by tapping them you increase the likelihood the consumer will act.
  • Avoid overwhelm. More choice is not always better. A person navigating a sea of choices might lapse into paralysis, unable to choose any. Offering about three options (and five tops) will help people focus and decide.
  • Make it easy to do the right thing. Structure options, keep things simple, and link recommended choices to the person’s existing intrinsic motivations. Provide encouraging feedback at each step along the way. Make the experience as similar as possible to familiar experiences that consumers enjoy, like shopping or picking a movie online.

At RedBrick Health we like to do what works, rather than what’s traditional. And—as it turns out—choice works.

Hear more insights from RedBrick Health by downloading the webinar: Creating Health Engagement & Behavior Change: The New Paradigm in Health & Wellness.