Mobile Health - the 2 big deals

I've been doing online consumer health for over 15 years, most of it with Kaiser Permanente. As I think back on some of the key capabilities that were originally visions on the far horizon and are now simply part of the landscape around us, I remember when each of these was "the next big thing."

• health information previously available only to professionals, made widely available to consumers
• health risk assessments with personalized feedback
  
• online appointment requests
• online prescription refills
• online appointments booked in real time
• select a physician online
  
• apply online for coverage
  
• email my doctor
• secure messaging with my doctor
• view my medical record
  

Each of these is now everyday reality to millions of Kaiser members. We've reached these horizons and moved on to the next. So what's next? When someone asks me, "What's the next big thing," I usually end up talking about two areas:

1. A better user experience
2. Broader reach

Despite lots of powerful and valuable possibilities for new functionality, from personalization to portable medical records to home monitoring, I think the biggest value to individuals and society will come from improving the user experience of the current functionality, and making that experience available to a broader audience.

1. Better user experience
We need to take all the capabilities we've already implemented, and make them...

• easier to use
• more integrated
• better adapted to real-life scenarios and tasks of our users

2. Broader reach
Over 3 million Kaiser members use the powerful tools we've provided. That's not nearly enough. In addition to increasing the number of web-using Kaiser members who use this stuff, we need to expand these tools to...

• people who are traditionally underserved by the healthcare system
• people who don't have easy access to PCs with broadband connections
• people whose physicians aren't currently part of an integrated group practice

The Mobile Factor
Cell phones won't take us all the way to these horizons. But they can certainly help us get there. In terms of user experience, mobile devices can make simple transactions ridiculously easy, and they can fill in the gaps between in-person, telephone, and desktop web interactions. If we do it right, mobile interactions will become a lynch pin of ubiquitous, integrated, cross-channel experiences.

Not only can mobile devices support much better experiences, it's getting clearer all the time that they can help us extend these services to people who are traditionally left behind by the latest technology. If we do it wrong, our mobile efforts will just exacerbate the already shameful chasm between the haves and have-nots. But if we do it right, and I think we can, we can use mobile technologies as a powerful tool in shrinking that gap.

Stages of Acceptance of User-centered Design

Here's a draft framework for thinking about how people move from not appreciating the importance of user experience to a place where they build it into everything they do.

The idea here is that if you want to create a user-centered product, you need to create a user-centered culture. And in order to create a user-centered culture, you need to move individuals through these stages of understanding. The type of training and influence required for an individual depends on which stage they're in.

Here's a hypothesis for the stages of "getting it" that people need to go through.

1. You are not your user
2. Understanding users requires direct contact with them
3. Knowledge about users must be grounded in real data and must be actionable
4. Business results depend on satisfying users
5. Every decision should be influenced by its implications for the user experience
6. Specialists can really help, but everyone is responsible for the user experience

What's your experience in helping people through stages? What part of this rings true, and what parts need to be removed or revised?