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AIS's Health Business Daily
Featured Story August 28, 2008 Presence in Virtual Worlds Could Help Health Plans Achieve Real-World Behavior Change Reprinted from HEALTH PLAN WEEK, the industry's leading source of business, financial and regulatory news of health plans, PPOs and POS plans. Second Life is a virtual world of avatars, sims and Linden dollars, and CIGNA, Corp., Partners HealthCare System, Inc. and the Centers for Disease Control and Prevention (CDC) are among the first health organizations to establish beachheads on its shores. But it's not, they say, because Second Life and other social networking media (e.g., Web sites) are new and flashy. Rather, their ventures are a response to changes in the way consumers are communicating and accessing health information. These organizations also see an opportunity to achieve real and sustainable behavior change by shifting the focus of health education from the message to the userexperience. "More and more people are choosing how they want to communicate with us, and we have to respond to that," says Peter Mills, M.D., chief health officer of CIGNA'S Health Solutions Unit. Mills tells HPW that his group is spearheading the company's new Second Life pilot. "We're always looking for ways to reach people where they are, and [Second Life] is a way to do that." Of all the virtual worlds, Second Life is probably the best known. Just five years old, it now claims 14 million registered accounts and "islands" inhabited by colleges and universities, federal agencies and corporations. The average age of a Second Life resident is 35 and edging upward. Facebook and MySpace are experiencing thesame trend. Second Life and other Web 2.0 social media also offer an opportunity to model health behaviors in an immersive and socially interactive environment. Erin Edgerton, content lead for interactive media at the CDC's Division of eHealth Marketing, says that Second Life is a perfect environment for modeling behavior. "When people practice health behaviors in a virtual world, they are more apt to perform them in the real world," she says. No one is arguing that Second Life is ready for clinical prime time. In addition to security, confidentiality and protocol concerns, becoming a resident on Second Life can be challenging for many non-techies. But the impact of Second Life and other social networking programs on health care delivery could be profound. The patient-physician relationship could be revolutionized as consumers gain access to new and innovative technologies, including mobile platforms, for managing their health and health care. CIGNA Builds Virtual Island CIGNA began working with Method, a "brand-experience" agency, about a year ago to launch its pilot Second Life island, or presence. Mills says that many people turn to the Web to search for health information. However, a growing number of them — especially those between the ages of 18 and 44 — are using it to find, connect and interact with others who share their interests. This, Mills argues, creates an opportunity for insurers to go upstream to where this new consumer demographic is congregating and reach them with tools and information that can help them better manage their health. Mills says Second Life can be a powerful health education tool that could generate real-world impacts because of its visually rich and immersive nature. It's also a social community that is highly interactive and peer-to-peer oriented. "People notice what their teachers and physicians say. But in the end, family and peers really drive what people choose to do," he says. So while CIGNA's island offers self-directed learning, these activities are designed to be shared with others. Claus Nehmzow, general manager of Method's London office, says that to control message accuracy, the site allows for the mixing of residents and medical experts, who can facilitate peer-to-peer discussions. "An expert from CIGNA can be there, but in an unobtrusive way and as one person among a larger group of peers." Virtual Services Tested on Employees CIGNA is testing its Second Life venture on its own employees as well as on a small number of its commercial clients. The health plan says it will decide where to go with its Web 2.0 experiment when the pilot draws to a close later this year. While nothing has been decided, Mills says that Second Life lends itself to several possible future applications. Among them: Providing a base level of virtual services for all CIGNA members, and upselling specific events and educational pieces, including virtual disease management programs, to other market segments and commercial clients. While CIGNA declines to comment on the financials involved in its Second Life pilot, Nehmzow says that setting up an island costs $1,675 up front and $295 a month in maintenance fees. "But how much a company wants to pay for upkeep varies widely." Upkeep includes everything from sponsoring seminars conducted by real-world instructors to 24-hour coverage by staffers acting as receptionists, counselors, facilitators and guides. Nehmzow says that a site could be visited by anywhere from 50 to 80 people at any one time. He adds that much of what happens on the island tends to involve conversations where others observe, listen and learn. A sponsoring company, such as a health plan, merely facilitates the conversations. As a result, one staff person can serve a large group of people at one time, and that can be cost-effective when compared to a call center. The CDC's experimentation on Second Life dates back to 2006, although the island it made available to the public this spring bares little resemblance to its original virtual community. The CDC, Edgerton says, created a Second Life presence in response to changes in consumer behavior driven by the Web and other technologies. "We knew that we couldn't wait for people to come to us. We had to find out where people are and then meet them in those spaces." Second Life, she says, is one of many emerging communications channels the CDC is using to influence health and safety decisions. CDC Conducts Avatar Interviews To help refine its strategy, the CDC conducted individual avatar interviews and an avatar focus group on its Second Life island. (An avatar is a computer user's representation of himself or herself, which can take the form of a three-dimensional model or a two-dimensional icon or picture.) Among the major findings: Second Life residents want health information, and they seek out other residents with similar health issues to share and compare experiences. Many also feel more comfortable accessing sensitive health information when they can remain anonymous. Each of the island's interactive tools is designed to help influence healthy behaviors. And everything on its island reinforces and supports the health content found on the CDC's main Web site. "We see CDC.gov as the hub with spokes going out to all of our virtual worlds, social media and real-world activities," Edgerton says. "All health and safety information on our Web site is repurposed for Second Life and other channels. The information is consistent across all channels but reconfigured for each channel." Second Life isn't the CDC's first venture into the virtual world. Two years ago, it partnered with Whyville (www.whyville.net), a virtual community targeting tweens (ages 8 to 15) to promote flu vaccine awareness. During its first year on the site, the CDC virtually vaccinated 20,000 Whyville residents. During its 2007-2008 campaign, 41,000 residents were vaccinated. Because grandparents use Whyville to connect with their grandchildren, the CDC was able to involve this important cohort in the awareness campaign. Health plans could use a similar strategy for their enrollees. Potential Seen in Emotional Communications Partners HealthCare, a Boston-based multihospital and physician group system, created its Second Life island two years ago. The venture is run by the Center for Connected Health, a division that applies consumer technologies and online resources to health care delivery. What interests the Center is Second Life's potential as a new platform for rich, emotional communications. "When a person spends time with his or her physician, it's almost always an emotional experience for that person," Joseph Kvedar, M.D., the Center's director, tells HPW. "Second Life is a tool for replicating that experience in ways that texting, e-mail and other tools cannot." Kvedar argues that keeping many of today's chronic diseases under control often has more to do with behavior change and ongoing self-management than with clinical interventions. "About 90% of what we're doing with chronic disease management involves behavior change," he says. "We could do more for our patients who have diabetes, weight problems or hypertension by helping them relieve their stress and achieve better mental health." As a first step in addressing this dynamic, the Center is conducting a virtual clinical trial of a relaxation program on its Second Life island. Kvedar cautions
that Second Life isn't ready for widespread clinical use. In addition
to security and confidentiality concerns, the site is still somewhat
difficult for many people to access and navigate. As a result, the Center
is using it to reach people who are already there. But he says its reach
and applications will expand "as soon as people can become a resident
of Second Life as easily as they can perform a search on Google." |
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