On Day 1 of HxRefactored, we heard from Matt Park, VP of North American Sales for dacadoo, about the company’s mobile patient engagement and Health Score technology platform. During the conference, we had a chance to sit down with Alex Rice, dacadoo’s North America Business Development Manager, to learn more about the company and its technology.
Medgadget, Mike Batista: Where did the idea for dacadoo and the Health Score come from?
Alex Rice: Our CEO and founder Peter Ohnemus is a long time entrepreneur who has been involved in the formation and IPO of a number of companies in both the high-tech and bio-tech sectors. In coming up with the concept around dacadoo, he was looking for something that would have a lasting positive impact on public health. The initial concept began with the idea that there needed to be a better metric to quantify personal health. Peter partnered with Prof. Laurence Jacobs who has held multiple positions at MIT, Harvard Medical School, and the University of Zurich Medical School. Working together, dacadoo and Prof. Jacobs developed the Health Score using data from clinical studies such as the Framingham Heart Study representing over 150 million people-years of data. Based on the Metric Health Model and other underlying models, the Health Score breaks down a user’s health into three areas: lifestyle, body, and mind. The Health Score provides users a validated, real-time quantification of his or her health status based on over 100 different data points we capture from users through both self-reporting and integrations with connected devices. The score is equalized across age, gender and other demographics so that everyone can fairly compare their scores. Based on changes in an individual’s Health Score, they receive direct feedback and guidance on living healthier, more active lives.
Medgadget: How does the platform work?
Rice: All someone needs to do to begin using dacadoo and see their health score is enter a few basic pieces of information: age, gender, height, and weight. They can then optionally begin connecting dacadoo with any of the popular wearable devices we connect with, add further biometric data, and answer questions similar to a health risk assessment to get a more dynamic health score.
For the end user, it’s really about daily engagement that informs the individual where their score is today, clarifies why their score has changed since the last time they checked the app, and provides guidance and programs to help individuals shift behaviors when there are areas for improvement. As a personal example, I tend to see a drop in in my Health Score due to lack of sleep, which is a nice reminder for me to make getting a better night’s sleep a priority. Two other examples of popular programs built into dacadoo I participate in myself are around cycling, for activity improvement, and eating more vegetables, for better nutrition. With preferences around when and how frequently you want to be engaged, dacadoo’s feedback and coaching programs provide opportunities to live a healthier lifestyle based on your personal preferences. Overall, our goal is to help users take ownership of their health through positive, lasting behavior change.
Medgadget: Who can use dacadoo? Is the focus a direct to consumer model or do you sell to enterprise clients?
Rice: Anyone can download dacadoo’s consumer-facing mobile app today. Once you download the app, you can try it out through a 30-day free trial before switching to a subscription to keep using the platform. In addition to individual consumers, we’re seeing a lot of success deploying dacadoo with insurers and employers offering dacadoo to their members or employees. We also offer fully customizable white label enterprise solutions, and the health score as a component for other technologies and platforms via our open API.
Medgadget: You mentioned integrations with connected technologies. How do you handle those integrations?
Rice: We actually have an interesting approach to our third party device and technology integrations. Instead of using data integrators, we directly integrate with all major connected devices. One reason for this approach is that data integrators can sometimes limit what data you can get from a connected device. Take the FitBit device for example. While an integrator may provide access to step data, directly integrating with FitBit’s API allows us to capture steps, heart rate, and GPS location data. That additional information is worth the effort of creating our own integrations with these technologies.
Medgadget: How do your clients engage with and use dacadoo?
Rice: Our corporate clients, who are typically insurers and employers, have access to anonymized user reports which summarize the data and Health Scores captured from their dacadoo platform users. These reports generally follow the same breakdown we show users around lifestyle, body, and mind. Our clients can be as broad or as granular as they want when evaluating their populations through these reports. For example, a large employer with patients across multiple regions can see a report for all their employees. However, more powerful insights can also be gained by seeing reports for each geographic region where their employees work to better understand geographically different strengths and weaknesses in the health and wellbeing of their employee populations.
From these reports our clients can measure the success of wellbeing programs, focus on successful initiatives, make adjustments if necessary, and provide actual metrics on the return on value to stakeholders. Take an example where an employer’s report shows that all of their employees are scoring well on body health but are doing less favorably on the mind components of their Health Scores. A corporate wellness team can use this insight to implement more mindfulness programs that address the specific challenge revealed by dacadoo’s analysis of their employees. Going back to the regional granularity, dacadoo’s reports may show that the same mindfulness program would benefit employees in one office but an activity-centric program would better serve employees in another.
Programs such as those I just mentioned can be managed from within the dacadoo platform. A selection of programs already exist in the standard dacadoo platform, and customized programs curated for our client’s needs can also be developed and deployed through dacadoo. Sometimes our clients already have programs in place or decide to implement programs themselves or with a third party. Another component built right into standard dacadoo is challenges. A common example we see all the time for corporate wellness is something like a month-long walking challenge. Individuals often engage in the program and there is usually a bunch of buzz at the organization but how does the business know if individuals actually improved their health as a result? Whether the program is deployed through our platform or separately, dacadoo is a powerful tool to quantify the success of these programs by tracking user Health Scores before, during, and after implementation. By putting real numbers behind these initiatives, we help our clients better identify which health and wellness strategies work best for their members or employees.
Since many of these programs exist already, another goal is encouraging individuals to take part in the programs offered by their insurance company or employer. If someone knows they are at risk for obesity and trending poorly in terms of their weight and BMI, they might be more likely to enroll in their employer-offered nutrition program than if they were being asked to participate without context as to why it is important to them. Programs can be designed to provide early intervention as well.
Medgadget: You mentioned that these reports are de-identified and aggregate in nature. Why not give user specific information to the organizations you work with?
Rice: In most instances we do not reveal user-specific information to our clients due to concerns around ethical, legal, and regulatory issues associated with privacy and access to personal health data. From a technology standpoint, with proper consent, we can create a permission based system to share health data. We are also adding a Health Professional View in an upcoming update that will allow the user’s clinician to connect to the health data within dacadoo. We of course take data privacy very seriously and make sure the user is in control of their data.
Medgadget: Do you have any statistics on how well users of dacadoo have been engaging with the technology?
Rice: Engagement on dacadoo has been amazing. One standard metric in social media and gaming to assess engagement is the ratio of daily active users (DAU) to monthly active users (MAU). In most technologies, you would be pretty happy with a DAU/MAU of 20-30%. Big, popular social platforms like Facebook can reach 50%+. We’ve seen DAU/MAU numbers from 40-60% at dacadoo which speaks volumes about our user’s level of engagement with the platform.
Medgadget: What about numbers around the health improvement users of dacadoo’s technology have been able to achieve?
Rice: AKD Research did a study on over 67,000 dacadoo users from 2011 to 2014 where they evaluated changes in both vitals and health risk variables. The ability to improve user health was profound. To use a few examples, we saw that 41.8% of users reduced their risk for diabetes with an average diabetes risk reduction of 28.4% in those users. Weight decreased for 29.4% of users with an average weight decrease of 2.7% in those users. A couple other important takeaways from the study were that we saw a 50-80% participation rate and 90% of users indicated satisfaction with and an interest in repeating the wellness challenges. Finally, on average, dacadoo users gained 2.5 “healthy years” as a result of using the platform.
Medgadget: We’ve talked a lot about your work with insurance and employer health and wellness. Do you see clinical applications for dacadoo and is that something we can look forward to in the future?
Rice: Absolutely. We are very interested in exploring that avenue and are in discussion with several large ACOs and hospital networks currently. dacadoo is a flexible technology platform that could easily integrate with clinical data. There’s a ton of information doctors are not looking at today that would significantly impact their perception of a patient. For example, a sedentary lifestyle is one of the biggest causes of diabetes. While a patient may claim they are active daily but their step data shows they only walk around when they head to and from work, that’s a consideration the provider can take into account to contextualize that patient’s definition of being active. There are of course privacy considerations to take into account in revealing that kind of information. Control of what and how to share their dacadoo data will ultimately lie with the patient.
To share a personal anecdote where I used dacadoo in a clinical setting, I recently switched to a different insurance plan and a new doctor. The doctor asked me about my previous cholesterol levels which I did not think to bring with me from my previous provider. However, I have this data in my dacadoo app and was able to share that specific information directly with my new doctor.
Medgadget: So might we be seeing more clinically-oriented tools from dacadoo in the near future?
Rice: Yes! Besides some new device support and functional improvements, the big thing coming out in the next version of our technology is the Health Professional View. Until now, dacadoo has really been focused on holistic well-being. Moving forward, we see opportunities to connect the dots between quantified-self data and the clinical information that lives within medical systems. We’ve already seen positive feedback from the medical community on dacadoo and think there are some important use cases where our new offering can play a role. One thing we’re cognizant of, however, is not overburdening the provider with a ton of information. Our health professional view will make it easy for doctors to view and digest important information captured by dacadoo about their patient.
Link: dacadoo homepage…
