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Digital HealthIt Takes a Village Interview: Bob Gold, GOMO Health

Bob Gold Explains Fundamental Consumer Motivations and Needs that Will Always Remain

Bob Gold is CEO of GoMo Health®, an innovative New Jersey-based company that is a leader in designing, implementing, and marketing award-winning, personalized patient engagement solutions that support the continuum of care.

Bob and his team have developed what they call Behavioral Rx®, which they describe as a scalable and cost-effective way that companies can use to engage with end-users that enables better self-management, healthy decisions, and improved outcomes.

GoMo is a bit like the Wizard of Oz – an engaged entity that is always out of sight, yet which is working its engagement magic for other companies. You can’t download a GoMo app and use it on your phone. If you are an end-user or a consumer of healthcare services, you might be interacting with a company that employs GoMo solutions and never even see its name.

What GoMo does, in essence, is to help consumer engagement experiences for customers who use the services of other healthcare companies.  Bob Gold is a positively brilliant man who has spent his life studying and codifying what makes consumers want to engage with companies. His clients span healthcare’s value chain of health plans, providers and innovators.

As I spoke with him, I was thinking about Maslow’s famous hierarchy of needs – the underlying needs, identified by a Russian psychologist named Abraham Maslow – that are supposed to be the main human needs that motivate people to act. Bob, in his way, has identified a parallel set of human motivations.

We’ll take a look at those in a few paragraphs. But first, let’s get an overview of the current healthcare landscape that Bob and all the other companies outlined in this book are constrained to work within.

The High View

We are now a decade into the age of the Affordable Care Act. Coincidentally, we are also 10 years into the digital healthcare revolution.

Since then we have seen about $50 billion invested in technologies that were essentially intended to help us manage chronic conditions across all populations of health.

But despite that level of investment, there are still gaps that are not being adequately addressed. Mental health and addiction assistance are two of them.

Why are those gaps still there?

Bob has an opinion. “It’s because we suck at engaging and interacting with people. I don’t care if you’re a provider or a health plan, you simply don’t know how to reach out and touch somebody in a way that doesn’t irritate them. You don’t elicit the level of participation from them that they need.”

Why End-Users Don’t Fully Engage in Healthcare

“The way healthcare has traditionally delivered its products,” Bob tells me, “ it does not provide any cognitive or behavioral value.

“In many cases, it only adds to anxiety, stress, and cognitive overload. Therefore, whether healthcare is delivered either in person or via technology, it reduces feelings of self-efficacy. That’s the short answer I can give about what is wrong with the way that healthcare providers engage with consumers.”

Lessons from Learning to Play the Piano

Why do healthcare providers fail to engage end-users to participate actively and effectively in their own care?

“Let’s say that a consumer has just been diagnosed with type 2 diabetes,” Bob says. “Let’s further say that you’re that consumer. You were just in the hospital, where you got diagnosed, and then you got released. Or maybe you just got diagnosed with asthma or heart disease.

“You go home, you’re frightened. You need guidance. But what happens next? You get told to come back to see the physician who diagnosed you, maybe in a month, or two months, or three. And when you go back, your appointment is squeezed into a little time slot. And you leave just as confused, and probably just as frightened, as you were when you first were diagnosed. You still aren’t sure what to do, much less when and why.

“Let’s compare that to the way a person learns how to play the piano. You first get an expert teacher, who sits with you. And they actually play and then they sit with you, and you play, and they correct you in that moment and you do it again in that moment, and then they watch you and then they meet again with you, and they watch you again and help you take corrective measures. It is  intimate and it is interactive.

“Now, let’s return to that situation in which you just found out you’re a type 2 diabetic. The doctor gave you instructions and now you’re on your own. No one is watching what you do. It makes no sense. Unless you are connecting the mind and the body, providing guidance and understanding on an intimate basis it is impossible to get patients to change their outlook or build their confidence and trust themselves and find themselves capable. They need help when they need it not when we want to provide it to them.

“If that physician is a top endocrinologist, he or she knows the things that a patient should do. But that physician is not there to explain what those behaviors are or to say to the patient, `I have seen you do what you need to do, and you have the knowledge and skills you need to succeed.”

The Wedding Planner Analogy

Bob offers another analogy, comparing planning a wedding to managing a health condition or disease.

“Imagine you’re planning a wedding and you go to a wedding planner who says, `Oh, no, I only do the first part of the wedding, what happens in the chapel. If you want a reception, you need another planner for that. You want flowers? You need a third wedding planner for that. And music? I don’t do that either.

“Yet this is precisely the structure we are told is acceptable in healthcare. You see a primary care doctor and then, maybe you are told you then need to see a cardiologist or a psychiatrist or an oncologist. You know how it works. And while it makes sense to have special teams, what you need is a digital, therapeutic or engagement program that integrates those experiences into a singular care experience for an individual., like what a real-world wedding planner does. He or she manages all these different experiences and makes it a single experience for you. And that is where we need to be going in the world of healthcare.”

ATM machines offer additional insights.

“People go to an ATM machine, and they stick in their little card,” Bob says. “And they enter their PIN, and they transact their business. They don’t have to get to know the bank, or understand where the cash is stored, or how it appears. Yet again, in the world of healthcare, people have been taught that they need to understand and manage all those separate processes.”

Capturing Important Data

Providers don’t own patients’ data. So how do they get those patients to provide it?

Bob says, “It’s actually extremely simple to do when you apply behavioral science to it. There are things you need to do to get someone to be reciprocal. The first is shared decision-making. The second is that you have to adjust to, and reflect, the lifestyle of the patient.”

Building Compliance to Care Routines

It is Bob Gold’s opinion that providers often have little understanding of why people listen to them or whether they will strictly follow their care recommendations. Why is that?

“Basically, you have to earn the right,” Bob says. “If you can get that individual to accept you as a credible source, which means that they believe you understand them, then all of a sudden they will take your recommendations to heart.

“But why do people continue adhering and taking part in their own recovery? It is because you are providing great content and great information that addresses their personal situation and needs. When people decide not to follow your recommendations any more, when they think what you are offering is not for them, that’s usually because you didn’t ask the right questions.

“They get into a position where they haven’t taken a medication in three months. But you keep sending reminders, you don’t understand them at all, because you have never asked about them. They think that you, as a provider, have no idea who they are.”

About Bob Gold

Bob Gold is Founder, CEO, and chief behavioral Technologist at GoMo Health (https://gomohealth.com/), an innovative New Jersey-based company that is a leader in designing, implementing, and marketing award-winning, personalized patient engagement solutions that support the continuum of care. Bob and his team have developed what they call Behavioral Rx®, which they describe as a scalable and cost-effective way that companies can use to engage with end-users that enables better self-management, healthy decisions, and improved outcomes.

Bob is one of the world’s leading behavioral technologists with more than 20 years applied research and development in the behavioral and cognitive science of human motivation, activation and resiliency; with a specialty in the human and social factors of individualized precision health digital therapies leading to increased activation of patients and clinicians in underserved vulnerable communities; both urban and rural. Follow Bob Gold on Linkedin, and if you are looking for a speaker for your next event (and The Digital Health Guy is already booked) have a look here.

You can read Bob’s full interview in The Digital Health Guy’s next book, “It Takes a Village“ coming soon!

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Digital Health Buzz! aims to be the destination of choice when it comes to what’s happening in the digital health world. We are not about news and views, but informative articles and thoughts to apply in your business.

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