The Activity Exchange: Adding doctor-patient accountability to the mobile health solution

By Carmel DeAmicis , written on June 24, 2014

From The News Desk

Telemedicine is growing up before our eyes, as a crop of new companies try to answer the question: How do you scale your doctor?

Entrepreneurs are tackling the problem from all sides. There’s video conferencing companies like Doctor on Demand or myMD that aim to make it easier for doctors to interact remotely with patients. There’s technological advances in image capturing allowing doctors to diagnose from afar, like TRUE-See which color corrects medical images so that doctors can safely make medical judgments without seeing a patient in person.

One of the newest entrants into the space is an under-the-radar company called The Activity Exchange, which offers a Web application for consumers to track the growing number of health and fitness apps they use. When they register, user are prompted to link from a lengthy list of options: Movement trackers like Fitbit or Moves; social apps for gym checkins like Facebook or Foursquare; medical apps for more obscure needs like “EyeDROPS” for tracking your eye meds; “Water Habit” for tracking your water intake; the list goes on.

The goal of The Activity Exchange is to be the aggregating platform of health tech – the place where all the data analysis comes together to ensure the consumer is staying on track with their goals. Furthermore, it’s supposed to provide a portal for the patient’s doctor to track their progress and to communicate round their efforts.

“You break a relationship with an app and move to a different app, but your provider can see that transition, it can see you’ve dropped certain things,” Nasch says. “Your doctor can send you a note saying, ‘Why are you no longer doing your ten minute walk?”

On the surface The Activity Exchange seems somewhat ill-conceived given the trends in mobile. After all, isn’t it common knowledge that the modern consumer views apps as individual portals? That theory is motivating Facebook and others to move toward discrete applications for individual use cases. As Zuckerberg told The New York Times, “[T]he real estate is so small. In mobile there’s a big premium on creating single-purpose first-class experiences.”

So if consumers look for individual apps to meet specific needs, aggregating them all in one place seems to be a step in the wrong direction. Are people really going to log into The Activity Exchange to see exactly how poorly they’ve done keeping up with their goals? Isn’t that one more nagging voice?

At the moment, it doesn’t matter what consumers think of the product. Nasch claims that insurance companies — not consumers — are the ones that will be paying for the service, and they’re intrigued by the possibility – at least initially. One — Humana — has already signed up for a trial run. If insurers can improve their patients’ health in a preventative way, they save money. And insurance companies see promise in fitness and health apps, but they believe the missing piece is the doctor, overseeing and governing all such activity.

“It’s not a health problem, it’s a marketing problem,” Nasch says. It’s the equivalent of your doctor sitting on your shoulder, giving you a poke whenever you start to slack. “To move the needle you’ve got to be there in a subtle way, continuously. It has to be tailored to the consumer.”

She believes a lot of preventative health management comes down to a communication problem. As an example she cited the nuances around telling someone who is chronically ill that they’re being lazy and need to work harder without offending them. It all comes down to language and rewards systems. Activity Exchange has already learned some key lessons along the way.

“The notion of a dashboard was super helpful for people managing chronic conditions with a lot of medications,” Nasch says. “It’s like having a little health concierge. Some people are on it five times a day.”

Furthermore, The Activity Exchange has gamification elements with rewards, like getting a $50 Visa card, for meeting certain goals. “We give information in a way a consumer would engage with it,” Nasch says. And, when necessary, they bribe you.

UPenn has been running a clinical trial comparing patients who use The Activity Exchange versus those who don’t. “We have a population already on the system working more than a year across various attributes: exercise, weight loss, all of the above,” Nasch says. The results won’t be released for a few weeks, but Nasch claims the preliminary data looks good.

If she’s right, Activity Exchange could be another compelling answer to the challenge of scaling medical care beyond the clinic. But like so many other things, just because it's good for us, doesn't mean we have to like it.

[illustration by Brad Jonas for Pando]