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Health assessments and coaching for the digital age

with Mat Griffiths, Product Manager, UX Designer at LiveSmart

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Knowing what’s going on in your body is essential to making the right decisions when it comes to your health and wellness.

But getting hold of information about your health can be a struggle - not to mention expensive! And when you do finally receive your data it can be baffling to make sense of it all.

Based in London, LiveSmart is a digital health platform that’s set out to make health assessments simple, accessible and actionable. Combining blood tests, online health reports and remote one-to-one coaching, LiveSmart uses a blend of technology, people power and behavioural change techniques to help people improve their health and wellness.

Joining us on this episode of HealthRedesigned is Mat Griffiths Product Manager and UX Designer at LiveSmart.

Why does LiveSmart exist? What problem are you solving?

LiveSmart is a digital health service that provides a health assessment with a health coaching program and is proven to make a difference to people’s health. So the problem that we’re solving is that the National Health Service in the UK could be better described as the National Disease Service - it’s there for you if you have a problem, for example if you have developed cardiovascular disease, whereas you use LiveSmart if you never want to get to that point where you have cardiovascular disease.

We provide a health screening where we carry out blood tests along with a lifestyle assessment where we look at your internal health and how your lifestyle is contributing to that. Through the app we give you loads of information that gives you a pretty much complete picture of your internal health, and then off the back of that you go into a coaching program where our health coaches are there to support you and to facilitate change so you can avoid chronic disease.

My part in that is as the product manager and UX lead is that I look at the research of how our customers interpret results, all the way through to how can the digital service help people change their behavior in a supportive and convenient way.

How do the blood tests work?

There are three options for the blood test. The first option is the home kit. It’s pretty popular and is the most convenient option. It comes to you sent through the mail, then you put your blood into some tubes and send that off to the lab. The second way is that we can send a nurse out to you, she or he can come to your office or your home wherever is the most convenient and then they’ll take your blood right there. The third and final way is that you can go to a clinic and they will take care of the blood from there. The most popular option is a nurse going into people’s offices to do blood collections we can do it for 30 to 50 people at a time in a morning.

Once you’ve sent off the blood kit you receive a health assessment which breaks down multiple variables in your health. How does that work?

The blood sample that you take goes to a lab where they process the results, that then goes to a doctor who writes notes and recommendations. These recommendations go over to a dietician who puts that in context for what that could mean to you on an everyday basis. And then finally, once the lab and the doctor and the dietician have written their notes, the user gets a notification saying that their health report is ready. They can then open their iOS or Android app or they can go online and look at it in a browser. And there is a treasure trove of information personalized about their health.

“We've done a lot of work and a lot of research into how people interpret their health results to try and make it insightful without being overwhelming and in-depth but simple enough so that they know what to do next.”

How do you help people to navigate this information?

One of our design principles that we use for the health report is - give just enough information and then offer more. So whenever you are looking through the results it should feel really natural, like an executive summary of different types of cholesterol and what they mean, but then also offer drill-down information on exactly what you can do about it. Our bodies are incredibly complex and explaining it in a simple way is quite a feat but that’s what we’ve set out to do.

So you give people actions to enable them to start taking control of their health?

Yeah absolutely. We give people three steps that they can take, and what we found almost by accident really, is that without those three simple steps our customers have felt like it’s an overwhelming amount of information and there’s no focus on how to put things right. So it is a really crucial part of our report that it’s boiled down to just three things that you can do right now. Our customers feel more in control and less anxious about the whole thing because they take some action right away.

For certain users it’s going to be a very overwhelming experience just to receive the results themselves. How do you deal with that?

We do have quite a broad range of use cases for the health assessment and health coaching. And for those that may have buried their head in the sand it can be quite an intense 20 minutes of their lives. And I’ve sat through some of those 20 minutes sessions with people just one-on-one while they get their health assessment. It’s intense, they’re taking in some pretty heavy information about themselves. It’s the kind of thing that you have to be there really to empathize properly and really understand what they’re going through.

When you provide people with an intelligible way to navigate their health. Does their behaviour change?

Definitely. I haven’t sat with anyone who’s got their health report and hasn’t felt a whole cocktail of anxiousness. Anxiety is probably a good way to explain it because there is a big reveal in the moment that you get your health report, especially if you’ve never had a health test before. What tends to happen is that people identify with at least a couple of things that come up in the report - maybe it’s a vitamin deficiency, often it’s high cholesterol and for people that are under 30 and have a high cholesterol and that is a cause of concern. Understandably and they want to figure out how to change that, so the Health Report really is a great tool to move people on in their attitude towards changing their lifestyle. Some people are actively wanting to change and the health assessments are a platform to do that. But for other people it comes as a surprise and then that moves them through the stages of change.

You pair the people that have done this health assessment with coaches that can help them to keep on track. What is the role of the coach and how does that interplay work between the technology the customer and the coach?

The app and the information that we give along with the three next steps that you can take is never going to be as powerful a tool as a coaching program. A coach can understand your life, what factors are going on, what’s stopping you from change and help you set better goals with a deeper understanding of who you are and what you can and can’t do which the app can’t do. So the health coaches are really the behavior change part of that. To guide people into the health coaching we put invitations from the health coach in easy places throughout the app. If your cholesterol levels are out of range, right next to that result there’s an invitation from your health coach who can speak to you tomorrow or the day after. You can either accept that invitation or pick another time. We’ve tried to make it as seamless as possible so it just all flows on from each other. Once you get your health assessment it then feels really natural to start speaking to your health coach.

The interplay between the coaches and the technology is fascinating because one augments the other.

Yeah absolutely it’s all woven into each other. When you finish your first health coaching call for example, normally the coaches try and nudge people to set three goals which takes 10 to 15 minutes at the end of the conversation. Then after your health coach will write up the notes and put in the goals, how confident you are about them and what your barriers to achieving them are. Then through the app you get a notification and your to-do list updates with these goals along with a summary of what you spoke about and an invitation to book your next health coaching call. The coaching and the web app are one thing working together and they play different roles but they’re connected.

What role have you played in the design between the coaching, the web app and the brand in general?

When I started it was my personal mission to bring a greater sense of collaboration to the company and also improve how we were doing user research. So one thing that we’ve done really well in the past year and a half is collaborating or facilitating collaboration between the design team and the medical team and really bringing design-thinking to the to the core of how everyone’s making decisions and how we’re all approaching problems.

“Combining that amount of collaboration and user research helps us. You can't mess it up if you have those two things right. ”

Do you have a personal story about someone that’s gone through the LiveSmart process?

Yeah. The one that springs to mind, and I have her permission to talk about this, is a lady called Jo. She was in her mid 30s when she had her first health assessment and she was just about to go on holiday. And the report came back with a warning on it saying that she was prediabetic. She went on her holiday and she didn’t tell her husband. But when she came back she followed up with her GP and he confirmed that she was in fact prediabetic, she needed to immediately make changes to her lifestyle. Fast forward past the health coaching and she’s lost three stone and she’s out of the prediabetic phase and she looks amazing.

How does LiveSmart for businesses work?

So far we’ve talked about how we can serve individuals and that’s absolutely how we treat employees or I prefer to call them professionals. So we treat all the professionals just as normal people but we take their data and anonymise it and then we can give it back to the employer so they can see from a data perspective what well-being initiatives are right for the company to take. And without that kind of data HR managers or CEOs are just stabbing in the dark about what they think would be good for people. We have done blood screens for Universal Music Group and we found, I can’t quote the exact number, but it was something around 70 percent of their employees had a vitamin D deficiency. So then in that case it makes sense for them to roll out an initiative where they either give employees vitamin D tablets for free or massively discount them.

Yeah and we can look at it in so many different ways as well. I don’t know if you’re familiar with Tableau? It’s a data reporting tool where you can pull out all sorts of information and find trends. So yeah there’s loads of fascinating stuff that you can find out about people and we do that for companies as well. We do custom reporting so they can drill-down into the details of what’s going on. In regards to privacy and security, we have really strict rules around what the population size needs to be before we give analytics back to employers so that no one can be personally identified.

How else do you address privacy concerns at LiveSmart?

To log into our app for example you have to authenticate every time you open it and you can do that using a PIN code, email address, multi-factor authentication which is recommended and then you can also do face I.D. and touch I.D. So for a start up of our size that’s pretty maxed out on security in terms of how authentication goes.

What’s the broader mission and purpose of the company?

We want to help people optimize their well-being. Everyone has different goals that they’re trying to achieve. Some people might want to feel better or some people might want to lose weight so optimal is different for everyone. That’s really our mission right there.

So by saying optimal is different for everyone. Is the real onus on personalization?

Yes and the more that I personally learn about what’s good and what’s not good for people the more I realize that everyone’s different. The only way is to help people figure out what their optimal is and help them get there.

Talking of tracking and measuring our bodies to improve them. Where do you see this kind of space going?

If we’re talking about quantified self. The space has changed a lot in the past six, seven years - definitely since I first started getting into it. It’s in a whole different place now, it’s way more accessible and way more people are doing it. Although they might not call it quantified self themselves, they’re doing some sort of tracking. And if you look at the reasons for that, why more people are doing it than ever before, and why people like you or me can do it a lot more than we used to be able to, is because technology is getting way smaller and cheaper. I did a presentation on this the other day where I showed what an accelerometer used to look like in the 80s and what an accelerometer looks like now. Now they are a quarter of the size of a 10p coin but they used to be these giant things that measured earth earthquakes. So there’s a huge reduction in size and also in costs. You can buy an accelerometer on the web now for less than a pound. There’s also social factors that have been changing, well-being is higher on the agenda than it ever has been. The UK government now bakes in well-being into policymaking. So you’ve got technological, economic and social factors all moving towards making it easier to track and understand yourself and I think it’s going to keep happening that way. Those trends are going to keep moving and it’ll be easier to understand more about ourselves.

It’s incredible how far we’ve come in such a short period of time. But it enables us to do these cool things right? I am wearing a continual heart rate tracker on my wrist and it cost me less than £30. It tracks my heart rate every minute throughout the day and the battery life asked lasts for eight days. It’s incredible.

It’s incredible that you can have this thing on your wrist which is able to tell you so much about your body.

Yeah and I think the cool thing with wearables and where we are now, speaking more broadly, is that our health and our well-being is really complex and has lots of different parts to it. You’ve got lifestyle factors like sleep, nutrition, exercise as well as social and financial factors. There’s a big wheel of things that are part of this complicated system of our well-being and by making it easier to access and understand all these different parts. We can start to put more pieces of the puzzle together and then aggregate them all into one place. That’s really what I’ve been trying to do over the past seven years.

Where LiveSmart is playing a key role is making this information accessible and relatable and finally actionable which is exactly where we should be going.

Yeah that’s really the thing that’s missing from a lot of the Quantified Self apps that are out there. They’re just there to be the data layer, they’re just information, and it’s up to you to what you do with that information. That’s fine for some power users, but it is quite a niche set of people that are into that. I think most people really need their hand held and need something that’s thoughtful and considered to help them understand and improve.

What is LiveSmart up to next?

We are releasing a huge product update we’ve got some high impact features that are coming up notably a much better health risks prediction tool so we can more accurately and in a more useful way show people’s health risks and what and what they can do about it.

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