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Engage Consumers July 14, 2016

Innovation Diffusion: A Mental Model for Increasing Digital Health Retention

Founder & CEO, Yogatailor
Key Takeaway
Personalized suggestions + timely, contextual triggers will create an engaged #digitalhealth user  -  @rameshdot0

Ramesh Padala is the Palo Alto-based founder and CEO of yogatailor.com, a personalized yoga & therapy app that creates customized programs based on the user’s ability and needs. It acts on scenarios like "I am a beginner; I want to sleep better and increase flexibility" and is now available on iOS, Android, and desktop platforms. Previously, Padala was the VP of Product & Growth at Saavn, the Spotify for India where he worked on improving engagement and retention of users. Here he shares ideas for increasing engagement of digital health platforms:

About 40% of actions we take daily are out of sheer habit. Everything from brushing your teeth, to taking the dog for a walk to driving to work to turning the TV on at 7:37 pm every day. And nowadays, a lot of these habits are technology-induced — we are all guilty of checking email every few minutes. We tap on that blue icon on our phones to see how many of our friends liked our latest photos or funny comments about world matters. In fact, you probably checked your email by the time you finished this paragraph!

About 40% of actions we take daily are out of sheer habit.

The apps that have managed to become habitual sit on our home screens. They get engagement and retention off the charts. Imagine if we can get the same engagement for our digital health apps! That means we get the user to get habituated with a health habit, something she will do every day, hopefully multiple times a day, thus improving the outcomes from our platform.

B = M * A * T

Behavioral Change requires 3 things : motivation, ability, and trigger , according to  Dr. B.J. Fogg of Stanford's Persuasive Technology Lab.

Key takeaway: For a behavior to occur, three things needs to happen simultaneously  - Motivation, Ability, and Trigger.



This is the aspect we can least control. This is something either the user feels or does not. For example, a user might be motivated by their chronic back pain or inability to control his weight. There are various types of motivations but Dr. Fogg categorizes them as Sensation (pleasure/pain), Anticipation(hope/fear), and Belonging (acceptance/rejection).

Even though we cannot influence the motivations of our users, if we can predict the peaks of their motivation levels, we can have them take some very hard actions which they typically would not. For example, in a weight loss app, if we can somehow predict the exact time when the user is really feeling motivated about weight loss and can trigger an action, there’s a very high chance that they would do something they would postpone at some other time.

Key takeaway: Users will do very hard actions when their motivations are very high.



This is a pretty simple one : the user needs to be able to do the action that is being recommended. Even though it’s simple, we often overlook this. We tend to overdesign our apps, add tons of features and forget about the actual user. For example, a novice yoga practitioner might not be able to practice an advanced stretch recommended by a fitness app. Worse, it might actually hurt them.

We tend to overdesign our apps, add tons of features, and forget about the actual user. - Yogatailor CEO Ramesh Padala

Another example is the timing of an interaction. If a user is at an office all day, it might be hard for them to make freshly squeezed orange juice for an afternoon snack ,  but we have weight loss apps that make exactly those kind of suggestions.

Key takeaway: Actions recommended to the user should be doable by the user at the time they are suggested. Personalization is not a good-to-have, it’s an absolute must-have.



Triggers are cues, call to actions, prompts, etc that get the user to take an action. There are two types of triggers :  external triggers, for example an alarm, and internal triggers, for example the user sees something in the app and that triggers an action.

In terms of a digital health solution, you have many ways to trigger actions : a beep on a wearable, an email, a notification on the phone, a phone call, a whatsapp message, a visual cue within the app, and more. It’s important to design and implement triggers that are time-sensitive, contextual, and relevant to the user.

An example of a good trigger is a reminder to take a med, along with the right dosage, at the right time. Also note that a user’s interaction with your app does not stop with the first action. Engaging the user involves the user taking a series of actions. Design the triggers that make them move through this sequence of actions.

Key takeaway : Triggers are the most important aspect in engaging and retaining your users.

The mental model that Dr. Fogg sets forth to induce a behavior is very useful to consider for those of us developing digital health apps and platforms. By creating apps that use data to predict motivation and ability and then trigger actions through the appropriate medium, we can create habits in our users. And these habits will lead to better health outcomes.

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