I’m going to respond to the response from @minthealth , because I patient motivation is important, and we should try to get to the truth behind it. I did participate in some offline discussion as an advisor to my friend, who writes for Harvard Business Review. He wanted to discuss the important problem of motivating healthier behavior. It seemed to me that this was difficult because MintHealth was only interested in promoting a particular point of view that would sell tokens. A number of things in the Minthealth white paper caused me to believe that MintHealth is more interested in selling tokens than in uncovering the truth about behavioral incentives.
- A claim that MintHealth has a unique approach that will “unify the medical marketplace”. I looked at a number of projects that are taking a very similar approach (Medicalchain, Healthcoin, Hearthy) and I am sure that Ed Bukstel found more among the 42 medical records ICO’s that are currently running. I have personally interviewed teams from 9 different (failed) personal health record projects, including ones from Google and Microsoft, and various “wellness” programs, so there is a long history of these schemes prior to the blockchain fad. And, the big health care players have not yet gotten into the act with their blockchain-oriented projects. Patients will only have the bandwidth to deal with one of these systems.
- Frequent use of the word “blockchain blockchain blockchain” to describe architecture that is clearly not blockchain. Many of the other projects are more straightforward, as they are proposing blockchain architectures.
- A claim, which seems ridiculous to me, that patients will want to use ERC20 tokens for their incentive points. If you actually try handling these tokens with your grandmother, it will quickly become obvious why only a tiny percentage of the population handles them. The population that receives medical services tends to be too young, too old, or too sick even for simpler mobile approaches. There is a related claim that token points (AKA Vidamints) will be as effective as actual money. There is already a weak link between financial incentives paid in REAL MONEY and patient behavior. This proposal takes even more value out of that link by forcing people to use a closed system of crypto-tokens.
- The oxymoronic claim that a company which is promoting “financial incentives” has an expert approach to behavioral motivation. In the articles that I looked at, peer pressure, social pressure, and gamification (which do not require asset tokens) had more impact than financial incentives. We may make progress on the hard task of getting people to accept good health advice, but it probably won’t be with small financial incentives. Samir is aware of this problem, as he writes “a growing body of literature has shown that social and financial incentives, along with gamification can drive healthier habits.” Notice how he circles around “financial incentives” with the more impactful “social” and “gamification”.
I read through many of the research links that Samir sent over. Given that these links were cherrypicked to demonstrate the value of financial incentives, I was impressed by how weak that link is, and how often it has to be supplemented with peer pressure and social pressure in order to be effective. The Kullgren paper showed the opposite of what MintHealth claims, with financial incentives yielding a weak result, and a social game giving a stronger result. A table of results is here. It shows that when you work with a group of people who are quite fat, but motivated to show up for a diet program, and offer them $100 per month, after 36 weeks the ones that remain in the program have a weight loss of … 1.7 pounds. Samir sometimes changes the subject to “value based care”, which is a doctor incentive scheme, not a patient incentive scheme. It’s notable that payers and employer wellness programs have tried many bonus and discount plans over the past twenty years and measured the ROI. Are payers represented in the list of MintHealth supporters? That would be a key proof point that I have not seen yet.
There are wellness products already in the market which already do a lot of the things that MintHealth claims they want to do, but in a more straightforward way. For example, b.well has payer sponsorship, a personal health record, and expanding group of related health services, incentive points with gamification and rewards, and proven ROI. They do this all with a mobile app and a normal database. One of their advantages is that they focus on results for patients and payers, not making claims about blockchain tokens.