Apps can be effective tools for helping patients better manage their health, but if an app fails to fully engage the patient, odds are the patient won’t use it as prescribed or at all.

Recognizing that solving the patient engagement puzzle plays a big role in the success of a healthcare app, Boston start-up Healthimation is combining digital animation, personal interaction and interactive learning to create a healthcare app aimed at keeping users interested and engaged for better managing diabetes.

Based on the Joslin Clinic’s Why Wait program for managing diabetes, Healthimation’s mobile app helps diabetes patients improve their overall health and lose weight by creating a fun and animated environment to guide them through the Why Wait program.

“Putting a structured medical program into an app is challenging, but creating an app that engages all the different user segments to prevent churn is equally as challenging,” says Seavey Bowdoin, CEO for Healthimation. “Engagement can’t just be achieved through the use of text and images.”

To give its app the stickiness needed to appeal to the wide range of diabetics likely to use it, Healthimation created an animated character named Lena that guides patients through the program and serves as a virtual companion on their journey.  As a character Lena is fit, but also funny, aspiration, and portrays emotions to which users can relate through facial expressions that celebrate a patient’s achievement or express concern when goals are not being met. She will also do the unexpected at times, such as remind the patient to weigh herself or ask the patient if she has eaten, to keep patients engaged, says Bowdoin.

Lena also guides diabetes patients through exercise programs, demonstrating the proper technique for each exercise. To ensure that Lena demonstrates proper form when doing each exercise, Healthimation wired exercise physiologists with body motion sensors as they performed each exercise and captured their movements in in three dimensional images. Lena’s character was then superimposed onto the 3D images. Exercise plans are personalized to a patient’s physical needs and conditioning.

Nutrition plans are tailored to a patient’s food preferences to establish healthy eating habits to help them lose weight and keep it off. Patients are also paired with a certified, personal health coach with which they can chat individually through the app and as part of a group session. Each coach manages a group of 15 patients.

The idea for adapting Why Wait to a healthcare app grew out of Bowdoin’s experience as a Type 2 diabetes patient at Boston’s Joslin Clinic, which is an affiliate of Harvard Medical School. After successfully completing the Why Wait program, Bowdoin approached his physician Dr. Osama Hamdy, who is also the medical director of the obesity clinical program at Joslin Diabetes Center and an associate professor of medicine at Harvard Medical School, about developing an app around Why Wait. Type 2 diabetes is a chronic condition that may be reversed through diet, exercise, and lifestyle changes.

“The Why Wait program has 12 years of clinical evidence that it works and I thought why not find a way to make it accessible to people outside the Joslin Clinic,” says Bowdoin a former executive with Warner Brothers Interactive Entertainment division.

Currently, several health systems—Atrius Health, UMass Memorial Health Care—and Boston Children’s Hopsital are using Healthimation’s Why Wait app. The company is also in discussions with insurance carriers and employers about making its app available. Arabic and Chinese language versions of the app are also being tested in Dubai and China, respectively, the company says.

Healthimation charges patients $49.99 a month to use the app, however, some insurers have shown a willingness to cover the cost of the app in trials, Bowdoin says. The company is also talking to insurance carriers about including coverage for the app in their plans.

Down the road, Healthimation plans to enhance the Why Wait app’s engagement capabilities by creating storylines for Lena outside diabetes management. One potential storyline involves casting the character as a film noir detective that interacts with users to solve a mystery. “Going outside the normal parameters of a health app to infuse entertainment helps develop more affinity for the app and trust in using it,” Bowdoin says.

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