Five Reasons why you need to use Digital Exercise Prescription Software

In this post we explore the benefits that digital products give us as clinicians and more importantly how they improve the service we deliver. 

A former Exercise Rehabilitation Instructor (ERI) in the Royal Air Force (RAF). He went on to compete for Great Britain in Modern Pentathlon. He is now an RAF Training Officer. As the CTO he leads the engineering team at Rehab Guru.

Simon Taylor - Rehab Guru Co-Founder

Photocopy vs digital

Stickmen, Photocopies or Digital Beauty?

Exer­cise pro­grams come in a num­ber of guis­es, rang­ing from hand-drawn stick­men to high def­i­n­i­tion video and smart­phone apps. Most clin­i­cians uphold the belief that exer­cise offers tremen­dous ben­e­fit in address­ing the root cause of pain and alle­vi­at­ing patient symp­toms. Giv­en this poten­tial, you would expect great care and atten­tion in the cre­ation of the coach­ing, mon­i­tor­ing and review­ing of an exer­cise pre­scrip­tion. How­ev­er, this is not the case. Hand-drawn or over­ly pho­to­copied gener­ic exer­cise pro­grammes are still the medi­um of choice to pre­scribe exer­cise. They are unin­spir­ing and do not encour­age patient advo­ca­cy reduc­ing any impact on an individual’s state of health between appoint­ments. It also presents missed oppor­tu­ni­ties for the clin­ic to project a pro­fes­sion­al image; change behav­iours and beliefs; recoup valu­able time, and most impor­tant­ly make peo­ple better.

Beautifully digital

Getting patients to believe in exercise prescriptions

Believe it or not, clin­i­cians are sales­peo­ple too. They must sell exer­cise as a treat­ment. This is hard when patients desire a quick-fix such as a quick manip­u­la­tion, mas­sage or piece of colour­ful tape.

Exer­cise is not the mag­ic wand they crave so the ben­e­fits must be pitched to the client for them to realise its worth for them­selves. Only then they will pos­sess the moti­va­tion to do any more than a sin­gle ses­sion. When peo­ple are asked to pay for some­thing and expend ener­gy in the process, they must see it’s worth before part­ing with their hard earned cash.

Belief, the trust, faith, or con­fi­dence in (some­one or some­thing) — Oxford Dictionary

Unless a patient/​client buys into the ben­e­fits of a pro­gram, they are unlike­ly to com­ply with instruc­tions, regard­less of its impor­tance. In a sim­i­lar vein, there is evi­dence of peo­ple not tak­ing med­ica­tion to treat ill­ness­es (The Prob­lem of Non-com­pli­ance with Drug Ther­a­py). If cer­tain parts of soci­ety are unwill­ing to com­ply with a pre­scrip­tion of antibi­otics, how can we expect them to adhere to an exer­cise pre­scrip­tion which lacks their advo­ca­cy? It’s much eas­i­er to believe in some­thing if it’s per­ceived to be of high qual­i­ty. Com­pare the pro­grammes in the image above. Which is a client going to believe in?

Iphones removebg

Selling Exercise Like Apple sell iPhones

Our patients/​clients are sus­cep­ti­ble to the same deter­mi­na­tion of qual­i­ty by how it looks’ and the brand it rep­re­sents as they would be in oth­er areas of their lives. We see this in com­mer­cial prod­ucts from com­pa­nies such as Apple, BMW and Rolex. What exact­ly makes them so desir­able? I would argue, it is the emo­tion­al con­nec­tion such prod­ucts gen­er­ate, either through what they stand for (i.e. suc­cess, sta­tus, her­itage) or their build qual­i­ty and price. (Undoubt­ed­ly, con­sumers attribute the qual­i­ty of some­thing by its price tag). Tak­ing for­ward the notion that clin­i­cians are in the busi­ness of sales, is it pos­si­ble to gen­er­ate a deep-seat­ed desire in clients to buy prod­ucts, which essen­tial­ly mean com­ply­ing with a treat­ment plan?

First­ly, we can gain much infor­ma­tion from the mar­ket­ing strat­e­gy of the brands above. If your patient/​client attrib­ut­es the qual­i­ty of some­thing by how it looks, then what do they think of a scrap of paper with a stick-man drawn on it? Do such hand-drawn pieces of paper instil in a patient a feel­ing of being val­ued’? Put sim­ply, if at the end of the con­sul­ta­tion the patient was offered two prod­ucts to take home, would they pre­fer the hand-drawn stick men or a pro­fes­sion­al­ly brand­ed, full colour, mul­ti-pho­to exer­cise guide with the option to view videos of each exer­cise on their smart­phone and track their progress?

Success image

Setting the conditions for success

Sec­ond­ly, there is set­ting up patients for suc­cess. A poor­ly per­formed exer­cise may not cause injury, but it’s not opti­mal. We need to squeeze every ounce of ben­e­fit from each piece of effort our client is will­ing to spend on our prod­uct. In my day job, I work in avi­a­tion train­ing where we reg­u­lar­ly dis­cuss fideli­ty: how close to real life a sim­u­la­tor or train­ing event is. We can apply this same con­cept to our exer­cise pro­gram­ming. How real’ are pho­to­copies or car­toon illus­tra­tions? Patients often strug­gle to trans­late the mean­ing of an illus­tra­tion or poor­ly print­ed pic­ture. Ques­tions arise from this lack of clar­i­ty, such as, how fast, how far, which direc­tion, hand/​foot posi­tion etc. All of these ques­tions can be answered by watch­ing a sim­ple five-sec­ond video clip. In such a video the mod­el exhibits per­fect form, and the patient can imme­di­ate­ly relate to the exer­cise. As a result, the patient has a much high­er chance of recre­at­ing the cor­rect pos­ture when attempt­ing the move­ment.

The ide­al sit­u­a­tion is to have a clin­i­cian coach­ing them in real-time. How­ev­er, this is not pos­si­ble, so a video pro­vides an ide­al medi­um to bring a high­er fideli­ty expe­ri­ence to our patients. It ensures they fol­low the cor­rect instruc­tions and get the most val­ue from the exer­cise prescription.

A brand for a com­pa­ny is like a rep­u­ta­tion for a per­son. You earn rep­u­ta­tion by try­ing to do hard things well.” — Jeff Bezos

Next, let’s look at brand­ing. We’ve already cov­ered the qual­i­ty of the images and video in our exer­cise pro­gram, ensur­ing clear direc­tion for the patient, so why does brand­ing have a place in this list?

Here we focus our atten­tion on the business/​corporate image we project through our prod­ucts and ser­vices. A patient’s expe­ri­ence under care has a direct effect on how much they buy-in to their treat­ment plan. While in con­trol of this with­in a clin­i­cal set­ting, it is often lost the moment the patient departs. We rarely have the oppor­tu­ni­ty to project a pro­fes­sion­al image of a busi­ness beyond the clin­i­cal set­ting. There is, of course, social media, blog­ging and adver­tis­ing but these take time and mon­ey to do well to gen­er­ate mean­ing­ful cus­tomer-loy­al­ty. Refer­ring back to our sales anal­o­gy, if we can pro­vide an excel­lent patient expe­ri­ence before, dur­ing and after our con­sul­ta­tions, we are elon­gat­ing their expo­sure to our ser­vices and in-turn cre­at­ing advo­cates for busi­ness­es. The ben­e­fits of this are two-fold:

1. Patients/​clients are like­ly to believe in you and will work for you. Akin to a trans­for­ma­tion­al lead­er­ship mod­el, patients repay your invest­ment by putting effort into the exer­cise plan and loy­al­ty to your prac­tice.

2. Cre­at­ing brand ambas­sadors who are hap­py to rec­om­mend your ser­vice. The pos­i­tive expe­ri­ence they share is invalu­able; some­thing you can­not cre­ate through tra­di­tion­al mar­ket­ing means.

To sum­marise this sec­tion, brand­ing is essen­tial in the pro­jec­tion of the qual­i­ty of ser­vices. To deliv­er a pre­mi­um prod­uct, it must look the part.

51n JG Cmk BML SL500

How we can drive engagement in our prescriptions

Last­ly, we’ll cov­er engage­ment. How can we ensure it with an exer­cise pro­gram and encour­age healthy habits? It’s inter­est­ing that I’m draw­ing upon my role as a founder of Rehab Guru, rather than my back­ground as a clin­i­cian for this last point. For it is our soft­ware that must eas­i­ly engage users espe­cial­ly when new prod­ucts, and their asso­ci­at­ed guides, can be chal­leng­ing. The soft­ware has to have a form of stick­i­ness’ to dri­ve engagement. 

The user needs to under­stand the ben­e­fits and advan­tages quick­ly. As a ser­vice, if we are unable to cre­ate an engag­ing expe­ri­ence, then our cus­tomers don’t hang around long enough to see the ben­e­fits. Our time, atten­tion and ener­gy are valu­able, so ser­vices need to be acces­si­ble and engag­ing from the out­set. If we do not receive a reward for our invest­ment, then we give it up. 

If the give and take’ bal­ance is suc­cess­ful then new habits are formed, but what can we offer in return for someone’s time and ener­gy? Social media’s drug of choice is dopamine, and Net­flix has the binge-watch induc­ing cliffhang­er. Such behav­iour manip­u­la­tion tech­niques aren’t coin­ci­den­tal; they are care­ful­ly researched strate­gies to keep peo­ple hooked. Indeed, a fas­ci­nat­ing book on the sub­ject goes by this very title, Hooked — How to Build Habit-Form­ing Prod­ucts” by Nir Eyal

Adult arm art 326559

Is it ethical to sell lifestyle drugs, like exercise?

There are undoubt­ed­ly eth­i­cal con­sid­er­a­tions when attempt­ing to make prod­ucts and ser­vices as sticky and habit induc­ing as pos­si­ble. As ther­a­pists, we aim to offer healthy habit-form­ing prod­ucts in the form of exer­cise pre­scrip­tion and advice in an all-encom­pass­ing treat­ment pack­age to aid recov­ery. As dis­cussed pre­vi­ous­ly, a writ­ten pre­scrip­tion doesn’t mag­i­cal­ly ini­ti­ate com­pli­ance; there needs to be an inner-dri­ve and moti­va­tion on the patient’s behalf to take own­er­ship of their reha­bil­i­ta­tion. While many patients seek med­ical help in the pur­suit of being fixed’, it is often not with­in our gift to fix them’ with­out the mutu­al under­stand­ing that you’re in it together. 

We need them to com­ply with our pre­scrip­tion, which is why we must do all we can to form new habits to aid recov­ery. There are numer­ous tech­niques for this, includ­ing goal set­ting, reminders, activ­i­ty mon­i­tor­ing, moti­va­tion­al mes­sages, jour­nal­ing, time accu­mu­la­tion, chain­ing (main­tain­ing a work­out streak), social out­reach, com­mu­ni­ca­tion, col­lab­o­ra­tion and com­mu­ni­ty. Div­ing into each of these is beyond the scope of this post; how­ev­er, what con­nects every sin­gle one is the abil­i­ty of dig­i­tal’ to make them possible. 

Love them or loathe them, smart­phones, tablets and com­put­ers have changed almost every inter­ac­tion we have with the world, and their util­i­ty to health­care is no dif­fer­ent. To have any hope of cre­at­ing new habits in our lives nowa­days, we must lever­age dig­i­tal media. Whether that is using a smart­phone to cre­ate rich and engag­ing pro­grams in real time or get­ting patients using their phones to exploit the advan­tages it gives them, such as moti­va­tion­al reminders activ­i­ty track­ing etc.

Allready mobile healthcare

Summary

It’s evi­dent that as the founder of an exer­cise pre­scrip­tion ser­vice, accu­sa­tions of bias have their place. How­ev­er, I hope this post man­ages to high­light just a hand­ful of the many ben­e­fits of using dig­i­tal exer­cise pre­scrip­tion tools bring. The bar­ri­er of entry to improv­ing exer­cise pre­scrip­tion is low, yet the rewards can be high. From a cor­po­rate iden­ti­ty per­spec­tive, using pro­fes­sion­al tools to deliv­er a ser­vice is imper­a­tive to project the right image to the world. Today, busi­ness­es are judged con­tin­u­al­ly by cus­tomers. We can do much bet­ter than have them leave the clin­ic with a scrap of paper with a stick man drawn on it!