The datacenter ecosystem spans seven layers, from storage and networking hardware at the top to network service providers at the bottom. We mapped the full supply chain into a single reference, covering the companies that design, build, deploy, operate, connect, and manage datacenter infrastructure globally. The complete datacenter ecosystem map is below.

The datacenter industry is in the middle of the largest infrastructure buildout in modern history, and the supply chain behind it is far more complex than most people in the industry give it credit for.

I've spent 20+ years working with companies across this ecosystem. The thing that consistently surprises me is how compartmentalized the knowledge is. A hardware vendor with deep expertise in their own category often has no structured view of the integrators recommending their products, the MSPs managing the environments those products end up in, or the operators expanding capacity in their target markets. The same is true in reverse. Operators know their tenants and power contracts but rarely have a complete picture of the software, service providers, and interconnection platforms running inside their own facilities.

We kept running into this problem in our own client work. Every new go-to-market engagement started with weeks of manual research just to establish who the relevant players were across the supply chain. Industry reports and analyst research cover individual segments well, but nothing connected the layers into a single view.

We decided to build that view ourselves.

What the Datacenter Ecosystem Map Covers

The datacenter ecosystem map covers seven layers:

- Storage and Networking Appliances including switching, routing, security, optical transport, wireless, storage hardware, and test and monitoring vendors
- AI Hardware and Cloud including silicon companies, server OEMs, and cloud platforms
- AI Datacenter Software including DCIM, monitoring, cybersecurity, IT service management, asset management, and power management tools
- System Integrators and Service Providers including global and regional system integrators, technology solution distributors, and managed service providers
- Datacenter Operators and Colocation Platforms including major operators and regional and specialized facilities
- Interconnection and Fabric Providers including internet exchanges and network fabric platforms
- Network Service Providers including carriers, fiber operators, and global backbone providers

Every company on the map was selected based on their active presence in the ecosystem today. The full map represents the organizations that design, build, deploy, operate, connect, and manage datacenter infrastructure globally.

Why the Full Datacenter Supply Chain Matters Now

AI workloads have made the interdependencies between these layers much more urgent than they were even three years ago. A storage vendor used to be able to focus entirely on their own category without thinking about cooling capacity at the facility level. Today, the density requirements of AI clusters mean that decisions in one layer directly constrain what's possible in another. New silicon drives new server architectures, which drive new cooling requirements, which drive new power contracts, which drive new builds that are being delayed by utilities rather than construction timelines.

According to McKinsey's 2024 research on datacenter demand, datacenter capacity in the US alone is expected to roughly triple by 2030. That kind of growth affects every layer of the ecosystem simultaneously, and the companies that understand how all seven layers connect will outperform those that only see their own category.

This map is a starting point for building that understanding.

How Companies Are Using the Datacenter Ecosystem Map

1. Channel partner strategists use the map as a visual reference for identifying partnership opportunities across the ecosystem. An integrator in the middle of the stack can see every hardware vendor above them and every operator below them in a single view, which is useful for planning channel strategy and identifying companies they should be engaging with but currently aren't. We've seen clients identify three or four new partnership targets within minutes of looking at the map for the first time, simply because they'd never had visibility into adjacent layers.
2. Vendor marketing teams get ecosystem context that internal competitive databases typically miss. Knowing where you sit relative to hundreds of companies across seven layers informs how you position yourself, who you partner with, and where your product actually ends up in the supply chain. A category-specific analyst report will cover your direct competitors, but it won't show you the three layers of companies between your product and the person who actually makes the purchasing decision.
3. Datacenter operators and colocation providers can see the full range of software tools, service providers, and interconnection platforms operating around their facilities. That kind of visibility supports business development and tenant acquisition in ways that would otherwise take weeks of manual research to assemble. When an operator understands which integrators are active in their market and which software platforms their tenants rely on, the conversations they have with prospects are fundamentally more informed.
4. System integrators and MSPs sit in the middle of the supply chain and influence purchasing decisions in both directions. The map gives them visibility into which hardware vendors and software platforms are active in the categories they serve, and which operators are expanding capacity in their target markets. That context is directly relevant to how they build their go-to-market strategy and which vendor relationships they prioritize.

What Building This Map Revealed About the Industry

Putting this together confirmed a few things that are worth noting for anyone operating in this space.

The datacenter software layer is far more fragmented than most people realize. Operators are running a dozen or more tools for DCIM, monitoring, cybersecurity, asset management, and power management, with minimal integration between them. This layer gets almost no attention at industry events despite being critical to how facilities actually operate on a daily basis.

The integrator and MSP layer is enormous, and it controls more of the purchasing process than most hardware vendors appreciate. These are the companies making product recommendations, managing deployments, and running long-term managed services contracts. If you're a hardware vendor and you're not actively building relationships within this layer, the integrators are recommending your competitor's product to the end customer.

AI is creating pressure across every layer at the same time, driving demand for new silicon, new server architectures, new cooling infrastructure, new power capacity, and new network bandwidth. The companies that understand the full ecosystem will be better positioned than those focused exclusively on their own category, because AI workloads have made the interdependencies between layers much more visible and much more urgent.

Keep the Map Current

If you spot a company we missed or one that belongs in a different category, let us know!

The ecosystem changes as companies merge, get acquired, expand into new categories, and enter new markets. We plan to update the datacenter ecosystem map as the industry evolves.

We built this because we needed it for our own work and because nobody else had put it together. If it's useful to you, share it with your team.

Learn more about how Propane works with datacenter and technology infrastructure companies here.

Propane, Digital Agency - San Francisco
San Francisco, CA - 94110
415 550 8692

Summary:

PE firms acquire companies, overhaul management, and streamline operations, yet revenue growth stays flat. Three problems explain this: they prioritize cost-cutting over innovation, lack a digital transformation strategy, and let portfolio companies operate in silos with no knowledge sharing. The fix: hire a Chief Digital Officer who oversees the entire portfolio and treats the firm itself as a platform for scaling digital strategies across companies.

I've spent 20+ years watching PE firms acquire our clients and seeing the aftermath.

PE firms purchase companies or brand franchises with the intention of streamlining them into profitable engines. Some acquire these brands at fire-sale prices, betting on turnaround potential. Others recognize untapped earning potential and believe the previous owners simply weren't extracting the full value available.

They overhaul existing management, try to streamline operations, implement standardized systems, and introduce new leadership. Yet despite these efforts, the new management often fails to outperform their predecessors.

Additional strategies follow: expanding into new markets, investing in R&D, implementing cost-saving measures, pursuing acquisitions or partnerships. Still, significant revenue growth remains elusive.

Why does this keep happening?

Recent data tells part of the story: 98% of private equity fund houses are in the process of digital transformation, yet only 7% have completed this journey. The intention exists, but the execution falls short.

Three Strategic Oversights in PE Portfolio Management

The pattern I'm seeing can be explained with three fundamental problems.

1. Cost-Cutting Over Product and Service Innovation

PE firms prioritize traditional cost-saving strategies over genuine service or product innovation. Real innovation requires design thinking, structured discovery, and validation frameworks. PE firms rarely have the internal capability to lead these efforts or even recognize when they're needed.

Here's the irony: innovation often already exists inside the company. The staff who just got replaced typically know the real issues.

They have ideas that management, budget constraints, or internal politics prevented from reaching the executive level. Even when good ideas did surface, proper innovation processes were missing: no business model validation, no ROI projections to justify the investment.

Design sprints and structured innovation frameworks unlock this trapped value. They surface ideas, validate them against business realities, and create defensible cases for action. The process often reveals that the answers were already there, buried under organizational dysfunction.

2. Absence of a Digital Transformation Strategy

Portfolio firms don't typically have a Chief Digital Officer or Chief Experience Officer on staff. Instead, they deploy change management personnel skilled at restructuring headcount but lacking a digital transformation vision.

They're missing the clear 3-5 year digital strategy or platform that integrates:

• Customer experience
• Brand transformation
• Workforce optimization

A robust digital strategy goes beyond surface-level technology adoption. It requires integrating customer experience, user experience, and employee experience into a single transformation roadmap. Without this integration, digital initiatives remain fragmented and fail to deliver measurable returns.

Mid-size companies could achieve substantial growth with a well-defined digital transformation strategy. Large consulting firms like Accenture, Deloitte, McKinsey, and BCG generate substantial revenue from digital consulting because they've proven it works. These firms have built entire practice areas around digital transformation for a reason: the results are measurable and repeatable.

Large enterprises already know this and can afford these engagements. Mid-market portfolio companies get left behind. For VC-backed startups operating with leaner teams, the problem compounds.

More recently, AI has become central to these strategies. Not AI as a standalone initiative or a marketing talking point, but AI embedded within customer experience improvements, operational workflows, and decision-making processes.

PE firms that treat AI as a separate line item miss the point. The value comes from integrating AI capabilities into the digital transformation roadmap, where it can enhance existing processes rather than disrupt them for disruption's sake. AI-powered customer analytics, intelligent automation, and predictive modeling deliver value when they're woven into broader digital strategy. Isolated AI projects without strategic context rarely survive past the pilot phase.

3. Siloed Portfolio Companies With No Knowledge Sharing

The most overlooked opportunity is the firm's own structure.

When you talk to portfolio companies within the same PE or VC firm, you find that CMOs rarely communicate with other CMOs. C-level executives across portfolio companies operate in isolation. There’s no structured way to learn from each other's wins or failures.

This represents a massive missed opportunity. Portfolio firms possess an inherent knowledge platform across their portfolio, but they fail to leverage it. A digital executive would view the firm itself as a platform: a network where one company pilots a digital transformation strategy, validates the approach, and then rolls it out to other portfolio companies.

One company's successful customer experience overhaul becomes a template for five others. A failed experiment in one portfolio company prevents wasted investment in ten more. This would mean stress-testing strategies in one environment before deploying across the portfolio.

The concept extends beyond informal knowledge sharing. PE firms should establish a centralized intelligence function that enables real-time insights sharing across portfolio companies, identifies patterns and opportunities across industries, and surfaces best practices automatically. When one portfolio company solves a customer retention problem, that solution should propagate across the portfolio within weeks, not years.

Instead, each portfolio company reinvents the wheel, making the same mistakes independently. The collective learning that should be a PE firm's structural advantage goes completely untapped.

The Solution: Centralized Digital Leadership Across the Portfolio

Hire a Chief Digital Officer who oversees all portfolio companies.

This person evaluates each company's digital strengths and weaknesses, then compiles a coordinated strategy across the entire portfolio. They identify where AI can augment existing operations, where customer experience improvements will drive revenue, and where internal tools can reduce friction.

The scope of this role extends beyond advisory. A portfolio-level CDO should:

• Conduct digital maturity assessments across all portfolio companies
• Develop a prioritized transformation roadmap based on opportunity and readiness
• Establish shared technology standards and platforms where appropriate
• Facilitate knowledge transfer between portfolio company teams
• Measure and report on digital transformation ROI at the portfolio level

Propane, Digital Agency - San Francisco
San Francisco, CA - 94110
415 550 8692

Not all businesses have a firm grasp on who they are as a brand or even where to begin figuring that out.

To stand out among companies, business owners need to define the qualities of their brand effectively. Intending to be different and special? Or worrying about how you can sell your vision to customers? Our team will take care of it!

Founded in 2003, Propane is a digital experience and platform agency. Our team delivers experiences that inspire action with brands. We offer various services such as:

Brand Strategy
Creative Design
Content Strategy
Digital Experience
Development
Connecting Marketing Ecosystems

Propane created new paths for discovery so people could better find events they’d enjoy. We get down to business and provide memorable brands.

With that being said, it is our honor and privilege that we announce our latest milestone with Clutch.

In case you don’t know who Clutch is, they are a hub for service providers that carefully curate lists of the absolute best agencies and organizations by industry and location, simultaneously enabling companies to establish credibility and buyers to find the right services. The ratings and reviews platform publishes the most extensive and referenced client reviews in the B2B services market.

Propane is jumping for joy to be recognized as one of San Francisco’s top branding services for 2021! With pride and dedication, here’s what our founder had to say:

“We're incredibly excited to be included in the Clutch Certified Business listing. This is really our biggest achievement this year, and we are inspired to do our best in everything we do. My sincerest gratitude to Clutch and its team. ”  -- Neil Chaudhari, CXO, Propane

In light of this huge success, we thank our clients for their trust and support in taking their business to us. Without them, this wouldn’t be possible. Your reviews on our Clutch’s profile will be treasured and cherished forever.

Take a look at our 5-star reviews on our Clutch profile:

Propane, Digital Agency - San Francisco
San Francisco, CA - 94110
415 550 8692

The year 2020 was a record year for ecommerce with online sales across the world bringing in $4.891 billion in revenue and the number is only projected to grow in the future.

As a business owner, one of the best ways that you can grow your business in this day and age is through your website. With a well-designed and attractive web page, you can make a strong first impression on visitors and boost conversions.
To achieve this, you can incorporate some of these web design trends that could help you increase conversions in 2021.

1. Simplified Layout
   The layout of your web page should be as simple and easy to navigate as possible. If there is a lot of clutter with images, pop-ups, large headers or different menu bars, then visitors may not be able to find what they want easily. It could result in potential customers leaving the website. In order to avoid such a situation, it is always a good idea to have a simplified layout of the website that tells exactly where to go. Try and incorporate negative space in your design or choose a grid that displays the all the relevant information. Even with your brand identity you can ask your graphic designer to create a design a simple logo that is fitting for a website. You can feature just the icon or a minimal version of the logo in the top navigation instead of the whole logo design. With a website that has a minimalist and modern layout, you can instantly appeal to the eye of the visitor and convince them to explore further. Some of them may even end up making a purchase or signing up for a good discount offer. Ultimately, this will help you boost conversions and experience growth in revenue.
   
2. Less Click Buttons
   It may be surprising to you but a lot of click buttons can cause people to turn away from the website and abandon their carts as well. Think of it this way. Most consumers prefer to just click on a ‘Buy Now’ or ‘Add to Cart’ option and then checkout quickly. With a lot of boxes to fill or actions to complete, people will most likely close the page and look for something else. In a highly competitive market, you do not want to drive potential customers away. So try removing any options which ask visitors to make an account for shopping or check several boxes before making a payment. According to a study, around 34 percent of potential customers abandon their carts because they have to make an account to checkout. This means that you can lose out on making sales and increasing your conversion rate with such options. As a business owner, one of the top web design trends that you can adopt to boost conversions is less clicks. By decreasing those and making your checkout process quick, you can reduce cart abandonment and keep visitors on the website as well.
   
3. Highlight Call-to-Action Clearly
   The CTAs or Call-to-Action buttons on your website are critical to lead conversion. If they are not clearly visibly or position in the right place, people may get confused about the next step to take. So to help consumers navigate and look for more information, you should highlight the call-to-action. You can use words which create an urgency such as ‘avail the offer now’ or ‘start today’ to encourage them to respond. Other than that, the right contrast of colors such as red, green or blue against a white or black background also works very well. It can highlight the CTAs and make them prominent. Take a look at the website for Peloton. The call-to-action buttons are featured in red and immediately catch the attention of the viewer on the page.

4. Creative Cursor Shapes or Animations
You might have come across websites where the cursor changes shapes or becomes animated. In 2021, this is on its way to becoming quite a big trend and can be useful for boosting conversions. You can incorporate a feature that leads to the cursor changing into an image that is relevant to your brand or into an animation.
This can help you engage more people and convince them to spend a few minutes on the page. If they like what you have to offer, they could make a purchase before leaving as well.

5. 3D Scrolling Effects
With websites coming up with unique features to interact with people, dynamic or 3D scrolling effect is a trend that looks to take over the digital world quite soon. This is basically a feature that animates images or videos as you scroll through the web page.

The website for Urban Style Drive which is a brand for unique bikes has incorporated 3D scrolling effects to make their page attractive and appealing to the customers. It can certainly help boost conversions and generate traffic as well.

6. Mobile-Friendly And Interactive Design
In this day and age, it is very important for your website to be mobile-friendly and responsive. According to a report, 79 percent of people with a smartphone have made a purchase using it during the last six months.
You could lose out on a lot of potential customers if your web design doesn’t adapt to mobile or smaller screens.

7. Color Co-ordination
This is quite a rising trend in web design and adds to the appeal of the website. You can choose a coordinating color scheme which is relevant to your brand and doesn’t clash with the images, typography or call-to-action buttons on the page.
Some of the most prominent color trends include pastel and muted color schemes that are easy on the eye, and allows visitors to concentrate on what you have to offer on your website.

To Sum Up
These are some of the web design trends that could help you boost conversions and stand out with your website. By adopting them, you might be able to reach out to a wider consumer base and expand your business as well.

Author Bio
Jessica Thomas hails from a small town in Texas. She has a degree in Psychology but pursues her passion for writing through freelance work. When not writing she likes to spend her time cooking and travel the world.

The complexity of digital experience expectations has taken on increasing nuance and, in turn, strategic importance. The most recent positive experience a customer has with a brand sets the bar for their minimum expectations of future experiences.

Engaging digital audiences in the moment requires considerations beyond simply timeliness of engagement – the experience must be highly personalized and increasingly contextual to be useful, usable, and desirable.

Since the inception of the Bazaar which introduced mass market consumerism in the 4^th Century, purveyors of goods have developed strategies to personally engage with customers in tactile interchanges. In contrast, a product of the late 20^th Century, digital engagement with consumers, irrespective of time and space - and the immediacy inherent in the global scaling of digital commerce - is still very much in its infancy.

To meet the hyper-evolving expectations of digital consumers, building a consistent platform for customer engagement can influence positive changes in customer experience (CX) and employee engagement, fueling the virtuous cycle of commerce. To address the needs of the contemporary digital bazaar, Propane focuses on integrating intuitive touchpoints throughout the journey between brand and consumer to develop high-performing engagement platform solutions for our customers.

Creating Superior Customer Engagement Experiences

Today, 89% of companies compete primarily on the basis of customer experience – up from just 36% in 2010. Employing psychology-informed approaches based on continued advancements in human/computer interaction, Propane’s approach to building customer experiences informs our thinking around intelligent platform design. This allows our team to create experiences that engage, educate, and convert customers throughout various touchpoints of the customer journey.

Presented with the challenge of creating an enhanced user experience (UX) design that helped to identify, create, and market new coverage options for Kaiser Permanente, a strict focus on patient centricity was essential in identifying (and solving for) the nuanced interdependencies and exchanges across the care value chain – from patient, to provider, to payor.

By focusing on solving human needs throughout the design and development lifecycle - with emphasis on removing friction in the digital patient journey - Propane ensured an increase in ease for patients finding the best value for their healthcare products, while simultaneously allowing Kaiser Permanente to increase competitive advantage in a crowded marketplace.

The Importance of Consistency in CX

Customer-centric companies are 60% more profitable than companies that de-emphasize focus on their customers and choose to employ a product or service focused approach to market. Jeremy Cox, a principal analyst at Ovum reveals that “today’s story is around customer experience in its totality and the ability of the enterprise to support customers in a way that they will want to come back.”

The work Propane has done with Sutter Health illustrates the importance of this engagement integrity through the delivery of single patient point of truth in brand/patient communications strategy. The team was tasked with consolidating and modernizing Sutter’s digital properties, with the goal of reducing patient confusion and guiding customers to the right service at the right location to address their healthcare needs.

Leveraging a flexible UX/UI design for Sutter’s network, developed with the patient experience at the forefront of consideration, the team were able to meet local hospital requirements and web accessibility guidelines and, in turn, grow mobile traffic as patients increasingly search for their healthcare information in the moment, expecting right information at the right time, in the right context.

The engagement resulted in a unified patient experience platform integrated across a highly complex informational system - delivering contextually relevance and heightened personalization to drive increased new and existing patient satisfaction.

The Impact of CX on Employee Experience (EX)

One of the primary challenges facing organizations today exists in navigating the challenges of successfully engaging employees across multiple business units and stitching together these often disparate touchpoints to deliver a consistent customer experience. Breaking down organizational silos and focusing on achieving an integrated 360-degree view of the customer to deliver on a single source of truth helps ensure that each interaction initiated by the user triggers a contextually relevant and increasingly personalized response.

Emerging research in the discipline of employee experience (EX) illustrates the importance of having an engaged workforce as key to influencing enhanced CX across all potential organizational engagement touchpoint with customers. As evidenced by companies with engaged employees outperforming their competition by 147%, Forrester reports that 76% of executives believe that improving CX is a critical organizational priority and many have established a Chief Experience Officer (CXO) position to integrate and align the customer and employee experiences.

Propane was able to bridge the gap between EX and CX for Banner Health by reimagining their online experience to better guide patients’ navigation through the complexity of existing Emergency, Urgent Care, and Nurse hotlines. In collaboration with Banner, the team were able deliver a simplified patient journey that increased confidence in personalized care decisions, leading Banner Health CMO, Alexandra Morehouse, to state: “the Propane team can navigate complex UX needs, provide creative that has the right amount of push while staying on brand, and employ developers that remain a seamless extension of your IT department. No project is too complex for the Propane team.”

Please Don’t Relegate CX to an Afterthought

Digitally savvy customers seek brand engagement on their terms, and brands must be capable of meeting them where they live and engaging with personalization and context. Strict focus on customer centricity is essential to address nuance in contextual engagement through a series of well-orchestrated and intuitive touchpoints throughout the journey between brand and customer.

Organizations that increase focus on CX are focused on value creation as paramount to their business success. These organizations endeavor to engage with their customers and employees in meaningful ways, rather than just a sales pitch. Using digital experiences as continuous feedback loops based on behavioral analysis provides the ability to incorporate real time experience data to deliver brilliant end-to-end customer experiences, great content, or interactive, real-time customer support.

Propane uniquely positions itself in comparison to other boutique agencies through a holistic focus on strategy, design, and progressive engineering to deliver business results. Propane’s mission is in working with clients to create digital ecosystems where customers can have seamless experiences whenever they interact with their organizations. Your customers deserve your very best. Propane is here to make sure they get it.

Propane was recently listed in Top San Francisco Digital Agencies from DESIGNRUSH, we are honored to have made the list!

Neil Chaudhari, CXO

Propane, Digital Agency - San Francisco
San Francisco, CA - 94110
415 550 8692

We are honored to be recognized as a minority-owned business on Clutch!

Propane has been listed as one of the highest-performing minority-owned digital marketing companies on Clutch’s directory.

Based in the center of Washington, DC, Clutch is a B2B market research firm that connects businesses and customers. Their independent team conducts research into B2B service providers by directly interviewing their former clients. This verified data is the basis of the reviews on Clutch, which help ensure their ratings and rankings are fair and transparent.

“We believe that BIPOC communities bring a creativity and diversity that can’t be substituted or ignored in any element of contemporary society” explained Clutch Senior Business Development Analyst DJ Fajana. “Recognizing this group of industry leaders for their accomplishments is not a trend; it is an overdue recognition of the extraordinary charisma, passion, and expertise each and every one of them demonstrated in overcoming the barriers necessary to rise to the positions they occupy today.”

We are also listed on Clutch’s sister site, The Manifest! The Manifest is a company listing resource. B2B service providers are segmented into shortlists according to location and service line. The site allows users to browse how-to articles and business advice. Propane is a leading SEO agency in San Francisco on the Manifest!

At Propane, we are thankful for all of our amazing customers, especially those who took the time to leave us a review on Clutch! Hear what they had to say about us.

“I was impressed with their creativity. The team was able to take our words and make them into something stunningly visual. It was very exciting for me.” – Publisher, Arts Calendar

We highly value our customers and their feedback on our work! Our 4.8-star rating on Clutch is all thanks to you, our wonderful partners!

Read reviews left by our customers on our Clutch profile to learn more about us and our past work. Ready to get started on your next project? Let’s talk.

By Neil Chaudhari
CXO, Propane

Propane, Digital Agency - San Francisco
San Francisco, CA - 94110
415 550 8692

What is addiction? Allow me a cliché right off the bat and let me define the term for you…

According to the American Society of Addiction Medicine:

"Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences."

What’s nice and hopeful about their definition is the last part.

“Prevention efforts and treatment approaches for addiction are generally as successful as those for other chronic diseases.”

With addiction being a disease and its treatment firmly in the current purview of healthcare, I wanted to focus on wellness and how our baseline understanding of everyday health will shift with a new conception of addiction.

Landscape

"Almost 21 million Americans have at least one addiction, yet only 10% of them receive treatment."
- Addiction Center.com

"Approximately 10% of any population is addicted to drugs or alcohol. Addiction is more common than diabetes, which occurs in approximately 7% of the population. Addiction crosses all socio-economic boundaries. 10% of teachers, 10% of plumbers, and 10% of CEOs have an addiction."
-Addictions and recovery

These statistics are for drug (both illegal and prescription) and alcohol addiction, however the issue of addiction is far more widespread. There are over two dozen types of 12-step groups which treat various types of substance abuse, gambling, sex & love addiction, overspending, overeating and more. When treating addiction there are long term rehabilitation facilities, group therapy as well as private therapy avenues.

Besides providing services for addiction treatment, healthcare also currently plays a part in diagnosis. When you visit your doctor you answer questions that help your physician determine if you need addiction treatment for smoking, alcohol and drugs.

But what isn’t covered by healthcare is the slate of “low level,” culturally acceptable behaviors and substances which studies have been shown to be addictive. You know the feeling. That habitual reach for the coffee in order to perk up. The fog and uncomfortableness that you can’t quite put a name to, but seems to disappear after that Rice Krispies treat. That feeling is nothing compared to the shaky feeling in the pit of my stomach if i’ve misplaced my iphone. Hi, my name is Kim-Minh and I’m addicted to sugar, caffeine and my smart devices.

Drivers

Biology
Turns out we’re hardwired to respond positively to a number of things.
When a substance or behavior signals the neurochemicals that get you high, happy and satiated our body tells us that we want some more (duh). But more recent studies show we can’t get any more of a high from that same substance/behavior when we engage again, but when we are without that stimulus our central nervous system and our immune system are signaled and we start to feel sick.

Genetics
This pull becomes much stronger when people are genetically predisposed to addiction.

Genetics explains 50 percent of whether an individual will develop an addiction.This is proven with twin studies. When one identical twin is addicted to alcohol, the other twin has a high probability of being addicted. But when one non-identical twin is addicted to alcohol, the other twin does not necessarily have an addiction. Based on the differences between the identical and non-identical twins, studies have shown that 50-60 percent of addiction is due to genetic factors.
- Addictions and Recovery.com

Culture
There is still a stigma surrounding addiction despite aging through the debate on addiction as a disease, watching the tobacco industry be brought to accountability and seeing countless stories of the opioid epidemic on the news.  Addicts are seen as not having enough will power, self worth or a correctly functioning moral compass even though science has provided genetic and other biological reasoning behind the phenomenon. If only 10% of addicts seek treatment, how many more haven’t even admitted to themselves and those close to them that they have a problem?

There is new scientific evidence that the opposite of addiction isn’t abstinence, but connection. Apparently soldiers who developed a heroin addiction in Vietnam were studied upon their return. Soldiers who came home to strong family and friend connections had little problem overcoming the addictive behavior, whereas soldiers with no support network had far greater trouble coping with their heroin addiction. Media outlets and a TED talk have surfaced coverage on this phenomenon:

“So it does indeed appear that the opposite of addiction is not sobriety, it’s connection. That said, developing healthy interpersonal connections as a part of recovery and healing is not easy. It takes time, effort, and a willing support network. The good news is that we now know for certain that this type of recovery and social connection is possible — even for the most problematic of addicts.”
-Johann Hari, TED Talk

Mental Health
Mental health conditions like depression and anxiety are widely concurrent with all forms of addiction, but in a classic chicken and egg debate, researchers aren’t sure which comes first. What is clear is that addiction treatment will need to include psychotherapy or other mental health care at all levels.

“Studies have found, for example, that depression quadruples the risk of relapse in alcoholics in the first year of recovery, and an 11-year study of heroin addicts found that mood disorders adversely affected every outcome in both the short and long term.”
-Psychology Today

Future of Addiction Conception Predictions

Of course there will be more addiction therapies and technology will play a greater role in those therapies. But the future of how we think about addiction will be expanding our acceptance of addiction as well as increasing the number of behaviors and substances that we chart as addictive. This of course will lead to more people seeking treatment for a wider set of addictions with a growing variety treatment tools.

Greater Understanding, Wider Definition and More Types of Treatment
As addiction science evolves, people will have a better understanding of the neurology, chemistry and genetics involved. Reduced stigma will follow. People will start to understand addictive behaviors in more areas of their own life. Do you have the person in your life who is addicted to drama? Is it you? Addiction to chemicals released in certain relationship and emotional dynamics will start to come into common understanding.

There  are already tools to help you become more aware of your screen time and smart device use because people understand their wellness is hampered by a technology, content and communication addiction. There will be greater social stigma about device use in the future and more cognitive behavioral programs and commercial devices to help snap us out of our marathon you tube sessions and perpetual instagram checking habits.

There will be more understanding and of the way specific food ingredients/additives and eating behaviors are addictive and problematic. People will want to counter these effects for reasons of health and vanity. As more medical treatments emerge for addiction (a vaccine for the effects of cocaine, substitute pharmacological treatments [like methadone for heroin addicts]) a market will emerge for medical interventions to hijack the own brain into not craving sugar, or a pill that will make you sick if certain substances/food types are eaten.

Healthcare Opportunities

So what part does healthcare need to play in addiction diagnosis and treatment in the future?

Healthcare Networks/Providers
Mental health access and programs will be key for all types of addiction treatment. Telehealth for private and group therapy will be a major part of this. Providing digital tools that aid in cognitive behavioral therapy, reward based systems, or provide various education models (TES, Therapeutic Education systems) for various addiction types can be a good service differentiator for any network. In addition to creating more group therapy programs, new social connection programs and family support can help strengthen other forms of addiction treatment.

For many chronic diseases lifestyle changes are prescribed (diabetes, heart disease, obesity). People trying to make diet-based changes can be helped by digital platforms that educate and provide programs for people trying break eating or sugar addiction habits (of course in addition to nutrition and food tracking tools).

Digital diagnostic tools can help people researching their own addiction behaviors and put them on a clearer track to recovery. These tools can pair their addiction types with any appropriate medical addiction treatments within your network (which can be everything from prescription medicines, vaccines and various types of psychotherapy).

Health Insurance
Most addictive behaviors can be deleterious to one’s health. Even if you have a behavioral addition like gambling or over-debting, the stress, the sleeplessness, the breakdown of your relationships aren’t going to do any positive things for your health.  This is even true in the case of technology addiction. When our phones are glued to our hands, we become less present parents and spouses. Kids with technology addicted parents are also more likely to be exposed to excess screen time which hurts mental and emotional development.

It is in Health Insurance’s best interests if any one in their covered population who has an addiction can recognize it and seek appropriate treatment as quickly as possible.

It will be incumbent upon health insurance to provide screening and education, as well as stigma-reducing education programs for the families and affected loved ones. Platforms that normalize treatment, provide easy diagnostic tools, and give access to live and digital therapy are all opportunities for health insurance to mitigate risk and increase better outcomes.

Medical Devices and Technology
Create devices and platforms that can pick up and trace types of neurological function as well as synthesize its meaning for a lay person. Imagine being able to understand the neurochemical balance going on in relation to certain behaviors or being able to watch your brain in a bio-feedback loop

Create wearable devices and platforms to aid in cognitive behavioral therapy. It would be helpful to have small, discreet objects you can interact with in specific ways when you recognize yourself having an urge. This would be good paired with a platform where you can recognize and track certain situational patterns or triggers.

Develop apps and platforms meant to deliver specific types of therapies for specific addictions. Whether they are meant to be used in conjunction with a human therapist or not, it would be helpful to track progress and identify feelings and behavior one gets not generally, but with specific addiction types (i.e. sex and love addiction gets specific tools and examples which are different than specific support needs for shopping addiction).

Create platforms that help addicts foster deep connections where they can build deep personal relationships or strengthen those they already have.

While you’re at it, there’s an opportunity to create devices and platforms that can not only identify ingredients in food but identify their addictive potential. Creating data and tracking your intake of these addictive substances would be helpful as well.

Thanks for reading. For more related topics, please check Lux for all of our Future of Wellness for Healthcare articles.

By Kim-Minh Huberwald
Director of Strategy, Propane Agency

Propane, Digital Agency - San Francisco
San Francisco, CA - 94110
415 550 8692

Sleep… everybody does it. Does anybody do it right? What's clear is that experts agree that sleep is essential for health.

Sleep deprivation has a negative impact on concentration, mood, personality and judgment. It can also increase our risk for medical conditions such diabetes, high blood pressure and vascular disease. Furthermore, the effects will accumulate over time. As the days and weeks and months go by, the impact will continue to increase. Many times sleep deprived individuals themselves are not aware of the full impact.
- Boston University Medical Center

Landscape

Every authority seems to agree that sleep is an important part of wellness. Yet, how many times have we heard this, “I’m fine on just 4 hours a night.” “I’m so tired.” “I’ll be awake as soon as I have my coffee.”? I’ve actually said all this just this morning.

We’re all sleep deprived. Well, not all of us. I am. And, chances are, you are, too.  

“More than a third of American adults are not getting enough sleep on a regular basis”
-Center for Disease Control

And the hits just keep on comin'. According to the CDC 6 out of 10 Americans have a chronic disease. So we’re already unwell, and lack of sleep worsens most conditions.

“Sleep, new research reveals, is a master regulator of health. A sleep deficit or disruption can create wide-ranging havoc, compromising our immune system, causing inflammation, and damaging our genes. Losing just an hour of sleep a night increases risk of cancer, heart attack, stroke and type 2 diabetes.
Lack of sleep can also lead to memory loss, negatively affect people’s reflexes and decision-making skills, cause hearing loss and psychiatric disease, and impede sexual function.”
-Experience Life.com

Drivers

What are the drivers for our relationship to sleep and what affects our behavior?

We’re in need of downtime
Netflix and chill…. and repeat. A lot of us are in a constant state of “doing” (working, parenting, overextending socially or overpromising our time) and our brains need a break. The endless internet scroll or binge watch at the end of a day lets our conscious brains take a break, but it also keeps us up, disallowing the real rest and rejuvenation that comes with sleep.  

Technology ≠ Sleep Hygiene
Our circadian rhythms are messed up. The blue light our devices emit during a Candy Crush Saga marathon or an endless YouTube video sojourn doesn’t set us up well to get enough sleep.

Culturally speaking, Busy > Lazy
Getting enough sleep isn’t laziness, it’s basic self-care. However, there is a cultural phenomenon of pride being equated with being up and “producing” whether that be from a late night of work, or an early productive morning.  We don’t have the same oomph from “bragging” about a solid 8 hours.

Future of Sleep Predictions

The future of sleep is, in short, manipulating sleep, measuring sleep and more productive sleep.

Manipulating sleep
Want to create more vivid dreams, or at least be able to control what you’re dreaming about (called lucid dreaming)? Well, if you’re open to being shocked with low levels of electrical current continuously through the night, you’re in luck. This technology is being developed currently to help people with nightmares and night terrors, but it seems ripe for recreational use. Imagine more vivid dreaming as an entertaining escapist venture or a promise to charge to your creativity.

More Productive Sleep
Scientists are studying the part of the human genome responsible for “light sleep” and working on genetic therapy to lessen the need for longer hours of sleep. What this means is people will be able get more effective sleep over shorter periods of time. Apparently there are military outfits funding this research in the hopes of building supersoldiers that don’t need to sleep as much (am I alone in thinking this is the beginning of a supervillain origin story?).  But imagine the opportunities in this vein for genetically modified sleep that promotes better healing during deep sleep for patients with trauma, stroke or illness. Even our culture’s more chronic conditions (diabetes, heart disease) might be able to benefit from this sort of therapy.

Measuring Sleep
Every morning my husband looks at his Fitbit app and comments on his sleep measurement. “I was laying in bed for six and a half hours but it looks like I only got five hours of sleep. See this spike in activity here? I bet that’s when I got kicked in the back...” For you, dear readers, I will say that the kicker in question is my four-year-old daughter and not me (I’m reasonably sure). What if my husband could know for sure what is causing his sleep loss? There are companies working on pajamas that do physical tracking across the body for more insight as to what parts of us are doing during sleep. There are also mattresses in development that not only measure movement, body temperature and disturbances, they can respond accordingly. Imagine a smart bed that can connect to your thermostat to keep your body at a predetermined temperature, vibrate or undulate in a way to lull you to sleep or gently wake you up. If we go a step further, this sort of technology can be used to measure and adjust conditions that affect your oxygen level, your rem cycles, and more. Maybe it can even be used to get someone to roll back over to their side or redistribute the blankets. One can dream, can’t they?

Healthcare Opportunities

So what part does healthcare need to play to help us understand sleep in the future?

Healthcare Networks/Providers  
Patient portals will increasingly use tracking tools for symptoms, medication and treatments. Sleep should be added into the mix with the platform able to track sleep, pull in sleep tracking data from wearables and intelligently offer context as to how your sleep habits are contributing to any current medical conditions.

Sleep education will be very important. With our common chronic issues (obesity, heart disease, stress, diabetes, anxiety and depression) being worsened by a lack of sleep, completing patient education for these conditions with sleep content and resources will help improve outcomes

Health Insurance
In most cases, the more their covered population sleeps, the better medical outcomes and the less risk posed to health insurance corporations.  With this in mind, being a driver for self-care education and promoting sleep, sleep tracking and the benefits of sleep will be crucial.

Incentivizing sleep in the same type of current fitness incentivization programs can be a part of the education platform. This and providing customers both the platform to measure and the technology to track sleep will be key in the program.    

Medical devices and technology products
Create products that can better track the “productivity” of sleep. How much time did I spend in a “healing” state, in a REM state or with specific brainwave activity that helps with X?

Develop products that can measure biological markers to signify too little or the right amount of sleep.

And, in a high-creep factor, create platforms and tools to allow us to study our own sleep, through video visuals, sound and measuring breathing and synthesize the results so we can better understand how our sleep is affecting our health and allows us insight without undergoing invasive studies with doctors.

It seems to me that the final answer for getting more sleep is a major cultural shift where we all have less we feel we “have” to do, value our own health and sanity and let go of our FOMO.  It’s 1:30AM as I finish this article up… Maybe I’ll sleep in… Thanks for reading. Sweet dreams.

Propane, Digital Agency
San Francisco, CA
415 550 8692

Hippocrates, ancient greek physician and the “father of western medicine” famously said, “Let food be thy medicine and medicine be thy food.”  If he came back to witness what’s happening with diet in America today, he’d probably say, “Aw geez. COME ON, people! Am I talking to myself over here?”.

The known scientific links between health and food were first ‘proved’ in the mid-1800's when Scottish naval surgeon Dr Joseph Lind, ran one of the earliest ever clinical controlled trials and showed that citrus fruits could prevent sailors from getting scurvy.  Since then, it’s been shown in countless studies that our highly processed, sugar laden, high saturated fat diet leads to obesity which leads to many health issues like cardiovascular disease, diabetes and some cancers. These diseases are among the leading causes of death in the United States.  

How will the changing landscape of information change our relationship with food? Since diet is inextricably linked to health and wellness, how must the healthcare industry evolve its offerings surrounding diet and nutrition to keep up with health effects and developing consumer expectations?

Landscape

We’ve put on a few pounds… In 2010 the US government’s office of Disease Prevention and Health Promotion set a goal through the “Healthy People” initiative that we’d lower our 30.5% national obesity rate by the year 2020. Well it’s 2020 and we’ve gone the opposite direction and now have an over 40% obesity rate.

It’s interesting, we have more access to information than ever before and yet we’re as unhealthy as we’ve ever been. Even in the midst of many food trends that are health conscious (veganism, organic, farm to table, gluten-free, paleo diet [the health effectiveness of each being somewhat debatable]) we’re collectively not as healthy as our ancestors. We’re not even as healthy as those of our parents on American diets (and they ate a bunch of canned food and so. much. mayonnaise.).

Part of the issue is confusion when it comes to research studies. As it turns out, most of the food research commissioned and published is funded by the food industry. Some of these studies designed to engineer positive results for the  food product in question. In 2015, an interestingly named food researcher, professor Marion Nestle, found that of 168 such food studies published that year, 156 showed biased results that favored the sponsor’s interests (1). So we’re being told things like “dairy raises your good cholesterol,” which might be true, but we’re omitting the fact that dairy can also raise your bad cholesterol. We’re also being told things like kids who eat sugary candy weigh less than kids that don’t. This “research” was done by a survey that only took into account what the kids had eaten in the previous 24 hours… hmmmm. That study was funded by the American Confectioners Association.

This misinformation also hurts us when it comes to the general understanding of nutrition. We still have a hunger crisis in this country, but on top of this we have a problem with malnutrition. Even when we get enough to eat, many people don’t get the right kinds of nutrients. This becomes a severe health issue especially when it comes to the nutrition of children.

More than half of American children do not get enough of vitamins D and E, while more than a quarter do not get enough calcium, magnesium or vitamin A, according to a recent Journal of Nutrition study. This can result in a compromised immune system, stunted physical growth, reduced mental ability, chronic disease and even death.
-The Guardian

Drivers

What are the drivers for our cultural relationship to food and what affects our behavior?

Media and Access to Information
Chances are you’ve streamed a show about food in the last year. By my unscientific count there are 2,900,349,404 series about cooking, food culture, baking, regional dishes, food documentaries and culinary competition shows available to stream. Not only do food, fad diets and eating trends get covered in mainstream media, but all media. Your feed is full of composed plate shots and there are food-brand sponsored influencers. We all need to understand the star-to-rating ratio of every restaurant we go to (sure it has 4.5 stars, it only has 19 reviews.) And, of course we have some of the most iconic advertising campaigns of all time for food and beverage brands (got milk?, the most interesting man in the world, yo quiero taco bell, keeps the hot side hot and the cold side cold [help, i’m trapped in a time tunnel]).

Out of all brand mentions on Twitter, food and drink brands are mentioned the most with 32 percent share of tweets. This is compared to 17 percent for clothing and accessories mentions, 11 percent for mentions about technology, general retail and entertainment, with the remaining percentage from beauty and professional services.
-Review Trackers

Globally, food is one of our shared languages, and that language that gets a lot of media time. This information shapes our unconscious choices (like social normalization of certain foods and ways of eating that aren’t necessarily that healthy for us) and also our conscious choices (like choosing vegetarianism due to evidence that cattle farming is harmful to the environment). We take this information and our cultural notions about food and turn our eating choices into an expression of our identity.

Food Industry
Turns out breakfast is not the most important meal of the day.  What? I’ll wait for you to stop weeping about your whole childhood being a lie.  This idea that’s been so ingrained in our culture is actually the product of food lobbyists. Cereal and bacon lobbyists to be precise. With messaging about Lucky Charms being part of a complete breakfast and competing food industry research, we get a lot of (mis)information that comes from the food industry itself.

Gov. Recommendation
We remember our food pyramid, don’t we? In fact, we remember it so well, that for those of us of a certain age (ahem ahem) it hasn’t really registered that there’s been a new shape for our USDA recommendation (called ”my plate”) since 2011. While new guidelines are published every 5 years, this is the first year the USDA is taking public sentiment into account as to the type. 2020 also marks the first year they’re going to make recommendations for children under 2 years old. These guidelines in the past have been met with controversy. Researchers at Harvard have written an open rebuke to the USDA guidelines and challenged their recommendations.

In 2016, experts from Harvard T.H. Chan School of Public Health said that USDA had ignored key recommendations by the advisory committee, such as avoiding red meat and choosing an environmentally-sustainable diet.
-The Counter

Future of Diet and Nutrition Predictions
Diet and Nutrition is a category where I feel like “the future is here.” Everytime I read about a new advancement, where science is today in 2020, I feel the same way I did when I discovered Dippin’ Dots, which is  “wow, they can DO that?.”  In addition to meat grown in a lab, new methods of cooking food, plus all the new flavors that get invented, the future is

Personalized Nutrition
Turns out not everybody needs to eat the same things to be healthy and feel good. Scientists have developed an algorithm based on your gut bacteria that outlines how different food affects you personally. Some companies are starting to make food recommendations based on your DNA. While this is new and not fully tested, we’re learning more every day about DNA.  Imagine a future where you can get your diet optimized for health every few days by providing a simple stool sample and a swab of the cheek (maybe switch that order).

Brain hacking
Imagine a world where when you get a craving for chili cheese fries, you then put on a Jeordi LaForge headset that connects to your brain and you can experience the flavor, the smell, the texture of chili cheese fries.

The Defense Advanced Research Projects Agency (DARPA) is designing implantable ‘neural interfaces’ that aim to boost human senses by transmitting high-resolution audiovisual information, and potentially smells and tastes, directly to the brain. - Science Focus

Modified Foods
Foods are being engineered to become more nutritious. Scientists are putting vitamins and minerals in food that doesn’t normally contain them (like putting beta carotene in bananas, for example). Imagine a world where when you get a craving for chili cheese fries, and you can choose potatoes that have 100% of your recommended iron, zinc, folic acid, vitamin A, C and B12.

Companies are also engineering sugar coated sugar. Well actually it is inert particles that are calorie free that are coated with sugar to maintain the taste. This, for better or worse, can also get fortified with vitamins, and we’ll have junk food that’s guilt free-ish. I don’t know if this is progress, but it is the future.

3d Printing
Imagine a future where when you get a craving for chili cheese fries, you go to an app and program your 3d printer to create a batch.

Until recently, 3D printing has been sugar-based, but technology is emerging that reliably prints savoury and fresh ingredients. Natural Machines has developed one such kitchen appliance that can be loaded with multiple ingredient capsules to create and cook all manner of weird and wonderful foods.
- Science Focus

Healthcare Opportunities

So what part does healthcare need to play in the diet and nutrition landscape of the future?

Healthcare Networks/Providers  
Healthcare networks will need to provide a new digital footprint for their patients. With DNA testing and gut biome assessments becoming more popular, EHR’s will need to contain new assets and allow new types of patient engagement with their information. Health networks can be the ideal place to not only provide nutrition information based on these new types of assessments, but can provide more complete information based on known medical history, current medical conditions and update it with ongoing research.

Healthcare networks and research institutions are going to be looked to more often provide nutrition guidelines as the governmental guidelines are increasingly called into question. Create engaging content and platforms that help people make better informed diet decisions. It’s common to get a diet recommendation when you’ve been diagnosed with a cardiac issue, diabetes, or are recovering from a particular procedure. Since food is so aligned with healing, providing guidance for any type of health condition, or desired physical result can help people achieve better outcomes, even when their conditions aren’t currently tied to a diet issue. Help people with eczema and psoriasis better go on elimination diets. Provide nutrition guidance for the range of inflammatory and auto-immune disorders. Give people tracking platforms so they better understand what foods cause unwanted symptoms.

Health Insurance
With so much food and nutrition misinformation in the environment, Health Insurance would do well to provide better education for their covered population. This is imperative especially for parents with children under two years of age. Provide apps and platforms that better help people track and understand nutrition. Give older kids ways to learn about nutrition and give them some ownership over their families’ diet, providing programs that help their whole family make better choices.

Partnering with schools to actually provide a nutrition curriculum would help with brand awareness and build brand affinity, as would providing general nutrition content for public consumption.

Create partnerships with paid meal plans and (those you cook yourself, and those pre-cooked) to better influence the diet of your customers. This is an ideal area for collaboration with workplace employer benefit managers.

Medical devices and technology products
Working in tandem with laser technology that can identify food ingredients, create apps and platforms that let people know that they are hitting their nutritional needs for the day or over-doing it for their sugar or oils intake.  

Create programs and services that can quicken the nutrition assessment cycle for their gut biome so people can get more accurate readings daily. Create new platforms that can help people use other bio-markers (blood, urine, what-have-you) to make effects of food on the physical body more transparent.

Wouldn’t it be great if a personalized platform knew your nutrient needs and deficiencies and could tell your 3D food printer to whip you up a little amuse-bouche, or a customized vitamin (less fun) that happened to fulfill your mineral quotient for the day.

Thanks for reading. I have to go. I suddenly have a craving for some chili cheese fries. We’ll cover more wellness integration opportunities for healthcare in the upcoming future of wellness articles for healthcare on LUX at Propane.agency.

By Kim-Minh Huberwald
Director of Strategy, Propane

Propane, Digital Agency
San Francisco, CA
415 550 8692

It’s common understanding today that exercise has physical and mental benefits and is part of our conception of wellness, but this hasn’t always been so. It wasn’t too long ago in food-scarce times that people thought more layers of fat meant more health. So what will we think about physical fitness in the future and what role should the healthcare industry play in our fitness goals?

Landscape

You can’t throw a wearable fitness tracker without hitting a gym, home workout system, group class, or an app featuring a personal training or weight loss program these days. Every human with a smartphone has some data about their activity they can choose to take advantage of (or ignore). While working out has been popular for decades, we find ourselves in the era of metrics. Metrics are nothing new; BMI, inches, pounds, calories- but never before have we had so much data. And it’s only increasing.

"The market size, measured by revenue, of the Gym, Health & Fitness Clubs industry is $34.1bn in 2020."
-Ibis World

"Roughly one-in-five U.S. adults (21%) say they regularly wear a smart watch or wearable fitness tracker"
-Pew Research Center survey conducted June 3-17, 2019.

"2019 Global Wearable devices market is 26.43 billion"
-Statista.com

Health insurance companies are providing fitness trackers and gym memberships at a discount for incentivization programs in the hopes that they’ll be able to stem some of the ill health effects that come from a sedentary lifestyle and pervasive poor nutrition habits. Some health network campuses are providing yoga classes for members/patients to promote healthy living and align themselves with value-based preventative care.

"$117 Billion in Annual Health care costs are associated with inadequate physical activity"
-Center for Disease Control

Drivers

Although the trends change, the drivers in this category remain as they always have been, performance, appearance, pain relief and convenience.

“People only change for two reasons; vanity or pain.”
-Onyia Pemberton, therapeutic massage practitioner and personal miracle worker

People want to perform better
Today is a golden heyday for people who want to apply metrics to their workouts. There are currently a growing number of advancements when it comes to measurement and tracking; Fitness apparel companies are creating smart clothes and shoes with a fleet of sensors to track steps, speed, and movements across the body. Of course our devices are getting smarter. Watches, wearables (and soon headphones) can track heart rate, steps, speed, and more.

Supplements to boost performance have been around for a long time. The ubiquitous GNC brand was founded 85 years ago and although it has suffered dips in popularity along its past, it has continuously found ways to position their products to fuel hope in increased wellness and performance. Now, there are also smart clothes that can enhance your performance with chemical and vitamin supplements. Under Armour is working on clothes that can release chemicals such as magnesium to get absorbed by the skin and help reduce blood pressure and regulate your heartbeat while you workout.  

Of course access to information drives performance enhancement trends as well. As the performance science for professional athletes gets tested on an elite level, the advancements trickle down and now us regular folk can fine tune our own enhancements knowing what NBA players are doing to amplify their own game. As the granular training for professional athletes becomes more transparent, people have started to be more granular in their notions of working out. Now preparation/warm up, performance, recovery, and prevention are all more common considerations in amateur workout vernacular.

People want to look good.  
While we as a society have embraced more body types in media, weight loss remains a high motivator for exercise. In a survey administered by the National Institute of Health, women reported exercising for weight loss and toning more than men, who reported exercising for enjoyment more than women.

"There are 34,479 Weight Loss Services businesses in the US as of 2020."
-Ibis World

People want to feel good
Do you have a hunchback? Me, too. Apparently we’re not alone in slouching at our desk or incessantly looking down at our phone. Studies show that neck flexion (head droopiness, also called "text neck") increases dramatically the longer you're in front of a screen. During this pandemic,

Physical Therapy is an increasingly popular method of treatment and it’s not just injuries, but rather the pains that stem from inaction and poor ergonomics that has people seeking help in the form of prescribed exercises.

There are also a number digital posture wearables and physical braces (all conveniently available on Amazon) vying to help us combat our Quasimodo tendencies.

People want easier and more effective ways to do all of the above
When it comes to new workout technology the key words are personalization and convenience. Many platforms are capitalizing on people continuing search for a holistic home workout regimen at home (like Mirror and Tonal). There are many apps that take in your goals and preferences and create a customized workout program or potentially pair you with a specific personal trainer. Other machines allow you to join different types of group classes or virtual courses  based on your goals (peloton).

Future of Physical Fitness Predictions

Working Out
More metrics please. Look for increasing numbers of devices and wearables that can take in new data like O2, lactic acid, breath rate and blood pressure levels in addition to heart rate, speed, elevation etc. Better bio visualization and feedback will be part of new data. There will be easier ways to monitor muscle engagement, form and strength in real time (un-engage your triceps and focus on your deltoids). This will be in addition to understanding chemical changes and depletions in the body in real time.

Beyond more numbers, people will always seek more fun, motivation, and engagement. There’s a scene from a semi-watchable Michael Bay movie set in the future called The Island where Scarlett Joanssen and Ewan McGregor’s characters are fighting each other Street Fighter II style in a virtual reality ring where they are being mimicked exactly by avatars. I remember thinking that if working out alone was that satisfying and multisensory I’d probably do it more. Well... I’m about out of excuses. We’re almost there now. This type of video game immersion exercise will become better and more realistic. Think MMORPGs where your character will only succeed if your broadsword swings and footwork are on point.

Ergonomics/Posture
While it’s possible that our culture will start to embrace our smartphone slouch, more likely ergonomic correction will be on the upswing. Beyond standing and treadmill desks, look for increased mobility solutions during work and device viewing screens and controls that are decentralized (imaging scrolling through your phone with hand gestures down by your waist while you stand tall with a screen by your eyes) .

Physical Therapy will be an even more popular self-referred treatment to help undo the effects of a sedentary lifestyle. Whether they be digital or in-person, physical therapy and personal training will become more commonly used in tandem for the more casual athlete.

Studies are coming out now about how our over extended necks are pinching vital nerves and causing lasting damage. As this becomes more widely known, people will want to understand and quantify the damage done to their nerves and related systems.

Fitness Identity
Our shared sedentary lifestyle and poor nutrition will become more an issue as our life expectancies shorten. People will care for ailing parents at a younger age and as a result people will want to identify with a lifestyle that is counter to what caused their health issues.

Healthcare Opportunities

So how could and should healthcare participate in physical fitness trends and ideals of the future?

Healthcare Networks
Today, doctors are dangerously viewed as miracle workers who are keys to magical pills that fix you with no effort on your part (you mean they’re not?...) . Now is the time to educate your patients and help them embrace Physical Therapy as a first line of defense in musculoskeletal issues.

The industry has an opportunity to make PT easy, more accessible and provide digital platforms to assess compliance and correct form for all prescribed exercise regimens. And highlight the fun parts! Physical therapists give you massages for goodness sake. Ensure your PT’s are up-to-date with the latest myofascial release training. Emphasize the potential PT relationship and how your physical therapist is a great person to have on your team, rooting for you and partnering with you to help your body operate to the best of your ability.

We see a lot of sports medicine departments becoming the official providers for professional sports teams. While this is lovely marketing, it’s not necessarily going to persuade me (average human) to seek out everyday care with the group. Become the providers that can help make sense of people’s physiological data and goals. Deliver guidance and programs beyond advice to hit a weight loss and bmi goal. Differentiate by highlighting how your providers can become partners through any transformation journeys patients want to go on. Further deepen your position as a fitness authority by certifying or partnering with personal training programs, gyms, exercise brands and methodologies.

Health Insurance
In the future it won’t be enough to offer cheaper gym memberships (although that will still be a popular offering).  You’ll need to make it easier for whole families to stay fit. Provide access to (or create) family fitness programs that deliver ways to impart health habits to the younger generation and normalize everyday movement.

Provide portals and platforms that get to know your covered population as individuals and family groups. Help understand and promote active hobbies and present personalized offerings that are local, motivational and fun.  Insurance companies have an opportunity to develop a digital platform to assess and reward certain types of physical activity. Beyond this, you can use the platform to assess and mitigate risk for particular conditions and monitor certain physical markers for worsening symptoms for known medical conditions

On the hunchback front… provide reimbursements for ergonomic assessments for employers that utilize your insurance products. It’s a win win proposition and makes your product more attractive to employee benefit managers.

Medical devices and technology products
Of course, everybody and their mother will provide more fitness and body data but the secret sauce will be in collecting that data from various platforms and synthesizing it to make personalized actionable recommendations to improve performance and reach goals.

Make working out more transparent for people like me.
Bootcamp coach: “Engage your deltoids…”
Me: “ I thought I was...”

Help people visualize what is happening in their bodies during a workout and get feedback as to which muscles are being engaged, hydration levels, breath rates.  and help them set goals for form, strength, speed and other behaviors and bio-markers.

And can somebody please, please, make a realistic full body sensor, immersive virtual reality workout where I can get assessed and train my real life body to unleash my inner Chun-Li. Allow me to set goals that translate into new, stronger power moves as I get physically faster, more flexible and increasingly superior at (virtually) beating up my husband.

Whew! Thanks for reading. We didn’t talk much here about the mental wellness and nutrition elements of physical fitness but I’ll be covering those in other Future of Wellness in Healthcare articles for Lux @Propane.

By Kim-Minh Huberwald
Director of Strategy at Propane

Propane, Digital Agency - San Francisco
San Francisco, CA - 94110
415 550 8692

According to the World Health Organization, mental wellness is defined as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.”

We’d all like to think we fit into this definition, but most of us have had those periods of “fluctuation” -- sometimes lasting much longer than we’d like to admit -- when we can’t cope with the normal stresses of life (am I alone here?... anybody?). As culture, society, the environment, and technologies continue to shift at overwhelming rates,  the topic of mental wellness has become increasingly popular yet is interpreted differently across individuals and organizations. What’s clear, though, is as public conception of mental wellness changes, healthcare’s response will and should change to meet consumers, customers and patients where they’re at.

Landscape

Awareness and seeking treatment
Mental health is everywhere. From mainstream media (the Today show doing meditation segments in-between cooking and weather) to education (currently 9 states mandate mental health education in schools). And every lifestyle magazine covers “stress” management tips a few times a year.

It’s clear that mental wellness is more on our collective mind and more part of the cultural zeitgeist than ever before. From understanding the concept that people need to care for their mental wellbeing to having a sense of what drives mental wellness, we are all more aware. This leads to more people trying to address their mental health whether it be by making lifestyle changes or seeking treatment

• 1 in 5 U.S. adults experience mental illness
• 1 in 25 U.S. adults experience serious mental illness
• There is still an unmet need for mental health treatment among youth and adults. Only 28.2 percent of youth with severe MDE (major depressive episodes) were receiving some consistent treatment, and over 10 million adults still report an unmet need for mental health care.
• Almost a quarter (22.3%) of all adults with a mental illness reported that they were not able to receive the treatment they needed. This number has not declined since 2011.

–  Mental Health America's 2020 State of Mental Health in America Report

The stats above really only pertain to those aware of their mental health needs.  There still exists a lack of understanding and self-awareness as to what signifies mental health  (see reality television and internet troll wars). For middle aged and younger adults the term “mental health day” has become a widely understood concept (if not a widely embraced one). But, for older generations, there is less normalization of needing to care for your mental health and more stigma for doing so.

Land of 1000 apps
One of the biggest indicators that there is a ground swell of understanding about mental wellness and a growing desire to address one's mental health is the influx of apps centered around mental health (pun intended). There are hundreds of apps of different types to address different aspects of mental health. Heck, your iWatch even comes standard with Breathe, a mindfulness app.

Some of the app trends the National Institute of Health outlines are as follows:

Self-Management Apps - tools for managing stress, anxiety or sleep problems. You can use additional tools to track heart rate, breathing patterns or blood pressure etc.

Apps for Improving Thinking Skills - These  are geared toward people with serious mental illness and help with cognitive remediation (improved thinking skills)

Illness Management, Supported Care - “The app may help the user connect with peer support or may send information to a trained health care provider who can offer guidance and therapy options.

Passive Symptom Tracking and Data Collection - Apps that collect your data without you having to do anything (“movement patterns, social interactions [such as the number of texts and phone calls], behavior at different times of the day, vocal tone and speed, and more”)and aggregate behavior

Drivers

We may generally understand that mental health is important, but we’re still mighty...unwell. A lot of factors are driving that.

We can’t get treatment when we want it
Individuals seeking treatment but still not receiving needed services face the same barriers that contribute to the number of individuals not receiving treatment:

• No insurance or limited coverage of services
• Shortfall in psychiatrists, and an overall undersized mental health workforce.
• Lack of available treatment types (inpatient treatment, individual therapy, intensive community services).
• Disconnect between primary care systems and behavioral health systems.
• Insufficient finances to cover costs – including, copays, uncovered treatment types, or when providers do not take insurance.

- Mental Health America's 2020 State of Mental Health in America Report

Social Media is the worst
It’s no wonder, with the pressure to “keep up” and the bullying comments, it seems as the negatives of social media outweigh the positives.

"Numerous studies found that greater daily time spent on social media, increased frequency of SMU, and multiple platform use were associated with both depression and anxiety.Research suggests that increased social media consumption may lead to negative online experiences, fewer in-person social interactions, and decreased ability to sustain attention."
- National Center for Biotechnology information | National Institute of Health

People don’t socialize enough
Turns out we need to socialize. We’re community based creatures. Investing in social time yields some very positive mental wellness results.

"A strong social support system improves overall mental health outcomes and the ability to bounce back from stressful situations."
- Mental Health America

"The number of friendships you have early in your adult life and the closeness of those relationships can influence your well being 30 years later."
- Mental Health America

Unfortunately we make some less stellar choices for our time

During the week, Americans watch an average of 2.5 hours of TV per day, but only spend half an hour per day socializing.
- US Dept. of Labor, 2018 American time use survey

Work is the worst
Adults spend most of their waking time at work and it's taking its toll..

“Poor work-life balance increases your risk for health conditions like sleep problems, digestive disorders, and mental health problems. This is especially true for people who work longer shifts or on nights and weekends."
- MHA National

Even if you like your job, it can be stressful. And while I’m sure you, dear reader, absolutely love your job, (I do, too... hi boss) take a gander at these bummer statistics.

• More than half of people who responded to MHA’s Work Health Survey say that they do unhealthy things (e.g. drinking, drug use, lashing out at others) to cope with workplace stress.
• More than two-thirds of people have had their sleep negatively affected by workplace issues.
• Over 75% of people are afraid of getting punished for taking a day off to attend to their mental health.                

- MHA National Work-Life Balance

On top of all this we are overwhelmed, have toxic people in our lives and are currently in a worldwide pandemic.

Future of Mental Wellness Predictions

What does the future hold? Well I believe we’re going get better at creating boundaries for our time, expressing our emotions and healthfully asking for what we need. Why do I think this? I have a daughter who is being taught these skills in school. She knows to hug herself and breathe deeply into her belly when she’s really upset. She asks for alone time for cooling off and recharging. And, although the allure of television and screens loom large she knows that running around, climbing and jumping outside makes her feel good and sleep better. She is FOUR YEARS OLD. I didn’t know these things until my 30s and still have a hard time incorporating them into my life. My parents have not yet approached this level of self-awareness.

Knowledge of what elements constitute mental health is spreading and will continue to spread. There’s an acronym that has been popularized that outlines all the facets of mental health; SEEDS - Sleep, Exercise, Education, Diet, Socialization.  People will start to understand their own needs in these categories and become more vigilant in tracking and implementing these not just for their own sake, but for the purpose of mental health. Learning new skills or expanding your mind, getting enough z’s, time with friends, and eating nutrient rich foods will also be the criteria by which we start to judge others. I can imagine a world where the dating population starts to use metrics across mental health categories (in addition to the timeless mating and dating criteria currently in use).

Of course there will be more technology to address these issues, but ultimately I think the prevailing wisdom will be that you can’t shortcut these behaviors. For instance, there are wearable devices being developed that vibrate in frequencies that cause the body to produce stress reducing hormones. While this may become popular for a short time, people will understand that (if able) they can get the same or better results from a jog and a hug.

Healthcare Opportunities

So how might healthcare participate in mental wellness trends and ideals of the future?

Healthcare Networks
In addition to expanding mental health diagnostics and treatment access, healthcare provider networks can start to differentiate by creating dedicated programs and spaces to engage behaviors that benefit mental health. Health systems already provide support groups for people with specific diseases and conditions, what about guidance or peer support for what to do about work burnout, or programs/content that help model and normalize healthy relationships. Perhaps they can even provide addiction help for those who have a hard time putting down their phones.  Health networks can also play a large part in destigmatizing talking to professionals about what you’re going through, absent a diagnosable mental health disorder.

Healthcare will also have the opportunity to differentiate by addressing the mental health component of physical conditions. Currently, in order to help deal with the depression and anxiety that comes from a cancer diagnosis and ensuing treatment, some networks offer therapists and licensed clinical social workers as part of their oncology programs.  Imagine that awareness amplified and routinely offering mental health help for things like the anxiety that can commonly plague people who have eczema, certain cardiac conditions, and many others.

There’s also the wonderful cuddly world of pet therapy. Some hospitals use pet therapy to help improve mood and healing of patients. Pets, as any animal lover will tell you, can drastically improve your quality of life and studies have shown the positive effect of  having an emotional support pet or pet therapy.…

“ Improve cardiovascular health and physical activity; Decrease stress and lower blood pressure;  and for people receiving treatment for mental illnesses, animal-assisted interventions reduce anger, anxiety, depression, and general distress, while improving the ability to socialize."
-Mental Health America, Animal Companionship

Health Network campuses can start to offer drop in pet therapy (or music therapy or art therapy) clinics on their campuses for existing members or patients.

Health Insurance
Of course, a big differentiator will be to offer comprehensive mental health benefits and encourage your customers to seek treatment. Making it easier to find a mental health provider is key. Today a lot of those lists aren’t up to date, and even if they are, there aren’t enough providers on them. Beyond that, health Insurance has the opportunity to educate their customers about the correlation between mental health and physical health and work to boost both.

"When it comes to diet, sleep and exercise, having good, strong routines is linked to improved mental and physical health."
-Mental Health America, Creating Healthy Routines

Health insurance companies can only benefit if their covered population can create those healthy habits. Build platforms and include educational content that helps illustrate what it takes to be mentally healthy. Create and offer incentives for programs that build positive mental health habits.

Loneliness is perhaps hardest on the elderly. One of the opportunities for Health Insurance is to help people to understand and reduce loneliness, which, according to Mental Health America, “increases risk of many chronic health conditions.”

Health insurance would do well to create platforms and programs where aging people can connect and perhaps become re-imbued with purpose, sharing some of their talent or experience.  

Medical devices and technology products
Telehealth access to mental health providers is huge today and will continue to be important. Allowing these sessions to be as robust as possible with potential interactive exercises as well as the ability to create notes, share content and parse out the “advice” given by providers in a way that allows that advice to become more actionable and surfaced more easily.

In addition to the slate of mindfulness and reminder apps, it would be helpful to have different digital tools that allow people to normalize their feelings and experiences and understand whether their symptoms warrant professional treatment. Create platforms that help people understand what behaviors or treatments might be helpful for their current situation or at least a good starting place. Create devices or platforms that can track behavior and build awareness of feeling, mood, and unhealthy thinking patterns as well as platforms that can build habits.

Thanks for reading. We didn’t talk much here about diet and nutrition's effect on mental wellness but I’ll be covering that in an upcoming Future of Wellness in Healthcare article for Lux @Propane.

Kim-Minh Huberwald
Director of Strategy, Propane

"The global complementary and alternative medicine market size was projected at USD 69.2 billion in 2019"
- Grandview Research

So, how must the healthcare industry evolve its understanding of CAM and its place in the modern conception of wellness in order to keep up with developing consumer expectations?

Landscape

All right, full disclosure time. I am a big believer in some forms of alternative medicine. I’ve suffered from asthma and eczema and had weird allergic inflammatory episodes my whole life. A shout out to the 24+ dermatologists, allergists, pulmonary specialists, and generalists i’ve seen through my life, but as competent and well-meaning as they are, they just haven’t been able to steroid away all my stuff. So I’ve sought out the help of naturopaths, Chinese medicine practitioners, acupuncturists and more. Turns out I’m not alone.

"According to a government survey, 36% of U.S. adults ages 18 years and older use some form of complementary and alternative medicine (CAM). This number goes up significantly if prayer is included in the definition of alternative medicine.... CAM approaches were most often used to treat back pain or problems, colds, neck pain or problems, joint pain or stiffness, and anxiety or depression, according to the survey... However, only about 12% of adults sought care from a licensed CAM practitioner, suggesting that most people who use CAM do so without consulting a practitioner."
- National Health Interview Survey outlined by verywell health.com

Some popular CAM therapies include acupuncture, botanical medicine (including chinese herbal remedies, ayurvedic medicine, and other naturopathic and homeopathic remedies [including CBD and Kratom  products]), mind and body healing (including yoga, meditation, energy healing, chakra healing, hypnotherapy and kinesiology) and magnetic intervention.

Healthcare has already started to meet this trend with shifting offerings and alignments of its own. You can’t watch a commercial for any healthcare brand from the last 15 years without seeing someone break into warrior pose or a sun salutation. Yoga has become a symbol of preventative and value based care across health networks, pharmacy and insurance campaigns.  Also, health insurance companies have increasingly been covering alternative treatments like acupuncture and chiropractors in the last decade. This year, 2020 marked the first year Medicare covers acupuncture.

“HHS Secretary Alex Azar said offering alternative treatments for pain management 'is a key piece of the Trump administration's strategy for defeating our country's opioid crisis.' According to CMS, up to 66% of patients with chronic lower back pain are prescribed opioids.”   - Advisory Board

Drivers

Everyone knows someone suffering from some auto-immune inflammatory condition or chronic pain that doesn’t have a distinct known cause (and if you don’t, congratulations on living in the world’s healthiest bubble or being under 18 years old).  As chronic disease stemming from lifestyle of the western world increases so does the search for what can bring balance or relief. Our sedentary habits, processed high-sugar high-fat food, and high-stress behavior don’t seem to be waning and so our search for wellness is somewhat about off-setting these as opposed to eliminating them.  

The opioid crisis is scary. People are getting the picture that going to the doctor for magic pills that fix all your problems isn't all it's cracked up to be. There is a trend of people looking beyond pharmaceuticals and western medicine to establish wellness as well as treat pain and conditions ranging from the everyday to more serious. Consumerism in this vein is driving the market.

Alternative medicine is expected to become more mainstream in the coming years, especially in developed countries. This can be attributed to a new acceptance displayed by physicians and doctors in U.S. toward alternative philosophies and treatments that were conventionally excluded from mainstream medicine. -Grandview Research

Future of Alternative Medicine Predictions

Imagine a world where acupuncture and ayurvedic medicine clinics line the boulevards like gelato shops.  Oh, you already live in California? Well strap in as we are transported forward in time. Walk with me down Main Street U.S.A of the future (bring your sunscreen, the climate change is brutal). Look, there’s a Reiki /Light energy clinic between the V.R. gym and the coffee shop. Let’s take a peek inside. Patients are able to measure and quantify results (understand the changes and benefits in the body) of their energy healing, and there’s also a functional medicine doctor on hand and a juice bar, too.  

Let’s head into the large chain grocery outlet of the future. People are able to buy what used to be niche herbs and compounds anywhere as easily as they once bought aspirin.  These botanical cures are mass produced, have cultivated brands and are advertised on a large scale. In 2017 Garden of Life, a whole food supplements and vitamins brand, was bought by Nestle. In the future we can see Kraft, Coca-Cola, Anheuser-Busch and more all have their natural foods, supplements and health-based brands. Some consumers do prefer to get their botanicals in their raw plant form from a known source, and that’s available here too right next to the make-your-own milk-alternative station.

Consumers get guidance through their chinese, ayurvedic or other botanical medicine treatment and the process is a very transparent one. People have tools to help them understand each ingredients' biological function and how they might work in concert with other herbs or food. The produce guy can actually answer some of your health and wellness questions, too.

And see those high school students outside that look like they are up to no good? They are up to no good, BUT some of them are considering acupuncture as a future career as there are now many enduring reputable places to get trained in America. Most of them have grown up with acupuncture being a commonplace recommendation for even low level issues like PMS symptoms and to speed healing from strains and sprains. All of them have received CAM treatments in concert with western medicine since childhood from their regular doctor.

Follow me into that office building. Wow, I didn’t think workplace fashion could get anymore athleisure. Employee benefit managers have become far more invested in employees health and have in effect become partners with health insurance companies. Their goal: keep their employees well. This workplace offers nutrition and healthy lifestyle counseling, onsite massages, pilates and yoga classes, smoking cessation programs, and they even get coverage for  baseline wellness practices and many more CAM options if they are sick.

Healthcare Opportunities

As research and trials of CAM treatments increase and consumers become wary of a “limited” western medicine approach, all fields of healthcare will need to consider how Complementary and Alternative medicine will coincide with their current offerings.

Healthcare Networks/Providers
Holistic will be the magic word you can offer your patients. Ensuring your providers have wide understanding across western medicine and potential CAM treatments will be a key way to differentiate your services and meet patients needs and expectations. Working in tandem with CAM practitioners, making CAM recommendations or having CAM trained MD’s onsite will be very attractive to potential patients. Don’t forget the behavioral health and physical therapy service lines. Offering  therapies like havening and hypnotherapy or body work like myofascial release and rolfing not only can potentially help outcomes but shows consumers you are in the business of understanding and practicing what works for a wide range of people and starts to add into the “personalization” value prop I know you’re all championing. Provider and research institutions can partner with Health insurance companies to provide valuable data on the efficacy of CAM treatments.

Be the providers that can assess symptoms and help set baseline measurements (so effectiveness of CAM treatments can be followed). Make this a digital platform that provides the  ability for patients to quantify and track progress beyond just  “feeling better.” And on the technology front, provide digital tools to understand pharmaceutical and herbal interactions

Health Insurance
Well, you don’t want to be the only insurance plan left that doesn’t cover a range of CAM treatments. That’s a surefire way to position yourself as stolid, staid and “old thinking.”. As consumers get savvier and understand their options for health and wellness aren’t limited to a doctor’s office, this CAM coverage will become competitive differentiation. And if you’re going to cover CAM, you’re going to want to guide the choices people make. Give your customers resources and tools that provide guidance on what courses of treatment might be helpful with any current condition. Provide platforms to make CAM practitioner recommendations, or at least provide ways to find doctors with CAM understanding

Medical Devices and Technology Products
Give the people answers to their questions. Their questions are invariably “Is this working?” “How does this work?” “What might work for X?”. You have the opportunity to make all types of CAM treatments transparent.

Provide platforms that translate herbal remedies (for all ayurvedic, homeopathic, chinese common botanicals)  into their biological result (i.e. turmeric helps with conditions a, b, c by creating specific anti-inflammatory elements in the blood)

Provide products that can measure fluctuations or quantify energy work

Create platforms that connect people to ideal CAM treatments for their desired benefits

You’ll also have the opportunity to create devices for home treatment that are friendly to the western market (see the “chi” machine, light therapy machines, acupressure devices).

Thanks for reading. Namaste. We’ll cover more wellness integration opportunities for healthcare in the upcoming future of wellness articles for LUX at Propane.agency.

Kim-Minh Huberwald
Director of Strategy, Propane

Small businesses help create a unique community identity as well as promote innovation and entrepreneurship.

It’s no surprise that small businesses are the foundation of their local communities.

Amongst many other things, small businesses increase economic health, promote healthy competition, and create local jobs. And that’s not to mention the individual benefits that small businesses have across industries and regions.

It’d be difficult to list all the benefits of small businesses, but there are other ways to recognize their significance. At this time more than ever, it’s vital that economic players of all shapes and sizes come together to support and bolster small businesses and the individuals who comprise them.

We’re a small business ourselves and that’s why our leadership team here at Propane would like to take this opportunity to highlight our appreciation for our employees. We couldn’t accomplish all that we do without their dedication and committed efforts.

Since 2003, we’ve been established as a digital experience and platform agency. Our small but mighty team of rockstars work to augment marketing and digital transformation initiatives.

We take pride in being explorers at heart. It has always been our mission to explore the limitless ways that digital technology can improve lives, business, and society.

Our team members embody our company culture here at Propane. They’re crafty and cool-minded creators who brainstorm solutions, maintain active partnerships, and share a passion for delivering projects that make a real impact for our clients.

In a recent project, we handled UI/UX design and strategy of a member portal prototype for a healthcare venture. The solution received positive feedback about its interface and it’s now being used by internal team members.

The CX and marketing director of the company kindly took the time to leave us an online review about our engagement. They said, “Vision of a future state, strategy, design, user experience, project management and agency leadership- they are the whole package. Mind you this was done during the COVID period and they did not miss a beat.”

See what we mean by dedication? Our employees are devoted to providing support through every step of the process and are driven by our vision. We’re grateful for this feedback because it helps us increases business visibility on platforms like The Manifest, where we’re listed as a top agency in San Francisco.

Our leadership team is thrilled to celebrate our employee’s successes and accomplishments! Propane has also been recognized by other organizations such as DesignRush. We would like to extend a big thank you to our hard workers and want to express our constant gratitude and appreciation for them.

If you’re ready to discuss your next project with us, let’s talk.

Propane, Digital Agency - San Francisco
415 550 8692

When’s the last time you left a doctor’s appointment, saying, “hey, that was an incredible experience?”  While it may not be the standard -- yet -- it’s starting to happen more and more.

Between concierge services like OneMedical, entirely re-envisioned preventive care like Forward, or even supplemental services such as SafeRide’s medical transportation platform, digital is unlocking better experiences across the healthcare journey. The common thread we see is a fierce commitment to removing friction, frustration, and pain from the patient experience in an effort to cut through to providing value.

With this rise of digital healthcare and its promises of efficiency, convenience, cost savings, and 🤞 healthier people, here are our top ten UX considerations that we’re tracking for creating outstanding experiences.

1. Patient-centered UX -- Start with Empathy in the Patient Journey

The most important consideration is meeting patients where they are. Healthcare journeys are often complex and personal. They are made up of multiple touch points, across days, months or even years. People’s emotions can bounce between frustration, anxiety, fear, satisfaction, and more all along the way.

Winning organizations recognize this and work to understand the wide variety of needs, feelings, and expectations of a patient at each step of their journey. Before ever getting to pixels and code, start with humans. Emotions, beliefs, and actions are the key to unlocking real potential in innovation, and helpful healthcare digital experiences. Generative research such as interviews, diary studies or even surveys will uncover insights around all of those and be the best soil in which to grow an experience that’s truly helpful.

After insights are gathered, sort, bucket, organize, or [insert your favorite verb here] them into a map of the patient journey.  To provide real value, this layer cake of empathy can then be used to ideate valuable opportunities against. This will generate a rough roadmap of options for which to design, build, .test and learn from.

With opportunities in hand, we recommend fast and energetic iterations using design sprints to get ideas off the whiteboard and into users hands as fast as possible. Seeing how people interact with a potential solution is the fastest way to validate an idea. And since it’s hard to move fast and break things in healthcare (because it could be a matter of life or death) having a way to test and validate an idea before it goes to the masses will help reduce risk and increase success.

Making winning user experiences in digital healthcare aren’t as easy as following a recipe of ingredients, but it’s also not hard.  It takes empathy and a process that puts your patients at the center of everything you do.

2. Utility - Patients Want to Get Things Done

It’s fair to say a lot of patients are short on time. Digital has opened a new door on saving people time and energy by being the front door of services. Booking airfare, hotel rooms, depositing checks, even having groceries delivered through apps and websites has become so commonplace that is the norm not the exception. This is utility and users expect it.  So when users come to your experiences, if they don’t have a way to self-serve and get things done, they’re probably going to move on to somewhere where they can.

That’s why we consider the principle of utility to be one of the top considerations in designing UX for digital healthcare. Do what it takes to let users take control and get value as early and often as possible. Design, build, leverage existing 3rd party tools and tie systems together so that users can book their own appointments, communicate with their care team directly, take preventative health measures, and even get treatment. Your users will thank you -- by remaining your users (and not going somewhere else to get it faster, cheaper, better).

3. Privacy & Security

Privacy and security is an important concern in digital experiences across any industry.  According to a Price Waterhouse Cooper 2017 survey only 25% of consumers surveyed believe most companies handle their sensitive personal data responsibly but 85% of them say cyber security and privacy risks are among the biggest risks facing society. So, consumers are aware of the importance of privacy and security of their data and feel that companies don’t necessarily handle it responsibly. This adds up to 85% of consumers saying that they will not do business with a company if they have concerns about its security practices.

Healthcare is a highly regulated field and with that comes the HIPAA privacy and security standards that organizations experiences must abide by.  But just because a health organization may know them inside and out (right??), it doesn’t mean that patients do.

As you design your user experiences, look for opportunities to reinforce the concepts of privacy and security through both features and content. Two-factor authentication, salting passwords, and military-grade encryption may work well, but if a user is unaware of what's going on in the background, then there’s missed opportunity to reinforce trust in privacy and security.

On the other side, considering the unique journeys patient to patient, there are needs for patients to share access between other trusted people like family members and caregivers. Great user experience around privacy and security is more than keeping the wrong people out, it’s also about letting in the right people. Make sure to consider your users’ needs on both sides of this coin.

4. Transparency

In this opinion editorial from Modern Healthcare, Joseph Fifer nails it. “Here is the bottom line: Consumers want to know their out-of-pocket prices and other care purchasers want to know what their actual payment will be for services provided to their employees, members, or customers.”

Use your user experiences to push for transparency on behalf of your users. Whether this is related to time, money, or expectations, users will appreciate your effort to be upfront and clear with them.

Examples of areas to consider transparency:

• Pricing -- make costs available upfront taking insurance information into account. Think of ecommerce or shopping experiences as a model to make you experience clear and easy.
• Insurance -- insurance often becomes a black hole with a lot of complicated language. Be upfront about insurance acceptance, it’s impact on the experience, and simplify the language for users so it’s easy to understand.
• Timing -- consider how up to date notifications on timing changes or delays can be worked into your experience. If you don’t want your users to be late, they don’t want you to be late either. Use digital experiences to coordinate and update on timing so everyone’s on the same page.
• Expectations -- Digital is a great means to set expectations. Notify users at the right time in their journey of what to bring with them, or what to expect during appointments. Let them know what the next steps are and even let them track their progress along the way. Systems of notifications, tracking, and feedback are excellent ways to manage expectations transparently.

Every digital session is a conversation between you and your users. You’d want someone to be straight with you in a conversation to your face, so be straight and transparent with your users.

5. Personalization

We’ve already mentioned how personal every patient’s journey is. So it should be no surprise that considering how to make room for personalization in their digital experience makes our list.

Personalization considers information about a user like their previous actions or profile data to help improve their experience. Our view of personalization in digital healthcare is that it should be in the service of promoting healthier, happier individuals -- not just advertising services.

For personalization consider how details about the user like their current state in their patient journey, geography, age, conditions, timing, weather, etc. (just make sure it’s all HIPAA compliant) could impact or improve their ideal experience.

For instance, this Banner Health tool for getting urgent care was designed to use a user’s current location to understand what time it is for them so that it can determine what types of search results to surface based on locations’ hours of operation. It’s subtle personalized content, that shifts a user’s actual experience and decision making.

Personalization doesn’t always have to take place in the background either. Giving users features so that they can tweak or customize their experience to their needs is another form of personalization.  An example is Apple’s health app, which lets a user select the types of activities & metrics that are important to them to monitor on a dashboard. This cuts through the noise, and helps deliver a personal experience that provides value to the user.

6. Human   (vs.)   and  AI

What’s a tech top 10 list in 2019 without the mention of AI? Our take on it though, is to focus on how it can integrate in the user experience to augment and help without detracting from empathic, human-based healthcare. To us, an ideal experience blends in AI at the right points to reduce friction, increase efficiency and increase accuracy, while still providing a warm, compassionate human-based care.

Chatbots in digital spaces can create human-like discussions upfront, which can help patients get to the right type of human-based care faster.  Full AI adoption is projected to raise the productivity of registered nurses by 40 to 50% which could represent tremendous savings for hospitals in developed countries.  AI can decrease the amount of time spent scheduling appointments or even reminding a patient to take their pills.

AI-powered automation allows for the automation of routine activities that often hamper doctors and nurses from focusing their attention on the patient in the moment.  Chatbots integrated with deep learning algorithms could be implemented in waiting rooms to handle the large numbers of walk-in patients that come in with non-emergencies.  This increased level of organization would allow hospitals to optimize staff while significantly reducing patient waiting time.

Look for opportunities to augment UX with AI in service of patients getting the best care possible, but ensure empathy and human relationships remain central.

7. Accessibility Standards

From our perspective (and the perspective of any good ux and interaction design organization), accessibility should be a consideration in all UX design. That being said, the universal importance of healthcare to everyone means accessibility is more than just a consideration, it’s a hard requirement.

To truly take a patient-centered approach to UX, we recommend starting with shifting attitudes towards the idea that accessibility is the responsibility of the designer of an experience, not the responsibility of the user of the experience. The social model of disability emphasizes that it’s not a person’s condition that’s the cause of limited access to a solution or experience. Instead it’s society’s lack of empathy and inclusion in the design of the system that leads to limited access. As an organization offering an experience, it’s your responsibility to make sure your users can access it fully and inclusively.

The World Wide Web Consortium (W3C) provides standards and guidelines to help ensure content and feature experiences are accessible. Their Web Content Accessibility Guidelines (WCAG) provide a series of success criteria defined to help test your user experience against to assess whether it’s accessible. Designing against these standards is a solid baseline.  

We also like Ruby Zheng’s recommendation in her article for the Interaction Design Foundation to assign conditions or disabilities to your personas so that as you design you’re always considering accessibility needs.

8. Language - Reduce the Jargon

Technically this section is an expansion on the concept of accessibility, but considering how common it is to encounter hard to understand, medical or technical language in digital healthcare experiences, we wanted to call extra attention to it.  Section 3.1 of the WCAG gives us criteria to ensure an experience is understandable and readable.

It includes:

• Programmatically determining the language of the page and its parts.
• Giving users a way to define unusual words like medical definitions.
• Presenting content in a lower secondary reading level, or presenting companion content for higher reading level content to make it accessible at a lower reading level.
• Providing pronunciation where its needed for context.

We like to approach solving for this by saying things simply and plainly, with minimal use of the big scienc-y words. Explain things to a user in plain language wherever possible.  For example, using “heart” instead of “cardiac” where possible.  Remember that we’re meeting users where they are, which means we want to talk to them in ways that allow for understanding without a medical degree.

9. Don’t Forget About Wellness

As designers it’s easy to fall into the trap of designing to solve an explicit problem. When a user has symptoms that require medical attention, get them to the doctor. When a user has an outstanding balance, give them the ability to pay. But at the same time, digital healthcare can be as much about preserving a current state as it can about fixing a current state.

Maintaining wellness or preventing dis-ease are examples of users not yet encountering a problem.  In these situations the “problem” hasn’t happened yet, but we can design to prevent it from happening where possible.

Here, meeting users who don’t have problems where they are, and understanding how to help them maintain or prevent is the basis for empathy.  Once you understand where there are opportunities for you to help them, you can find ways to bring experiences to life that encourage and motivate them to stay the course.

For instance, consider how gamification can be used to encourage users to take preventative measures that will protect them down the road. We love Yu-kai Chou’s framework for gamification, Octalysis. It maps different understandings of human motivation and provides a series of mechanics for how to leverage those motivations to help them achieve a desired outcome. An example of this out in the wild is Fitbit’s achievement badges -- they use an understanding of a user’s “accomplishment motivation” to give users rewards for accomplishing goals.

10. Integrate

Last but not least in our top 10 considerations for digital healthcare we want to highlight the concept of integrations.  What do we mean by this? Don’t reinvent the wheel. Understand your user’s current digital ecosystem and work to blend yourselves into it, helpfully. Don’t expect users to switch to an experience you create from one they are already using, just because you build it. For instance, if users are already using SMS, do you need to build a separate app just to chat and notify them about their appointments?

Often times we see teams lured by the deceptive ease of custom building “the perfect experience” including features or functionality that might already exist. It’s easy to underestimate the overhead in building something from the ground up. This leads to design teams over-designing only to find out that IT or development can’t (or won’t handle the lift). Or, we see development teams start an undertaking that leads to long timelines or delays before delivering anything of value to users.

As an organization, look for opportunities on the user side to leverage current experiences and accounts like calendars, email, chat apps, and connected devices that users are already using. This can actually lead to users using your experience more, because it conveniently fits into their digital life.

On the organization side, look for opportunities to integrate different systems together to provide better context and more functionality for users. For example, if you have a billing system separate from your patient portal, look for ways to combine the two in an experience that gives users one place to go to manage their relationship with you. Bonus points for getting your appointment booking in there too 😉.  

It might sound hard or even impossible, but striving for a single sign-on and one place for a user to manage their health care digitally with you can build long term brand affinity. And, you don’t have to do it all at once. Build a roadmap, and take on challenges incrementally in a priority order that helps your users most, first.

Conclusion

With an unyielding commitment to meeting your users where they are, and empathizing with them, you’ll have an ongoing basis to always design and develop new value that only you can provide. We’re excited about the future of digital healthcare. There’s so much potential for digital experiences  to help users become happier and healthier. We hope that this list can help spark direction and motivation in your digital healthcare experiences. Of course, if you ever need or want help, we’d be happy to meet your users where they are, and bring new digital possibilities to life.

Propane, Digital Agency - San Francisco
170 Capp Street, 3a
San Francisco, CA - 94110
415 550 8692

Businesses of all sizes are always looking for an opportunity to improve their customer experience (CX).

Many companies focus on building new features and services that provide their customers with greater convenience, flexibility, and/or control. Others are beginning to see the benefit in looking internally at their employees, to nurture their growth in hopes that their CX prospers as a byproduct of their efforts. This second cohort of companies is focused on using creative culture-building techniques to produce well-rounded employees that are more inclined to supplement the company’s efforts in creating an optimal CX.

The fact remains that employees who aren't motivated to get the job done as per their company’s and customer’s expectations, can bring down an entire company. By fostering a positive, energetic work environment that is built around employee engagement, businesses of all sizes can help drive the CX in the right direction. Let’s review some of the most important links between employee engagement and CX are, which companies have had success in focusing on employee wellbeing, and how your company can embody a culture of engagement too.  

How Companies are Addressing Employee Engagement and CX?

It's no big surprise that companies that take an active interest in the wellbeing and happiness of their employees find it easier to attract the best talent.  Sadly, it’s often only after an employee has left the company that you realize just how much they contributed. What’s worse is that one in five new employees will leave their job within the first 90 days and one in four CFOs say that unwanted turnover accounts for 25% to 50% of labor costs.  

Shane Petersen, Head of Customer Operations at Shell, says it best in his statement that, “without happy employees, you won’t have engaged employees. And, a lack of engagement has a direct impact on CX.” This goes to show that customers will never love a company until it shows that it loves their employees just as much as their customers. Let’s look at some companies that embody a culture of positive employee engagement and how that has worked out for them recently.

Customer satisfaction has been shown time and again to be directly linked to employee satisfaction and financial success. Therefore, employee engagement is indirectly linked to financial performance for the business as a whole. A recent Gartner survey found that 86% of CX executives ranked employee engagement as having an equal or greater impact than other factors such as project management and data skills. These are the types of skills that have helped revolutionary companies like Toyota Motor North America and Starbucks become more organized and focused on initiatives that are dedicated to helping improve their CX.

Toyota Motor North America

Toyota Motor North America is more than just an automaker. They're constantly looking for ways to make our roads safe and pave the way for the future of mobility. This mentality goes far beyond the production lines and showrooms. It starts and ends with how the company develops strong communication channels between employee groups that aim to reward and recognize positive attributes.

Toyota also deals a lot in learning and development trainings where leadership encourages employees to find ways to give back to the community and reflect on Toyota’s values in the process. Toyota Motor North America’s CFO, Tracey Doi, says that by making every team member feel valued, “they will be passionate about what they are doing, and that will translate to higher-quality manufacturing as well as customer service on our marketing and sales operation.” This passion can be a huge driver for customers to continue coming back to an organization that they can relate to in the real people that they interact with, rather than just the company’s advertising.

Starbucks

Starbucks continues to show customers that the needs of its employees are valued which has allowed the coffee giant’s revenue to increase dramatically from less than $7 billion in revenue in 2005 to over $26 billion in revenue from June 2018 to June 2019. The company prides itself on taking care of its employees through initiatives such as stock options, competitive wages, education reimbursements, quality training, and health benefits. Starbucks has completely bought into the ideology that happy employees can naturally create a more welcoming atmosphere for their customers, thereby improving their CX in the process.

In short, diehard Starbucks fans like the company because they like the way it treats its employees which shows in the way their employees treat their customers. The reason for this is because happy employees create less friction on the backend processes. Less resistance on the backend allows staff to feel better about their job and the value they provide which also translates into a better experience for the customer.

Keeping Employees More Engaged = Improved CX

The White House Office of Consumer Affairs found that 80% of US consumers would pay more for a product or service if it meant that they would receive a superior CX as a result. As the U.S. Consumer Confidence Index (CCI) continues to decline with no signs of rebounding, one can understand how consumers are now more selective about where and what they spend their hard-earned money on. When consumers catch wind of companies that treat their employees with respect and value their opinions, input, and efforts on how to make the business better, they tend to spend more money on that company’s products or services.

On the flip side, when employees are unhappy in their current roles for whatever reasons, it can lead to dips in productivity, lost sales, and additional recruitment and onboarding costs that can eat into the company’s bottom line. With less profits coming from a deteriorated workforce, the organization’s CX can diminish and create deep seated morale issues that can decrease the chances that the company can respond to market changes in an agile manner. By focusing on creating a corporate culture that employees feel proud of being a part of because it embodies their individual values, they tend to be happier, and less likely to leave and contribute to higher turnover rates.

Natalie Baumgartner, Chief Workforce Scientist at Achievers says that, “you have to take care of your employees if you want them to take care of your customers” which is incredibly true as data shows that only 31.5% of employees in the U.S. report they are engaged in their work. In the end, when employees finally understand how they can make a difference, they will find their work more inspiring and engaging, thereby trickling down to the customer side and leading to a more empathetic, real CX.

Propane, Digital Agency - San Francisco
1153 Mission Street
San Francisco, CA - 94103
415 550 8692