the money wasn’t enough. There needed to be a way for us to stay in close contact and support him socially in the morning and the evening for the first couple of months while he was quitting.
In behavioral economics, the research shows that a couple of hundred dollars as a reward can triple one’s success rate in quitting smoking and quintuple success rates in losing weight. That meshed with emerging social health science research that shows that when you bring friends and family together, that’s your best motivator. They can hold you accountable, and that improves your success rate.
WR: Okay, so walk me through how the service works and how people are using it.
ZL: HealthRally lets friends and family—and soon brands and companies and health plans—pledge money to support, inspire, and motivate someone to achieve a health goal, whether that’s losing 30 pounds or going to yoga three days a week or taking a diabetes medication. You can use it in two ways.
One is to take charge of your own health; you know what you want to achieve so you pull in your friends. But unlike Facebook, this is a private social network—you are bringing in the four to 30 people that you would really tell the truth with. You choose a reward that will inspire and motivate you. Maybe it’s cash, maybe it’s an iPad, maybe it’s a day at the spa with your girlfriends, or maybe you’re raising money for charity. You launch your rally, and it’s three to six months long, and your friends inspire you through a private activity feed. It’s like a Kickstarter for health. What we are seeing in the initial user base is that rallies are either radically funded, or not at all.
The other way people use it is when your friends and family decide whether you reached the goal. There is a social verification process, so you don’t just get the money. It’s only if they declare you succeeded. That amplifies the level of social support, because you have accountability. If your aunt puts in $50 and you have mom puts in $30 and your five friends put in $20 then you have $180 on the line to lose 15 pounds in three months, and those people are checking in with you. We also have an internal artificial-intelligence engine called Rally Coach that monitors the motivation levels of the rally. If you haven’t updated HealthRally in a couple of days, we ping you or a random supporter and say, Hey, check in on them.
With my brother, he was psyched. He said, “This is great, I have tried to quit smoking three times and I didn’t have any help. You’re giving me a kicker? I’ll take the challenge.”
WR: What’s the neuroscience behind all this? In what way does the design of HealthRally’s rallies reflect what we know about how the brain deals with rewards?
ZL: What we know is that an uncertain reward keeps people interested and involved, and when that reward is provided it spikes your dopamine [a neurotransmitter associated with reward-based learning]. So you are going to stay involved, because your brain wants that dopamine spike. But that is only half the game. The second half is the social support, which increases your serotonin levels and boosts immune health and makes it possible to achieve more difficult goals. If you’re going to get off the couch and run that 5K, it’s going to require your whole brain system to be involved.
WR: There are several companies that administer rewards-based programs for large companies to help them incentivize their employees to make healthier choices, with the goal of lowering the employers’ healthcare costs in the long run. You aren’t going after that market, at least not yet. Why not?
ZL: You do have enterprise-to-employee programs out there, and they are not effective because when your coworkers get involved, that’s cute and interesting but those are not the people you are really accountable to. There are also some systems out there that are nice form the perspective of badges and levels, which are also commendable approaches to motivating people to achieve goals, but they will run their course. From what we can tell from the data, it’s getting loved ones involved that is the real accelerator.
WR: So you’re not a big fan of “gamification” in health.
ZL: It’s cute and it will work for some people, but the middle of the bell curve is not going to be driven to substantial behavior changes by badges and levels. It’s a big world out there and change is hard. The beauty of having your close, authentic social network as your motivational team is that they are basically gaming you all the time already. That is the game mechanics you want—the real humans involved in your true life experience.
WR: What do you think of Keas, here in San Francisco? They’re one of the leading companies organizing health-focused competitions within companies.
ZL: They have a fine approach. There is an incentive ecosystem emerging. It’s a huge space, because we’ve got to figure out how to motivate people to be healthy. I think the core philosophical difference between our approaches is that
