1. Optimizing Engagement
Through Design
Eric F. Shaver, Ph.D.
Director of Behavioral Research & Design
HIMSS11
February 21st – 23rd 2011

2. State of the System
• Health care in the U.S. is at a crisis point.
• More than ever people turn to the internet for
health information.
– 80% of internet users (Pew Internet, 2011)
– 59% of U.S. pop are health information seekers.
• But, is that information trustworthy – let alone
engaging?

3. State of the System, cont.
• Designers are vying for people’s attention in a
information saturated world.
• Need to design experiences that are:
– Engaging
– Educational
– Enduring
– Encouraging
– Executable

4. What is Engagement?
• Characterized by attributes of:
– challenge
– positive affect
– endurability
– aesthetic and sensory appeal
– attention
– feedback
– variety/novelty
– interactivity
– perceived user control (O’Brien and Toms, 2008, p. 941).

5. What is Engagement?, cont.
• Other definitions:
– “…the process of involving users in health content in
ways that motivate and lead to health behavior
change.” (Lefebvre, Tada, Hilfiker, and Baur, 2010, p. 667).
– Also defined by website metrics (e.g., visits, time on
site, plays, downloads, etc.)
• No currently accepted universal definition.

6. Why is Engagement Important?
• Engaging technology can assist users with
being more proactive in their health care.
• Engaging technology is an important element
to facilitate user participation.
• Increases the likelihood that users will
re-engage, as necessary, in the future.

7. Why is Engagement Important?, cont.
Actively
Exposure to Attention to
Process
Content Content
Content
Store and
Accept Comprehend
Retrieve
Message Content
Message
Behavior
Select
Perform Results in
Appropriate
Behavior Intended
Behavior
Outcome

8. Why is Engagement Important?, cont.
Actively
Exposure to Attention to
Process
Content Content
Content
Store and
Accept Comprehend
Retrieve
Message Content
Message
Behavior
Select
Perform Results in
Appropriate
Behavior Intended
Behavior
Outcome

9. Designing for Engagement
• Determine how the technology will be used.
• Understand the needs, wants, and desires of
users.
• Personalize content so it’s relevant to the user.
• Provide content that user’s need at the time they
want it.

10. How Does Unity Do It?
User-
Driven
Design- Data-
Driven Driven
Unity
Theory- Medical Market-
Driven Technology Driven

11. Takeaways
• Don’t design technology in a vacuum – context
matters.
• Designers of health care technology must
remember it’s not about you – it’s about the end
user!
• Know thy user.
• Engagement is important.

12. References
• Fox, S. (2011, February 1). Health topics. Pew Internet & American Life
Project. Retrieved from http://pewinternet.org/Reports/2011/HealthTopics.aspx
• Lefebvre, R.C., Tada, Y., Hilfiker, S.W., & Baur, C. (2010). The assessment of
user engagement with ehealth content: The ehealth engagement scale.
Journal of Computer-Mediated Communication, 15, 666-681.
• O’Brien, H.L., & Toms, E.G. (2008). What is user engagement? A conceptual
framework for defining user engagement with technology. Journal of the
American Society for Information Science and Technology, 59, 938-955.

13. Contact Information
• erics@unitymg.com
@ericshaver