Crossing the Wellbeing Chasm: Why we need a Health Score

by dacadoo

If the goal of corporate wellbeing programs is to get employees engaged in healthy lifestyle activities, then the ultimate goal has to be to get employees to take full responsibility for their health – to own it. I constantly hear from wellbeing program managers that they are trying to solve the “engagement problem” – how to get, and keep, employees engaged in healthier lifestyle activities. Yet, despite free access to interesting programs, events and financial incentives, long-term engagement remains elusive. It is time to explore new ways to solve this problem.


The Wellbeing Chasm

If we look at “engagement” in wellbeing as a journey - from initial engagement to crossing the chasm to complete “ownership” of one’s own health, then it would help us understand what needs to happen at different stages of the journey, as well as how a new tool could help keep employees on the right path across the chasm. There are three stages along this journey: 1) Understanding your health; 2) Improving your health; 3) Owning your health.


Understanding your health – part of the problem is that health is very complex. Even though the focus on holistic health has increased, and the direct impact to one’s health from exercise, sleep, nutrition, stress and mental wellbeing are now well documented, it is almost impossible to immediately know, for example, how a poor night’s sleep has affected one’s physical health. And when continuous bad habits do manifest themselves as a symptom or disease, it is often too late to do anything about it except to take medication. What if there was a way to inform you immediately how such behaviors improved or worsened your health, and by how much?


Improving your health – most people would say “yes” to the question: “Would you like to improve your health?” And most people know already what good eating and exercise habits look like. So why is it so hard to stick with it? One answer is that the benefits of new healthy lifestyle behaviors don’t necessarily show up right away? You don’t lose weight, or lower your blood pressure with every workout or healthy meal. Without immediate positive reinforcement, it is very difficult to stick with changing your own habits. But what if there was a way to see your health improving with every one of your healthy activities?


Owning your health – in order to cross the chasm to full ownership, you will need to feel a sense of empowerment: an understanding of how you can control your own health, and a belief that you can make it happen. In order to achieve this you will need constant, meaningful feedback to teach you how your own behaviors are influencing your health every day.


The Health Score

To help people along the road to cross the chasm, we need a health score. Everyone understands a score. Look at any aspect of life from the time we are children – we are used to measuring everything: height, age, test scores, the temperature, sports scores, etc. These are simple measurements – single numbers that let us know how we are doing, who’s winning. But health is complex and confusing – we need a health score to simplify it. In fact, there are some health scores in use today, just that they are not designed to inform and enlighten individual users.


In October, 2016 an article appeared in Bloomberg View titled: We Already Have Health-Risk Scores, Now Let’s Use Them.1 In this article the authors explain that personal health-risk scores are already being calculated for you by healthcare organizations, but are not very useful to individuals, nor to the overall healthcare system because they lack consistency, transparency and portability. They also mention that most people know they have a credit score and know where to find it – a good suggestion that the concept of a “credit score” would be a good place to start when thinking about creating a proper, useful health score that could positively impact individuals and the entire healthcare system.


The FICO score, the most commonly used credit scoring system, provides a good model for how a similarly complex problem, personal credit worthiness, has been solved. Some interesting facts about the FICO Score: a) invented in 1989; b) in 2013 consumers got free access to scores; c) in 2016 10 billion FICO Scores were produced.2 This has become a ubiquitous and useful tool throughout the financial services sector. FICO lists 5 building blocks of a great credit score as:

  • Predictive
  • Fairness
  • Massive Coverage
  • Transparency
  • Consumer-Centricity


In 1989 the technology did not exist to collect the data to enable a health score. But it does now – based on readily available wearables, monitors, AI, and purposefully designed apps.


Using the above model, let’s look at what the 5 building blocks of a great Health Score need to be:

  • Predictive – current health and projected future health.
  • Consumer-Centric – allow users to understand the score, what is affecting it, andhow they can improve it.
  • Trusted – health data is owned by the users and is protected at all times.
  • Validated – based on significant medical and scientific research and proven to beaccurate.
  • Real-time – score changes in real-time, based on one’s holistic health.

Benefits of a Health Score

Creating long-term engagement - remember, everybody loves to keep score. Now with a real-time Health Score, people will want to check their score every day – and at the same time see how it has changed during the last day. This, in turn, serves as a subtle reminder that they “did this” themselves – the early stages of the journey: I understand my health in a new way. They can see immediately the impact that their behaviors, for example nutritional or sleep habits, are having on their health.



Next, as they receive personal reminders and suggestions based on their Health Score, they get involved in more ways to improve their health. And as their score goes up, they receive immediate positive reinforcement, encouraging them to stick with it. Over time, this all adds up to a true understanding that they are in control of their health – they “own” it!


Measuring Wellbeing

Measuring the ROI of wellbeing programs is another significant challenge – how do we prove that we are making a positive impact on our employees. Companies try to prove the ROI and VOI on programs by looking at claims, productivity and absenteeism - all involve complicated analysis. But what if you could measure the true health impact of your programs immediately with an aggregate population Health Score? That means you could report on the change in health caused by every event and challenge. You could communicate the health benefits gained on a regular basis and would have data for planning and budgeting for future programs.


When done correctly, the Health Score becomes the great equalizer across wellbeing programs – a consistent measure of impact, and a universal way to move people across the wellbeing chasm!




  1. Bloomberg View: We Already Have Health-Risk Scores. Now Let’s Use Them.
    By: Peter Orzsag and Timothy G. Ferris, Oct 12, 2016 now-let-s-use-them
  2. FICO Score:



About the author:

Matt Park is Vice President of dacadoo americas, inc. The dacadoo Health Score and digital health platform enable employers to engage employees in active and healthy lifestyles. Matt works with corporations and health plans throughout N. America to help them create unique strategies for the new generation of wellbeing constituents. Matt will be presenting at EHBC 2017 in Los Angeles at 2:00 PM on October 4th.