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Connecting digitally with consumers is great, but successful efforts often have one rather old-fashioned trait in common. Before launching their programs, providers with well-utilized consumer connectivity efforts sit down face to face with their audience to sort out their needs. "I can buy something for $100 and give it to my mother, but it has no value unless she'll use it," says Sandra Elliott, director of consumer technology and service development at Meridian Health, Neptune, N.J. Meridian recently wrapped up a pilot program-which it will continue-that tested delivering medication reminders to seniors through cell phones.

But before it handed out the first phone, Meridian went to great lengths to interview prospective users of the system. "We were trying to understand the complexities of medication management," Elliott recounts. The in-person field work yielded real benefits in eventual system design. For example, patients firmly stated they did not want to be bombarded by phone calls-one a day, even for those on multiple medications, would suffice. Furthermore, they did not want the pre-recorded communications to spell out every medication by name. "We may think we know what consumers want," says Elliott. "But it is often very different from what we imagine. You need to learn that from a ground-up perspective."

That's the approach taken by Mad*Pow, a design firm based in Portsmouth, N.H. Founded by Amy Cueva, the firm has designed multiple Web sites for a wide mix of health care organizations, including software vendors marketing PHRs and health plans attempting to promote utilization of online tools. Cueva's firm typically engages target audiences one on one before building design templates. "The value of the interaction has to be clear and the interaction has to be easy," she says. "Patients are tired and they're grouchy. So you cannot just deliver the utility, you need to add surprise and delight to the experience."

For example, Cueva's group designed an online search tool for Aetna, designed for consumer use. The tool pops up results in a series of graphic clusters that look like a molecular structure. The visual tool helps users sort out the results more easily than would a more straightforward list, Cueva says. Thus, a search on diabetes reveals a visual map that includes symptoms, local doctors and cost information, neatly arrayed in information bubbles. One key factor drives consumer use of online health applications, she contends. "They want to know what's in it for them. So you have to leverage technology to meet their goals."