Force for Health · Concept Brief

Healthy Coins as a Health Currency

Turning Reality Health Games engagement into a standards-based, de-identified signal that the Pennsylvania HIE, payers, and public health can actually use, price, and act on.

HL7 FHIR R4 De-identified (HIPAA Safe Harbor) Engagement → Outcomes Household-level linkage
Illustrative prototype. Every number in the charts below is synthetic — placed only to show what the tool would display and to frame the hypotheses. No real patient, member, or FFH user data is represented. Any correlation shown here is a design mockup, not a finding.

The idea in one paragraph

CTO + CFO hats.

Right now, Healthy Coins are an internal reward — they buy gift cards and drive engagement inside the Academy. The opportunity is to give them a second life as an interoperable health signal. If a coin balance, a badge, or a "Certified Patient" credential is expressed in the same standard language an HIE already speaks (HL7 FHIR), then engagement stops being a marketing metric and becomes a measurable, exchangeable unit that sits next to claims and clinical data. The PA HIE's core job is moving standardized health data between organizations. We give them a brand-new, prevention-side data stream they don't have today: proof that a person (or a whole household) is actively learning and changing behavior — and a de-identified way to test whether that engagement tracks with fewer ER visits and lower cost.

1. Why coins become a "currency"

A currency needs a common unit and a shared ledger. FHIR is that shared ledger for health.

The move that makes coins valuable outside FFH is translating each engagement artifact into a FHIR resource. Once it's a FHIR resource, any HIE, EHR, or payer system can ingest it without custom integration — that's what turns an internal point into a tradeable signal.

FFH artifactFHIR resourceWhat it asserts
Healthy Coin balance / streakObservation Quantified engagement (e.g., "health-education-minutes", "engagement-index") with a date and value
Badge (Learn It / Live It / Share It)Observation + Coding A completed, verifiable competency at a defined level
Certified Patient credential (e.g., Asthma)DiagnosticReport / Observation Health-literacy + adherence score reportable back to a care team
Educational "prescription" from a providerServiceRequest / CarePlan The order that sent the patient to FFH in the first place
Redemption / reward eventProvenance Auditable ledger entry — who earned what, when, and how it was validated
The loop: Provider order FFH engagement (coins/badges) FHIR Observation/DiagnosticReport back to the HIE HIE routes the prevention signal to the payer / care team value flows back to fund the coin pool.

2. The de-identified engagement-to-outcomes tool

This is the part that answers "is there actually a correlation?" — safely.

What it measures

  • Engagement tier — none / light / active / power user, from coins + streaks
  • Credential depth — badges earned, Certified Patient status
  • Household effect — 1 vs 2+ engaged members under one roof
  • Outcome proxies — ER visits, avoidable admissions, total cost of care, appointment adherence

How it stays de-identified

  • HIPAA Safe Harbor: strip all 18 identifiers before analysis
  • Match on a one-way tokenized ID (privacy-preserving record linkage) — the HIE holds the key, FFH never sees claims
  • Report only cohorts, never individuals; small-cell suppression (n<11 hidden)
  • An expert-determination review before anything is shared externally
Architecture: FFH engagement (Supabase) nightly FHIR export tokenize + de-identify HIE links to claims/utilization on the token aggregate cohort stats returned to a dashboard. FFH sees engagement + outcome rates; it never sees a member's claims.

3. What the dashboard would show

Illustrative view — synthetic data, for shape and hypothesis only.

–31%
Illustrative ER visits: power users vs non-engaged
2.4×
Illustrative appointment adherence lift with a Certified Patient badge
$540
Illustrative avg annual cost-of-care gap per engaged member
ER visits per 1,000 members, by engagement tier synthetic

Hypothesis: higher sustained engagement associates with fewer avoidable ER visits.

Not engaged 420
Light 350
Active 285
Power user 240
Illustrative outcomes by household engagement synthetic

Hypothesis: a second engaged member in the home amplifies the effect (shared habits).

0 engaged in home Base
1 engaged –18%
2+ engaged –37%
Higher utilization Lower utilization
Credential vs adherence synthetic

Hypothesis: specific badges/credentials predict specific behaviors better than raw coin totals.

No badge 31%
Learn It 44%
Live It 59%
Certified Patient 75%

4. The study design (so a finding would hold up)

To make any correlation credible to a payer or public-health reviewer, the tool is built around a real study frame, not just a chart:

5. What it's worth — and to whom

Buyers of this signal

  • PA HIE — a new prevention/SDOH data stream to route to members
  • Medicaid MCOs & payers — quality (HEDIS-adjacent) & cost-avoidance evidence
  • Health systems — Certified Patient readiness before the visit
  • Public health / grants — population engagement + outcome reporting

How FFH captures value

  • Per-member-per-month for the engagement data feed
  • Analytics/reporting license for the correlation tool
  • Outcome-based bonus if cost-avoidance is demonstrated
  • Payer-funded coin pool — the reward that drives it becomes self-funding

6. Compliance guardrails (non-negotiable)