Acquisition, engagement, retention, optimal outcomes, and advocacy: This is the ideal patient lifecycle. It sounds straightforward enough, but this cycle often collapses in the wake of common breakdowns on the patient side of the care equation –– lack of buy-in, missed appointments, and ultimately, attrition.
So, how can therapy providers solve these compounding issues to ensure their patients achieve the best possible health outcomes, thus empowering those therapists to demonstrate their full value? Play to patients’ behaviors.
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Behavioral science and design are not new concepts. It’s all around us –– in our inboxes, our online shopping carts, and even our hometown grocery store aisles. For years, it has helped marketers and sales teams predict consumer habits and capitalize on these behaviors to fuel growth within their organizations and industries. This bodes the question: why aren’t we using it in health care?
Dubbed the next frontier in healthcare value, behavioral design can help you address and overcome the patient engagement problems specific to your practice –– whether you want to encourage people to sign up for your newsletter or improve patient adherence to drive better outcomes.
As it’s quite a robust concept, let’s narrow our focus to the fundamentals of behavioral design and how providers might implement it through habit chain reactions.
Simplifying behavioral design
There are many theories, books, and approaches to this concept, but Dr. BJ Fogg, founder and director of the Stanford Behavior Design Lab, has a theory I believe to be the most useful and practical in its approach to scientific application. His elegantly simple formula, B=MAP, shows that three elements –– motivation (M), ability (A), and prompt (P) –– must converge in order for a behavior (B) to occur.
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I think we can all relate to this. Picture the last time you were driving down the road and saw a sign for an ice cream shop. If you were hungry (motivated), had the time (able), and saw the sign (prompted), you might just pull over to get some ice cream.
Similarly, Charles Duhigg explains this concept in a “cue, routine, reward” cycle. Think of the reward aspect as the piece that cements the behavior and forms the habit.
A company that’s mastered this nudge and trigger concept is Amazon, presenting us with prompts like “Frequently bought together” and “Customers who bought this also bought…” right before you’re about to place an order. Before we know it, we’ve ordered more items than we anticipated prior to checking out. This is B=MAP at its finest.
Making change painless
To really understand this framework, let’s take it a step further. For this, I’ll again reference Dr. BJ Fogg and his behavior model. When thinking of this concept as a graph, envision the y-axis as consumer motivation and the x-axis as consumer ability. Now imagine an “action line” that slopes between the two. Any time a prompt is presented above the action line, the behavior will occur every time. Alternatively, when the prompt falls below the line, the result will fail to trigger the behavior.
Let’s apply this theory to a practical healthcare scenario. Perhaps you have a newsletter you want your patients or clients to sign up for. If you are inviting them to learn about an irrelevant topic –– say, astrophysics –– their motivation will be relatively low. Pair this with difficult tasks — like requiring them to complete a 50-question survey or provide their credit card number — and you’ll only further stymie motivation. Low motivation combined with a high degree of difficulty will cause the prompt to fall below the action line every time. In other words, people will not be signing up for your newsletter.
Conversely, if you offer a newsletter explaining medication side effects (incurring high motivation) and people interested in signing up only have to provide their email address (making it easy for them to do) your chances of getting more signups each time you trigger the behavior rises exponentially.
When a desired behavior isn’t occurring, I’d argue that your best recourse is to first focus on making the process easier rather than incentivizing patients (or potential patients) with offers that may increase motivation. The gist of this approach is that the easier you make something, the less of a factor motivation becomes—which in turn makes taking those habit-forming baby steps all the more painless. Introducing small tweaks now will position you to make a larger impact in the long term.
Creating a chain reaction
To ensure a behavior occurs consistently, it must take the form of a habit. However, forming habits is much easier said than done. One of the best ways to start — or to spur someone else to create a habit — is to anchor that habit behind existing ones, creating a habit chain reaction. The beauty of the baby step approach is that as your patients achieve small successes, they will build natural motivation. So start small, and slowly tweak the process to maintain success.
A few years ago, I ran a study with an innovation division of a large tech company where we researched how to help people form the habit of weighing themselves on a daily basis. One of my favorite stories from the study was about helping an individual design this habit into his life. To ensure his consistency, this individual anchored the new habit to his daily routine of making a cup of coffee (the prompt) by placing the scale on the kitchen floor next to the coffee pot (easy). The habit stuck for the first few weeks—until he moved the scale. After that, his consistent weigh-ins stopped completely. In short, he removed the trigger and made the task more difficult, ultimately causing him to fail in the long term.
When you pair small tweaks that cater to patient behaviors with habit chain reactions, you have a powerful tool to engage your patients in their care. And when patients are more engaged, they’re more likely to schedule additional visits, achieve better outcomes, and become raving fans of your practice.
Russell Olsen joined Phoenix-based WebPT as Vice President of Innovation and Product Management in 2017. He leads category design, product management, user experience and product discovery—as well as applying disruptive innovation approaches to accelerate growth while solving customer and market problems. Russell brings with him deep experience in healthcare and growth companies, and has delivered innovations impacting millions of lives over the course of his 15-year career.
Prior to WebPT, Russell led product teams at other healthcare organizations. His roles included Vice President of Product and Innovation at Phytel, an IBM company, and Offering leader at IBM Watson Health, where he led the creation of provider-led population health tools and the integration of Watson and machine learning into several offering portfolios. At IBM he also led the development and launch of Watson Care Manager, helping care managers improve the lives of chronically ill individuals across the globe. Additionally, he led teams at MDdatacor (now Symphony Technology Group), uncovering new ways to use natural language processing to improve the payer driven quality programs.
Russell graduated from Brigham Young University with a degree in electronics and information technology. He also received a certificate in “Disruptive Strategy” from Harvard Business School in 2017.
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