HEALTHxSCIENCE was held on August 2, 2018 at Y&R in New York City.
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Featured Presentations
How Behavioral Science Insights Drive Better Patient Outcomes
Colleen Welsh-Allen – VP Qualitative Research, Kantar Health
To drive behavior change, we need to understand all influences on behavior. Behavioral science broadens our understanding of patients from a holistic point of view, not just through the lens of their illnesses.
Key takeaways:
- Patients are empowered — never before have we had so much of a say in what we’re prescribed, what treatments we’ll accept, and even our outcomes. But we’re also in the age of the biggest epidemic of non-compliance and non-adherence.
- The reasons for non-compliance and non-adherence are varied: economics, denial, difficult regimens, side effects, dislike of taking pills, forgetfulness, lack of trust, lack of education on the reason for the medication, inertia and apathy. While not a panacea, behavioral science can address some of these causes.
- Our cognitive process is divided into two systems: System 1, which is fast and driven by heuristics, and System 2 which is slow, thoughtful and rational. 95% of our thinking is System 1. As humans are driven by heuristics, shortcuts, and biases, we need to understand these to drive behavior change. A number of common heuristics are described:
- Framing – The way a question, offering, or decision is presented has an impact on our response.
- In healthcare, messages can be gain-framed (as consequences of healthy behavior) or loss-framed (effects of not so healthy behavior). For almost two decades, a lot of the health promotion messages were loss frame.
- Research shows that while gain-framed messages drove better behavior in some cases (such as sunscreen usage), in others (e.g. detection), loss frame messages were more effective. This means that framing is important, but it is also necessary to do the research to determine what type of framing will work for a specific outcome.
- Priming – People’s subsequent behavior can be altered if they are first exposed to certain sights, words, or sensations.
- Applying this to healthcare, one experiment in a surgical ICU found that exposing individuals to a fresh citrus scent increased hand-washing adherence.
- Affect – Emotional associations strongly impact decisions and actions every day.
- A New Zealand study surveying patients during doctor visits found that compliance was related to trust and the physician-patient relationship.
- Loss aversion – Individuals care much more about avoiding losses than they care about making gains.
- This is the rationale behind loss frame messages in health promotion, and measures like increasing the taxes on cigarettes and alcohol. Penalties do work in some cases, but research is needed to identify what those situations are.
- Hyperbolic discounting – Individuals prioritize small rewards now over large rewards later. The longer that period of time between now and later, the more we discount.
- Designers are looking at ways to give consumers moments of delight for taking their medicine, providing a small reward in the now.
- Messenger – The weight we give to information depends greatly on the reaction we have to the source of that information.
- Commitment – We seek to be consistent with our public promises.
- Defaults – Defaults are pre-set courses of action that take effect if nothing else is specified by the decision maker. Setting defaults is an effective tool when there is inertia or uncertainty in decision making.
- Framing – The way a question, offering, or decision is presented has an impact on our response.
- Adherence programs that don’t take into account behavioral economics and use research to understand when different heuristics apply will not succeed.
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Digital Disruption: Use of Connected Devices, Wearables and Data
Ritesh Patel – Chief Digital Officer, Health & Wellness, Ogilvy Consulting
The brave new world of connectivity, AI, and data is changing consumer and healthcare practitioner behavior, and impacting the delivery and consumption of healthcare engagement.
Key takeaways:
- In the past few years, there has been a disruption of healthcare in every area and every facet. The pace of innovation is getting faster and faster, it is a global phenomenon (not limited to silicon valley), and everyone is fearless about pursuing a piece of the health care industry.
- This disruption is being driven by mobile technology – mobile is changing consumer behavior while enabling the disruption that’s occurring.
- Digital health is manifesting in a multitude of areas from consumer wearables and connected biometric sensors to telemedicine and health system disease management apps. A few examples:
- Smart thermometers can send readings directly to the doctor or help moms decide what to do next. An update of the stethoscope, the Stethee, is a handheld device that connects to mobile or even the EMR system of the hospital. It collects data and applies machine learning to give doctors more guidance around trends in the patient population.
- The value is in the data and using it for trends, alerts, etc., with the product as a means to gather the data.
- Fitbit is applying its capabilities to clinical brain wearables, while Proteus offers RFID technology in a pill. The pill transmits patient vitals and the time the medicine was taken before dissolving in the stomach.
- A group of clinical psychologists created a chatbot that can help people regulate their moods.
- Virtual clinical trials aim to address one of the biggest challenges in bringing a drug to market. By collecting the data directly instead of waiting for self-reports, it may be possible to conduct the trials faster and bring the products to market sooner.
- While technology will not fix all of healthcare’s problems, there is a demand and a population enabling this. As these technologies become cheaper and more widespread, they will become available to more individuals. It may not be now, it may not be all of these innovations, but some of these will be the way we deliver care in the future.
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Think Fast: Applying Behavioral Economics to Tackle Chronic Diseases
Tryggvi Thorgeirsson, M.D., MPH – CEO and co-founder, SidekickHealth
Traditional healthcare approaches often fall short because they target the rational side of our brains. But a combination of behavioral economics, gamification and technology can guide people along a healthier path to avoid chronic diseases. This presentation looks at the key drivers behind people’s lifestyle choices and how digital therapeutics can be applied.
Key takeaways:
- A tsunami of lifestyle-related diseases is sweeping across the globe, largely related to unhealthy diets, physical inactivity, and stress. These diseases are causing the majority of deaths and bulk of health costs.
- To prevent some of these conditions, we can take concepts from behavioral economics and apply them for lifestyle change interventions.
- Pillar 1: ‘Fast thinking’ controls most lifestyle choices.
- Most of our choices are controlled by the emotional, impulsive parts of our brain rather than the rational parts. While food advertisers seem to recognize this, public health communications tend to use an overly reason-based approach.
- Many digital health solutions likewise focus on numbers and graphs. But as over 60% of adults struggle with numerical health information, a different approach may be needed. Health information design should be visual and easily interpretable.
- There are a number of ways to appeal to the fast thinking part of the brain, including gamification and tools such as competitions, challenges, and rewards.
- Pillar 2: People use mental shortcuts, which can lead to errors.
- This is particularly relevant in food consumption and how we use shortcuts and make our food choices based on external signals, instead of internal stomach signals.
- One way to tackle this is with simple exercises in mindful eating and appetite awareness training to help people focus on those relatively weak internal signals.
- Pillar 3: Stress can cause greater reliance to fast thinking.
- When individuals are stressed, tired, or distracted, they tend to outsource more of their decisions to the fast thinking part of the brain.
- It is important to keep this in mind when designing lifestyle interventions.
- Pillar 4: People tend to discount future costs and benefits.
- People tend to discount what happens in the distant future in favor of what happens in the now. For health behaviors like flossing teeth, the cost to the individual is in the present but the benefit is in the future.
- The challenge is to bring cost and benefit together in time. Gamification techniques can bring rewards into the present through instant gratification mechanisms.
- Pillar 5: People are motivated by altruism.
- Altruistic rewards can be quite powerful.
- Findings from a study of 150 individuals compared a standard in-person lifestyle change program and one infused with behavioral economics. The enhanced program yielded improved adherence and an increased likelihood of achieving the set weight goal.
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Presentations
Panel Perspectives: Behavioral Economics Magic or Mindset?
Fred Petito – Group Strategy Director – Health Practice, Y&R
Scott von Lutcken – Director, Global Customer Insights, Customer Strategy, Merck
Scott Kressner – Managing Partner, BASIS
Moderator: Marjorie Reedy – Director, Digital and Consumer Innovation, Merck
How can marketers and researchers make behavioral economics more actionable in their organization? How can they use principles of behavioral economics to inspire patient engagement and ultimately improve health outcomes? Explore how to apply the science of behavioral economics to the art of communication.
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Leveraging AI: Understand WHY & WHEN Pharmaceutical Creatives Change Behavior
Frank Buckler, Ph.D. – Founder & CEO, Success Drivers
Jeffrey Kenin – Senior Manager, Consumer Insights, Bayer
How AI, content profiling and emotion measurement combined, enable insights that can be leveraged to learn about the DNA of successful creatives and the do’s and don’ts with allergy and other pharma ads.
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The Value of Behavioral Economics in Building Health Brands
Brian Robinson – Global Chief Strategy Officer, Havas Health & You
Behavioral economics has improved our understanding of actual health behaviors and build more connected, and powerful health brands. The result? Greater uptake and improved outcomes for both the individual and for the system as a whole.
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Successfully Produce Sustainable Healthy Habits
Matthew Loper – CEO, Wellth
Jill Carroll – IT Project Manager, Mount Sinai Health System
The costliest problem in healthcare results from patients with chronic diseases who don’t take their medications and don’t listen to their physicians. How can technology and rewards incentivize patients towards better health, improve adherence and decrease readmissions?
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From Theory to Practice: Case Studies in Promoting Behavior Change
Dana Safran – SVP, Chief Performance Measurement & Improvement Officer, Blue Cross Blue Shield of MA
Best practices and results are shared based on work combining anticipatory guidance, financial incentives and social support to drive behavior change with two unique target populations. And, directions for future research and innovation based on these findings.
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Behavioral Economics: The Last Mile of Health Engagement
Karen Horgan – Co-Founder & CEO, VAL Health
The field of behavioral economics recognizes that we have a difficult time changing our behaviors, especially when it comes to our health and how we receive medical care. Case studies illustrate the science behind irrational behaviors and challenge the audience to think differently about how to drive consumer behavior change.
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