Empowering patients means understanding human behavior and 'nudging' them along the wellness path

October 26, 2016
Adrienne Rupp, Senior Director of Marketing, Geneia


I had the opportunity to attend last week’s Partners Healthcare Connected Health Symposium in Boston. The conference theme was “Digital Technology That Cares: Bringing the Human Element to Life.” The human element. Patients. Patient-centered care. Patient engagement and empowerment.

As I flipped through the conference program book to review the list of keynoters, panel presentations, industry satellite sessions and more, the session titles spoke volumes:

  • Behavior Change and the Psychology of Motivation
  • Innovations in Patient Empowered Care and Wellness
  • The Next Era of Behavioral Medicine
  • Patient-Generated Data: Putting the Patient in the Thick of Things
  • Where Does Health End and Wellness Begin? Personalization of Connected Health
  • Saving Health Care: Treating Chronic Conditions, Using Technology and Engaging Health Consumers

We all know that patient-centered care and effectively engaging patients in their health and well-being is essential to achieving the Triple Aim – better outcomes throughout the population, lower per Choosing a Healthy Lifestylecapita cost and an improved patient experience. But knowing the importance of patient engagement and empowerment and actually achieving it are two very different things. And it is the latter that continues to prove elusive – to providers and patients alike.

Lifestyle change is simple – or is it?

When I say that patients struggle with effectively engaging in their own health and wellness, it may sound puzzling. After all, if you want a copy of your medical record, ask for it. If you don’t understand why your doctor is recommending a certain treatment, ask. If you want to lose weight, exercise more, eat less and avoid junk food.

If you want to stop smoking, sign up for a smoking cessation program (most if not all health insurers offer them free of charge to members). You remember to brush your teeth and comb your hair every morning, so it should be easy to remember to take your medications, take your blood pressure or test your blood glucose level.

That all sounds simple, right? But it’s not. And any healthcare provider who takes a quick glance at his or her patient panel will confirm this, based on, for example, the number of patients with chronic conditions, the number of patients overdue for preventive care or the number of patients who usually forget to refill prescriptions.

Making lifestyle change is difficult. And asking patients to take an active role in their care and decision-making, when for so long we’ve trained them to be passive recipients of information and accept treatment recommendations as gospel, is more challenging than many realize.

Humans are irrational.

In fact, this was the topic of Zoë Chance’s keynote “Taking the Easy Road to Health: Inspiration from Behavioral Economics.” Chance is a marketing professor at the Yale School of Management who focuses her work and research on influencing behavior change.

Her talk focused on why there is often such a gap between the health choices we want to make and the actions we actually take, leading to frustration and guilt over a lack of willpower. She discussed how the science of behavioral economics can help us design choice environments that reduce the need for willpower and make healthy choices easier.

Behavioural ChangesBehavioral economics differs from conventional economics in the understanding and acknowledgment that humans are predictably irrational and don’t always make reasonable, data-driven decisions that will advance their self-interest.

Particularly when it comes to healthcare decision-making, we are guided more strongly by a desire to avoid unpleasant outcomes or loss rather than the prospect of future gain. We make decisions using familiar rules of thumb instead of systematically researching and analyzing available research. We also suffer from decision fatigue, often resorting to what’s easiest and available (the reason junk food is easily available and immediately consumable at the cash register, the point at which shoppers are most likely to suffer from decision fatigue).

So what’s the answer?

Unfortunately, there is no magic bullet. However, paying attention to behavioral economic theory and combining patient engagement strategies with technology has the potential to improve results in this area.

Strategies that employ short-term, incremental rewards for behavioral change and incorporate peer-to-peer support and recognition of achievement are proving effective. Healthcare providers are taking advantage of the wealth of technology now available to remotely monitor patients and capture biometric data, transmit that data wirelessly to a technology platform, and send alerts to help “nudge” patients to make healthy choices or to help care providers make earlier treatment decisions.

Geneia does this through our @HomeSM remote patient monitoring program, which combines technology with robust care management and patient engagement strategies, and is seeing positive results and lower costs.

We also offer education and training to healthcare providers through The Geneia Institute. Courses such as Motivational Interviewing, Patient Engagement Strategies, Patient Engagement for Effective Chronic Condition Management and Change Talk are designed to help care team members communicate more effectively with patients, empower them to take a more active role in their health and well-being, and identify the best strategies to help patients be successful.

At Geneia, when we think about our mission to improve the lives of the people we serve, we understand that patient engagement and empowerment is central to that goal. And in the new value-based healthcare reality, where reimbursement and rewards are tied to outcomes, we realize the importance of continuing to develop tools and resources that encourage patients to make healthy choices (to “nudge” them along) while at the same time coaching them to become empowered healthcare consumers and drivers of their healthcare decisions.


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