Columbus, OH The rise of service design has brought about a huge change in how we think about designing products and services. It has shifted our focus to the real, human needs of people and the underlying resources we have available to deliver on those needs.

Service design has helped us bring fun and imagination into MRI scans for kids and even designed an extreme low cost baby incubator for use in third world countries.

User journey mapping is a key tool we use in service design, especially in healthcare. While we may only be responsible for delivering a solution at a particular time for a particular indication, patients have an entire journey they must embark on before and after getting a script and taking their medication.

Understanding patient’s emotional needs throughout their voyage helps us design solutions that delight and support them. Pharmaceutical brands have gotten this message and are providing an entire suite of services designed to care for patients as they walk on the path to better health. They’re enabling these through patient portals, HCPs tools, apps and third party partnerships.

But almost a third of prescriptions in the US are never filled, and about half of all patients don’t take their medications as prescribed.

What if mapping the patient’s journey isn’t enough? What if we’re missing the real, underlying drivers for behavior?

The Role of Behavioral Economics in Health Decision Making

It may come to surprise you, but contrary to what we may tell ourselves, human beings are not rational in their actions. We don’t always make decisions based on careful calculations of benefit and risk. Instead, our behavior is heavily influenced by our emotions, identity and environment, as well as by how options are presented to us. In the field of behavioral economics, academics study these behavioral influencers to identify what truly drives us.

  • Our irrational behaviors are neither random nor senseless- they are systematic and predictable. We all make the same types of mistakes over and over, because of the basic wiring of our brains.” -Dan Ariely, Professor of Psychology and Behavioral Economics at Duke University

In the healthcare world, these irrational drivers have a big impact. Medical decision-making is filled with uncertainty, complexity and emotion — all of which make it hard to weigh our options. This creates opportunities for us to act in self-destructive ways that may be against our own self-interest.

  • There’s starting to be a broad recognition that decision-making environments in health care could better reflect how doctors and patients actually make decisions. -Dr. Kevin Volpp, Director of Center for Health Incentives and Behavioral Economics at the University of Pennsylvania

For doctors, often times the ways they care for patients has less to do with medical science than habits and environmental cues.

  1. Prescribing the default: Doctors tend to prescribe a drug not because it is more advantageous, but because it is the default selection on their electronic ordering system
  2. Thinking of others instills action: Physicians are more likely to wash their hands if prompted to think about a patient’s health vs. their own
  3. Social pressure beats scientific evidence: HCPs will more readily change their medical practice if show data on how their colleagues do something differently than data about a treatment being effective or not

For patients, incentives and choice structures are usually more influential on behaviors than the actual health impact of the choices themselves.

  1. We overwhelmingly tend to stick with default options when given a choice: Organ donation rates are over 90% in countries where it is a default option vs. 4 -27% where it is opt in
  2. We tend to overvalue the present: Most of us prefer one free coffee now to two free coffees next week
  3. More choice leads to inaction: People are less likely to buy a product or make a decision if they’re given dozens of choices instead of just a few

Using Behavioral Drivers To Impact Adherence

Wellth is a startup that has developed an app to reward patients to take medications using researched-backed methods. They apply behavioral economics to achieve better adherence, engagement and health.

  • We want to give them immediate, tangible rewards for healthy behavior… however ultimately, we’re from the business of habit formation. We want behaviors to stick.” -Matthew Loper, Wellth CEO

Why This Matters

If we want to truly drive patients (or even HCPs) to new behaviors, we need to understand their underlying drivers. Leveraging insights from behavioral economics can help us be more effective as marketers. We can arm ourselves with data about how emotions, identity, environment and the presentation of options influence decision-making. This enables us to create experiences that impact health outcomes.

To do this, we need to infuse these insights into the tools and processes we use to design solutions for our customers. Going beyond the traditional ‘patient journey’ and creating a ‘behavioral journey map’ is a great start.

About the Author:

Zach Friedman