4 trends with the potential to change behavior in the patient journey

Whether medication compliance, kicking a bad habit, or some other form of behavior modification, change remains elusive, yet it’s obviously extremely vital. Read about these four trends that hold the promise of nudging healthier behavior along the patient journey (excerpted from MM&M)


  1. STAGE: EXPERIENCING SYMPTOMS | TREND: Marketers get serious about behavior change

“Behavior change has been in place in a lot of ways in marketing for decades and decades,” says Johanna ­Skilling, EVP, director of planning, U.S., at Ogilvy CommonHealth Worldwide. “Every time you ‘click here’ or ‘call here’ or download something, that’s behavior change. We just didn’t call it that. So we’ve been doing it, we just didn’t necessarily mean it.”

Nowadays, healthcare communications agencies are talking the talk and walking the walk, underpinning behavior change approaches with serious academic rigor. Skilling herself has worked on numerous support programs, from the Get Quit program prescribed along with Pfizer’s smoking-cessation pill Chantix to newer partnerships with patient-centric bodies.

These are built on behavioral modeling and take aim at getting people to think and act like nonsmokers, as in the case of Chantix, and leveraging other psychological tenets to uproot other entrenched behaviors. Change agents must “get people to think differently before they do something differently,” says Skilling. “We [can’t] shortcut that.”

Fostering a healthy habit requires prodding them along what’s known as Prochaska’s stages of change, which range from precontemplative to contemplative and preparation and then to action and maintenance.

Even when patients know the end result of not changing is likely to be serious, they might still be mired in precontemplation due to certain kinds of thinking (“my dad smoked and he was fine,” or “I smoke, but only when I drink”). These notions can take months to address.

If the patient is not ready to change, even the most innovative intervention could be useless. “Most of our interventions seem to be focused on the action phase, and there are maybe 20% of patients in healthcare [who] are actually in an action stage,” noted Dr. Richard Payne, a behavioral psychologist and consultant, at the 2016 MM&M Transforming Healthcare conference.

Next, when helping people commit to behavior that’s better for them, it’s important to get the communication right. That means not lecturing, which in and of itself is an ingrained healthcare marketing tactic.

Novo Nordisk’s Cornerstones4Care is a prime example. This program added co-pay support, email reinforcement, and personal coaching from a certified diabetes nurse educator.


  1. STAGE: DIAGNOSIS AND DECISION | TREND: Virtual humans make their presence felt

Being a primary care physician is harder than I had imagined. My first patient, “Laura,” a 32-year-old retail manager, had been home from work for the better part of a week nursing a nasty cough. She was pushing hard for antibiotics.

An empathetic person by nature, I do my best to show concern. “You really want to get back to your routine, and this cough won’t quit,” I say.

“Yeah, it’s terrible. I have bills piling up,” she replies.

Encouraged at that, I decide to go back to the empathy well again. “At least it’s Friday, and you can rest on the weekend!”

“No, I work in retail. I’m paid by the hour,” Laura chides, frustration apparent in her voice. “And if I call in sick again this weekend, I’ll miss two more days of work.”

Ouch. Laura may have only been a virtual patient, and I merely role-playing the physician, but the interactive experience taught a lesson: If you want to show empathy, don’t start out with “at least.”


  1. STAGE: TREATMENT | TREND: Health tech goes granular

Behavior change in healthcare is perhaps most associated with chronic disease, but diabetes and heart disease tend to attract the most attention. A number of new companies are now tackling other chronic health problems such as depression.

One of these is Iodine, whose Start app (pictured) aims to help people make an informed decision, after six weeks, as to whether an antidepressant is working for them or not by tracking doses and monitoring side effects. It can also be used to share progress reports with doctors.

It was one of six CareKit apps available, as of this writing, following Apple’s March 2016 launch of CareKit to give developers a framework for building apps that manage daily well-being. It followed Apple’s March 2015 launch of ResearchKit, which seeks to help researchers gather data for clinical studies, and HealthKit, the platform launched in fall 2014 that lets app developers ­integrate tracking of health metrics.


  1. STAGE: CONDITION MANAGEMENT | TREND: Uber fuels on-demand ride revolution

Many parts of the healthcare system are plagued by outdated software. The system that hospital transportation coordinators use is no different. Some 3.6 million patients miss their appointments annually due to lack of transportation access.

What if someone could soften the issue of patients getting to their lifesaving appointments? “For the disabled low-income populations that rely on nonemergency medical transport, this is a real issue,” reports John Brownstein, the PhD epidemiologist behind digital health tools like the MedWatcher mobile app and StreetRx.com. He has partnered with Uber on a new effort called Circulation to eliminate bottlenecks at this leg of the patient journey.


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