back to Transform arrow
TRANSFORM

Can digital help solve one of healthcare's biggest problems?

back to Big Thinking arrow
TRANSFORM

Can digital help solve one of healthcare's biggest problems?

Mark Lightowler
Founder and CEO
Phorix

LinkedIn Twitter

Mark Lightowler, CEO of Phorix – Better by Design – is rewriting the way we think about communication. The combination of medical research, marketing, storytelling and digital tools set Mark on a journey to understand human behaviour and why it’s time to change the way we think about healthcare.

To improve health outcomes in today’s world, people – both patients and doctors – often have to change their behaviour. Mark Lightowler considers how we can address this complex issue

The need to change people's behaviour is at the heart of many professions. Politicians try to change our political behaviour. Traffic police try to change our driving behaviour. As parents, we continually attempt to improve the way our children behave. Marketing and communications have behavioural change firmly at the centre of their agenda, yet behavioural science is not a standard part of marketing education. And in healthcare, this seems even further away.

However, when you look at making a sustainable change in people's health, changing behaviour remains the biggest problem for the medical profession. Behaviour represents the largely unconscious actions we take every day and affects how we take medicine (adherence), whether we get enough exercise (physical activity), eat the right food or avoid cigarettes and alcohol. In the same way, we also need to look at the behaviour of healthcare professionals. Prescribing habits, hand washing and assessing diagnostic panels are all areas that behaviour influences.

Most of these behaviours seem hard to change and are out of reach. This is in part due to the difficulty in observing and influencing behaviour. Until recently it’s been challenging to track people's actions, predict their behaviour and understand the choices they make. But technology now allows us to make sense of behaviour through sensors, mobile communication like smartphones, and machine learning that can use the vast datasets that are being recorded.


When you look at making a sustainable change in people's health, changing behaviour remains the biggest problem for the medical profession


Healthcare, like many industries, has seen digital offerings and solutions increase at an exponential rate over the last ten years. While other industries are harnessing the maturity of Artificial Intelligence and mobile computing power, healthcare has been slow to explore how these digital capabilities can be used to support health-related behaviour change.

A prime example is the incorporation of gamification into blood glucose monitors for paediatric diabetes patients. This has certainly improved compliance and helped turn a somewhat unpleasant experience, carried out several times daily, into something fun and engaging. Something more mentally easy to do.


Conventional change programmes

Behavioural change programmes involve understanding the behaviour, designing interventions and measuring their effect. This requires a different approach and mindset compared to traditional patient research. While there are many theories of behavioural change, the COM-B model and Behavioural Change Wheel by Michie et al. is emerging as a practical framework to craft interventions in the healthcare and commercial spaces. The three-layered wheel demonstrates the need for more holistic programmes of change that address elements such as capability (knowledge, skills, stamina), opportunity (physical, social, political, cultural) and motivation (automatic or self-reflective).

Based out of UCL’s Centre for Behavioural Change, Professor Susan Michie –along with her colleagues and collaborators – has successfully used the wheel as a design tool to improve health-related behavioural change in adherence, smoking cessation, diabetes management and other conditions. At Phorix we’re currently exploring its potential to aid the design of digital interventions in asthma and chronic kidney disease, as well as addressing the change of behaviour needed by physicians to adopt new medical practices.

There are other tools and processes that help in assessing people's behaviours. Customer and patient journeys, for example, can highlight what’s going on in a complex system, often in a visual way that helps teams see the cause of the behaviour and how to formulate potential solutions. While storytelling is an on-trend pharma tactic, the skill of understanding medical narrative is relevant, if something of an older and forgotten ability. Documenting and analysing the stories from medical narrative can pinpoint language, metaphors and images that articulate the what and how to affect change.


Digitally enabled change programmes

Digital tools have been able to take communications into the homes and pockets of patients. This allows data to be gathered and algorithms to predict behaviour before it happens and communicate with people in real time, thus helping to make behavioural change sustainable.

Tools like smartphones, smartwatches, smart spaces, Internet of Things and Internet of Medical Things as well as other connected ecosystems have taken us to the moment and place that behaviour occurs. They’re helping to find the leading indicators of behaviour and act as a channel to communicate with people to affect and sustain change.

We need to learn new and complementary ways to assess behaviour and find applications beyond education if we’re to make behaviour change effective and sustainable. Digital tools are a significant advance in technology, but without a deeper understanding of what these devices need to communicate – and when it's best to communicate – we may not realise their real potential.

 

Share this article

 

To improve health outcomes in today’s world, people – both patients and doctors – often have to change their behaviour. Mark Lightowler considers how we can address this complex issue

The need to change people's behaviour is at the heart of many professions. Politicians try to change our political behaviour. Traffic police try to change our driving behaviour. As parents, we continually attempt to improve the way our children behave. Marketing and communications have behavioural change firmly at the centre of their agenda, yet behavioural science is not a standard part of marketing education. And in healthcare, this seems even further away.

However, when you look at making a sustainable change in people's health, changing behaviour remains the biggest problem for the medical profession. Behaviour represents the largely unconscious actions we take every day and affects how we take medicine (adherence), whether we get enough exercise (physical activity), eat the right food or avoid cigarettes and alcohol. In the same way, we also need to look at the behaviour of healthcare professionals. Prescribing habits, hand washing and assessing diagnostic panels are all areas that behaviour influences.

Most of these behaviours seem hard to change and are out of reach. This is in part due to the difficulty in observing and influencing behaviour. Until recently it’s been challenging to track people's actions, predict their behaviour and understand the choices they make. But technology now allows us to make sense of behaviour through sensors, mobile communication like smartphones, and machine learning that can use the vast datasets that are being recorded.


When you look at making a sustainable change in people's health, changing behaviour remains the biggest problem for the medical profession


Healthcare, like many industries, has seen digital offerings and solutions increase at an exponential rate over the last ten years. While other industries are harnessing the maturity of Artificial Intelligence and mobile computing power, healthcare has been slow to explore how these digital capabilities can be used to support health-related behaviour change.

A prime example is the incorporation of gamification into blood glucose monitors for paediatric diabetes patients. This has certainly improved compliance and helped turn a somewhat unpleasant experience, carried out several times daily, into something fun and engaging. Something more mentally easy to do.


Conventional change programmes

Behavioural change programmes involve understanding the behaviour, designing interventions and measuring their effect. This requires a different approach and mindset compared to traditional patient research. While there are many theories of behavioural change, the COM-B model and Behavioural Change Wheel by Michie et al. is emerging as a practical framework to craft interventions in the healthcare and commercial spaces. The three-layered wheel demonstrates the need for more holistic programmes of change that address elements such as capability (knowledge, skills, stamina), opportunity (physical, social, political, cultural) and motivation (automatic or self-reflective).

Based out of UCL’s Centre for Behavioural Change, Professor Susan Michie –along with her colleagues and collaborators – has successfully used the wheel as a design tool to improve health-related behavioural change in adherence, smoking cessation, diabetes management and other conditions. At Phorix we’re currently exploring its potential to aid the design of digital interventions in asthma and chronic kidney disease, as well as addressing the change of behaviour needed by physicians to adopt new medical practices.

There are other tools and processes that help in assessing people's behaviours. Customer and patient journeys, for example, can highlight what’s going on in a complex system, often in a visual way that helps teams see the cause of the behaviour and how to formulate potential solutions. While storytelling is an on-trend pharma tactic, the skill of understanding medical narrative is relevant, if something of an older and forgotten ability. Documenting and analysing the stories from medical narrative can pinpoint language, metaphors and images that articulate the what and how to affect change.


Digitally enabled change programmes

Digital tools have been able to take communications into the homes and pockets of patients. This allows data to be gathered and algorithms to predict behaviour before it happens and communicate with people in real time, thus helping to make behavioural change sustainable.

Tools like smartphones, smartwatches, smart spaces, Internet of Things and Internet of Medical Things as well as other connected ecosystems have taken us to the moment and place that behaviour occurs. They’re helping to find the leading indicators of behaviour and act as a channel to communicate with people to affect and sustain change.

We need to learn new and complementary ways to assess behaviour and find applications beyond education if we’re to make behaviour change effective and sustainable. Digital tools are a significant advance in technology, but without a deeper understanding of what these devices need to communicate – and when it's best to communicate – we may not realise their real potential.

 

Share this article

 

Mark Lightowler
Founder and CEO
Phorix

LinkedIn Twitter

Mark Lightowler, CEO of Phorix – Better by Design – is rewriting the way we think about communication. The combination of medical research, marketing, storytelling and digital tools set Mark on a journey to understand human behaviour and why it’s time to change the way we think about healthcare.

Request a demo of The Hub