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Insights

Thoughts and writings from the world of Ionia

The power of a nudge...

They call it “nudging”; the idea is that people can be convinced to make the right decision by positive reinforcement and indirect suggestions, rather than by beating them over the head with a stick. It’s an idea that governments have been quick to embrace as well as healthcare, when we consider the power of the nudge in healthcare, we can expect positive patient and clinical outcomes. But, when we discuss behavioral economics within healthcare organizations, what are we actually discussing? Integrating behavioral economics is about trying to make a realistic model of how people actually behave. In economic, healthcare, and political models, we have made naïve assumptions about policies and prescriptions for patients and the intended outcomes. Often, it turns out patients’ behaviors are more complicated than we’ve previously assumed; essentially, we are using applied psychology to build a more realistic and effective model of the patients we serve and build policies and practices around this important fact.

Often, it turns out patients’ behaviors are more complicated than we’ve previously assumed; essentially, we are using applied psychology to build a more realistic and effective model of the patients we serve and build policies and practices around this important fact

Nudging conceptually articulates the idea that patients (and providers) can be persuaded to make better decisions by a simple change in the environment and choices presented to them. In 2008, this ground breaking theory was presented in the book Nudge by Richard Thaler. Largely, the theory says that patients make bad decisions in many areas of their lives from finances, wellness, and general issues like how they treat the planet. Simply put, patients don’t act in purely rational and predictable ways, but their choice making doesn’t always benefit their health, finances, or even those around them. If you’ve worked in medicine for a while, this shouldn’t surprise you at all. What should surprise you is this: Why haven’t we been applying these principles sooner? 

Simply put, patients don’t act in purely rational and predictable ways, but their choice making doesn’t always benefit their health, finances, or even those around them. If you’ve worked in medicine for a while, this shouldn’t surprise you at all. What should surprise you is this: Why haven’t we been applying these principles sooner? 

Nudging and behavioral economics has shown success in multiple sectors: paying taxes on time, insulating attics for energy savings, signing up for organ donation, smoking cessation during pregnancy, giving to charity — it’s saved taxpayers tens of millions of dollars, for example. For healthcare entities, combining nudges and behavioral economics with proper operational methodologies erases the current limits of a system focusing only on current processes, like Lean management principles. Focusing on current process and efficiency hasn’t allowed for applying new, established tools of behavioral modification that have already shown their promise of success across the healthcare landscape. At the core of behavioral economics, nudging, and our desire to synthesize it with healthcare delivery is the belief that patients and providers don’t always act in their own self-interest. All caregivers, as well as patients can be undone by anxiety and swayed by a desire to fit in with the actions of others around them or similar to them. In addition, caregivers and patients have biases and habits, can be quite lazy, and if faced with a choice, are more likely than not to make a choice at all but rely on the default option (the options chosen for you). Behavioral insights’ chief aim is to optimize and improve care delivery from the perspective of both the provider and patient, and it’s our joint goal to accelerate its uptake within the global healthcare delivery culture. 

Behavioral insights’ chief aim is to optimize and improve care delivery from the perspective of both the provider and patient, and it’s our joint goal to accelerate its uptake within the global healthcare delivery culture

Matt is a Behavioral Economics expert and would like to arm each of you with behavioral science tools to address strategic and delivery challenges. His firm, Ionia.codesigns processes to optimize human motivation, persuasion, influence, perception, behavioral nudges, and gamification. If you are interested in engaging with your patients and providers, please email him at matt@ionia.co or call at 205.434.3499

Matthew Cybulsky