by GK Strategy 12th June, 2018

To improve health outcomes, why not ‘nudge’?

Behavioural economics is being widely applied in the field of public health and there is huge potential to improve health outcomes in the future if we are prepared to grasp the latest digital health technologies.

Since the creation of the Behavioural Insights Team (BIT) by the coalition government in 2010, “nudge theory” has become popular in social and public policy. The theory harnesses certain psychological factors – namely the desire to fit in and avoid losses – to subconsciously ‘nudge’ us towards the default option.

There is huge potential to utilise ‘nudge’ in the health space.

Health at its core is the by-product of daily decisions made by doctors and patients. People do not always make decisions regarding personal wellbeing based on careful calculations of risks and benefits.

Rather, their behaviour is influenced by emotions, identity and environment, as well as by how options are presented. By uncovering what truly motivates individual behaviour we can ‘nudge’ people towards healthier choices.

Nudge in Practice

Social networks can have a particularly important influence on behavioural choices, with social norms often more powerful than messages about risks and benefits.

Indeed, a study found that when patients were exposed to the number of patients who did actually attend their hospital appointments as opposed to missing them, it resulted in a 32% reduction in appointments missed.

A further study of 20,000 NHS patients at Barts Health NHS Trust by the Institute of Global Health Innovation found that a simple message telling patients their failure to attend would cost the NHS £160 reduced missed appointments by almost 25%. With the NHS losing around £750 million a year in outpatients appointments and £162m in GP appointments, nudge could help prevent 400,000 missed appointments a year and could save the NHS at least £1m a week.

Digital health & data

However, the field of digital health is where the greatest potentials for nudge arguably lie.

Interventions that provide a choice between participation and non-participation can be particularly effective when it comes to health.

Digital health can incorporate the principles of nudge; framing decisions and giving feedback on norms and behaviours, whilst also setting small and realistic short-term objectives for improving public health. The social element of many new health apps further incorporates the principles of nudge, as users can track and record their progress amongst others.

In the smartphone-enabled medical system, technology will be the hub of medical records, diet and fitness.

There are now over 165,000 mobile health apps and it is evident that more of us want insights into our exercise, eating, weight and sleeping patterns.

Indeed, a new report by GK and onefourzero has found that demand from patients has for health tech has risen dramatically since 2014. Our research, published this week, indicates that the number of patients searching for online GP and prescription services has almost doubled since 2014, increasing by 99%.

With usage increasing, the vast amount of data collected from these apps has the potential to provide new insights into patient habits and behaviours. Knowing more about patients’ decisions will allow practitioners to ‘nudge’ patients more effectively – in turn improving outcomes.

However, the extremely sensitive nature of the data collected from these new apps presents a risk to providers. As the recent Cambridge Analytica scandal, and 2017 controversy involving over NHS test app “DeepMind” test breaking UK privacy law indicate, health apps must demonstrate excellent data protection policies to avoid becoming the subject of breaches.

Opportunities to improve care

At a time of significant pressure on NHS services, health technology ensures accurate, personal, and real-time feedback which can reinforce the efficiency of messages.

The rising demand for health tech presents an opportunity to incorporate ‘nudge’ principles into health policy.

These new apps provide patients feedback on how they are doing in relation to their treatment and progress, possibly compared to another group or age cohort that can motivate people to improve their behaviours and stick to treatments. The data collected from users can, if used correctly, provide valuable insights on patient behaviour and strengthening the field of behavioural science.

For those which harness the advances and deploy insights correctly, an opportunity exists to reduce pressure on frontline services, increase efficiencies and make much needed financial savings.

For more information on how GK’s health team can help you engage with the stakeholders that matter or to receive a copy of our report into the online GP market, contact jack@gkstrategy.com

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