A presentation I gave to an audience of national healthcare executives on using behavioral economics to achieve better healthcare messaging outcomes.

1. Choosing
Well(ness)
Crafting Healthcare
Choices in a More
Digital World
Erik Snyder

2. In this presentation…
The Digitally-Empowered Patient Journey
Medical Decision Making in the Age of Google, iPhone and Yelp
Cognitive Consequences of Choice Abundance
Confusion, Paralysis and Dissatisfaction
Behavioral Frameworks That Help
B=MAT, Duel Process Theory, and Wikipedia’s Big List of Cognitive Biases
Examples From the Field
OB, Cancer Screening and Bariatrics
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3. The Digitally-Empowered Patient Journey
20 years ago, what would you do if you had a pain and needed to see a
physician?
• Ask friends & family
• Use the phone book
• See a sign and walk in
• See traditional advertising
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4. The Digitally-Empowered Patient Journey
Today, what would you do if you had a pain and needed to find a
physician?
• Ask friends & family (on social media)
• Google it
• Read reviews online
• See advertising (traditional AND online)
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5. The Digitally-Empowered Patient Journey
Patients today are: Mobile, Connected, Informed
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70%
Access healthcare
information using
their mobile phone
(Pew Research)
90%
Would trust
medical
information shared
by strangers online
(Google)
53%
Ask their doctor
questions based on
information found
online
(Google)

6. The Digitally-Empowered Patient Journey
How often are medical
decision makers (usually
moms) going online for health
content and where are they
looking?
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7. The Digitally-Empowered Patient Journey
Trend in Google searches for “doctor near me” continues to spike
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8. The Digitally-Empowered Patient Journey
Google has moved health information right to the results page
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9. The Digitally-Empowered Patient Journey
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10. The Digitally-Empowered Patient Journey
This journey is increasingly
impacted by paid advertising.
In the example to the right,
most of the increase is
attributed to for-profit specialty
centers (in this case, cancer
centers).
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11. First Research: Symptoms
& Conditions
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The Digitally-Empowered Patient Journey
Second Research: Treatment
Options
Third Research: Providers

12. Cognitive Consequences of ChoiceAbundance
More choice is good, right?
With an overabundance of
information and choices,
patients are impacted by:
• Time Constraints
• Cognitive Error
• Trade Offs
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13. Cognitive Consequences of ChoiceAbundance
As choices expand, healthcare consumers incur…
• Time Costs: More time is now required to decide, which comes at
the expense of other, more preferable activities
• Error Costs: Fewer choices are considered overall and simpler
heuristics are used to decide, especially if the decision is complex
(ex., relying on a friend’s advice or going with the lowest cost as a
proxy for choosing what’s really best)
• Opportunity Costs: Considering all the choices one might have
made (trade offs) increases dissatisfaction with the options left
behind - commonly felt as buyer’s remorse
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14. Cognitive Consequences of ChoiceAbundance
Knowing this, some simple first steps should be:
• Carefully curate choices to reduce total cognitive load
• Create guides that provide an appropriate heuristic
• Allow more time for the decision making process
• Provide reinforcement post-choice
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15. Cognitive Consequences of ChoiceAbundance
These costs result in healthcare consumers
either choosing poorly or not at all.
How can behavioral economics help?
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16. Behavioral Frameworks Can Help
Duel Process Theory: Intuition and Reasoning
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System 1: Intuition System 2: Reasoning
Controlled largely by instincts and
drives, system 1 thinking is:
• Fast
• Emotional (hot)
• Impulsive
• High-capacity
Controlled more by logic, system
1 thinking is:
• Slow
• Reflective (cool)
• Problem Solving
• Low-capacity
Systems 1 and 2 are not opposed, they often work together and
complement each other in the same decision making process.

17. Behavioral Frameworks Can Help
B=MAT: Behavior as a function of motivation, ability and triggers
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To change behavior, we can modify:
• Motivation: Incentives, punishments,
appeal to values, etc.
Ex: Stickk.com with a co-worker
• Ability: Either make the task easier, or
increase ability through training
Ex: Climbing Mt. Everest w/ sherpas
• Triggers: Increase frequency, visibility
and/or effectiveness
Ex: Sticky notes from your spouse

18. Behavioral Frameworks Can Help
Big List of Biases: wikipedia.org/wiki/List_of_cognitive_biases
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19. Behavioral Frameworks Can Help
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Knowing them doesn’t make you immune, however…

20. Examples from the Field: OB
Issue: How to get expectant
mothers to choose our hospital for
delivery
Framework: Dual Process Theory
Tactic: Move from system 1 to
system 2 thinking
The Shift: Trusting medical
professionals instead of living with
mounting anxieties
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21. We have answers to
help set you at ease.
Having a baby means
having lots of
questions.

22. Examples from the Field: Cancer Screening
Issue: Lung cancer is treatable if
caught early, but former smokers
most at risk are apathetic and
fatalistic about their own lives.
Frameworks: Re-Framing and
Loss Aversion
Tactic: Re-frame the request
The Shift: Thinking about the
years their families will be robbed
of if they don’t get screened
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24. Examples from the Field: Bariatrics
Issue: How to get morbidly obese
people to consider weight loss
surgery at our hospital
Framework: B=MAT
Tactic: Increase effectiveness of
trigger, decrease difficulty of task
The Shift: Realizing they have to
do something about their weight
now, not later
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26. Questions?
erik.snyder@gmail.com