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The Psychology of Persuading Physicians

Jun 10, 2012• 2

By Michelle Snyder

Over the 11 years I spent building the network at Epocrates, I learned a lot about physician behavior, motivation and the use of incentives. And while influencing nearly 50% of U.S. physicians to use a product requires that it meet a true need, fit into their workflow and be extremely easy to use – building one of the most trusted brands in healthcare goes beyond the product. It’s about being fanatical about understanding your users, engaging them at the right time, helping them support you and ultimately creating incredible loyalty.

Though we had a very analytical approach to user acquisition and brand strategy, I want to focus this article on something more fundamental – behavioral psychology. Truly understanding not just physician behavior but human behavior was core to the business at Epocrates and permeated throughout our business, marketing and product strategy. We focused early on in engaging physicians as consumers – B2C rather than B2B. Though a significant percentage of MDs are characterized as “small business owners”, we saw them as consumers first – hence, understanding human behavior, motivation, and influence drove product adoption and usage.

I was reminded of this recently listening to Dr. Robert Cialdini, speak at the 4th Annual Consumer Medicine Summit. If you haven’t read it, “Influence: The Psychology of Persuasion” is one of those dog eared marketing “bibles” that has remained on my shelf for years because its lessons on how to influence people are universal and timeless. In fact, I made it required reading for some members of my team. (Future postings on other favorites such as Nudge and Predictably Irrational, coming soon!).

Attention Innovators: The My Air, My Health HHS/EPA Challenge is Open!

Jun 8, 2012• 1

By Ruthanna Gordon

When I came to work for EPA as an American Association for the Advancement of Science fellow, I hoped to connect my social science background with my passion for the environment. In my time on EPA’s Innovation Team, I’ve found such connections in places I never expected. I’ve grown particularly excited about our work on portable air quality sensors.

As a psychologist, I have learned that people care about a problem more, and come up with better solutions, when they see how it affects them personally. Air pollution is a great example—when people can measure particulates on their jogging route, it’s far more meaningful than just hearing about the issue on the news.

The My Air, My Health Challenge, announced yesterday by EPA’s Science Advisor Dr. Glenn Paulson and Dr. Linda Birnbaum of the National Institute of Environmental Health Science, aims to gather the best work in this area, and bring it to the next level.

The challenge calls on academics, industry researchers, and garage-lab do-it-yourselfers to connect wearable air and health sensors, allowing citizens and communities to collect highly localized data and create a meaningful picture of how the environment affects their well-being.

The data integration and analysis component of the challenge is particularly exciting.

A few weeks ago, I was privileged to attend the Apps and Sensors for Air Pollution workshop in Research Triangle Park, NC. There, I listened to cutting edge sensor developers talk about their work. They had some fascinating projects, ranging from cheap ozone monitors carried by students to a community initiative measuring black carbon in the homes of elders. Our challenge took its final shape from these experts’ input.

Seriously: Is Digital Health The Answer To Tech Bubble Angst?

Jun 8, 2012• 3

By David Shaywitz

As an ever increasing amount of money seems determined to chase an ever greater number of questionable ideas, it’s perhaps not surprising that inquiring minds want to know: (1) Are we really in a tech bubble? (2) If so, when will it pop? (3) What should I do in the meantime?

I’m not sure about Question 1: I’ve heard some distinguished valley wags insist we’re not in a tech bubble, and that current valuations are justified, but I also know many technology journalists feel certain the end is neigh, and view the bubble as an established fact of life – see here and here. The surge of newly-minted MBAs streaming to start-ups has been called out as a likely warning sign of the upcoming apocalypse as well.

I have the humility to avoid Question 2: as Gregory Zuckerman reviews in The Greatest Trade Ever, even if you’re convinced you’re in a bubble, and you’re right, the real challenge is figuring out when to get out. Isaac Newton discovered this the hard way in the South Sea Bubble, leading him to declare, “I can calculate the motions of heavenly bodies but not the madness of people.”

I do have a thought about Question 3, however – what to do: reconsider digital health — serious digital health.

Here’s why: Instagram and similar apps are delightful, but hardly essential; most imitators and start-ups inspired by their success are neither. It doesn’t strain credulity to imagine investors in these sorts of companies waking up one day and experiencing their own Seinfeld moment, as it occurs to them they’ve created a portfolio built around nothing.

The Importance of Data and Care Coordination

Jun 8, 2012• 9

By Jonathan Bush

This house believes that society benefits when we share information online! This was the topic of debate before the Economist magazine’s Ideas Economy: Information 2012 conference here in San Francisco on Tuesday afternoon. Tom Standage, digital editor for the Economist, moderated this lively battle of wits.

Defending the motion was John Perry Barlow, former Grateful Dead lyricist and co-founder of the Electronic Frontier Foundation. “This is a little like defending sex!” he started off by saying.

I am paraphrasing here but he went on to say, ‘The Internet is an environment where what is great about human beings can manifest itself…collectively we are much smarter than any individual. Just as my mitochondria are unaware of my thoughts, we are largely unaware of our collective genius.’

I could not agree more.

Opposing the motion was Andrew Keen, Internet entrepreneur and author of “Cult of the Amateur.”

Again, paraphrasing, ‘Repressive governments and private companies who make the 1% look poor, are also benefitting. Most of the information is being stolen,’ Keen said. ‘Today everything has to be social.’

Keen rails against our intimate selves being taken from us and traded on by bazzilionaires, with not much coming back to we, the sharers. ‘Barlow would not be who he is, if he not had his years of very aloneness,’ said Keen, paraphrased.

Mayor Bloomberg’s Soda Ban Proposal Hits the Wall

Jun 8, 2012• 26

By Marion Nestle

Yesterday, New York City Mayor Michael Bloomberg announced a ban on sales of sugary drinks larger than 16 ounces in restaurants, delis, sports arenas, and movie theaters.

The reactions have been ferocious, and not only from the soda industry, which placed an ad in the Times (see below).

The New York Times also weighed in with an editorial arguing that the mayor has now gone too far and should be sticking to educational strategies.

Alas. If only educational strategies worked. But they do not.

We know this from what it took to discourage people from smoking cigarettes. We also know this from research on eating behavior. This shows that it doesn’t take much to get people to eat too much.

Just barrage us with advertising, put food within arm’s reach, make food available 24/7, make it cheap, and serve it in enormous portions.

Faced with this kind of food environment, education doesn’t stand a chance.

That’s the point the Mayor’s proposal is trying to address, however clumsily. After all, a 16-ounce soda is two servings.

Sugary drinks—especially large ones—make sense as a target for a portion size intervention.

Patient Power

Jun 7, 2012• 8

By Barbra Rabson

What happens when consumers are able to compare the performance of primary care physicians in their state using Consumer Reports, the magazine that’s so highly regarded for its ratings of thousands of products and services we all use every day? Well, for the first time ever, we’re about to find out.

A special Massachusetts version of July’s Consumer Reports magazine will feature a report entitled “How Does Your Doctor Compare?” along with a 24-page insert that includes ratings of nearly 500 primary care physician practices from across the state. The ratings are based on data from a comprehensive patient experience survey conducted by Massachusetts Health Quality Partners (MHQP), a coalition of consumers, physicians, hospitals, insurers, employers, government agencies, and researchers. The physician ratings report is also available online at www.mhqp.org.

In recent years, there’s been a lot of talk in the health care community about the importance of consumer empowerment and patient-centered care. This experimental collaboration between MHQP and Consumer Reports, funded by the Robert Wood Johnson Foundation’s Aligning Forces for Quality program, helps move theory into practice, and will test some key assumptions about the value of transparency in the effort to improve the health care system. In many respects, ratings of primary care physicians are not new to Massachusetts. We at MHQP have been reporting the results of patient surveys and clinical quality data since 2006 and these reports have had a positive effect on health care in our state. But let’s face it, Consumer Reports adds a whole new dimension to the notion of transparency. Not surprisingly, their involvement has been met with both excitement and some trepidation in the physician community.Continue reading…

Without Patient-Centered Health Plans, It’s the Same Tired Script

Jun 6, 2012• 13

By Joshua Archambault

As the next act of the Massachusetts health care drama plays out on Beacon Hill, the same characters return to the stage with a tired script. The ostensible hero of the production, the patient, is left to watch the tragedy from the back row.

Legislation being debated on Beacon Hill ignores patient-centered health plans and health savings accounts, or HSAs, which are lower-premium insurance plans that direct pre-tax dollars into a bank account to cover an individual’s current health care and save money for future medical expenses. An HSA is the most direct way to engage patients in the health system. They cover out-of-pocket medical, dental, and vision expenses, are fully portable, and owned by individuals for their entire lives.

Unlike the self-interested solutions of insurers, providers, and government, HSAs are a proven way to contain the cost of care.

Nationwide, 11.4 million people of all ages and income levels purchase patient-centered plans, up over 250 percent from 2006, when they were created. Among HSA account holders, fully half earn less than $60,000; almost three-quarters have children; and about half are over 40.

Safeway, one of America’s largest supermarket chains, rolled out a patient-centered plan in 2006; per capita health care spending shrank 13 percent, and costs remained flat for four consecutive years.

Safeway’s plans have reduced employee obesity and smoking rates to roughly 30 percent below national averages. This health dividend is priceless as 70 percent of health care costs are directly related to lifestyle decisions.

Lightning Strikes Datapalooza

Jun 6, 2012• 3

By Michael W. Painter

It didn’t appear on the lightning strike map, but lightning did indeed strike a young medical student inside the Washington Convention Center right in front of about 1,500 amazed spectators on the first day of The Health Data Initiative Forum III: The Health Datapalooza. Everyone is fine—though our medical student may never be the same again.

Actually, this story began long before Datapalooza, of course. Fourth-year medical student, Craig Monsen, and his Johns Hopkins Medical School classmate, David Do, started collaborating on software applications soon after they met in first-year anatomy class. Craig graduated from Harvard with degrees in Engineering and Computer Science and David from University of Minnesota in Bioengineering.

They’re not quite Jobs and Wozniak—neither dropped out of anything—yet—although Craig, at least, is planning to skip or delay residency. You see, after seeing the Robert Wood Johnson Foundation (RWJF) Aligning Forces for Quality Developer Challenge last year—they got very serious about bringing to life their vision of new applications that could help patients and consumers make great health care decisions.

A Life in the Day of an EIR: Health IT Ain’t No Bubble for Venture Capital (…. so apply for the DC to VC Health IT startup showcase)

Jun 4, 2012• 1

By Missy Krasner

Everyone is always asking me what it is like being an EIR and why I decided to do it after my 5+ years working on Google Health. First of all, for those of you who are not familiar with the term – an EIR stands for either Entrepreneur in Residence or Executive in Residence. In the case of Morgenthaler Ventures, they were looking for a person with extensive experience in the Health IT sector at an executive level. This differs from a more traditional EIR title (entrepreneur in residence) where you are asked to incubate a startup from scratch with some support and resources. As an Executive in Residence, I work hand in hand with the firm’s partners to author the current health IT investing thesis, map out the industry, source companies that match our areas of interest, and help with diligence. The goal of my EIR term is to find a company that Morgenthaler can invest in and then join that company as part of the executive team. I picked Morgenthaler Ventures because of their track record in health IT (invested in Practice Fusion before Health IT was in vogue) and their leadership in the industry with the creation of the first DC to VC conference.

In its 3rd year, DC to VC was initially started by Rebecca Lynn, IT Partner at Morgenthaler Ventures to bring the venture capital community together with Washington D.C. policymakers. This year, I am proud to say that I am co-directing the DC to VC event and the health IT startup contest along with Matthew Holt and Indu Subaiya from Health 2.0. The contest will take place on the last day of the 2012 Health 2.0 Annual Fall conference in San Francisco on October 10, 2012. Online applications open today, June 4, 2012 and stay open until August 3, 2012.

Size Matters: Hospital Consolidation and Physicians

Jun 2, 2012• 2

By Richard Reece, MD

As health reform evolves, I’ve been watching multihospital systems grow in size and power and speculating what their gigantic size means.

Here, as of 2008, were the 10 largest systems in revenue size

1. Veterans Administration Hospitals, $40.7 billion
2. Hospital Corporation of America, $28.4 billion
3. Ascension Health, $12.7 billion
4. Community Health, $10.8 billion
5. New York Presbyterian, $8.4 billion
6. Tenet Health, $8.3 billion
7. Catholic Health Initiatives, $7.8 billon
8. Catholic Health West, $7.6 billion
9. Sutter Health, $6.9 billion
10. Mayo, $6.1 billion

What strikes me about this list are that such giant systems like Kaiser, the Cleveland Clinic, Johns Hopkins, Duke, and Health Partners in Boston don’t even appear, and the large number of Catholic multisystem chains. The revenues of multihospital systems has undoubtedly grown since 2008. In 2011, hospital mergers and acquisitions hit an all time high.