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Tag: Psychology

Applying Psychology to the Challenge of Internal Health Adoption

Adoption of technology in the healthcare field has been happening at an incredibly slow pace. This is a fact that few would disagree with. The market is saturated with health tech companies that are vying to be the next big unicorn in the field, but long sales cycles and simple underestimations of what is needed for HIPAA and FDA approval has led to the demise of many of these projects. The ones that do receive enough series funding to produce finessed products for health systems and pharmaceutical companies however soon realize that the battle against time is not over.

Simply getting into a health system is not enough. Once a contract is finally ironed out and the software is exchanged, the next uphill battle against the slow-pace of internal adoption is mounted. Not only is a speedy adoption important for hospitals to demonstrate that their purchases and investments were appropriate, but it is also key for founders who hope to demonstrate that their product works. Nothing is worse than the painfully slow adoption internally of a piece of technology. One bad experience has the potential to tarnish an organization’s appetite for future tech ventures.

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Offensive Fouls and Defensive Medicine

LeBron James exploded past his defender and raced towards the lane.

Serge Ibaka, the Thunder’s mountainous center, planted his feet and raised his hands straight up into the air.  LeBron ducked his left shoulder and plowed right into Ibaka, who went crashing backwards into a nearby cameraman.

Offensive foul?

Maybe if it had been the first quarter.  But given that this was the last minutes of a tightly fought game, the referees chose to restrain themselves, not wanting the game to turn on their actions.  Was this even controversial?  Not a bit.  In such situations, announcers typically applaud the non-call, intoning platitudes like “this game should be decided by the players.”

In their excellent book Scorecasting, Tobias Moskowitz and L. Jon Woertheim explore the psychology of sports through exhaustive and yet entertaining analyses of all kinds of topics that have fueled many a heated bar stool argument.

Are referees biased against your favorite team?  According to their analyses, they are biased against your team only if it is playing an away game.  Turns out that their unconscious desires to please fans cause referees and umpires to back away from controversial calls that will raise the crowd’s ire.

One of the most fascinating chapters in the book involves what the authors call “whistle swallowing.”  All else equal, referees and umpires avoid sins of commission over sins of omission, a preference for inactivity nicely summarized by veteran NBA referee Gary Benson: “It’s late in the game and, let’s say, there’s goal tending and you miss it.  That’s an incorrect non-call and that’s bad.  But let’s say it’s late in the game and you call goal tending on a play and the re-play shows it was an incorrect call.  That’s when you’re in a really deep mess.”Continue reading…

Is Prostate Cancer Screening Truly Harmful?

Dr. Timothy Wilt, a member of the United States Preventive Services Task Force, stood in front of the American Urological Association audience and explained why the task force could not recommend that men undergo routine PSA screening. At most, he explained, the test had been shown to benefit one out of 1000 men. Meanwhile, the test would cause hundreds of men to experience anxiety, and scores of them to experience impotence and incontinence from unnecessary treatments.

Twenty minutes later, I stood behind the same podium and asked the audience members to raise their hands if they disagreed with the task force’s conclusion. Ninety percent expressed their skepticism. What happened in the time between Wilt’s presentation and mine reveals a great deal about why experts cannot agree whether screening tests, like the PSA in middle-age men or mammograms in 40-year-old women, bring more benefit than harm, and about what psychological forces impede our ability, as a society, to figure out what basic bundle of healthcare services all insurance companies ought to pay for.

Wilt’s presentation was a model of scientific clarity. He explained that only two randomized clinical trials were conducted with enough scientific rigor to provide useful estimates of whether the PSA test saves lives. One trial showed no benefit and the other revealed the one in 1000 number which the task force took as the best case scenario. Wilt was followed on stage by Ruth Etzioni, a biostatistician at the Fred Hutchinson Cancer Research Center in Seattle.  Etzioni presented a statistical model suggesting that the PSA test benefited many more than one in 1000 men.

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