Does Behaviour Change always have to be a real change in behaviour?

DrDoctor co-founder, Tom Whicher, was recently on a panel at the Digital Health Tech 2018 exhibition in London discussing: ‘What is the best way to get patients to adopt a new technology for accessing their healthcare?’ One thing stuck with me after listening to the talk. User ‘behaviour change’ that accompanies the successful uptake of new digital innovations is often far subtler than it first seems. Taking this idea forward, DrDoctor hopes to drive innovation that is seamless for patients to adopt.

There were a variety of opinions on the panel on how to spark adoption of new technologies amongst patients. One speaker suggested the best way to make change is to just change it. This opinion says, ‘Don’t give the patients a choice in how to access the system other than this one new way’. Tom suggested gentle disruption – a way of changing the system from the inside out, bringing everyone in the system along with the change. This (especially for healthcare) is important to transition smoothly from the old system to the new one, without the system breaking.

What struck me while listening were the examples of change from across different sectors. Technological change has been seen in cash machines replacing bank telling, in using an app to hail an Uber rather than call a taxi, in ordering food from Deliveroo rather than from your local takeaway restaurant, and in plenty of other sectors.

On the face of it these all seem to require a large change in user behaviour, but digging a little deeper, the question becomes how different is the new behaviour really?

For withdrawing cash from the bank, a person still has to physically travel to a bank and give identification details in return for cash. For hailing an Uber, a person still pulls out their phone, books on their phone and stands on a pavement to wait. For delivering takeaway food, again, the user goes to their phone to find and order their food.

In each of these examples, the new tech only changes the user’s behaviour at the very end of the process. The start – deciding you want to do the task, then walking up to the bank, pulling out your phone and waiting for a taxi or ordering food – is the same in both. Only the very last step of the process is different.

Taking insight from the Behavioural Insights Team EAST behaviour change framework (Easy, Attractive, Social, Timely), this makes perfect sense – under the category of making the behaviour change easy. When starting a task a user starts with an expectation of how to do something, based on previous experience. If you, the innovator, want them to adopt a novel way of achieving this task, the easiest process to adopt is one that from start to (almost) finish is exactly the same as before. Changing just the last stage requires only a small extra effort and thus is easy to adopt.

There’s a reason why changing the last step only is important. By this stage, the person has already put in most of the effort. This momentum (‘I’ve already spent time trying to do this – I should finish it’) will mean they are more likely to put in the extra effort (‘this step is new but I’m already invested so I’ll try it’) to complete the task.

If we apply this to healthcare (say, a process for a patient to reschedule their appointment), the first step is to learn exactly what they do at the moment, without tech. The second step is to build a technology that adjusts only the very last part of the process. Following the above logic, this technology will be most successfully picked up and used by the patients.

We at DrDoctor see this as just one example of combining behavioural science and gentle disruption to bring digital technology into the healthcare system – i.e. to allow patients to most easily adopt new digital solutions using similar processes as before. To learn more about how we have used behaviour change to improve patient experience in healthcare, see our case studies.

Of course, there are examples that go against this trend (e.g. online shopping). These changes have higher friction to start with (remember the difficulty in trying to introduce an older relation to online shopping) but offer huge benefits so this friction is soon forgotten.

However, for most new digital solutions, given that the first switch-over is most often the biggest hurdle in the way of achieving user behaviour change, it’s important to focus on making the first transition as smooth as possible.