It’s time to re-design medical data - Happy + Well : Happy + Well

It’s time to re-design medical data

Written by on November 12, 2015 in Digital Health, Wellness with 0 Comments

UnknownDespite there being more information available to us now than ever before about what we should be doing or not doing to prevent health problems ranging from diabetes and heart disease to cancer and obesity, many of us persist in engaging in behaviours that are bad for us, even though we know doing so is to our detriment.

This refusal to do what we know is good for us to i.e. eat better, exercise more, quit smoking, take our pills when we’re supposed to, is what’s known in the business as ‘non-compliance’ and is the subject of much soul searching by the medical profession.

One person who’s given a lot of thought to the issue including what to do about it is the speaker in this presentation, Thomas Goetz, CEO and co-founder of digital health startup Iodine, author of The Decision Tree: Taking Control of Your Health in the New Era of Personalised Medicine, and a star keynote at next year’s Happiness & Its Causes and Digital Health Show conferences.

According to Goetz, this problem of behaviour change isn’t, in fact, as intractable as it seems. Indeed, the dentistry profession may have even solved it. Goetz says, “It’s one of the great preventive health successes we have in our health care system. People brush and floss their teeth. They don’t do it as much as they should but they do it.”

So why are folk so diligent at practising dental hygiene? By way of explanation, Goetz describes an experiment done more than 30 years ago by some US dentists who “decided that they wanted to get people to brush and floss their teeth more often, and they were going to use one variable: they wanted to scare them.”

The first thing they did was divide their patient population into two groups: low fear and high fear. The low fear group was told that if they didn’t brush and floss, they’d eventually lose their teeth and have to get dentures but everything would be fine. The high fear group was told that failure to brush and floss would result not just in the loss of all their teeth and the need for dentures, but eating anything other than mush would be impossible and they’d also suffer a bunch of horrific health problems.

Goetz says that crucially, the dentists measured one other variable and that was “the patient’s sense of efficacy”. Tellingly, those patients who replied positively to the question asked of them at the start of the study about whether they could stick to their new teeth cleaning regimen, were much more likely to do so than those who replied negatively. Goetz continues, “Fear was not really a primary driver of the behaviour at all. The people who brushed and flossed their teeth were not necessarily the people who were really scared about what would happen. It’s the people who simply felt that they had the capacity to change their behaviour.”

As far as Goetz is concerned, this sense of efficacy is what the medical profession needs to work hard at promoting to achieve better health outcomes, this belief that I can change my behaviour for the better. And it’s very doable, he suggests, by providing patients with personalised information. “When you give people specific information about their health, where they stand, and where they want to get to, where they might get to, that path, that notion of a path – that tends to work for behaviour change.”

Unfortunately, much of the data patients currently receive about their health is impersonal and impenetrable. Goetz asks us to consider standard blood test results as a case in point, riddled as they are with acronyms, numbers and values many of us don’t have a clue about. He says, “They’re packed with information. They’re just not for us. They go right to doctors”.

His hope is that we re-direct this and any other “body of latent information” to the patient since “it’s the person who actually, in the end, is going to have to change their life and start adopting new behaviours … Ordinary people are capable of understanding this information, if only we go to the effort of presenting it to them in a form that they can engage with.”


Thomas Goetz is CEO and co-founder of digital health startup Iodine, former executive editor of Wired magazine and author of The Decision Tree: Taking Control of Your Health in the New Era of Personalised Medicine. He will be presenting sessions at both the Happiness & Its Causes and Digital Health Show conferences in 2016. To register for Happiness & Its Causes, click here. To register for the Digital Health Show, click here.

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