The last mile

Sick care and disease prevention has become one big data management exercise. Patients are data sets and doctors are data managers. In addition, in the gap between the data and the doctor, are many others including data scientists, navigators, care coordinators, and, of course, the payers.

But, for any of this to do any good, there needs to be an intervention based on identified risk factors and that intervention must change behavior.

Take this test.

If you took the time to take the test, you will get some understanding of why it's so hard to change human behavior and habits and why people don't. Simply put, we're all built differently, were brought up differently and have different approaches to changing our habits.

In researching and writing Better than Before: Mastering the Habits of Our Everyday Lives, Gretchen Rubin realized that all of us differ dramatically in our attitude towards habits, and our aptitude for forming them. She described four distinct groups: Upholders, Questioners, Obligers, and Rebels.

Half of heart disease, for example, is preventable and related to five risk factors-f high cholesterol, hypertension, diabetes, obesity, and smoking.?Although the death toll has steadily declined over the past 30 years due to prevention and treatment measures, heart disease is still the leading cause of death in the U.S., causing one in every four deaths, or 610,000 deaths each year, according to the Centers for Disease Control and Prevention. Yet, about 80% of people reported exposure to at least one of the five risk factors. Getting them to change is a big challenge.

Research like this is giving us a better understanding of patient psychographics and what makes them tick, particularly when it comes to changing their behavior. Giving people data alone does not change behavior. Giving people money only changes behavior up to a point. Behaviorial economics might give us some answers.

For information to be effective, patients?need the tools to change and the motivation to do so. Until then, throwing data at doctors and patients might be an interesting way to try to make a few bucks, but it's unlikely to improve outcomes. Changing patient and doctor behavior is the last mile and the most difficult to traverse.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack