Christian Terwiesch, a Wharton professor of operations, information and decisions, has co-authored two new studies related to technology and health care. The first, which examined the impact of e-visits on primary care, found some surprisingly negative results about connectivity: E-visits can take up more of a physician’s time rather than making patient contacts simpler and more efficient. That has contributed to more physicians feeling overburdened and burnt out, with less ability to take on new patients. The second paper looked at how some of those negative effects could be turned around. Terwiesch sat down with Knowledge@Wharton to talk about these topics, which he describes as a “hot area” that sits at the intersection of medicine and management.
Humans are social animals, and providers can use those social connections as a driving force for better patient engagement. Peer support and coaching programs can lead to better care management for patients with chronic conditions, for example, said David A. Asch, M.D., executive director of Penn Medicine Center for Health Care Innovation, and Michele E. Heisler, M.D., professor of internal medicine and health behavior at the University of Michigan, during an event hosted by NEJM Catalyst.
A more complete view of human behavior seems necessary for more effective medicine. Health is fundamentally the product of myriad daily decisions made by doctors and patients, and by uncovering what truly motivates us, we may be able to nudge one another toward wiser decisions and healthier lives.
The promise of behavioral economics for health is that many of the same messages, incentives, and choice structures used so effectively to lure people into situations where they may be exploited can be redirected to attract them to healthier choices that improve their well-being. Health programs are more likely to be successful if designed not based on how perfectly rational people ought to make health decisions but on how humans actually make them.
The real problem here is not economics or behavioral economics or psychology. It is obesity. Losing weight is insanely hard to do. And keeping weight off is even harder.
Health care organizations, newly focused on population outcomes, can develop and test social interventions for advancing health. Given the increasing evidence that behavior is contagious, there’s good reason to believe that such models could work. You are more likely to smoke if people close to you smoke — and more likely to quit if they quit. Yet most health care interventions are designed for the individual. For some time, doctors have recognized that some patients’ social connections have a beneficial effect on their health. Now, doctors and hospitals can develop new approaches to prescribe social engagement for everyone else.
A team at the University of Pennsylvania Perelman School of Medicine is harnessing the convenience of smartphones, wireless blood pressure monitoring technology, and electronic health records (EHRs) to more closely monitor the blood pressure of post-partum patients after they go home from the hospital.