Using Behavioral Science to Unlock Hidden Patient Insights

Over the past two decades, the behavioral sciences have significantly deepened our understanding of patient and physician behaviors and helped to inform a new wave of treatments, medicines, and interventions. Yet, the potential for applying these insights to improving the patient experience remains relatively untapped.

Research has revealed a range of unconscious factors that limit our ability to understand the reasons why we behave the way we do—especially in relation to stressful or emotive topics, such as health. This means traditional methods for understanding patient experience based on self-reporting are unlikely to be as reliable as assumed due to factors including:

  • Post-hoc rationalization: We unconsciously distort our recollection of previous events to protect our identity and self-esteem (e.g., we misrepresent the impact of waiting times on anxiety levels because we identify as an understanding person).
  • Social desirability bias: We report previous experiences in a way that presents us in favorable light against perceived social norms (e.g., we under-report the amount of alcohol we consume).
  • Hyperbolic discounting: We “discount” future costs and benefits compared to short-term ones (e.g., we overestimate our ability to make small lifestyle changes to avoid large long-term health costs, but then succumb to short-term pleasures).
  • Fundamental attribution error: We tend to attribute the cause of negative outcomes to external circumstances and other people (e.g., the treatment didn’t work because the physician didn’t explain it properly, when in reality we didn’t follow instructions).
  • Poor affective forecasting: We struggle to predict how we will respond emotionally to events in the future (e.g., we overstate our willingness to adhere to treatment because we underestimate emotional impacts and costs).

This deeper understanding of biases and barriers has led to a range of technologies and techniques to overcome them. Many of these approaches seek to circumvent them by measuring non-verbal responses to stimuli. Ironically, this often involves the use of biometric technologies originally developed for diagnosis purposes, such as EEG, fMRI, and Galvanic Skin Response (GSR), which researchers claim more accurately detect participants’ emotional responses.

Some researchers are also using Implicit Association Testing (IAT) to detect subconscious conceptual associations of participants. Others use facial recognition technology to link participants’ automatic expressions to hidden emotional drivers. However, some critics highlight how the link between biological markers and emotions can be misleading. Classically, a facial expression classified as “angry” could equally be a sign of curiosity…or gas!

As a result, other researchers focus more on ethnography, participant observation, and co-design techniques to understand how patients’ lived experience influence emotions, decisions, and behaviors. The power of these approaches is they take place in authentic contexts, rather than research facilities, and focus on observation and collaboration to unearth the drivers of human behavior often hidden by our biases and defense mechanisms.

The application of behavioral science represents a huge opportunity for healthcare. By embracing its research methods, as well as its insights, we can access new ways of understanding patient experience as the basis for new strategies to improve it.

  • Steven Johnson

    Steven Johnson is Director – Behavioral Science at WHY, a BCW consultancy specializing in the science and technology of behavior change. Steven has spent the last 15 years working at the intersection of behavioral insights, data science, and human-centered design. He has led insight and design on a wide range of award-winning behavior change projects, incorporating over 40 randomized controlled trials (RCTs).

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