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Abu Dhabi, UAETuesday 25 September 2018

Netflix can teach doctors how to treat patients

Retail and entertainment companies have been early adopters of neurotechnologies originally developed to serve medical practitioners, says Olivier Oullier

Dubai Diabetes Centre using AI to detect eye disease. Doctors have traditionally been slow to adopt neurotechnologies / Courtesy Dubai Health Authority
Dubai Diabetes Centre using AI to detect eye disease. Doctors have traditionally been slow to adopt neurotechnologies / Courtesy Dubai Health Authority

Earlier this year, Apple announced the release of its new Health Records, an app where patients can store all their medical data. The move is the next logical step for Apple, which has paired up with 39 health systems in the US. Each has adopted the tech company’s Health Records system for patients to securely access – and get instant updates on – their medical information.

It coincided with the announcement of a joint healthcare venture by JP Morgan Chase, Berkshire Hathaway and Amazon, which plan to form an independent healthcare service for their own employees amid frustration with the existing system.

Traditional and new players in the healthcare space whom I spoke to on a visit to Silicon Valley last week are anxiously scrutinising the moves of big tech. With global spending on health estimated to rise from $7.83 trillion in 2013 to $18.28 trillion in 2040, according to a study published in the Lancet, not investing in healthcare would be a major strategic error.

Unsurprisingly, investments in artificial intelligence applied to healthcare are growing exponentially, with Google being one of the more active companies on that front.

But there is a paradox at the core of the AI revolution that we are witnessing in healthcare. At one end of the healthcare spectrum, amazing achievements such as precision medicine give the ability to treat cancers that people were dying from not so long ago. That is truly amazing.

But at the other end of the spectrum, the way caregivers handle patient behaviour can sometimes be as intuitive as performing brain surgery with a butcher's knife.

Take non-compliance and non-adherence to treatment for example, a major behavioral issue in healthcare. According to the Annals of Internal Medicine in the US, it claims up to 100,000 lives each year and costs the US healthcare system close to $300 billion annually.

There are many reasons why patients do not comply with treatments, from denial of their medical condition to those on a low income not being able to afford the cost of treatment. Inconvenience is also a major hurdle as some treatments are not easy to take and can have side effects that lead to frustration and exasperation. Add on top of this misinformation and trust issues and we have a recipe for behavioural disaster.

As I was researching, I visited the website of a health system that, after explaining why people would not comply with treatments, provided the following advice: “Talk to your doctor if you find it difficult to adhere to treatment”. But how do they think a physician who did not manage to convince a patient to comply in the first place is the person who will best know how to change that behaviour?

This is not the fault of doctors. They were simply not trained in consumer psychology.

For too long, medical practice has been based on the assumption that informing patients was enough to convince them to comply with a medical treatment – wrongly so.

Knowing that a treatment improves your health should be sufficient for patients to comply in theory but providing people with the most accurate information does not necessarily change their behaviour.

Doctors should look at their own example: if that were the case, none of them would be smoking, given how well-informed they are of the dangers of tobacco consumption. What is more, in many countries the ratio of smokers among doctors can be higher than in the general population.

The medical world needs to understand two things urgently. First, the people who know most about our behaviour, how to change it and engage us are not working in medical facilities.

They are employed by the consumer and entertainment industries. The data speaks for itself. Amazon, Wal-Mart, Netflix, as well as movie and game producers, have a much better track record at influencing us and creating new habits than our doctors. Unsurprisingly, they leverage AI to improve their performances.

Second, the patient is above all a consumer. It is the same person buying a canned drink in the morning who is going to the hospital in the afternoon. Hence, it is vital for the medical world to stop looking down on consumer behaviour experts and to start learning from them.

The irony is that the retail and entertainment industries have been early adopters of consumer neuroscience and neuromarketing, using neurotechnologies originally developed to serve medical practitioners to better understand and incentivise us.

Meanwhile, the healthcare industry has totally disregarded the insights from neuroscience on consumer behaviour.

According to a health report published by McKinsey and Company research firm, nearly 70 per cent of total healthcare costs in the US are linked to consumer behaviour.

Medical schools are right to revisit their curriculum in light of the artificial intelligence revolution. But they should also very quickly add behavioural economics, consumer psychology and neuroscience as mandatory classes for every would-be caregiver.

Health systems that already have behavioural nudge units, consumer neuroscientists and chief behavioural officers among their executives have a key competitive advantage. They understood before their competitors that as revolutionary as a new AI-based medical treatment might be, if patients did not comply with what was prescribed to them, that treatment would be useless.

Professor Olivier Oullier is the president of Emotiv, a neuroscientist and a DJ. He served as global head of strategy in health and healthcare and is a member of the executive committee of the World Economic Forum

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