We’re all at least somewhat aware of the benefits of healthy behaviors. Many people, however, underestimate the difference that small changes can make – with some experts believing that about 8 percent of chronic diseases are driven by lifestyle factors such as diet and exercise1.
When it comes to illnesses, another crucial element is treatment adherence. But worryingly, in the US alone, half of patients with long-term conditions don’t stick to their medications. What’s more, as many as 30 percent of all prescriptions are never filled, and as many as 40 percent of all people stop taking their medications within 90 days owing to either cost, side-effects, or lack of interest.2 The result of this is a yearly and entirely preventable $300B cost, making it one of the most expensive problems in healthcare. This issue is set to spiral, too, with conditions such as diabetes, heart disease and chronic obstructive pulmonary disease (COPD) increasingly becoming more and more common.
So how can this be addressed? Nobel Prize winner Richard Thaler has strong thoughts on altering behaviors. He is very much of the opinion that if you wish to encourage people to act in a certain way, inspiring positive changes is infinitely more effective than imposing sanctions. Placing fruit at eye level where it's easily accessible is more effective than banning junk food. This is known as Nudge Theory, which, along with the likes of loss aversion and present bias, is a behavioral economics concept. And Wellth, a digital health company invested in by New York Life Ventures, a New York Life affiliate, is harnessing such notions, combined with an appreciation for human nature, in a bid to help develop better habits.
Sweden’s “speed camera lottery” perfectly demonstrates the concept of nudge behavior: Stockholm implemented a system whereby citizens were entered into a prize draw if they were recorded driving under or at the speed limit, with the money coming from fines paid by those who went over the limit. The results spoke for themselves: and the average speed dropped from 32 km/h to 25 km/h, which is exactly the speed limit of Stockholm’s main roads.4
Such “choice architecture” principles have been put into practice far and wide ever since the notion was popularized by Thaler’s 2008 book, Nudge: Improving Decisions About Health, Wealth, and Happiness. But in what areas is it proving to be particularly impactful today? Interestingly, medication for healthcare purposes tops the bill.
“Carrot or stick” is of course the age-old reward or punishment adage of management and motivation. It asks the question – which is more effective, putting a carrot in front of a donkey, or jabbing him from behind with a stick? When it comes to healthcare – carrot proves to be the most successful route, and a similar way of thinking has been applied to encouraging people to take medication. Enter the concept of “digital nudging.”
Because, if there’s one thing we know for sure today, it’s the extent to which we rely on our smartphones (to put it mildly). In fact, it’s thought that most of us check our phones around 58 times a day5. While this isn’t necessarily a positive thing, could our heavy reliance on tech be used for good?
This is exactly the model that digital behavior change company Wellth is pioneering. It works by offering members incentives, nudges and behavioral reinforcements to help them establish healthy, lasting habits when it comes to medications. They are encouraged to use the platform to submit scheduled check-ins that align with their care plans, including uploading pictures of their “target behavior” – such as photos of medication in the palm of their hands or a glucometer or blood pressure cuff reading – at a set time. These check-ins are processed by Wellth’s AI technology for verification, with insights relayed to care teams.
If and when behaviors are met, members keep their endowed daily amount, which they can at certain milestones as they progress on their program. The benefits are manifold – first and foremost are the physical rewards, combined the instant gratification (which tech is so good at affording us) of knowing that they completed their assigned tasks.
The results have been nothing short of extremely impressive: Wellth members demonstrate more than 89 percent average care plan adherence over a 12-month period as well as a 45 percent reduction in readmission rates after heart attacks, a 92 percent decrease in avoidable emergency department visits, and a 1.3 reduction in HbA1c levels amongst high-risk diabetes6.
New York Life Ventures is one of several prominent investors that believe in this platform. With 85 percent quarter-on-quarter and 403 percent year-on-year enrollment growth in Q1 2020, Wellth plans to use this new capital to support rapid scaling to address larger and broader populations of patients.7
Like the aforementioned speed ticket lottery example, the app doesn’t restrict users’ choices, it just makes behavior more attractive in a fun, engaging and creative way, with and potentially lifesaving benefits to boot.
1 https://health.clevelandclinic.org/5-healthy-habits-that-prevent-chronic-disease Sep 2, 2020
2 https://www.healthcarefinancenews.com/news/choosing-carrot-instead-stick Aug 30, 2010
3,6,7 https://www.wellthapp.com/news/wellth-raises-10m-to-drive-better-health-outcomes-through-behavioral-economics May 6, 2020
4 https://medium.com/swlh/the-7-most-creative-examples-of-habit-changing-nudges-7873ca1fff4a Aug 15, 2019
5 https://elitecontentmarketer.com/screen-time-statistics Nov 5, 2021
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