December 13, 2015

Hacking at the Root of Chronic Disease

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Healthcare is Sick; The Prescription is a Matter of Choice

There are a thousand hacking at the branches of evil to one who is striking at the root. ~ Henry David Thoreau


he US healthcare system is sick, hobbled from its overindulgent behavior manifest in over-treatment and under-prevention. According to the Center for Sustainable Health Spending, the cost of US healthcare in 2014 totaled an astounding $3.15 trillion [1] , and by July 2015, estimates for the 2015 seasonally adjusted annual spend rate were tracking around $3.22 trillion [2].

Related: [U.S. Health-Care Spending Is on the Rise Again]

To put $3.22 trillion in annual healthcare costs in perspective, consider what such a sum means when measured as Gross Domestic Product (GDP) [3] . The US healthcare system would rank as the fifth largest economy in the world, closing in fast on Germany and Japan. Adding insult to injury, the US healthcare system stands as a glaring exception to the rule, “you get what you pay for”. Since the World Health Organization published its World Health Report, 2000 – Health Systems: Improving Performance (Geneva: WHO, 2000), the US has consistently spent more and delivered less than other industrialized countries [4].


Source 1: CNN Money

Health care spending in the U.S. far exceeds that of other high-income countries…despite its heavy investment in health care, the U.S. sees poorer results on several key health outcome measures such as life expectancy and the prevalence of chronic conditions. ~ Commonwealth Fund

Reports such as the World Health Organization’s suggest many possible reasons for the US’s abysmal return on investment in healthcare. We need only look at reports from our own Centers for Disease Control (CDC) to see that the US healthcare system’s misguided economic incentives are designed to hack at the branches of costly disease by financially rewarding treatment over prevention, when it’s clear that prevention is the best treatment.

The doctor of the future will give no medicines, but will interest his patients in the care of the human frame, in diet, and in the causes and prevention of disease.~ Thomas Edison, 1902


ccording to the CDC, over 80% of healthcare spending and almost half of the deaths in the United States are caused by chronic, preventable conditions.

Related: [CDC Chronic Disease Overview]

The seeds of chronic disease – the source of so much physical, emotional and financial cost and suffering – are planted early, take root in the garden of poor choice, and are fed by unhealthy behaviors (e.g., smoking, over-eating/poor eating, lack of exercise, and over-indulgence in alcohol). Eliminating, or at least mitigating such unhealthy lifestyle choices could prevent as much as 80% of all heart disease, stroke, and type 2 diabetes as well as over 40% of diagnosed cancer cases [5].

Prevention is best achieved with empathetic, informed consumer engagement. Patients are consumers of healthcare product. They are individuals that must be considered against the backdrop of their community – the world in which they live. To engage with insight™ is to approach prevention with an awareness that behavior driven by individual choice and habit sits at the root of preventable chronic disease. Striking at the root of disease to meaningfully bend the proverbial healthcare cost curve demands effective persuasion – a helpful nudge – aided by technology to personalize engagement.

Related: [Blink by Malcolm Gladwell and Nudge: Improving Decisions About Health, Wealth, and Happiness by Richard Thaler and Carl R. Sunstein]

In August, 2014, we published Going Deep with Big Data to explore how the marriage of behavioral economics and big data analytics techniques can enhance consumer engagement beyond the “picks, skips, and clicks” commonly used to anticipate how and when to push tailored purchase suggestions to specific consumers. In our post, we introduced the notion of modeling elements of behavioral economics, which, when aided by big data analytics techniques, can provide insight into why individuals choose what they choose.

Understanding why individual consumers make specific choices is the surest path to impact what choices are made. By analyzing data through the lens of applicable behavioral models, Next Generation Behavioral Analytics seeks to understand consumers as individuals in the world – personality, tendencies, mood, and motivations – to derive a more empathetic perspective and offer a deeper, more personalized understanding of the individuals that compose a population. Armed with empathy, we can move beyond what the consumer might do and understand why. Rather than merely predicting behavior, we can “nudge” behavior – encourage choices and behaviors that will enhance personal health and wellness, and reduce the incidence of preventable disease.

With better insight into individuals’ decision-making processes and evidence about how certain choices impact health and wellness, we stand on the precipice of a new generation of person- centered engagement. Our next post in this series will discuss how to actively listen to the increasing chatter emerging from a rapidly growing digital health ecosystem and to derive the insight needed to strike at the root of preventable, chronic disease.


[1] Altarum Institute, February 2015

[2] Altarum Institute, September 2015

[3] Meriam-Webster defines Gross Domestic Product as, “the total value of the goods and services produced by the people of a nation during a year not including the value of the income earned in foreign countries”.

[4] The Commonwealth Fund, June 2014

[5] Centers for Disease Control, 2009

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