Perspectives
Designing successful digital health tools means addressing the fears and concerns that many doctors may have about technology. Jacob Collins explores why new tools can make physicians more apprehensive than new drugs.
New technology means new challenges and that’s true in healthcare just as it is in every aspect of life. In fact, research shows that doctors and healthcare providers can face more challenges than other groups when it comes to adopting innovative technology and can even be more susceptible to bias than patients.
The truth is that we can all be reluctant to use new tools for reasons that in retrospect may seem odd or funny. In digital healthcare, however, these barriers have real consequences. They can slow business growth and hinder patients getting better treatment.
In our health market research testing digital health tools, we have encountered more irrational, knee-jerk reactions than we do for most new drug treatments. The bottom line is that for many doctors innovative drugs are exciting, whereas new technology is potentially threatening.
We typically divide these reactions into three key areas:
1. Ambiguity aversion
As in any profession, the fear of the unknown, such as AI, can trigger all sorts of reactions. Popular culture and articles that talk about the threat to humanity and jobs are all playing their part and doctors have specific concerns about how it will impact their patients, liability and reputation for example.
Many see AI algorithms as something that they don’t understand and hence are concerned about – even when the AI is a tool that can help them do their job or even potentially reduce their workload.
They share the concern of many professions that they will be replaced, rather than recognising that the combination of AI + Human is better than Human or AI alone. The fact that AI can increase the accuracy of detecting cancers on MRIs or increase the volume of MRIs that are reviewed in a set time, for example, has yet to overcome this fear. As such, they need a clear articulation of ‘what is in it for them’ for each tool.
It's not a reaction we get with other technologies. Doctors are perfectly happy to order and use the results of MRI scans, even if some cannot explain how an MRI specifically works (and happily accept that they don’t know how it works), they have built an established trust and relationship with it due to a decades-long industry familiarity.
Overcoming such concerns means guiding healthcare providers and practitioners through the process of exploring how the tool could deliver on unmet needs, moving the focus away from the ‘unknown’ into their existing reality and how it could be improved.
2. Status quo bias
We all know that many doctors are struggling with their workloads. A new digital health tool means more work in the short-term, even if it saves time once they have integrated it into their processes.
Success means doing more than just selling the tool to an organisation at a corporate level, it also means addressing legitimate concerns from a practitioner level.
You can swing the mental dial in favour of a tool by highlighting the value of accumulated wins and time saved – such as three hours a week saved using voice to text in doctor notes or peace of mind with the ability to ‘set it and forget it’ with programmed reminders. The NICE heralded success of Sleepio that reduces the number of GP appointments people with insomnia need and will also cut the number of prescriptions for sleeping pills delivered by pharmacists is another example.
At a practical level, you also need to ensure the planning process maps out the ‘repair work’ required, i.e. how the new tool/innovation will change the current workflow/ processes for both payers and physicians.
Initial use will, of course, disrupt current processes, so effort is required by the team(s) who use the current process or support services to then rebuild the process with the innovation integrated.
The lack of consideration of such ‘repair work’ often proves the biggest barrier to adoption of new tools, because teams see the amount of effort required as overwhelming or not worth the gain. It is critical for teams looking to launch digital health tools that they provide suggestions on how to diminish the effort required or ideally find funding streams to cover the time investment needed.
3. Learning capacity
There is a feeling that as we age, we find that the process of learning new approaches or using new technology becomes harder. Some people remain keen on technology throughout their lives, whereas others see it as a necessary evil, something they know that they need to learn but will often lean on others to either use the tech for them or teach them slowly how to use it.
They may also be hampered by a fear that they could ‘break’ the tool.
When this group is included in market research to test ideas they will naturally push back/ react cautiously to the new tools, even if with the right training they will ultimately adopt and become users.
To overcome this barrier, you must ensure that tools come with training that makes them feel ‘safe and easy’ to use.
A great example of this is the simple inclusion of the home button on many early smart phones. It turns out that the home button was not technologically required, but was included as a training device as it is an easy way for the user to return the phone to a known position. It made it clear to users that whatever they did to a phone, the home button would make it all ok again.
Overcoming these barriers is critical to any future vision of healthcare. In the near future, the UK government wants 75% of adults in England to be using the NHS app, including for digital face-to-face consultations, by March 2024. That won’t be achievable unless practitioners are also happy with the changes involved.
Globally, the Lancet estimates that some $259 billion in healthcare spending could shift to virtual healthcare. But it also warns that any transfer, if it is to be successful, must be built on trust, among patients, practitioners, and healthcare providers.
We can only deliver on the potential of digital tools if we build trust by addressing the three behavioural barriers highlighted above.
