Creating Habits in Healthcare: How We Helped a Large Pharma Partner Design Better Symptom Tracking for Cancer Patients
Imagine that you have cancer. You wake up. It’s a Tuesday. You’re feeling weak and fatigued, and there’s a pain in your mid-section that wasn’t there yesterday. Fast-forward to Friday. You feel fine now. No pain. You know you’re supposed to log your symptoms for your doctor, but what is there to report? You feel fine today. And you only have a vague recollection of Tuesday. Plus, you want to focus on the fact that today is a good day – and anyway, reporting symptoms can be a hassle.
And this is the problem with symptom reporting for cancer patients. While we know that regular symptom reporting can improve care and well-being, getting patients to log their symptoms at all, much less habitually, can be challenging.
The Challenge
How Do You Build Habits in Healthcare?
We set out to change this by redesigning a digital patient monitoring (DPM) platform to encourage patients with liver, kidney and breast cancer to regularly log their symptoms. The goal: offer physicians a comprehensive health overview and provide patients with the best possible care by encouraging (at least) weekly reporting of cancer patients’ symptoms.
We reviewed competitors, performed lateral category analyses, and did extensive qualitative behaviorally-informed research (including with cancer patients). The resulting key insights informed a complete product redesign.
Step 1: Behavioral Diagnosis
Our team used the Behavioral Design process to understand why people weren’t reporting their symptoms regularly through the digital patient monitoring app.
While in behavioral science trying to create a routine at the same time every week—with some flexibility—can be a promising strategy for encouraging action, our behavioral diagnosis highlighted the shortcomings of that approach for oncology symptom reporting. As a result, we designed a completely different approach to reporting than the oncology DPM platform had previously taken.
Step 2: Identify the Psychologies at Play
It turns out that prospective memory failure, or intending to do something – e.g. report a symptom – and then forgetting, occurs not only in everyday life, but especially often in cancer treatment settings. The treatments themselves can exacerbate forgetting. Financial scarcity (mounting bills), time scarcity (logistical challenges setting up and receiving medical care), and difficulty navigating newly complicated interpersonal relationships all contribute to increased forgetting.
Remembering something and taking an action are very different. Given the difficulty of remembering that a symptom occurred and accurately reporting on it days later, we realized that we needed to redesign the app to account for how memory actually works.
Step 3: Behavioral Design
Since remembering at the end of a week was so challenging, especially for less severe symptoms, we needed another approach. We found that the symptoms themselves are a natural reminder – salient and immediate. People know when they feel bad, and they want immediate relief.
Building a Clear Mental Model: Report When You Don’t Feel Well
We redesigned the product mental model to leverage these natural memory cues and to make it easy to report in the moment.
Social Norms + Timely Feedback: Highly Relevant Ways to Feel Better Now
To keep people using the app regularly, we made sure it rewarded them right after they logged their symptoms. Immediate, positive reinforcement is key to fostering consistent product engagement.
We made the app’s responses depend on how patients reported their symptoms. If someone logged a symptom right in the moment, like a sudden headache, the app quickly gave advice on how to feel better, like drinking more water or taking a specific medicine.
Our behavioral research uncovered that tips proposed and voted on by similar others – people with cancer symptoms just like them – were more likely to be trusted, appreciated, and potentially heeded.
Choosing the Right Messenger
To further support reporting, we leveraged the messenger effect, our cognitive tendency to judge the validity or relevance of information based on its source. Studies have found that the message is only as effective as the person delivering it, and that leveraging trusted authorities as messengers can increase receptivity to information. Reminders from someone close to the patient, like a family member, or their doctor, were designed to help make this task feel more important.
A Two-Tiered Approach to Symptom Reporting
But we also needed more nuanced information from patients on a consistent weekly basis, and if they didn’t report any symptoms, confirmation that they felt okay that week. So we designed a two-tiered symptom reporting system that included weekly reporting as well.
- In the moment: We reduced in-the-moment reporting from five or more questions to just two, addressing the urgency and simplicity needed for acute symptom logging.
- Weekly reporting: To support a more comprehensive health overview, we designed simplified questions and made previously reported symptoms salient as low-friction selections, making the process faster and more personalized.
For those filling out their weekly symptom diary, we offered advice, including tips generated by cancer patients like them, that could help them in the long run and made sure the advice wasn’t the same every time. This allowed the app to learn over time what’s most helpful and give relevant, useful advice, ensuring a personally valuable experience.
Additionally, by altering the design to display recently experienced symptoms up front, we reduced the cognitive load for users, minimizing barriers to regular use.
The Impact
Empowering Patients to Be Active Participants in Their Care
Our partnership went beyond just helping patients and doctors create habits in healthcare. It showed how behavioral insights can make us rethink and ultimately redesign the existing model for using technology to provide better care.
By introducing two-tiered symptom reporting, focusing on patient-centric design, including clear reminders from trusted individuals, and giving timely and useful feedback, this project has made it easier for patients to consistently report their symptoms. The result is a better patient experience and richer information for doctors to tailor higher quality patient care.
Want to learn more about behavioral science – and how it can drive health product success? Check out our Behavioral Design for Health Bootcamp today.