I use my smartphone to run much of my life. It is with me wherever I go so it seems logical that I use it as often as I can to enhance the things I’m doing. At the gym it feeds me audio books while I track my workouts. In the car it feeds me music from the cloud or keeps me up to date with podcasts. At home it times my steaks on the grill, finds me recipes and the latest Katy Perry song for my kids. I track my tasks (sort of), my banking info and my Starbucks balance. It is a part of me (for good or bad). These mobile interruptions all seem, well, natural to me. I can’t remember a time when they didn’t.
Sometime during the past 10 years my behaviour changed – gradually, perhaps imperceivable to me – and, when I read an article on Fast Company about a new wristband that reminded doctors to wash their hands I found myself wondering if mobile can actually change behaviours enough to get rid of laziness altogether. Behaviours don’t change over night and I always caution the companies that I work with to not be in the “behaviour change” business – it’s like being in the health sciences or alternate energy business: potentially lucrative but seriously long-term. This mobile revolution seems to have accelerated the changes in all of us – we have modified the way we work, play, interact, communicate and share. Adoption of these devices in our lives has usurped that of radio, television, PCs and the Internet.
Can a mobile technology help curb human laziness?
I was a smoker – a GOOD smoker. I took pride in my ability to smoke a cigarette. The ash was never too long, my lighter was not a bic it was a Zippo or equivalent – a work of art or science but not common – and I always thought sleeping just seemed to interfere with my habit. My last smoke was March 2, 1999 and I used a computer to quit. The premise of the computer, called LifeSign, was to change the behaviour of my smoking pattern. It would tell me when to smoke, how often to smoke and the time between smokes. The whole premise was cessation through modifying my smoking behaviour. I bought it, executed on it and haven’t had a cigarette in 5073 days (which translates to roughly 76000 smokes I haven’t consumed). This little mobile device changed my life in 5 weeks.
How many of you have heard of LifeSign? Right. So despite it working for me and many others, it seems to have disappeared. There are cessation programs now on smartphones and maybe they work but I would hazard a guess that the success rate is not as high as a stand-alone device that cost more than 99 cents. If memory serves correct, I paid over $100 for the privilege of quitting smoking via LifeSign. It was a real commitment, not a distraction or something that could easily be ignored as one of a hundred apps on a phone.
Curbing laziness is changing behaviour
Could I have quit smoking by myself? Not sure. I was too lazy to find out. I used technology to get me through it (and perhaps a small amount of crying and some booze). I needed a helping hand.
So, back to this article on Fast Company and the wristband that reminds doctors to wash their hands. It is a serious issue and this simple act – a doctor washing their hands more – can help in reducing the spread of infection in hospitals. The limited trials of this technology have actually improved compliance – almost doubling it in some instances. Can this stick or will it end up in the junk pile next to LifeSign.
Technology searching for a home
In late 2010 the Persuasive Tech Lab at Stanford University published a list of the top 10 mistakes in behaviour change and they seem a good litmus test for this technology. I won’t itemize each one – you can take a look at them for yourself. Instead, let’s look at how and where mobile technology could be implemented in order to make something like a doctor washing their hands a more ingrained behaviour.
In that list from Stanford are some clues to the outcome of the Hyginex solution.
First off, in order to get the wristband up and running the hospital needs to instal sensors throughout the building, set up the right computing infrastructure, get their doctors and nurses to wear the devices at all times and then have someone monitor and maintain the technology (service them, charge them, download the data, integrate the data into workflow, etc.). These are not simple nor small changes. This is, as the researchers say, a “big leap” not a small step. They recommend seeking “tiny successes” one after another.
Once that system is in place the triggers need to be set. According to the Stanford list, triggers beget behaviour change so something needs to happen to move the doctor to the sink. In the case of the Hyginex wrist band it is a vibration that triggers the action and the vibration that acknowledges the completed action. This type of trigger alone won’t work as well as hoped – think of the number of times we ignore our phone. Triggers need to bring with them an ease of engagement. The hospitals will need to move sinks into the open so when a doctor or nurse is triggered, they can take action immediately or have a visual cue that compliments the vibrating bracelet.
What is my motivation?
The last question may be a bit existential but what is their motivation? To track and implement something like this across a hospital there needs to be something more than a prison-like wristband that buzzes when you haven’t washed your hands. Militant it may be, behaviour changing it is not. Not without a reason – something that resonates and sticks. Something concrete. Something that is tangible. This isn’t about pushing information, that doesn’t work. This is about making this change a part of a routine. “Saving lives” is what they already do so whatever the reason for washing hands it needs to be translated into a hyper local understanding on the impact it will have on them, not that it will save a million lives in the United States.
Ok smart guy, what is the solution?
Take a step back and look at the signs. There is a problem here, no one is denying that. The results have been great so far, no one is denying that. How does this continue and scale. What is the most effective way to trigger a behaviour like this. Is it mobile or just mobile for mobile’s sake?
Maybe the bracelet is the right approach but there seem to be many obstacles to changing behaviour that this initiative goes against. There are, however, interim steps that can take advantage of current mobile technology already in hospitals around the world.
Give the power to the people
When was the last time you asked your doctor if they washed their hands? I know I have never asked. Maybe we should. Perhaps the best approach is to give the power to the patients or their families by giving them a voice. Let the families use their mobile devices to reward the doctors that wash. Where is the app that does that? Where is the QR code or NFC poster that we can tap after we ask that question. Where are the reports of the “cleanest” doctors offices or hospitals like the ones we have for restaurants? Why aren’t these being driven by this one very important metric? Why don’t the patients have a voice.
To change behaviour in this instance may just mean shifting the power from the doctors to the patients – because it matters most to them, they are the most vulnerable, they are the ones that are at risk. Our behaviour at that moment is open to change because we are interested in protecting ourselves or our loved ones.
Start with smaller steps
The lesson here? Technology often has a place but should never lead, the idea should. Technology has also enabled a generation of voices that, combined, has the power to influence and change behaviour. Give the power to the right voice, enable them with the right technology and change will happen – faster than forcing a change on a reluctant audience.
While hospitals spend their time and money rolling out these wristbands, let’s start a movement by simply asking the doctor in front of you to wash their hands before touching you. Who knows, that just might work.