Breakfast Session, Department of Health. Laura Freeman, Principal Analyst Department of Health Behavioural Insights Team

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1 Breakfast Session, Department of Health Laura Freeman, Principal Analyst Department of Health Behavioural Insights Team

2 Access to patient records: applying behavioural insights 5 June 2015 Laura Freeman Principal Analyst- DH behavioural insights team

3 almost all of us would donate organs after we die high awareness of the organ donor register it takes 30 seconds 3

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7 Cabinet Office and DH : Applying Behavioural Insights to Organ Donation: preliminary results from a randomised controlled trial 7 DH Leading the nation s health and care

8 Benefits of behavioural insights Understanding how people actually behave helps us design effective policy and implementation programmes. Behavioural insights can inform interventions that are: Cheap: often optimising existing processes or materials Scalable: do not require intensive training or system reorganisation Light touch: limited burden on those who wish to continue as they are 8 DH Leading the nation s health and care

9 About 1 in every 10 NHS outpatient appointment is missed This leads to poor patient care It wastes NHS resources: one estimate put this at 225 million Challenge is to reduce missed hospital appointments by a quarter - without spending any money - without retraining staff or introducing complex system changes - without penalising patients 9

10 Appt at St Barts Hospital on Sep 26 at To cancel or rearrange call the number on your appointment letter. We are expecting you at St Barts Hospital on Sep 26 at Not attending costs NHS 160 approx. Call if you need to cancel or rearrange. Existing message Specific Costs Hallsworth M, Berry D, et al: Stating appointment costs in SMS reminders reduces missed hospital appointments. (2015: publication pending) 10 DH Leading the nation s health and care

11 Behavioural insights / concepts Surprise Hyperbolic Discounting Social Learning Priming Placebo Effect Decoupling Proccrastination Availability Impact Bias Long-Tailed Risk Social Identity / norms Habit Anticipation of Reward Simplification Band Wagon Effect Anchoring Optimism Bias Intertemporal Choice Business Norms Intuition Messenger Planning Fallacy Key Influencers Hindsight Bias Loss Aversion Attention Collapse Identity Salience Status quo bias Hedonic Framing Cognitive Load Gaming Sunk Costs Defaults Regret Choice Bracketing Certainty Bias Altruism Social Proof Mental Accounting Ambiguity Effect Reciprocity Framing Information Avoidance Endowment Effect Inequity Aversion Commitments Representativeness Participatory Effect Teachable moment Cognitive Dissonance Over-Extrapolation Actor-Observer Bias Omission Bias Attribution Error Segregation Effect 11 DH Leading the nation s health and care

12 Access to patient health and care records There is a lot of potential for behavioural insights to be used to inform the NIB programme of work, for example: Improving flow of patient information between clinicians as part of an individual s own care Increasing uptake of online services e.g. booking appointments online But taking the example of access to patient health and care records, what can BI offer to: Encourage patients to access and use their records? Encourage clinicians to make use of records for improved workflow? Encourage managers to make use of records for performance management purposes? 12 DH Leading the nation s health and care

13 Reduce effort Simplify messages EASY Break the goal down into simple actions Defaults 13

14 Attract attention Incentives & Rewards ATTRACTIVE Images & Colour Lotteries Personalisation 14

15 Make a commitment Public promises SOCIAL Networks Social norms 15

16 Prompts Make a plan We are expecting you at St Barts Hospital on Sep 26 at Not attending costs NHS 160 approx. Call if you need to cancel or rearrange. TIMELY Specific Costs Immediate costs and benefits Reminders 16

17 Recap of the benefits of BI Behavioural insights can inform interventions that are: Cheap: often optimising existing processes or tech innovations Scalable: do not require intensive training or system reorganisation Light touch: limited burden on those who wish to continue as they are Great framework: search for behavioural insights EAST Laura Freeman: 17 DH Leading the nation s health and care