COVID-19 has forced numerous changes in how organizations and industries operate and serve their users.
In our own industry, lockdowns and social distancing have accelerated trends towards flexible work arrangements for employees and providing digital offerings for customers. Many corporate leaders are now realizing that what they thought were technological barriers to progress were instead human behavior challenges.
Consider some recent statistics from England’s National Health Service (NHS). Before the pandemic, about 85% of the country’s approximately 25 million monthly General Practice (GP) appointments were face-to-face and the remaining 15% were remote. However, since the first COVID-19 lockdown in March 2020,1 face-to-face GP appointments in England have, not unexpectedly, dropped dramatically: from March to December 2020, approximately 43% were remote.
What was surprising was what replaced face-to-face appointments. Video and online appointments, which one might have expected to increase, instead fell sharply, dropping by almost half from an average of more than 150,000 a month pre-lockdown. Telephone consults, on the other hand, almost tripled, to an average of more than nine million a month.
Some in the healthcare profession are suggesting that phone consults, which clearly emerged as popular, effective, and efficient during the pandemic, may be here to stay. Which begs the question: if telephone consults are so effective, why did it take a pandemic to make this 150-year-old technology so popular?
The telephone’s potential benefits in medicine and healthcare have been evident since it was first invented. Indeed, The Lancet’s February 9, 1878 issue contained a Letter to the Editor that suggested the telephone could improve medical diagnostics, especially in conditions for which listening for certain sounds did not require being face to face.2
Or consider the story behind the iconic first words spoken by Alexander Graham Bell, inventor of the telephone, using his creation on March 10, 1876. Many people may know that those first words were "Mr. Watson, come here, I want you," but fewer might know that Bell was calling for medical assistance, as he had just spilled sulphuric acid on his clothes.
- See also: Telephone as Case Management Tool
Clearly, the clinical benefits of doctor-patient telephone conversations have been known for nearly 150 years. However, even as recently as a year ago, the telephone was not the instrument of choice for medical consultations. Why was that the case? Could it have been due to certain inherent limitations, such as lack of visuals or an inability to use touch or smell? These elements might have indicated a need for new technologies to replace face-to-face consults. Then again …
In With The New?
There is often a tendency to assume that new technologies may be the most effective way to spur behavioral changes. The astonishing global revolution in digital connectivity, the speed of which ramped up substantially during the COVID-19 pandemic, has prompted assumptions that change requires brand-new solutions, preferably from novel digital technologies.
However, developing something new many not always be the best or most effective solution. For example, text messaging, a technology in widespread use for more than 20 years, has proven one of the most effective ways to influence behaviors such as improved medication adherence, diabetes control, and more.3
It is not just healthcare that has found existing technologies to be simpler, more productive, and more popular. From the rapid adoption of Zoom, a software introduced in 2013, to the massive increases in online shopping, one lesson of the COVID-19 pandemic is that often, good technology solutions may already be available.
Our own life and health insurance industry has adapted remarkably well to COVID-19’s challenges. The past year of enforced restrictions in face-to-face contact provided an impetus for changes that might never have occurred under normal circumstances. Most insurers, for example, now permit the majority of their workforces to work remotely and have come to realize the extent to which sales, underwriting, and claims management processes can function well in these circumstances, and may even be improved through the use of existing digital solutions.
The pandemic also highlighted the role of invention and innovation in tackling new problems. The remarkable speed at which effective vaccines were developed for COVID-19 is one testament to this impetus. However, many of the healthcare industry’s current challenges are behavioral rather than technological, and developing a new technology may not always be the right solution.
There is a reason for this: many behaviors around health are strongly habitual and reinforced by environmental and social factors. The current pandemic has shown that it is often easiest to change habitual behaviors when these environmental and social factors change. This does not mean adoption of new technologies and ideas must wait for epochal events: there are many proven ways in which context can be influenced at a smaller scale. But it also does not mean we can assume the benefits of a new technology alone will overcome the context of a situation and habitual factors at play.
- See also: Are We Giving Social Distancing a Bad Name? A counterintuitive look at how terminology influences behavior.
Shifting Innovative Thinking
This lesson must be taken forward into future change discussions. There is a human tendency to lean toward creating a shiny new technology and then discarding it when not immediately embraced by users. For all but the most inherently appealing and addictive of technologies, driving adoption and use will always be hard. Often timing is crucial: just because something did not work this year does not mean it should be completely dismissed.
The insurance industry needs to make sure existing ideas or technologies are not being overlooked. Some of these ideas and technologies might just need a few adjustments, along with effective adoption strategies, to make a real impact. For example, the recent changes in how underwriting questions are phrased and framed have been shown to both increase disclosures and improve customer journeys,4 but have yet to be fully adopted across the industry.
It will always be more exciting and glamorous to create a revolutionary new technology-based solution. However, driving adoption of a good solution – whether new and revolutionary or not – is often much harder. Behavioral science can help companies drive both adoption of solutions as well as development of new ones. If more attention is focused on making the best that exists better, and on maximizing the behavioral impact of a technology or idea that is good enough, we may continue to find that the solutions to many of our challenges already exist.
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2. Aronson SH. The Lancet on the Telephone 1876-1975. Medical History. 1977 Jan; 21(1): 69-87. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1081896/
3. Armanasco AA, et al. Preventive Health Behavior Change Text Message Interventions: A Meta-Analysis. American Journal of Preventive Medicine. 2017 Jan 7; 52(3): 391-402. https://www.ajpmonline.org/article/S0749-3797(16)30586-4/abstract