Turning Insight into Action

Introduction

A perennial problem (or opportunity) in medicine is that human beings don’t always turn insight into action when it goes against our short-term interests. Research has proven that high calories, sugar, alcohol, and saturated fats are bad for long-term health, yet very few people make choices to eat and drink healthier. Obviously many people in the US don’t have the resources to make healthier choices a reality. But even the average person with adequate resources usually eats poorly, skips routine checkups, avoids getting tested, and pays for gym memberships they seldom use. Kaiser Permanente, the largest managed care organization in the US, recently took a small action to combat this tendency and drive more people to action: They changed the way patients see their medical information.

Since Kaiser is an integrated managed care organization, it has an integrated electronic medical record, so any Kaiser customer can always see their full history of test results online. Until 2016, a typical customer getting a routine physical would see her past blood tests presented this way:

TEST NAME DATE
Lipid Panel 3/04/16
Hemoglobin A1C 3/03/16
Lipid Panel 8/25/14
Lipid Panel 2/28/13
CBC (Complete Blood Count) 2/28/13
Lipid Panel 11/7/11

A patient could click on each test (each row) and see the results presented this way:

LIPID PANEL
Ordered By Dr. Smith
Date of Results 2/28/13
Cholesterol 165 MG/DL
HDL 59 MG/DL

Since most patients aren’t also doctors, these numbers don’t mean much to most people. So the average person would close his browser and go on about his day, making very few changes to his diet based on the information. But in 2016, Kaiser made a switch. Now, when a patient clicks on a test result, this is what he can see on his mobile app:

Instead of looking at numbers, the patient is looking at his life. As time has passed, he sees evidence that his cholesterol is climbing. It’s approaching the upper limit of what Kaiser considers a “standard range.” This information is much harder to ignore and Kaiser is betting it drives more patients to turn insights about their cholesterol levels into action at the grocery store and dinner table.

What does cholesterol have to do with government inaction?

Kaiser’s example is a microcosm of the challenges faced by governments everywhere: how to use information in a way that helps people make smarter choices that are in their best interest and in the best interest of society. Many governments are struggling to turn insights about their performance into smart and effective delivery changes. There are a host of reasons why and most aren’t as simple as changing an online chart for residents or employees (although some are).

In this guide, the Center for Government Excellence (GovEx) will explore the common causes for government inaction and suggest strategies to either overcome them, work around them, or simply understand them.

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