Why We Need Innovations in Empathy, Not Just Technology, in Health Care

There has been a lot of innovation in recent years in the use of mobile technologies in health care, but often it’s the techie types that get very excited while ordinary people (patients and health care workers alike) remain on the sidelines—confused or even feeling alienated by the intervention of technology. This was recognized at a recent Stanford conference, Mobile Health 2011, where the focus turned away from "gee-whiz demos" to looking at the experience of the end user. Words like "emotion" and "compassion" were common currency.

One field in which these types of insights are occurring is "behavior modification," a process of reducing bad behaviors or increasing good behaviors by making small interventions into a patient's life. Mobile phones are particularly useful in delivering messages to patients reminding them of their behavior change goals. Text messages can be sent automatically to patients to remind them to engage in a good health habit (taking a scheduled birth control pill) or refrain from an unhealthy habit (abusing a drug).

Empathy with patients can improve the success of these types of programs. Fred Muench of Mobile Health Interventions, which provides health-related SMS reminders, mentioned during his panel that reminders could be more effective if the patient herself writes the text of the message for later use. Health blog Text in the City noted that this behavior modification method also "gets around issues of confidentiality and concerns about parents/family seeing messages on patient cell phones," particularly when the message is about a stigmatized issue like sexuality or substance abuse. Thinking about the patient experience also influenced the creation of "Carmen" a virtual friend presented by Abby King of Stanford University that counsels elderly Latino women to get more physical exercise.

There were also panels on the business side of mobile health, such as "What Really Works in the Business of Mobile Health" and "What Really Works in Changing Behavior: Commercial Impact," but patients were clearly the central focus. Jeremy Vanderlan of AIDS.gov distilled the spirit of empathy in a blog post:

The elderly and the poor are the demographics that would benefit most from mobile health. They are also the most likely to experience fear or embarrassment at their lack of technological savvy. We, the technophiles, embrace technology. We wield it, it is our friend. The barrier of fear that exists for the elderly and the poor must be overcome if mobile health is to be implemented effectively for everyone, for it to realize the enormous promise and potential that mobile health represents.

Viewed from a human rather than technical perspective, it's easy to see how sometimes the source of a health innovation may not be an improvement in technology, but an improvement in empathy, in which health technologists find a better way to understand the patient.

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This article beautifully articulates what I see as a major "gap" in Healthcare and Medicine.

I think that as Physicians & Healthcare providers we have a moral & ethical imperative to focus on this human component of our ever-changing technology. I applaud the work presented in this article and look forward to reading more and getting involved through these venues. My own specialty of Radiology certainly offers many opportunities to connect with "emotion and compassion".

Connie A. Innis, M.D.
Seattle, WA U.S.A.

Emotion and compassion are justifiably attractive attributes for care delivery, but having worked with behavior modification for years I would state unequivocally that is not the way to produce such a qualitative change in health services. In a word, reinforcements are fine, but behavior modification soon becomes an end in itself dominated by "control freaks" who manipulate methods to artificially create the appearances of conditioned care responses. Ultimately patients sense the thin wall of methodology and repel and rebel against being treated by a methodology. If you want compassion in Health care, revamp the system of market reduction and place a premium on interpreting the patients needs and fears. Stop the phoney regression back to behavior modification...its been abused for close to a century and it is typically embraced by the mechanics of a business administration who see everything and everybody in their path as obstacles to manage and control.

Thanks for your brave and important counter to the ubiquitous assertion that technology provides the answer to whatever ails us. Sometimes we benefit most from interaction with a real,live, kind, and respectful human being more than interaction with a new app or a new pill. Your post provides a vital reminder.

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