Your Phone is a “Commitment
Device”
Who Cardiologists Actually
Follow: Other Cardiologists
Most of us (okay, all of us) have intentions
to improve health behaviors at some point
in the near future. Making a concrete step
to pre-commit to our “future selves” may
actually translate that intention into action.
Pre-commitment as a means to overcome
resistance and improve self-control is seen
in many areas: for instance, think automated
payroll deductions for retirement plan
contributions and moving your alarm clock
out of arm’s reach so you can’t reach the
snooze button.
“Commitment devices attempt to
enforce people’s voluntarily imposed restrictions until they have accomplished their
goals, or their voluntarily imposed penalties for failing to accomplish their goals,”
said Todd Rogers, PhD (@Todd_Rogers_;
170 Tweets, 1433 followers). Dr. Rogers is a
behavioral scientist and associate professor
at Harvard Kennedy School of Government.
He coauthored an opinion piece on the
topic of commitment devices in JAMA in
2014, in which he suggested several ways
of building better commitment devices to
improve health.2
One idea would require patients to opt
out of commitment devices, rather than
attempting to convince them to proactively
sign up. This has been shown, for example,
to increase enrollment in organ donation
programs. Also, commitment devices can be
engineered to provide immediate positive
feedback and to help with long-term behavior maintenance.
“Leveraging advances in wireless technologies to make dynamic feedback easier,
cheaper, and timelier” is important, said Dr.
Rogers, as is “leveraging the influence of
existing social networks.” Clearly the mobile
app writers have already thought of this:
Search “health” in the Apple’s App Store
and you get 209 results; “exercise,” 173 hits;
and “fitness,” 185 hits.
Want to ensure you don’t sit immobile on your computer for longer than 60
minutes at a stretch: there’s an app for that.
There’s another one to count your fruit and
Special to CardioSource WorldNews, Greg Matthews from MDigitalLife ran an
exclusive analysis of the MDigitalLife Health Ecosystem database to determine
who are the cardiologists most followed by other cardiologists. Drumroll, please…
veggie servings. Isn’t it always easier to
stick to your diet when you might win some
money off a less adherent friend? There’s an
app for that too.
Here’s an interesting one you might
have seen on Kickstarter or Shark Tank:
kSafe is a smartphone connected safe that
allows you to place something you need
or want into a safe and lock it in until you
achieve the goal you’ve set. The safe syncs
with fitness trackers and smartphones. So,
for example, do you want to make sure you
get that morning run in? Throw your wallet
or car keys in the safe at night and set it to
unlock after you’ve taken a certain number
of steps or burned enough calories, as evidenced by your Fitbit or the built-in motion
processor on your smartphone. The device
comes in a few sizes and costs about $50.
The biggest problem with commitment
devices is that people don’t use them
enough, according to David Glance, PhD
(@david_glance; 3,986 Tweets, 1,971 followers), director of the Centre for Software
Practice at the University of Western Australia. He has worked for several software
companies, including Microsoft.
“This may be because of a lack of
awareness on the part of the general public,
or more likely, the unwillingness of people
like health professionals to recommend
them.” But look at that in reverse: how much
power and influence might smartphone
apps gain if they are actively developed and
promoted by physicians?
Indeed, at the 2016 meeting of the
Healthcare Information & Management
Systems Society, investigators presented
a survey of 2,600 WebMD users. When
asked whether they used wearables like
fitness trackers, seniors (born prior to 1942)
typically said no and the reason they gave is
because a doctor hasn’t recommended it. ■
34
CardioSource WorldNews
1.
Eric Topol, MD
@EricTopol
Chief Academic Officer
Scripps Health
La Jolla, CA
2.
C. Michael Gibson, MD
@CMichaelGibson
Professor
Harvard Medical School
Boston, MA
3.
Harlan Krumholz, MD
@hmkyale
Professor
Yale School of Medicine
New Haven, CT
4.
Robert Harrington, MD
@HeartBobH
Chair, Department of Medicine
Stanford University
Stanford, CA
5.
John Mandrola, MD
@drjohnm
Electrophysiologist
Baptist Health
Louisville, KY
6.
Seth Bilazarian, MD
@DrSethdb
Vice President of Interventional Cardiology, Abiomed, Inc.
and instructor at Harvard Medical School
Boston, MA
7.
Christopher Cannon, MD
@cpcannon
Brigham and Women’s Hospital
Harvard Clinical Research Institute
Boston, MA
8.
Westby Fisher, MD
@doctorwes
Director, Cardiac Electrophysiology
NorthShore University HealthSystem
Glenview, IL
9.
Melissa Walton-Shirley, MD
@MWaltonShirley
Cardiology Associates of Southern Kentucky
Glasgow, KY
10.
Mehmet Oz, MD
@DrOz
Director, Integrative Medicine Center
Columbia University
New York, NY ■
REFERENCES:
1. Blenner SR, Köllmer M, Rouse AJ, et al.
JAMA. 2016;315:1051-2.
2. Rogers T, Milkman KL, Volpp KG. JAMA.
2014;311:2065-6.
Physician Use of Social Media
AA Recruit patients and market a practice
AA Identify services patients desire
AA Connect with other doctors
AA Connect with patients
Cardiologists Most Followed by Cardiologists - Top 10:
AA Keep up-to-date with health news,
technology’s impact on health, and the
delivery of health care
AA Recruit research subjects
SOURCE: Thanks to Greg Matthews (@chimoose) and MDigitalLife (@MDigitalLife)
April 2016