In this episode of Creating a New Healthcare, Dr. Zeev Neuwirth interviews Kyra Bobinet MD, CEO & founder of engagedIN – a healthcare behavior design firm which uses neuroscience and state-of-the-art design techniques that make products and communications more engaging for consumers.  Kyra has an impressive background in developing health apps, blockbuster products, and evidence-based programs in wellness & metabolic medicine.  Prior to founding her own company, she served as a physician executive at Aetna, where she designed large-scale population health management and wellness interventions for Fortune 500 companies.  In 2015, she authored the ‘Well Designed Life: 10 Lessons in Brain Science and Design Thinking for a Mindful, Healthy, and Purposeful Life’.  In addition to her companies work, she also co-teaches patient engagement and health design with Dr. Larry Chu at the Stanford School of Medicine.  

This podcast episode is a critically important to anyone interested in patient engagement & behavior change.  Kyra has spent years studying and combining the most up-to-date, evidence-based brain science, behavior change and design thinking – and embedding them in healthcare programs and products.  You will come away from this interview with a very different understanding of behavior change.  As Kyra puts it, “we have learned more about the brain and behavior in the past 5 years than in the previous 5,000 years – offering the potential and power to reach, influence and improve health and well-being at scale”.

There are  a number of pivotal learnings to be gained from this interview.  Here are a couple.

One of the most compelling advantages of Dr. Bobinet’s approach is the absence of blame, shame or guilt.  In this model, there is no sense of personal failure.  If there is a failure, it is in the behavior design, not in the provider or patient; because the intent is not in manipulating or psychologizing the individual; but rather in manipulating the design.

Another advantage to this approach is that it’s based on brain science.  Kyra describes a part of the brain called the Habenula.  It’s purpose is to prevent us from repeating behaviors that might harm us.  As Kyra describes, the Habenula is essentially a ‘failure counter’.  If we perceive a failure – like in trying to lose weight or starting some new exercise regimen or eating healthier – the Habenula downgrades our motivation.   So – not only do we not achieve the intended behavior change, we also feel bad about it, and are demotivated to try something else.  The Habenula pathway is literally a physiologic demotivator.  Realizing the unintended consequences of this evolutionary neural pathway, the Design approach attempts to side-step the Habenula’s failure mode.  If we perceive a design attempt as an externally located learning experience, rather than a personal failure, the Habenula failure counter and cycle of suffering is far less likely to be activated.

The Design approach transforms behavior change from compliance-based to creative-based.  And, this is not a theoretical model.  It is a practical one that has been deployed in industry and in healthcare.  Kyra describes how companies like Facebook use this creative iterative approach.  She also shares some of her own projects that have deployed this approach.

There are numerous pearls, parables and personal takeaways that Kyra offers up in this interview.   Kyra is, above all else, completely genuine and authentic; and therefore her voice is incredibly compelling.  It’s truly a delight and a privilege to share this interview with you.