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We just wrapped up our 6th business building block sprint on Key Behaviors. In summary, we completed two main objectives:

• Questions to ask for the canvas on the Key Behaviors building block
• Defining how to create healthcare Key Behaviors

To do this successfully, we also asked some additional questions that were relevant to this building block:

• What is behavioral economics and why does it matter for health?
• What is behavior change how does it affect health?
• What do rewards and incentives have to do with health?

Questions to Ask on the Canvas for the Key Behaviors Block

We defined the questions that should be added to our business model canvas for helping practitioners define their Key Behaviors:

1. What Key Behaviors are required from the Customer Segment (Buyer & User) to complete their JTBD and realize the Value Proposition?
2. What negative Key Behaviors must be overcome by the User?
3. Which negative Key Behaviors result from your business model and how can they be removed?
4. How difficult will adoption of the Key Behaviors be for the Customer Segment?
5. Which of these Key Behaviors require stimulus from Key Influencers?
6. Which of these Key Behaviors are affected by Intermediaries and how?
7. What behavior change model(s) are you using to drive the Key Behaviors?

How to Define Healthcare Key Behaviors

We also built a model for helping practitioners define their healthcare Key Behaviors.  This is in addition to the answers derived from the questions asked for this canvas building block. The result of this block should produce some Key Activities that your business model needs in order to help the Customer Segment realize the full Value Proposition.

“Behaviors” are the (re)actions of an entity to stimuli within a system. In modelH, your Customer Segment is the entity and your business model is the system. To understand what action you want to be performed by your Customer Segment, you have to understand the Key Behaviors required by your business model.  Behaviors are at the heart of any healthcare business model, but behavior change is extremely hard to do. Try it on yourself and you will see.  Most Users think of managing their health as either too difficult or too tedious. The effect is poor health. For business models that rely on healthy Users to be profitable, this is a problem. For business models that drive behavior change for health Users, this is a bonus.

But either way, Users are humans and as humans they think and act irrationally at times. If you understand this variable, you can use it to elicit the responses you want. They key is to deliberate and build the Key Behaviors into your business model using a systematic process – this new science is referred to as Behavior Design.  The modelH method for defining Key Behaviors is as follows:

1. Enumerate the Key Behaviors
2. Apply a Behavior Change Model
3. Build Behavior Triggers Into Your Key Activities
4. Reward and Reinforce the Key Behaviors

 

Enumerate the Key Behaviors

The critical first step in this process is to map out the Key Behaviors you need to elicit to make your Value Proposition work.  These Key Behaviors can be mapped out as a series of user flows or steps. You must first define what the User must do, as well as what you and your business model must do, to help the User start and finish their JTBD. This will come in two forms – what you can directly influence, and what must be indirectly influenced through others. Keep in mind the User is affected by both Intermediaries and Key Influencers, so that will have to be taken into account.

These steps occur before, during, and after a User completes their JTBD. Some behaviors are positive and reinforcing to the steps. Unfortunately, many others have the opposite result.

All controllable behaviors can then be evaluated for the actions needed to encourage future Users.  In addition, the uncontrollable behaviors can be evaluated for how to help Users avoid them. It is critical in a realistic business model to understand the complexity of the behavior change necessary for the User to complete their JTBD.

It is accepted thinking that Key Behaviors are needed to create good health conditions, but what about Customer Segments who refuse to implement them? Not willing to change behavior is a Key Behavior as well.

Understanding the major principles of Behavioral Economics and the decision-making models people use will greatly assist your work in this area. Behavioral Economics is the study of the decision-making process humans go through as they weigh opportunity costs (and benefits) to calculate the right choice that will yield the maximum benefit. In order to drive the Key Behaviors, we need healthcare Users to perform and do so consistently. We must understand how they make decisions to buy and use our Value Propositions.  A business model can use these principles to impact a Buyer’s purchase decision and a User’s usage decision by employing them into Value Propositions.  This can be done via a product development cycle, into Customer Relationships via the marketing plan, and into Channels via the experience design. Some examples of these decision models are choice architecture, hyperbolic discounting, optimism bias, information avoidance, loss aversion, and many more.

This process will illuminate where changes both large and small need to occur. However, this process also requires that you be honest with your own business model and the effect that it has on your User.  You should focus on identifying any negative stimuli that your business model creates or enables, particularly in the sense of shared value we so often advocate.

 

Apply a Behavior Change Model

Once you have the Key Behaviors mapped out, determine how to get people to do the first behavior in the user flow. If this first step is obstructive or unnatural for your User, figure out how to get the next Key Behavior to happen. In a step-by-step manner, you should continue this process until the user flow has a reasonable chance of happening.  The idea is that Key Behaviors will not happen in one step, but rather progresses through stages on the way to a successful change. Moreover, they will occur at an individual pace as each User is affected differently by the change they enact. Certain types of people have a higher prevalence to sustain change than others. Each behavior also requires a readiness to change before change can happen.

Behavioral Change is the science of understanding how effectively human beings can take actions and sustain them relative to personal goals.  This transition progresses in the face of issues and tasks that relate to changing behavior. Simply put, it is the study of how we make and break habits – good and bad.  When applied to healthcare business models, the result is the ability of a User to perform the Key Behaviors necessary to complete their JTBD and realize the Value Proposition. Business models should understand and incorporate applicable behavior models into how they enumerate their Key Behaviors.   Therefore, they can realistically assess the likelihood of their Value Proposition  realized by their Customer Segment.

There are several proven models that can be applied to ensure defined health behaviors. I caution that there is no one size fits all for choosing a behavior model. Some Key Behaviors are too complex for a given model, and some are too simple. You may need more than one model depending on the actions you are trying to elicit. The key is to match your stimulus to the system.

Some of the most popular ones are shown in the list here:

• Expectancy Theory – Vroom
• Persuasive Design  – Fogg
• Social Cognitive Theory / Self-Efficacy – Bandura
• Theory of Reasoned Action / Planned Behavior – Fishbein & Ajzen
• Transtheoretical Model / Stages of Change – Prochaska
• Hierarchy of Needs – Maslow

 

Build Behavior Triggers Into Your Key Activities

Once you understand the Key Behaviors on the User’s side of your business model, it is time to define the Key Activities that are needed.  Instruction on how to build these behavior triggers into your Key Activities will be covered in the modelH section on Key Activities.  (NOTE: WE WILL UPDATE THIS SECTION AFTER WE COMPLETE THAT SPRINT)

 

Reward and Reinforce the Key Behaviors

And finally, it stands to reason that rewarding for the behavior you want just makes good sense. As we pointed out, when properly applied to a business model, the result can expedite the Key Behaviors you need from your Buyer/User so their JTBD is complete.  Plus, the User realizes the fullness in your Value Proposition.

Rewarding Key Behaviors does not have to be cost prohibitive. It can be overcome by combining real/tangible financial incentives with perceived/intangible incentives to create a low or no-cost reward model. There are many reward models to choose from:

• Key Partner (merchant) funded rewards as cash or coupons
• Discounts on purchases
• Rebates or cash back on purchases
• Multi-purchase discounting such as 2 for 1 deals
• Gamification principles

 

In Conclusion

In conclusion, the manner in which healthcare Users behave is highly complex and often counterintuitive. Humans have a bias towards short-term gain over long-term benefits.  People often fool themselves into thinking they are healthier than they are, or they have more time to get healthy than they really do. As we stated above, the science of Behavioral Economics reminds us that while our Customer Segment’s choices may not be logical, their Key Behaviors are usually predictable. The science of Behavior Change can help you create business models that influence Users to take desired actions to complete their JTBD and realize your Value Proposition.  And, the application of rewards and incentives to your User’s Key Behaviors can expedite their completion.

Take time to incorporate these approaches into the Key Behaviors block in your business model canvas. Regardless if your business model is aimed at Patients, Providers, Payers, and or Purveyors, defining the Key Behaviors as well as the Key Influencers required to enact them will ensure your Customer Segment can realize your Value Proposition in a timely and complete manner.

 

What is Next?

Next up we are going to do a doubleheader on Key Influencers (1.7) and Intermediaries (1.3).

 

To your health,

The Team at imagine.GO

 

This was cross-posted from Kevin Riley & Associates BLOG – http://bit.ly/modelH_keybehaviors