Health inSite: Consumer-directed Healthcare Part IV


This is part IV in a four part series. Links for Part I, Part II, and Part III

There are numerous components that the sharing economy and new applications have developed that will likely make an impact on healthcare moving forward.

Two-step verification

One major integration point that social networks have started to implement is that of two-step verification. This allows for identifying an entry-point for any given social network so that if someone attempts to access your profile from a device that is not recognized there is a second layer of security. In the age of mobile, this has been helpful in beginning to lock down the username/password issue of the past. But there is more needed from this methodology. One day, either through bio-markers or technology insertion, such two-step verification might further button down security related to social networks.

Social sign-on

There are a number of sites that are now beginning to rely on social sign-on where an OAuth call brings over the credentials of a particular user’s information from a major social network to bypass a number of the traditional sign-up information needed to create a new user, creating a “virtual passport.” This usually passes a limited amount of information between the two sites. Some sites, such as Tinder, might bring over your friend list and interests, where other sites may bring over only your identifying account from Facebook. This level of information sharing enables the user to activate the social network to act like a passport for accessing different sites across the web.


Once credentialing information has been brought into the secondary system such as through the ‘social sign-on’ system, it is combined with information related directly to the application into which you ported your ‘passport’ information. However, having a “passport” doesn’t guarantee two way communication, which is the goal. A passport gets you into a country but doesn’t necessarily allow for your travel itinerary to be shared with your country of origin. It affords access to local resources without necessarily communicating back to the issuing authority. As a result, your local identity can be managed locally, only. Which means that while those external credentials can be managed by the external authority, local, additional data (credentials) can be managed within the new authority.

Identity management

But, as a user accesses, and enables that passport to be used across the web, a composite identity can be realized through the passport. Similarly to the stamps that end up in your passport, a comprehensive view of the “travels” you acquire while moving through the social web can be realized. With secure technologies and stronger information security protocols through these passport services, a comprehensive yet protective identity can be managed across the social web.

Essentially, this allows for a deeper sense of security in identity. If you’ve ever tried to apply for a birth certificate, you know that an insane amount of information is collected by a host of agencies and coordinated to test for the authenticity of the person requesting the information. Similarly, a social footprint through the social web’s passport allows for a full, historical picture that can act in much the same way as a credit score or an issuing agency for birth certificates. So long as users can help to manage the information related to that social passport.

Social network analysis

Another opportunity that using these social platforms for credentialing affords is bringing over the social structure information from the network into another platform. Dating sites like Tinder and Hinge have already made strides in trying to develop ways of identifying social connections and even likelihood of compatibility of matches through their apps by analyzing this information. Deeper forms of social network analysis could make possible analysis into what that social network might do once it enters into a third-party application.

Friends of Friends

A study into Social Network Analysis (SNA) quite quickly reveals the possibility of using the information related to hubs, links, nodes, and clusters for the dissemination (or potential, thereof) information with a certain amount of predictability. We in healthcare should look at this as the Holy Grail for culture change and treatment adherence. By enabling that social network, inherent to an already existing system of networks like Facebook, means that information doesn’t have to be populated from the healthcare side. Attempts to do so in the past have been seriously lacking in critical mass. And looking at studies like the Framingham study point to how important our social networks really are in our health behaviors, so healthcare needs to identify a way of making this a reality.

Influencers, mavens, and hubs

But even without the nebulous interaction points and influences in any given social network, by processing the data from networks like Facebook as to link influence and the flow of information and influence, it would be possible with a fairly limited amount of that information coming into a third-party application to reasonably predict these patterns of influence and identify influencers, mavens, and hubs within geographic, familial, and even professional networks.

Social integration for experience-sharing

All of this social integration has value for both the system attempting to impact health behavior and outcomes, but also to increase the overall shared experience of the users as they are able to interact with one another around those behaviors, as well as their personal experience in a given system – such as the healthcare system. Further, those experiences would continue to impact the reevaluation of that experience by members as they share those experiences. Social integration is also becoming a necessary reality to create a consumer experience in competition with the rest of the world that patient is experiencing.

Mutual rating networks

Even further, by bringing the data from a social network into a third-party application for healthcare and allowing for that data to be combined with new data derived by the system’s application, a seemingly private interaction currency could allow for consumers to rate the outcome and behavior experiences they have, their connections have, and they have with their attending providers as well as other members of the healthcare system (the current other 2 Ps in the healthcare system – payer and purchaser). In the healthcare system, this means monitoring of transactions to identify opportunities for improved patient care.

Big data

This all leads to the combination of social, physical, occupational, emotional, intellectual, financial, and possibly environmental and spiritual data for a composite view of the current, past, and future version of ourselves as we actively engage and interact with the healthcare system. This, folks, is what Big Data is all about. It’s not silos or collecting all the information into a repository, but the opportunities inherent in bringing together, ad hoc, the disparate pieces of data so that recombining that data results in insights into helping people. It’s why we get up in the morning at my company: “to save lives and influence the course of human events.”


What I’m suggesting is that there is a coming Uber-ification of healthcare that is the next step in the sharing economy’s development. It’s not certain to me how that shift is going to occur and certainly the healthcare system is significantly more regulated by government, more powerful than taxi companies, more necessary in the daily lives of individuals than most of the ways that the companies we identify as disrupting traditional markets. But I believe it’s coming regardless. We will see consumer-directed healthcare in the coming years become more commonplace with patients that are empowered to take control of their health and wellbeing. The question is only how, and how is the healthcare system preparing for the peak that we’re all approaching that is a consumer-directed healthcare system.


Health inSite: Consumer-directed Healthcare Part III


This is part III in a four part series. Links for Part I, Part II, and Part IV

And now, we get to the purpose of this series. What does the sharing economy have to do with the consumer-directed healthcare system? First, let’s look at what is at the core of purchasing: economic offering.

Levels of economic offering

In their book The Experience Economy (I did a post on this too, forever ago!), Joe Pine and James Gilmore explain the value pyramid.

As products increase in differentiation (customization), a higher asking price for that product can generally be realized. In this way, value to the consumer comes in the ability to match the need with the offering and in healthcare, this means enabling smart, simple decisions.

In a consumer-directed healthcare system, shifting healthcare transactions to goods, rather than experience, and focusing the overall healthcare purchasing and maintenance up to that of an experience will be critical to success. This can be done when the exchange, for example, becomes broker, maintenance organization (think HMO), and coordinator of one’s health record (not an Electronic Health Record as we know them, but a coordinator of the health profile mentioned earlier). For such a situation to work, the exchange then will need to either build out, or partner with organizations with experience in guiding human behavior, to successfully engage those patient-consumers in maintaining their profile as well as actively pursuing greater levels of health.

Examples of how they work

The sharing economy is also making significant changes to the way that we engage as consumers. This economic shift allows for individuals to make transactions with little to no broker (for example, a bank) in order to make purchases. Most of the sharing economy relies heavily on technology to enable people to come together. A chart of examples is below:


Organization Primary offering Industry disrupted Innovation Description
Uber/Lyft Car service Taxis By allowing individuals to directly contact a driver, users interact with an app that can manage their payment and reservation.
AirBnB Housing Hotels Users submit their social network credentials as “proof of trust” for user-to-user reservations of rooms
Car-2-Go and many others Cars Every car company Cars placed around the city, can be “rented” for one-direction travel.
Bitcoin and other cryptocurrencies Currency Banks Distributed, “proof-of-work” based cryptocurrency which allows for peer-to-peer exchange of value.
Kiva Microfinance Lending companies Individuals can register their needs for financing and other members of the Kiva network can make those loans direct to the borrower without a traditional lender.
GoFundMe and other crowd-sourced finance platforms Project Funding Investors Individuals can create a project page with donation-level rewards for contributing to the financing of a project or product.

Considering these examples, I believe that there may be some interesting opportunities for alternative funding and insurance when it comes to healthcare. Consider this: what would it look like if traditional insurers were no longer the primary location to insure oneself. In the current healthcare system, some groups (usually smaller companies with less leverage than bigger companies) might choose to pool their collective employees into what’s called a captive insurance group. What if a similar model were to be contemplated where individuals were to select a captive group of similar patients, almost self-selecting to become a part of a patient-centered medical home model. Exchanges could do the same with their patient population by segmenting those patients into population groups.

Now, what if those groups could be funded by individuals wanting to bet on the success or failure of those groups. This allows for more direct funding for investors and patients that could result in dividends for the patients and investors when benchmarks are achieved or maintained. What other possibilities for alternate funding models might still be out there to be explored?

The core of the sharing economy


At the very core of the sharing economy is a redistribution of trust networks. By decentralizing trust models from institutional to peer-to-peer, the sharing economy refocuses and reinforces a community around the exchange of goods and services by moving brokerage to a fluid, and seemingly direct, brokerage for those exchanges.


The other side of this change to the sharing economy is supply and demand monitoring and coordination. Uber has the ability to simplify the exchange of need for transportation with the supply of excess time (and access to a vehicle) on the part of the driver all while it is in the process of cutting out the institutional (and very infrastructure-heavy) taxicab industry.

What that means for institutional healthcare

So WHAT DOES this mean for institutional healthcare? Great question! It could mean realignment around roles within the healthcare system. It could mean small market-share loss if the idea doesn’t take off easily. It could mean more competitive models. I’m interested to hear your thoughts.

The Conclusion: Part IV

Health inSite: Consumer-directed Healthcare Part II


This is part II in a four part series. Links for Part I, Part III, and Part IV

Behavioral economics

The complexity of the healthcare system as it currently is already embroils patients in the very difficult position of having to make decisions with imperfect, nonexistent, and unintelligible data. When individuals are forced to make a decision in a situation where these factors are present, depending on the cognitive capacity of the individual (complexity of thought, for one – see Thinking, Fast and Slow), sometimes results in fast thinking that may include cognitive bias (errors). When this occurs, decisions are poorly conceived and may result in catastrophic results. For that reason, we need a single, comprehensive, coordinated, and collaborative profile.

A personal profile/avatar

Which brings us to the core of a consumer-directed healthcare system’s BIG need. A longitudinal profile. The fantastic Jenn Dennard replied to a question posted on twitter recently

to which I say, Yay! There is a need, in a consumer-directed healthcare system, for the individual to be empowered in their decision-making by having the data on their past, present, and future outlook in the same way that we have the ability to understand our financial wellbeing over time. Organizing this information in a comprehensive, yet easily summarized way can help the consumer make determinations about what works for their short- and long-term investment in their healthcare options. While I’m tempted to refer here to the SAMHSA model of wellbeing to outline the information that should be collected in this profile, I’ll speak briefly on a few that I think are critical to the goal and then finally how they might work in tandem to help with decision-making.


Obviously, if we’re going to talk about a profile related to healthcare decisions, a comprehensive health record, complete with genetic profile, risk-factors, behaviors, and the like should be consolidated and coordinated. Something that looks along the lines of the EHR that is contemplated in this TED talk by Thomas Goetz comes to mind.


I’ve long said that healthcare is as much a financial decision as about providing care, but in more than just from the payer perspective. The provider’s ability to understand the financial impact in concert with the patient’s needs should be coordinated through this profile. But in a consumer-directed healthcare system, this also means empowering the patient with projections based on their health record that helps to estimate the financial burden that they may experience based on their health reality.


If you’ve not read any of my previous posts, I recommend checking the various postings on the importance of ‘social’ in shaping our health reality (I’ll point you to the latest here). The way we interact with our friends, family, neighbors, co-workers, etc. all shape our health reality. Incorporating and ‘animating’ those connections – really analyzing and understanding them – is a key element to making significant changes in our behavior as well as helping to alter the health reality of each consumer.


The psychological aspects of healthcare range from simple awareness (or lack thereof) to the complex co-occurring conditions to their interactions as the patient tackles their health reality. Further, the interpersonal experiences available to the consumer through their social network is sometimes limited by the psychological reality of the consumer – the functions or dysfunctions of cognition, personality, etc.

Game-state evaluation

In all of these components, it’s important to keep in mind that we are not static over the entire course of our lives and rarely so even when looking at only one factor. While research points to potential for adjustments in things like resiliency, literature also shows that we have hard-coded tendencies such as temperament. For more on game-state evaluation and other related topics, see my post on Decision Support, Games, and Making People Healthier.

Why tracking is important

A method for tracking those changes and dynamically responding to those changes along all axes can provide context for how the consumer should, and can, act on their purchasing, but also their locus of control and potential efficacy in using the system through the plan they intend to use/purchase.

Part III

Health inSite: Consumer Directed Healthcare Part I



I was recently invited to participate in an interview for Stride (on twitter), a developing local Health Information Technology ecosystem that is the first of its kind in scope and vision. I’ll let you check out their site for details and spare them here, but I was excited to participate in helping to promote this project as a local member of the Health IT community in Colorado. While reading through the questions that had been prepared, I was thinking about the way in which Stride is poised (intentionally) to disrupt our current healthcare delivery model by bringing together stakeholders from startups and the institutional healthcare system. As a company that’s been around for 35 years, MINES & Associates is certainly in that latter category in many respects; however, one of the reasons that I have decided to make MINES my home is that, as a company, we have embraced technology as a tool to reach our organization mantra: to “save lives, and influence the course of human events.”

This is part I in a four part series. Links for Part II, Part III, and Part IV

A shifting landscape

The Affordable Care Act has caused a seismic shift in our healthcare landscape and some are preparing for the fault lines’ impact on what were once the prairielands of the healthcare system. The new mountain ahead of us consists of layers of changes that I will attempt to outline as I see them. These are the result of following some very bright people that I will try to mention as I go. Follow these people! They are making huge steps toward preparing for these changes.

One of the opportunities (or threats, depending on your viewpoint) of consumer-directed healthcare may be the collapsing of the system within which the decisions in healthcare are made at an administrative level. Those changes could result in significant, down-stream implications for how the future healthcare consumer engages with their health. As a fellow Health 2.0 Denver/Boulder chapter member of mine, Sumanth, mentioned while on a panel regarding open-innovation models in healthcare, ‘We have a sickcare system, we’re working toward a healthcare system, but I’m interested in a health system.’ When we begin empowering people by giving them purchasing power, we also saddle them with the responsibility of that decision and we need systems in place to make those decisions reasonable.

Institutional vs. startups

If there is one person that I’ve heard that captures this coming change the most succinctly from the institutional perspective, it’s Aetna CEO, Mark Bertolini. A keynote at HIMSS 2014, Mr. Bertolini explained how Aetna is preparing for a more engaged, consumer-like patient in the Aetna model. If you don’t believe it, simply look at their acquisition of iTriage (among other advances, led by Michael Palmer, Chief Innovation and Digital Officer) that put the power of access and empowerment in the hands of their future patient.

Aetna made the right move by acquiring iTriage. By purchasing tech, rather than trying to build it out themselves, Aetna’s model is to scout and engage experts trying to help quell the shift in the landscape by harnessing technology. This means that rather than developing that internally, at a potential loss to the organization if it’s unable to deliver, Aetna can focus on its core offering. It also highlights a bigger shift in the healthcare ecosystem – one that Stride is very interested in nurturing – coopetition. Because these lean startup organizations have the ability to make changes quickly and bring in top talent to tackle tough, smaller issues – issues that can then be used in many different arenas. In my opinion, that nature of coopetition is a critical element to the new model of healthcare delivery, as I hope to illustrate in this blog series.

This is what disruption looks like


There’s no question that telemedicine is becoming a more regular part of the healthcare industry with companies like CirrusMD, Call-a-Doc Plus, and AccessCare Technologies’ Aveo platform and many others (disclosure: MINES currently has business relationships with CADR+ and AccessCare Technology) making strides to disrupt the traditional delivery model for healthcare by enabling secure text messaging, prescriptions by phone, and HIPAA-compliant video telemedicine, respectively – this isn’t an exhaustive list of what these platforms do, but just a couple of examples. This enables asynchronous, non-geographically-specific, and convenient communication between a provider and patient. While our current model of on-site care is relatively new compared to the entire history of medicine where patients go to the provider, the bigger disruption here is in the fact that the premises is moving away entirely.

Retail health

The weekly #HITsm chat had a great discussion on January 24th (transcript) regarding retail healthcare – the movement of retail organizations into the healthcare space. Companies like CVS, Walgreens, and Target are making movements to put clinics in their retail locations to decrease barriers to accessing care for routine events like physicals and non-urgent medical needs. If you want to check out a really cool aspect of this, Theranos is partnering with Walgreens to make onsite blood testing a realistic part of this system.


If you’ve not heard of wearable tech or the Internet of Things (of which wearables are only a part), you soon will. While Nike took early steps in tracking the efforts by athletes with the Nike+ system, this sub-industry has exploded with newcomers like Jawbone UP, Misfit Shine, FitBit, and even a tracker that will shock you into behavior change. While these various tracking devices are great at providing data to the person using them, efforts to make them usable in healthcare have been lacking. That said, there are efforts between Apple, the Mayo Clinic, and Epic EHR to solve this problem through Apple’s HealthKit. However, this change is only helpful to those that are on the iOS ecosystem. As you probably know, Google’s Android continues to gain ground in market share and as these devices continue to become more customizable and cheaper, iOS will either need to adapt or face staying in an ever-growing, niche market.

These are only the first step in a long development cycle of devices (and even things that don’t look like devices) that will someday be a part of our daily lives. In fact, watch the sequence a few minutes after Ewan McGregor’s character wakes up in the movie The Island, and you’ll get a sense for how this might play out in our daily lives. Actually, while trying to find that toilet scene where the character’s urine is tested while he is excreting, I found this article on a real-life example! Which now has my mind wandering on sample integrity…

Other major tech innovations

In fact, there are A LOT of people – very smart people – working on a number of innovations related to healthcare. Look no further than the IBM 5-in-5 if you’re ever wondering what some of those things might be. But we are quickly moving into a world where the things that are imagined in movies and TV are becoming reality – or are being worked on now to become reality. If you want a great example, check out the Tricorder X-prize. If you’re not familiar with what a tricorder is, here ya go!

A word on purchasers

The purchasers of the past are slowly slipping into the fog of a system going the way of dinosaurs. While our current healthcare system relies on someone purchasing insurance on behalf of a group of people, the new model of consumer-directed healthcare would include patients insuring themselves in a similar way to most other insurances – life insurance, car insurance, etc. In this model, the purchaser is correctly aligned with the responsibilities for maintenance. During deliberation of the Affordable Care Act, the Supreme Court actually highlighted how insurance could be mandated because cars can be mandated to be insured by the state. To ensure protection for all others in the pool of “drivers,” in much the same way that maintenance of one’s health and insurance for that health is a responsible act for the pool of citizens.


Consumers make this sort of decision regularly. When purchasing electronics, for example, there are often options for insuring the item from damage and even loss. When confronted with this decision there is, in the mind of the consumer, a cost:benefit decision to be made. When making a decision regarding level of coverage to insure one’s vehicle, a similar cost:benefit decision must be made for the consumer regarding their risk tolerance related to the value and potential loss in value of the vehicle. But in these situations, consumers are aware of their role as a consumer; that same level of awareness needs to be at the core of a consumer-directed healthcare system if we expect those decisions to be more straight-forward and realistic.


Millenials are fast becoming the largest part of the consumer segment of the economy; and they do things a little differently than their predecessors. As the CTO of Connect for Health Colorado (the health insurance exchange in Colorado), Proteus Duxbury, mentioned in a Prime Health Collaborative event that Millenials are soon to make up as much as 50% of the purchasers through the exchange in Colorado and they are preparing for this group which prefers peer-reviews to authoritarian ones. When I asked him about this posting, he shared this report from the White House on Millenials that you might find interesting for more details. Keeping an eye on the factors that make up this group is going to be important for their continued planning and development and healthcare organizations from insurance to consumer-facing wearables should take heed to the particulars of this shifting landscape. Community-focused, socially-aware, technology-forward, and averse to traditional signals of “growing” up like marriage and purchasing a home are all key differentiating factors. As those factors become more pronounced, healthcare will need to be aware of, and respond to, the way that these individuals view themselves and the world. Further, the section on a personal profile below will become even more pronounced and necessary to keep these individuals engaged and aware.

Is 4PHealth going away?

If you’re not familiar with my concept of 4PHealth, check out my earlier blog post for details (secretly hoping I can stop linking to this post at some point!) but the long and short of it is that there are four P’s in the healthcare system: payer, patient, provider, and the patient’s peers. Truthfully, there’s actually a fifth P that was not originally contemplated in that post but comes to light when you consider a consumer-directed healthcare model: purchaser. For most people in the US, the purchaser is an employer, or in the case of labor organizations, a trust into which employers contribute along with the dues from the members. But now that is shifting as smaller organizations are actually sending their employees to the health insurance exchange. Increasingly, I expect this to grow; and that’s a good thing. When the purchaser and the patient are the same, there is a shift in the financial onus for having a particular benefit plan; which means we need more informed consumers (patient-purchasers). But it also creates an opportunity for further collapsing of our very tiered silo. If the consumer could then also become the payer (see more in shared-economy model, below), we could very well see a one-to-one relationship between the provider and the consumer (patient-purchaser-payer). Hold on to your seats, kiddos. It could happen.

Part II

Health inSite: Placebo, by any other name, is just as effective?


The Placebo App

A review of a year and a half of Health inSite research and how I think one group is probably more on target than some might think.

I’m going to start out by laying out a couple of concepts for review.

Placebos and psychology

A placebo is defined as “a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient.”  This causes what is called the placebo effect.  A patient is said to have experienced a placebo effect when the intended deception manifests experienced results.  While the research indicates that there is a small range of people that are susceptible to the effect, that range hovers at around 30% of the population.


One might ask, “How is it possible that the effects of a non-drug could be experienced as having the results of an actual drug that has the intended, or actual, impact on a patient?”  This is explained as the product of self-fulfilling prophesy, or a form of expectation bias.  If you recall the previous posting on Thinking Fast and Slow, one of the difficulties we face as human beings is both our difficulty in matching up experience and memory, as well as overcoming biases that tint our understanding of rational data.  In a word, we are not always rational beings and sometimes our understanding of an experience or idea is subject to our memory and cognitive constructs that allow us to think fast.  We respond the way that our mind has told our body it expected to experience the event.  The concept, “Where your mind goes, the energy goes,” has been mentioned extensively by my colleague Dr. Mines in his series on Psychology of Performance, beginning with his first posting.

Hysteria (or mass psychogenic illness)

If you happened to miss the events in Le Roy, NY, where 18 people experienced Tourette’s-like symptoms for an extended period of time, there were many that identified the cause of the experience of these individuals as mass psychogenic illness.  Mass psychogenic illness has been largely attributed to situations in which individuals are experiencing similar physical effects (tics, for example) without any clear physical reasons (e.g., environmental toxins, viral or biological triggers, etc.).  Historically, this has been referred to as mass hysteria.  The complexity of the condition has led many to write it off, but the core assumptions of mass psychogenic illness are sound given what we know about social influence.  Oftentimes in mass psychogenic illness, an index case is discovered in which someone’s conversion disorder acts as a catalyst to the development and spread of the illness through the network.

Assuming that this is the way in which mass psychogenic illness works, index cases could be used to induce behavior change in a network towards a positive outcome. In this way, it is not mass psychogenic illness, but mass psychogenic salutogenesis (widespread generation of health through the influence of the mind over the body within the social structure of a network).

CBT and treatment adherence

Critical to adherence to any health maintenance or treatment protocol plan is the ritualizing of new behavior.  In the chemical dependency field, we’ve known this for a long time.  By creating new routines that positively impact our behavior; we are able to more easily overcome the many triggers that previously caused our substance use.

Triggers are defined in the substance abuse field as events, emotions, or thoughts that trigger the addiction response.  They are a major focus in many treatment protocols and are especially important for recognition in the cognitive behavioral therapy (CBT) model.  The goal in CBT is to identify why it is that we respond to thoughts, emotions, and events and then to develop, for ourselves with the help of a therapist, ways to counter the effect of those triggers.  In this way, it’s not the abolition or avoidance of triggers so much as a rational understanding of the trigger and building tools to overcome that trigger’s effect on the coached patient/client.

Network theory, social comparison, and braggadocian behavior

If you’ve read all of the links to other blog postings in the Health inSite category, but missed the posting on braggadocian behavior, the concept is very simply that social media has enabled us to engage in bragging around the things that we are doing and that this activity can influence the way that others perceive us – and we do this to intentionally accomplish that change in perception.  This gives us the ability to influence the way that others behave as they engage in responses which may include trying to match our behavior (wittingly or unwittingly)  or rejection of our behavior as a method of coping with one’s own deficiency in the category of behavior being expressed.  This has a powerful impact on the social network in which agents operate as they can directly and indirectly influence the behaviors of individuals that are proximally or distally connected to them.

In their book ConnectedChristakis and Fowler explore the significant effects that our social network has on our health and health behaviors.  Social networks, of course, are not just websites like Facebook or Twitter, but all forms of interaction that we have with various people in our lives, including our family, friends, co-workers, neighbors, and even the people at the grocery store.  The power of individuals to have an effect across a network based on their location within the network is a clear and well-documented reality.

Suspension of disbelief

As I mentioned in an earlier blog posting on the fourth and fifth wall, suspension of disbelief is critical to the effectiveness of theater.  Without the audience allowing suspension of disbelief, a presentation falls flat in its ability to engage the audience emotionally.  Think back to a PowerPoint presentation that was particularly awful because the speaker failed to actively paint a picture that the audience could connect with.  Similarly, engagement strategies are starting to use these concepts to create thick tapestries of story that immerse the audience in the story-line, and even sometimes ask them to co-create the story, as in the case of the Lizzie Bennet Diaries spin-off series, Welcome to Sanditon.

New technology

Recently, an IndieGoGo campaign was started for a new project that would create a placebo app.  You might think to yourself, “How the heck could a placebo app affect someone’s health?”  The app, which leverages the power of mirror neuron activity and the placebo effect by creating positive thought-feelings in the brain, could actually override the systems in the brain that cause us to act irrationally in terms of triggers and cognitive biases by leveraging suspension of disbelief.  Further, the app allows individuals to interact with their social network around their use of the placebo app, creating a unique opportunity for mass psychogenic salutogenesis.  Now all we need are some index cases to start the process toward a tipping point.

It will be interesting to see the resulting data from this project as we would expect that there is a real opportunity for this to be leveraged to significant effect, not only for those directly accessing the placebo app, but also those that end up interacting with those users.  But the rest of the story is still to come.

Whew, that was quite a round-up of research, huh?  Comment or send questions!

For more…

…check out a G+ Hangout from HuffPost on placebos and their effect.

Ryan Lucas
Supervisor, Marketing
To stay ahead on topics related to this, follow me on Twitter @dz45tr