Health for Hire
Clayton Christensen, Rebecca Fog, Andrew Waldeck
Unleashing Patient Potential to Reduce Chronic Disease Costs
As healthcare leaders determine how best to meet the care delivery demands of the 21st century, they cannot afford to overlook the problem of chronic disease. While more than half of all Americans suffer from at least one chronic condition like obesity, heart disease or diabetes, the traditional healthcare delivery model is designed primarily to treat acute illness and injury – not long-term health problems. By applying the Theory of Jobs to Be Done, healthcare innovators can design solutions that enable individuals to consciously prevent or effectively manage chronic disease on their own.
"Only patients can ultimately identify the set of solutions that will work for them, while providers must be experts in evaluating the solutions’ health consequences."
The Theory of Jobs to Be Done is a framework for understanding consumer choice. It explains that consumers don’t shop for brand promises, product categories and features. Rather, they seek solutions for “jobs” that constantly arise—the functional, social and emotional wants which change in priority depending on the circumstances.
The Jobs Theory teaches us that everything people do (including doing nothing), they do for a reason that’s valid to them, even when their behavior may seem self-defeating to others. A person striving to feel less lonely might hire a smoke break with colleagues each hour at work, log more hours on Instagram, adopt a cat, or join a walking group.
Each of these “solutions” has health consequences. Only patients can ultimately identify the set of solutions that will work for them, while providers must be experts in evaluating the solutions’ health consequences. Jobs Theory gives patients and providers a structure they can use to identify, design and facilitate changes in behavior that produce positive health consequences.
A jobs-based approach to healthcare delivery is particularly suited to chronic disease management for five reasons:
1. It considers patients' full capacity (not just willingness) to change.
When asked if they want to improve their health, most people would say they do. But the Jobs Theory helps providers get beyond the superficial to determine patients’ true capacity for change. Factors like career choice, home life, family obligations, education, income and lifestyle contribute to a patient’s level of dedication and capability to make trade-offs to improve their health. With the Jobs Theory, providers can develop plans that make the most use of a patient’s capacity for change.
2. It works with (not against) patients' existing beliefs about health.
People’s unique beliefs about health—what it means, what it takes, whether it is attainable—influence their healthcare decisions and behaviors. This creates what is called a health reference point, or the level of mental, emotional and physical health people believe possible or necessary for themselves and the trade-offs they are willing to make to hit goals.
Providers and patients collaborating to tackle chronic disease are challenged in understanding the interacting forces influencing patients’ health decisions, including the health reference point. The Jobs Theory provides options for designing health solutions that harness those forces in favor of making better choices.
3. It illuminates the broader determinants of individual health status.
The traditional healthcare delivery model has no explicit framework for uncovering and utilizing the biological, psychological and social factors driving individual health behaviors. The Jobs Theory provides a more complete view of barriers to health and encourages whole-person solutions. It can help any stakeholder—from provider to family member to patient advocate—articulate unaddressed needs and find partners across disciplines to weave together solutions.
4. It clarifies the real competition to healthy behavior.
The Jobs Theory enables providers to better understand what activities people are hiring instead of healthy behaviors. Such insights are critical so that providers can work with patients to craft health solutions that perform those jobs better than unhealthy alternatives.
5. It shifts unit of performance from “outcomes” to “progress.”
The healthcare industry has shifted its focus from managing care transactions to managing care outcomes. While this shift will improve cost and quality, it won’t have an impact on chronic disease. That’s because managing outcomes tracks single, short-term events. Chronic disease prevention and management are long-term series of events, so success cannot be measured by outcome. Rather, progress –improving health – must be the metric of success.
A gap exists between the kind of care chronically ill people need and the episodic, acute care our traditional healthcare system is designed to provide. Using the Theory of Jobs to Be Done, healthcare innovators can bridge this gap by creating health solutions that people have both the will and the capacity to embrace, unleashing their potential to manage their health more effectively and independently.
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