Healthcare Decision Support Tools: Consumer’s Rational Approach (Part 1 of 2)


Consumer decision support tools were going to transform healthcare.  They promised automated enrollment and deeper consumer education leading to consumer empowerment weighing value over price – it didn’t happen. Selecting healthcare decision support tools is challenging. Bridging the gap between theory and practice becomes essential to realize the initial promise of value.

Let’s explore the origin of consumer decision support tools, the major categories of support tools, barriers to consumer adoption and strategies to maneuver closer towards consumer satisfaction.

Where to Start

Stepping boldly forward, with the intention of improved customer experience your organization has decided that a consumer decision support tool will improve consumer satisfaction, drive enrollment, and improve the overall customer experience.  Where do you start? Where should you start?  Looking to your right, most leaders will jump into the wilderness with talk of real-time data, big data analytics, integration, cloud platforms and other concepts that conventionally drive value.  Looking to your left, the rest of the leaders will start by spinning up focus groups, generating observation studies, and pulling together data apparently directly from the consumer.

Of course it becomes hard not to have your mind wonder over to Steve Jobs when pondering consumer insights. During an interview with Business Week in May 1998 Steve Jobs said, “A lot of times, people don’t know what they want until you show it to them.” About 80% of folks will take one of these two ‘accepted’ approaches: either based on real-time data or focus groups. Why? They are both safe and easy to defend in front of a CEO, board or other c-suite leaders.  I’d offer neither of these will generate 10x results. Arguably they might not generate any results at all. For this journey we must start inside the mind of the consumer.

Cynefin Framework

To move the curtain and discover the why consumers are making decisions, the Cynefin Framework initially appears helpful. There are five domains cross segmented by unordered and ordered decisions, that encapsules the appropriate choices when making decisions within each domain.  The unordered domains include complex (probe, sense, respond) and chaotic (act, sense and respond)and the ordered domains include simple (sense, categorize, respond) and complicated (sense, analyze and respond) and a trailing fifth called disorder. Unfortunately, this logical decision making process doesn’t translate well to the real decisions consumers make.

We can all learn a lot from Michael Porter.  Michael Porter wrote the initial model for the Five Forces in 1979. He published “What is Strategy” in a classic 1996 Harvard Business Review article.  Porter then wrote his seminal book Competitive Strategy in 1981 and Competitive Advantage in 1985. There is little question that Porter is a visionary and many of us, find ourselves referring to his earlier works with regularity. However, these strategies were all before the internet.  They are models and theories that didn’t consider how to compete with ‘free.’  Porter’s contributions to strategy and competition were also before behavioral economics research.  Behavior economics is a subfield of microeconomics that studies how individuals and organizations make economic decisions.  This research suggests that consumers do not make rational decisions and therefore markets are not rational.  Emotions dominate.

How Consumer’s Choose

Let’s apply these principles to consumer decision support tools. The process of selecting healthcare products and care treatment is complex. If this premise is valid then why wouldn’t the complex domain apply, following a logical probe, sense and response approach? The answer is that decisions are often instantaneous and based on gut and while applying a logical sequential thought processes appears practical, logic is often not applied.

In Blink, The Power of Thinking Without Thinking, Malcolm Gladwell states that, “truly successful decision-making relies on a balance between deliberate and instinctive thinking.” Gladwell pokes at the notion that instantaneous decisions at times are better than decisions resulting from thorough rational analysis.

In Thursday’s post, I’ll expand this thinking and cover rational consumer decisions in greater depth exploring selection, barriers to avoid, and five specific strategies for success when choosing consumer decision support tools.




Megalomania, T. (2008). Does the brain make decisions rationally or irrationally? (online image). Retrieved November 2, 2015, from


Peter Nichol, empowers organizations to think different for different results. You can follow Peter on Twitter or on his blog. Peter can be reached at pnichol [dot]

Previous articleHealthcare’s Two Biggest Problems Impacting CIO Performance
Next articleHealthcare Decision Support Tools: Consumer’s Rational Approach (Part 2 of 2)
Peter is a technology executive with 19 years of experience, dedicated to driving innovation, digital transformation, leadership, and data in business. He helps organizations connect strategy to execution to maximize company performance. He has been recognized for Digital Innovation by CIO 100, MIT Sloan, Computerworld, and the Project Management Institute. As Managing Director at OROCA Innovations, Peter leads the CXO advisory services practice, driving digital strategies. Peter was honored as an MIT Sloan CIO Leadership Award Finalist in 2015 and is a regular contributor to on innovation. Peter has led businesses through complex changes, including the adoption of data-first approaches for portfolio management, lean six sigma for operational excellence, departmental transformations, process improvements, maximizing team performance, designing new IT operating models, digitizing platforms, leading large-scale mission-critical technology deployments, product management, agile methodologies, and building high-performance teams. As Chief Information Officer, Peter was responsible for Connecticut’s Health Insurance Exchange’s (HIX) industry-leading digital platform transforming consumerism and retail oriented services for the health insurance industry. Peter championed the Connecticut marketplace digital implementation with a transformational cloud-based SaaS platform and mobile application recognized as a 2014 PMI Project of the Year Award finalist, CIO 100, and awards for best digital services, API, and platform. He also received a lifetime achievement award for leadership and digital transformation, honored as a 2016 Computerworld Premier 100 IT Leader. Peter is the author of Learning Intelligence: Expand Thinking. Absorb Alternative. Unlock Possibilities (2017), which Marshall Goldsmith, author of the New York Times No. 1 bestseller Triggers, calls "a must-read for any leader wanting to compete in the innovation-powered landscape of today." Peter also authored The Power of Blockchain for Healthcare: How Blockchain Will Ignite The Future of Healthcare (2017), the first book to explore the vast opportunities for blockchain to transform the patient experience. Peter has a B.S. in C.I.S from Bentley University and an MBA from Quinnipiac University, where he graduated Summa Cum Laude. He earned his PMP® in 2001 and is a certified Six Sigma Master Black Belt, Masters in Business Relationship Management (MBRM) and Certified Scrum Master. As a Commercial Rated Aviation Pilot and Master Scuba Diver, Peter understands first hand, how to anticipate change and lead boldly.