Designing improvements for real-world problems

Jodie Chan ’16 heads to the afternoon bus for her mentorship at Duke, where she worked with Dr. Peter Ubel, a professor of business, public policy, and medicine.

Before Jodie Chan ’16 began her mentorship with Dr. Peter Ubel at Duke University, she knew next to nothing about health insurance. Now, after several trimesters of working with Ubel and his team, Chan could coach NCSSM employees as well as fellow students on how to make smart choices about insurance coverage.

“My research has been about how confusing the [insurance] plans are, but at this point they don’t seem confusing,” Chan laughs. “I remember the first day, when my mentor taught me about premiums and deductibles, I was very overwhelmed. Now I’m pilot testing some of our ideas on my friends, and they’re so confused.” 

Ubel says Chan’s willingness to learn is exactly why he agreed to work with her.

“We are trying to help people understand this important choice they make every year [about which option to choose for health insurance],” says Ubel, a professor of business, public policy, and medicine at Duke and an expert on healthcare decision-making. “Most people come at this with very little knowledge. A bright high school student comes at it with the same amount of knowledge, but with their intelligence, they can get up to speed very quickly.”

“Jodie did hallway testing of different website designs, just starting to show options to people. You start seeing things through their eyes, then. It’s a great way to learn, as a researcher,” he says. “It’s been fun to have her on the team. It’s less about a student’s capabilities than about their attitude, and she has a great attitude.”

From several projects that Ubel offered, Chan chose to work on how the website presents information about health insurance plans. “There’s a lot of information and it can be confusing,” she says. “They give you a breakdown of costs, of premiums, deductibles, etc. We wanted to look more at the estimated yearly costs by combining all those things.”

Ubel wrote an editorial about improving the website while Chan was working with him, urging the national site and various state exchanges to redesign some of their features based on research about how consumers make decisions. The team was pleased to see adopt some of those recommendations, including the estimated annual total cost.

“So now we’re testing whether consumers understand the idea,” Chan says. In surveys her team designs, they present three insurance plans and ask seven questions. Different versions of the surveys offer screenshots of website pages to see how design, color, and emphasis may affect consumers’ choices. Often, she notes, consumers will choose an option just because it’s the first one listed. Or, as Ubel found when he labeled plan options with “gold,” “silver,” and “bronze,” they’d choose gold no matter the costs or benefits.

Chan has read Ubel’s latest book, Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together (Harper Collins, 2012). A Durham native, Chan is interested in pursuing behavioral economics, the intersection of business and psychology, in college. “Economics is how perfect beings would make decisions; this is the more about the real world,” Chan says. She has spent so much time on that she forgets that most people don’t understand the options available and how to make good choices.

Ubel says he has banged his head against the wall for years about how little people understand about health insurance choices and the healthcare system. “It’s hilarious,” he says, “how quickly Jodie ran into the same problem.”  

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