Thursday I headed into New York for part of Social Media Week. The first speaker was Jay Walker, @TedMedJay. He spoke about how we are living in a world of evolving systems that engineering thinking just doesn't work for dealing with such systems. Instead, he spoke about how we need to think about mental models. He started off by looking at a simple, powerful, and frequently used mental model, "What Would Jesus Do". He then moved on to talk about mental models in health care; invincible teenage boys, the born lucky model, where people think that health outcomes won't affect them, because they're lucky, and the car mechanic model where folks go to the doctor simply to get fixed up. He then went on to talk about models like the 'specialist' model, which is getting more and more challenged by more and more specialization and the Star Trek model where nanobots will fix everything. There is also a 'rational actor model' whereby patients are believed to make better health decisions if they are simply presented with better information.

Yet, technology, Jay went on to say, doesn't solve problems, it creates tools that can be used to help people solve problems based on their mental models. For example, technology, in and of itself, cannot end racism. And as to the rational actor model, it fails to explain why so many people, even though they know smoking is bad for them, still smoke.

All of this was well and good, but the thing that would have been more interesting would have been a discussion about how we help establish new mental models. Jay did talk talk about 'personal informed model', based on being open minded and continuously learning. It sounds like a good idea, but as Jay noted, too many people decide they are done learning when they leave school.

Looking at bigger systems, the pharmaceutical, insurance, medical complex is not set up to encourage doctors and patients to pursue more cost effective health outcomes. So, the bigger question becomes, how do we challenge and change the pharmaceutical, insurance, medical complex?

Perhaps some of the discussions that took place during the rest of the day provides clues, but that will have to wait for another blog post.