An Open Standard for APIs Could Lead us to Better Health


Xconomy National — 

[Updated, 12:05 pm ET] There’s a parable about the elephant and the rider that’s been used by Chip and Dan Heath, and that originated with Jonathan Haidt, to describe how humans make decisions. A person’s mind can be thought of as consisting of a rider, representing the rational part of human thinking, and the elephant she’s riding, representing emotion. Both of these play a role in how a person decides things, and many of us believe the rider–the rational part–is in charge. The rider taps the elephant with her guide stick, and the elephant obediently moves in that general direction or does a specific task, like carrying lumber from place to place. [Editor’s note: This paragraph has been updated to attribute Jonathan Haidt with originating the elephant/rider metaphor]

Except that’s not how a lot of decisions actually get made. Instead, the elephant sees a bunch of bananas, or a herd of other elephants, or a nice cool river to bathe in, and goes that way instead. And the rider…well, the rider can’t do much about it except, after the fact, rationalize how she always wanted to go in that direction to begin with. Yeah, it was time for a bath, sure

This framing has stuck in my mind for years and it’s a really helpful way of looking at many of the odd things that people do or say, ranging from climate change denial, to believing genetically modified organisms are inherently evil, to smoking despite everything we know about the harms that result, to even saying that Paul Blart, Mall Cop II is really, you know, not that bad–really. And it also speaks to one of the more vexing problems we have in human health. Why do people keep doing things they really probably shouldn’t, and know they shouldn’t, if they want to stay healthy?

I’ve touched before on how the power of digital tools can help make it easier for us to make good decisions. OPower is doing this for power consumption and conservation, and with the advent of tools like Apple’s Healthkit and the proliferation of activity trackers, the time is right to do this for health.

That’s where the open standard for a specific type of application programming interface (API) comes in. Such a standard will help provide the right rewards, immediately. People need to get quick positive (or negative) reinforcement for the decisions they make. In the absence of that kind of rapid response, I don’t think trackers, in and of themselves, will encourage healthy behavior.

Before I go further, a few quick definitions: APIs are simply the protocols that allow outside programs to interact with a given piece of software. It’s how programs talk to each other and trade data and instructions. An open standard is a general agreement that each piece of software will have APIs that will be made public to allow other programmers to work with and connect to that specific software tool.

Now, with respect to current health and activity trackers, the data are still coming in on how effectively devices help people change their behavior by themselves. Some research, however, suggests the people most likely to benefit are already inclined to use self-tracking data to change their behavior and improve their health. You might say they represent the cases where the rider and the elephant already have similar goals. What about everyone else? Quick feedback and reinforcement could help them carry out and repeat behaviors that are important for their health, because behavioral economics suggests long-term gratification and goals just won’t do.

It’s true that many of the different apps and trackers already have elements that encourage people to change behavior, providing rapid feedback and rewards. These range from gamification and incorporating social media into activities and goals, to providing quick feedback when milestones are reached—like when a Fitbit buzzes once you reach 10,000 steps. But I don’t think that’s enough. I propose we need to … Next Page »

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Kyle Serikawa works as a consultant in the life and health sciences fields with a focus on genomics, technology, and innovation. Follow @

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2 responses to “An Open Standard for APIs Could Lead us to Better Health”

  1. Mike Swift says:

    You should give Jonathan Haidt credit for the elephant/rider story

  2. Kyle SerikawaKyle Serikawa says:

    Thanks for identifying the source. I’ll talk to the editors about updating the reference.