Reimagining Halfway Technologies With Behavioral Science
Authors: David A. Asch, Kevin G. Volpp
Journal: Annals of Internal Medicine (2017)

Ideas and Opinions3 October 2017Reimagining Halfway Technologies With Behavioral ScienceDavid A. Asch, MD, MBA and Kevin G. Volpp, MD, PhDDavid A. Asch, MD, MBAFrom the Perelman School of Medicine and the Wharton School of the University of Pennsylvania and the Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania.Search for more papers by this author and Kevin G. Volpp, MD, PhDFrom the Perelman School of Medicine and the Wharton School of the University of Pennsylvania and the Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-1449 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In 1971 (1), Lewis Thomas outlined 3 levels of health care technology. The first he called “nontechnology”: care that attends to ill patients but does little to alter the course of disease. Second were “halfway technologies”: those that do not eliminate diseases but at least postpone their effects. In this large group he put everything from solid organ transplantation to cardiac care units—what today we might call chronic disease management. Third was technology so transformative we often take it for granted, such as childhood vaccines to prevent diphtheria and antimicrobials to treat syphilis. He urged further investment in the basic ...References1. Thomas L. The technology of medicine. N Engl J Med. 1971;285:1366-8. [PMID: 5121191] CrossrefMedlineGoogle Scholar2. Choudhry NK, Avorn J, Glynn RJ, Antman EM, Schneeweiss S, Toscano M, et al; Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE) Trial. Full coverage for preventive medications after myocardial infarction. N Engl J Med. 2011;365:2088-97. [PMID: 22080794] doi:10.1056/NEJMsa1107913 CrossrefMedlineGoogle Scholar3. Emmons KM, Colditz GA. Realizing the potential of cancer prevention—the role of implementation science. N Engl J Med. 2017;376:986-990. [PMID: 28273020] doi:10.1056/NEJMsb1609101 CrossrefMedlineGoogle Scholar4. Hull MW, Wu Z, Montaner JS. Optimizing the engagement of care cascade: a critical step to maximize the impact of HIV treatment as prevention. Curr Opin HIV AIDS. 2012;7:579-86. [PMID: 23076123] doi:10.1097/COH.0b013e3283590617 CrossrefMedlineGoogle Scholar5. Emanuel EJ, Ubel PA, Kessler JB, Meyer G, Muller RW, Navathe AS, et al. Using behavioral economics to design physician incentives that deliver high-value care. Ann Intern Med. 2016;164:114-9. [PMID: 26595370]. doi:10.7326/M15-1330 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the Perelman School of Medicine and the Wharton School of the University of Pennsylvania and the Corporal Michael J Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-1449.Corresponding Author: David A. Asch, MD, MBA, PCAM South Tower 14-171, 3400 Civic Center Boulevard, Philadelphia, PA 19104; e-mail, [email protected]upenn.edu.Current Author Addresses: Dr. Asch: PCAM South Tower 14-171, 3400 Civic Center Boulevard, Philadelphia, PA 19104.Dr. Volpp: 423 Guardian Drive, 1120 Blockley Hall, Philadelphia, PA 19104.Author Contributions: Conception and design: D.A. Asch, K.G. Volpp.Drafting of the article: D.A. Asch.Critical revision for important intellectual content: D.A. Asch, K.G. Volpp.Final approval of the article: D.A. Asch, K.G. Volpp.This article was published at Annals.org on 19 September 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMaking the Grade during Pandemic: Early-stage and Late-stage Provisional InstitutionsRegenerative medicine, organ bioengineering and transplantationBehavioral economic insights to improve medication adherence in adults with chronic conditionsDoes Using an iPad Make an Intervention Innovative?Shivan J. Mehta, MD, MBA, MSHP and David A. Asch, MD, MBA 3 October 2017Volume 167, Issue 7Page: 505-506KeywordsBehaviorCancer preventionCardiovascular therapyDisclosureForecastingHIVHealth careMyocardial infarctionVaccinesViral transmission and infection ePublished: 19 September 2017 Issue Published: 3 October 2017 PDF downloadLoading ...