Disruption is dangerous.

Shiny, new and better doesn’t mean immediate adoption.

Atul Gawande makes a rather brilliant observation, framed in the context of healthcare. Adopting new behaviors sometimes defies logic and highlights humans irrationality. The “harder, faster, stronger, better” argument and solution is not enough to tempt people to change their behavior. It is a question of existing norms, perpetuated by location, social connections, and experience as well as the speed of introduction.

Besides, neither penalties nor incentives achieve what we’re really after: a system and a culture where X is what people do, day in and day out, even when no one is watching. “You must” rewards mere compliance. Getting to “X is what we do” means establishing X as the norm. And that’s what we want: for skin-to-skin warming, hand washing, and all the other lifesaving practices of childbirth to be, quite simply, the norm.To create new norms, you have to understand people’s existing norms and barriers to change. You have to understand what’s getting in their way.

…In the era of the iPhone, Facebook, and Twitter, we’ve become enamored of ideas that spread as effortlessly as ether. We want frictionless, “turnkey” solutions to the major difficulties of the world—hunger, disease, poverty. We prefer instructional videos to teachers, drones to troops, incentives to institutions. People and institutions can feel messy and anachronistic. They introduce, as the engineers put it, uncontrolled variability.

But technology and incentive programs are not enough. “Diffusion is essentially a social process through which people talking to people spread an innovation,” wrote Everett Rogers, the great scholar of how new ideas are communicated and spread. Mass media can introduce a new idea to people. But, Rogers showed, people follow the lead of other people they know and trust when they decide whether to take it up. Every change requires effort, and the decision to make that effort is a social process.

— Atul Gawande, Slow Ideas

Understanding why the current behaviors and norms exist is crucial and something that can be extremely complex, time-consuming and potentially fruitless (to some). In product design, you can make a great product that looks slick, has a smooth user experience, but that will not necessarily make it successful. What will make it successful is adoption and successful adoption comes out of a qualitative understanding of the existing user behaviors,why they exist and using that knowledge toward a gradual change.

In the article, Gawande outlines a discussion with a nurse at a rural Indian hospital. During the course of a child’s birth, the nurse did not wash her hands, take the mother’s blood pressure or, in an effort to prevent infant hypothermia, swaddle the baby skin-to-skin on the mother’s chest. The nurse explained why she did what she did for a variety of reasons (not enough time, never a problem in the past, the baby looked fine), but over time, through the subtle mentorship and budding friendship of another, this nurse changed her ways.

So, there is not only understanding the existing behaviors, but another point that Gawande raises, which is related to qualitative understanding: the power of repeated social interaction. He mentions a tool used by a pharmaceutical salesman (oh yeah, they still exist): the rule of seven touches. The salesman literally touches the doctor seven times. Over time, these repeated social interactions build rapport, outside of the relationship of salesman-mark, to a friend-to-friend one.

We are more likely to trust and change to the behaviors suggested and used by the people we are closest with.It is an odd mix of psychological understanding, social enquiry and a study in behavioral economics, but one that needs to more widely adopted.

Reading this article in the New Yorker, I was reminded of another article I read earlier that day: Don Norman on the Paradox of Wearable Technologies. Wearable technologies, namely Google Glass, provide infinite benefits to the wearer that are a step ahead of our heads-down Smartphone-centric behaviors. While the benefits are clear, the adoption and reactions to it are mixed.

We are entering unknown territory, and much of what is being done is simply because it can be done.

This is the crux of the issue. It’s a paradox and nagging problem of innovation where our technical abilities are increasing at a greater rate than we, as humans, are ready for. We ask for a better solution, but when given it, we are slow to trust it. We know the benefits, in the most objective way and hyper logical way, but these new solutions (like Google Glass) appear to be made without adequate understanding of the existing behavior patterns and norms; so, they are harder to latch on to.

The problem is not just the complexity of the solution, but the jarring, disruptive introduction. We are infatuated with disruption. But guess what? It is called disruption for a reason — it is a conflicting, diametric change from the existing. It can be fabulous, but it is unknown. Humans can be fantastically illogical and irrational in their behavior, as Gawande talks about. To use his example, sterilizing surgical tools in carbolic acid and not wearing the same blood and bodily-fluid encrusted surgery coat to reduce the rate of infection is a brilliant idea. There are fewer deaths and more doctors get paid (dead people don’t). But it was in direct conflict with the existing behavior and required more effort to learn and implement it. So it did not catch on right away. Look at the beautiful irrationality.

The answer to the irrationality and combating it is:

• Understanding of the why behind the existing behavior.
• Social context and influence of behavior.
• Incremental introduction of new behavior within the paradigms of the old.