Christopher Herot's Weblog

How BAD Are U???

 How well do people understand the privacy implications of sharing information online and how well do they apply that knowledge?  According to some recent research from Carnegie Mellon University, they do much better on the understanding than they do on the application. In a paper, Strangers on a Plane: Context-dependent Willingness to Divulge Sensitive Information to be published in the February 2011 issue of the Journal of Consumer Research, Leslie K. John, Alessandro Acquisti, and George Loewenstein report on a series of experiments where they asked their subjects to fill out on-line questionnaires soliciting sensitive information. What they found was that even when people picked up on clues that the disclosure might be hazardous, they provided it anyway.  Even more surprising, their likelihood of providing information was often inversely proportional to the perceived risk.

In the first experiment, 890 visitors to John Tierney's New York Times blog were invited to rate the ethicality of various behaviors, ranging from "littering in a public place" to "cheating on one’s tax return." Half the participants were asked point blank if they had themselves engaged in the questionable behavior while the other half was asked in a way that was incidental to the rating of the behavior.  The result was that participants who were asked indirectly were 1.48 times as likely to admit in engaging in those activities, even though most (88%) had provided their email addresses in advance. 

In a second experiment, laptop computers were placed around the CMU campus and solicited responses from 200 students to a questionnaire on "student behavior." Three  versions of the questionnaire were prepared. They all ask the same questions about such sensitive and incriminating behaviors as drug use and drunk driving. One version (below left) presented a devil face with the legend "How BAD Are U???" while the other displayed the university seal and the title “Carnegie Mellon University Executive Council Survey on Ethical Behaviors” (right). A third more neutral version served as a baseline. While the subjects rated the devil-face as more risky, when it came to answering the questions they were 1.98 times as likely to admit incriminating information to that site than they were to the more professional looking version.

This result led to two possible explanations. One was that the devil-face version caused the participants to perceive the described behaviors as more socially acceptable.  The other, which the experimenters favored, was that the unprofessional interface caused the questions to be perceived as less intrusive.

In a third experiment, the subjects were asked to rate the intrusiveness of the questions and the desirability of the behaviors, with the finding that the desirability of the behaviors were the same on both versions but questions on the devil-face version were perceived as less intrusive.

The final experiment was designed to see if the amount of information revealed could be affected by raising the subjects' privacy concerns before asking the questions. The control group was given a (neutral) photo-identification task - to "find the endangered fish" while the other group was given the privacy-sensitizing task of identifying phishing emails.  As the experimenters suggested, when subjects were this pre-sensitized, there was no difference in the amount of disclosed information no matter which version of the web site was presented.

The conclusion, which the experimenters did not test directly, is that making assurances to a web site visitor about privacy, e.g. posting a privacy policy may have the perverse effect of making the visitor more cautious and less likely to disclose information.

At the end of the paper, the authors explain the "Strangers on a Plane" allusion, which refers to the tendency of people to tell things to total strangers under the assumption that they are unlikely to see that person again, i.e. "What happens in Vegas, stays in Vegas."  Like Las Vegas, web sites often lack the cues that would remind us of the consequences of our actions.

Telemedicine - The benefit of video

Does videoconferencing really reduce costs and improve outcomes in health care? A recent peer-reviewed article by researchers at the University of Adelaide suggests that it does, although the benefit of video is dependent on the organizational model of care, with home care and specialist on-call to hospital being the two that saw the most benefit.

In A systematic review of economic analyses of telehealth services using real time video communication, the authors found 1,187 articles and selected 36 that met their criteria for rigor and comparable data on outcomes and economic benefit.  While the technology in most of the selected articles was video over ISDN, there were some that included broadband or the PSTN, and results appear relevant to more modern modalities.

Home health care was one area that showed the most benefit.  In eight studies, seven showed reduced costs and one showed no difference in cost. Most of those also showed reduced hospital admissions, reduced transfers to nursing homes, and more rapid improvement of functioning.

In providing on-call specialists to hospital intensive care units, there were two studies, both of which found lower costs, reduced mortality, shorter hospital stays, and lower complications.

Rural health care, in both outpatient and inpatient models showed a more mixed result. A cost savings was only realized if the accounting included the patient's travel time, and the outcomes were not as favorable as in-person care, but the authors point out that in-person care may not be a practical alternative in many cases.

The least benefit was realized in providing specialists to primary care. Since the model was usually one of the general practitioner and the patient jointly calling the specialist, more physician time was consumed than when the patient saw them in sequence. Outcomes were similar and although there was some potential for increased knowledge transfer and improved case management when both providers were present, the data was inconclusive on that score.

The results in these studies seemed to reflect real-world configurations and costs.  For instance, several studies reported communication problems in 30% of the cases and one complained that "the hourly cost of ISDN communication was almost identical to the hourly pay of a consultant neurologist" and others indicated that the capital cost of the equipment amounted to 78% of the total cost of delivering the service.  One would expect ever greater benefit as advances in technology ameliorate these problems.

In conclusion, there is demonstrated benefit to using video in delivering health care, but as with all technology the degree of improvement depends on how it is applied, and any analysis must consider not just which alternatives are theoretically available but which are practical.

g2gConnect

Today I caught up with Tim Miller who, together with Serge Kogan, founded Boston-based g2gConnect. Like many entrepreneurs, when faced with the issue of how to care for aging parents they turned a problem into an opportunity and started a company to help seniors and their families stay in touch.

As part of their market research, Serge conducted a series of seminars at local senior centers, including a demonstration of how to use Skype to stay in touch with family and friends. Interest was very high, although the senior's level of comfort with computers was very low. One especially interesting finding was that the communal computers at many senior facilities were mostly used by visiting family members and not the seniors themselves and that tech support was often a hot-or-miss activity provided by volunteers.

Their conclusion was that if they could address the support and usability issues, especially playing down the "C word" they would have a service that seniors and their families would eagerly adopt.

The company was selected as a finalist in the MassChallenge startup competition and has set up shop on Fan Pier at One Marina Park Drive.

Chrome to Phone

Yesterday, Google released Dave Burke's incredibly useful little utility that sends things from the Chrome browser on your PC to your Android phone.  Once you install the Chrome to Phone Extension on the PC and the corresponding application on the phone you get a phone icon in the toolbar of your PC's browser. Press it and the URL is sent instantly to the phone where it opens the same web page.  Very useful if you've started reading an article and want to take it with you.

If you are in Google Maps, it will open that location in Maps on the phone.  Highlight some text and it goes into the phone's clipboard where you can paste with a long press on the text box.  Highlight a phone number and it tells the phone to dial the number. It also works with YouTube.

The program is open source, so (Apple willing) it could also work on the iPhone.