What Healthcare Can Learn From Uber: Nudges That Change Behaviour 

Uber can’t tell its drivers when to work, yet it keeps them on the road when demand is highest. What healthcare can learn from Uber is simple: change the environment in which people make moment-to-moment decisions – with goal framing, defaults and real-time alerts – and the healthy choice becomes the easy one. 

Key takeaways 

• Uber uses earning goals, progress alerts and ‘forward dispatch’ defaults to keep drivers working. 

• The same nudges – reminders, progress cues and healthy defaults – can help patients follow through on treatment. 

• In a trial in China, triggered text reminders lifted optimal adherence to 87.3%, versus 51.8% with standard care. 

• Nudges work best when they serve the patient’s own goals and are designed with behavioural rigour. 

How Does Uber Use Behavioural Science to Keep Drivers on the Road? 

Because Uber treats drivers as independent contractors, it cannot dictate when they work – so it relies on behavioural techniques to encourage drivers to log on, and keep driving, when demand is highest⁵. 

Earning goals. Uber sets personalised earning goals and alerts drivers when they are close to reaching one. This reflects the goal-gradient effect: people accelerate effort as a reward comes within reach. In a café loyalty-card study, customers bought coffee roughly 20% faster in the final purchases before earning a free drink³. Uber’s driver dashboard manufactures the same psychological pull, shift after shift. 

Forward dispatch. Uber queues up a driver’s next fare before the current ride ends – much like Netflix’s autoplay, it takes less effort to keep going than to stop. A driver trying to log off might see ‘You’re $10 away from $330 today – are you sure you want to go offline?’, with ‘Keep Driving’ as the highlighted default. 

How Can Healthcare Apply Uber’s Nudges to Patients? 

The same principles can be redirected toward patients not following through on prescribed treatment. 

A patient could receive a text reminding them to take a medication each day, or an alert when a prescription is close to running out: ‘You have 3 days of medication left – would you like to refill now?’, with ‘Refill Now’ pre-selected. The same logic applies to completing a course of antibiotics, attending every stage of a vaccination schedule, or returning for a follow-up. None of these require new clinical evidence or incentives – just a path of least resistance that is also the healthier one. See our introduction to nudges and choice architecture. 

Why Do Defaults Matter So Much in Healthcare? 

Because doing nothing is the path most people take, whichever option is set as the default tends to be chosen disproportionately often. Countries that require citizens to opt out of organ donation consistently see substantially higher consent rates than opt-in countries² – see opt-in versus opt-out organ donation in France. The same principle applies inside a single app or portal: whether a reminder defaults to ‘Refill Now’ or ‘Remind Me Later’ can shift what patients actually do. 

Do Real-Time Nudges Improve Adherence? Evidence From Asia-Pacific 

Yes. Randomised trials in China and Thailand show that real-time, personalised reminders improve adherence and outcomes. 

• China (HIV): at an HIV clinic in Nanning, a wireless pill monitor triggered a personalised text whenever a dose was missed. By the final month, 87.3% of patients achieved optimal adherence, versus 51.8% with standard care alone – and the gap was wider among patients who had struggled at the outset⁴. 

• Thailand (type 2 diabetes): tailored two-way SMS reminders over four months led to better blood glucose control and quality of life than standard care¹. Where mobile penetration is high, SMS is a low-cost, high-reach channel. 

• Lesson for practice: the mechanism mirrors Uber’s – a real-time nudge delivered when a behaviour is at risk of lapsing. 

Designing a patient reminder or adherence programme? DeltaMV’s Healthcare Behavioural Strategy team can help you build nudges into real patient touchpoints. 

How to Apply Uber-Style Nudges in Healthcare: 4 Steps 

1. Find the moment a behaviour is at risk of lapsing – a missed dose or an unbooked follow-up. 

2. Show progress toward a goal, such as doses completed in a course of antibiotics. 

3. Make the healthy option the default – pre-select ‘Refill Now’ or ‘Schedule My Follow-Up’. 

4. Send real-time, personalised reminders – see how Medisafe goes beyond simple reminders and how Wellth uses loss aversion to drive adherence. 

What Are the Limitations of Uber-Style Nudges? 

• Nudges must serve the patient: Uber’s techniques served the company; in healthcare, nudges should support goals patients already share. 

• Design matters as much as the idea: reminder systems treated as an afterthought are unlikely to deliver trial results. 

• Evidence comes from specific settings: the China and Thailand trials studied particular groups, so programmes elsewhere should be tested locally. 

Frequently Asked Questions 

What can healthcare learn from Uber? 

That behaviour changes when the decision environment changes. Goal framing, defaults and real-time alerts can help patients take medication, refill prescriptions and attend follow-ups. 

What is the goal-gradient effect? 

The tendency to speed up effort as a reward gets closer – customers bought coffee about 20% faster as they neared a free drink³. 

Do SMS reminders improve medication adherence? 

Yes, in Asia-Pacific trials: triggered reminders raised optimal HIV treatment adherence to 87.3% in China, and two-way SMS improved glucose control in Thailand. 

Next Steps: Turn Nudges Into a Patient Engagement Strategy 

Uber redesigned the environment in which drivers made moment-to-moment decisions. Healthcare organisations have the same opportunity with patients – but only if adherence programmes, portals and reminder systems are designed with the same behavioural rigour. 

Want to build Uber-style nudges into your patient engagement? Get in touch with DeltaMV’s Healthcare Behavioural Strategy team. 

References 

1. Chiaranai, C., Chularee, S., Prawatwong, W., & Srithongluang, S. (2023). Two-way SMS reminders for medication adherence and quality of life in adults with type 2 diabetes: A randomized controlled trial. Pacific Rim International Journal of Nursing Research, 27(3), 457–471. https://doi.org/10.60099/prijnr.2023.262244 

2. Johnson, E. J., & Goldstein, D. (2003). Do defaults save lives? Science, 302(5649), 1338–1339. https://doi.org/10.1126/science.1091721 

3. Kivetz, R., Urminsky, O., & Zheng, Y. (2006). The goal-gradient hypothesis resurrected: Purchase acceleration, illusionary goal progress, and customer retention. Journal of Marketing Research, 43(1), 39–58. https://doi.org/10.1509/jmkr.43.1.39 

4. Sabin, L. L., Bachman DeSilva, M., Gill, C. J., Zhong, L., Vian, T., Xie, W., Cheng, F., Xu, K., Lan, G., Haberer, J. E., Bangsberg, D. R., Li, Y., Lu, H., & Gifford, A. L. (2015). Improving adherence to antiretroviral therapy with triggered real-time text message reminders: The China Adherence Through Technology Study. Journal of Acquired Immune Deficiency Syndromes, 69(5), 551–559. https://doi.org/10.1097/QAI.0000000000000651 

5. Scheiber, N. (2017, April 2). How Uber uses psychological tricks to push its drivers’ buttons. The New York Times. https://www.nytimes.com/2017/04/02/technology/uber-drivers-psychological-tricks.html