At our recent MHRN investigator meeting, we were discussing the challenges of evaluating mobile health tools in real-world healthcare systems.

In the commercial world of mobile health tools, there’s a relentless push to reduce the small barriers that get in the way of adopting a new technology.  Design and engineering focus on minimizing the number of seconds or number of taps on the screen needed to download, install, give permission, and engage.  Any small delay or extra step is an unnecessary source of friction in a process intended to be smooth and seamless.

In our research on mobile health tools, it sometimes seems that we do exactly the opposite:  inevitably imposing small barriers that delay and distort the process of adoption.  Some of our health care systems will not permit us to contact potential research participants via email or text message.  So we invite people to download an iPhone app by sending them a paper invitation through the US mail.  For anyone under age 35, we might as well send the invitation recorded on an 8-track tape.  If our goal is to evaluate the acceptability or uptake of a new intervention, imposing anachronistic barriers will likely lead us to the wrong conclusion.

As we were complaining about these barriers, one of our NIMH colleagues suggested the term “science friction” to describe those small barriers that delay or distort research on new models of mental health care.  A clever label like that is good for more than a laugh.  Having an appealing name for those barriers can help us to notice them and call them out for what they are.

Of course, it’s easier for us to call out the barriers imposed on us by health systems’ Institutional Review Boards, Privacy Offices, and Risk Management Departments.  We are less likely to notice or call out our own habits or behaviors that contribute to science friction.

The clever “science friction” label prompted me to investigate the history of “friction” as a concept in organizational functioning rather than physics.  Applying the concept of friction to organizational behavior actually dates back to Carl von Clausewitz, the Prussian general also credited with describing the “fog of war”.  In the 1820s (about 200 years before the invention of the iPhone), he described organizational friction as the “myriad of small, but collectively numerous things” that delay or derail the greatest plans.  And he recognized that “each part is composed of individuals, every one of whom retains the potential for friction”. 

So I’ve promised to start asking myself:  How have I retained my potential for science friction today?  And how soon can I let go of that?