Nudges Informed by Behavioral Economics to Reduce Lower Value Cancer Care

DESCRIPTION
This project assessed the effect of introducing an electronic medical record default order designed to alter physician ordering of unnecessary daily imaging for palliative patients with cancer. The study involved seven radiotherapy sites, 22 physicians and over 1,000 patients. It found that the “nudge,” or use of the default order, cut unnecessary daily imaging by half, from 68% to 32% after implementation of the intervention.

IMPACT
The findings further informed and underscored the importance of the 2016 National Radiation Therapy Guidelines that call for weekly, rather than daily, radiation treatments. Approximately 250,000 patients with advanced cancer receive palliative radiotherapy to lessen pain, control bleeding, or improve quality of life.

PEOPLE
Sonam Sharma, MD;  Mitesh Patel, MD, MBA; and Justin Bekelman, MD.

PARTNERS
The Penn Medicine Nudge Unit and the Department of Radiation Oncology.

FUNDING
Penn Medicine Nudge Unit and the Department of Radiation Oncology.

FOCUS
Incentives to Change Behavior