March 17, 2017
CHIBE Deputy Director Scott Halpern, MD, PhD, MBE was recognized this week with two awards as part of the Translational Science 2017 Awards Program. Halpern received not only the Association for Clinical and Translational Science Distinguished Investigator: Translation from Clinical Use into Public Benefit and Policy Award, but also the American Federation for Medical Research Outstanding Investigator Award. The Outstanding Investigator Award is presented annually to an investigator age 45 or younger in recognition of excellence in biomedical research, while the Distinguished Investigator Award recognizes senior investigators who have had an impact on clinical and translational science resulting in a major change in clinical practice and health care for the benefit of the public.
Source: LDI eMagazine, January 3, 2017
The University of Pennsylvania LDI Center for Health Incentives and Behavioral Economics' 2016 Behavioral Economics and Health Symposium was both a spotlight on the latest research work as well as the conclusion of a Robert Wood Johnson Foundation and Donaghue Foundation funded program that began seven years ago. CHIBE played a lead role in the initiative whose goal was to explore the ways behavioral economics principles might be applied to health-related behaviors.
Source: Penn LDI eMagazine, November 2, 2016
On October 27 and 28, 2016, CHIBE held its ninth and largest-ever retreat of scientists collaborating through its ongoing NIH P30 Center of Excellence Roybal research program. The Penn-CMU Roybal Center is a partnership between the Center for Health Incentives and Behavioral Economics (CHIBE) at the Leonard Davis Institute and CMU's Center for Behavioral and Decision Research (CBDR). Also attending were affiliated scientists from Harvard, Johns Hopkins, Duke, NYU, Fordham, Rutgers and Case Western.
Research from CHIBE's Fostering Improvement in End-of-Life Decision Science (FIELDS) program was highlighted in The Economist after the publication of a JAMA Internal Medicine article entitled, "States Worse Than Death Among Hospitalized Patients with Serious Illnesses."
The magazine wrote: "Asking people approaching, or threatened with death, how they feel about it, and the moment at which they would like it to come, is a welcome development. Both sides of the doctor-assisted-dying debate should pay attention to it."
The Philadelphia Inquirer featured an article on the FIELDS program, highlighting their current studies and recent publications. FIELDS is " the country's only program devoted to applying the principles of behavioral economics, in essence the study of how people make choices, to end-of-life care," says director Scott Halpern.
Source: LDI News, May 11, 2016
NEJM Catalyst has appointed national "Lead Advisors" and a committee of "Thought Leaders" in three areas of healthcare delivery. Kevin Volpp was chosen as the Lead Advisor for the Patient Engagement core and David Asch and Scott Halpern were chosen as two of the seven Thought Leaders. The core participated in the NEJM Catalyst Event Patient Engagement: Behavioral Strategies for Better Health at the University of Pennsylvania on February 25, 2016.
Source: Medical Express, May 9, 2016
A study published in JAMA Internal Medicine, led by Mitesh Patel, found that a change to prescription default options in electronic medical records immediately increased generic prescribing rates from 75 percent to 98 percent. Patel commented "Our results demonstrate that default options are a powerful tool for influencing physician behaviors but that they have to be well-designed to achieve the intended goals."
Source: Medscape, March 3, 2016
An article published in the Journal of Clinical Oncology, authored by Eric Ojerholm, Scott Halpern and Justin Bekelman, explores what defaults are, why they work, and how they could be used to improve quality and value in oncology. The article includes three examples in which a default option could be useful clinically.
CHIBE hosted a free web event, produced by NEJM catalyst focused on improving the quality and value of health care through patient engagement. Ten preeminent business and clinical experts with in-depth knowledge of psychology, habit formation, behavioral economics, social marketing, and benefit design (several from CHIBE) shared their perspectives on ways to change patients’ health behavior that are scalable and usable across a wide range of clinical contexts.
Sources: New York Times, Wall Street Journal, Washington Post, Reuters, NBC News, CBS News, Fox News, The Guardian, Los Angeles Times, TIME, The Philadelphia Inquirer, Huffington Post, US News & World Report, Business Standard, NPR, ABC, Tech Times, Yahoo Finance, The Business Journals, Knowledge@Wharton, LDI Health Economist, May 13, 2015
A study led by Scott Halpern, recently published in the New England Journal of Medicine, compared five smoking cessation techniques in 2,538 employees of CVS, along with their friends and relatives. The study found that many more people signed up to a program that offered them an $800 reward than one that threatened them with losing a $150 deposit and only offered a $650 reward. However, those in the penalty program were twice as likely to quit.
"We found that those programs that first required people to deposit $150 of their own money were less acceptable to people than programs that were pure rewards," Halpern said.
"However, among those who would have accepted either program, the deposit-based programs were twice as effective as the rewards-based programs and five times more effective than the standard of care which was provision of free access to behavior modification therapy and nicotine replacement therapy."
Cass Sunstein, director of The Program on Behavioral Economics and Public Policy at Harvard Law School, compared the penalty program to taxes in an editorial for the New England Journal of Medicine.
Based on the results, "CVS Health is rolling out a campaign called '700 Good Reasons,'" Halpern said. "Instead of requiring a $150 deposit, it will require a $50 up-front deposit. If people are abstinent at 6 and 12 months, they'll not only get their $50 back but get an additional $700. Because they'll still have some skin in the game, it should be fairly effective."
Scott Halpern has been elected to membership in the American Society For Clinical Investigation (ASCI), a century-old medical honors society that supports the research work of physician-scientists. New members were announced and inducted by the ASCI Council at the organization's annual meeting in Chicago. Nomination and election to ASCI membership is based on the career accomplishment of "meritorious original, creative and independent investigations in the clinical and allied sciences of medicine."
Scott Halpern has been awarded a five-year, $3.17 grant from the National Institute on Aging (NIA) to conduct a pragmatic randomized trial among seriously ill patients admitted to nine electronically integrated hospitals within the largest nonprofit health system in the U.S. The study will investigate the effectiveness of changing the current “opt-in” approach for palliative care consultations in the ICU to an “opt-out” model. In addition, the study will provide experimental evidence regarding the effectiveness of inpatient palliative care consult services in real-world settings, and will also gauge which types of services work best for certain types of patients.
Scott Halpern joins Carrie Colla of Dartmouth and Bruce Landon of Harvard in a NEJM Perspective Roundtable moderated by Harvard's Atul Gawande to address the problem of low-value care and discuss how physicians can work with patients to make appropriate choices regarding "low-value" interventions.
A recent study in JAMA assessed the absolute risk a kidney donor faces after the operation and the added risk incurred as a result of it. Although the added risks from donating a kidney are very low, Scott Halpern comments that "people are notoriously bad" at weighing increased risks of unwanted outcomes against a very low probability that it will ever happen. He also offers that in order to help prospective donors make the right decision, transplant surgeons should ask them to focus on how low the probability of the poor outcome is to begin with.
A recent study conducted by Scott Halpern and Jason Wagner dispels the notion that resource-strained ICUs will ration critical care resources and negatively affect patient care. They found that when ICUs were at their busiest, patients were discharged more quickly, without affecting patient outcomes. This study was published in the October issue of Annals of Internal Medicine.
FIELDS Director Scott Halpern has been named an Institute of Medicine (IOM) Anniversary Fellow for a two-year term during which he will serve on an expert study committee and participate in other health and science policy work.
According to IOM President Harvey Fineberg, this year's four Anniversary Fellows were selected for their professional qualifications, reputations as scholars, professional accomplishments, and relevance of current field expertise to the work of the IOM. The IOM provides nonpartisan, evidence-based guidance to national, state and local policymakers, academic leaders, health care administrators and the public
Scott Halpern has been named an Institute of Medicine (IOM) Anniversary Fellow for a two-year term during which he will serve on an expert study committee and participate in other health and science policy work. He is one of four Anniversary Fellows that were selected for their professional qualifications, reputations as scholars, professional accomplishments, and relevance of current field expertise to the work of the IOM.
Kevin Volpp and Scott Halpern discuss how insights from behavioral economics can improve the health of the population. Volpp offers that interventions that combine telemedicine and behavioral nudges can strengthen traditional care approaches while Scott Halpern speaks to decision fatigue and the importance of framing.
On a 6ABC news segment covering the lung transplant waiting list rule, Scott Halpern offered his thoughts on the ramifications of the decision to overturn the current rule that keeps children under 12 from qualifying for adult lungs. He commented that we may not "want judges making medical decisions any more than we want doctors deciding Supreme Court cases" and pointed out that “every child under the age of 12 who gets an adult lung, that’s someone else, probably a child who is 13 or 14, who is not getting that lung.”
A new study comparing different types of advanced directives conducted by Scott Halpern finds that while most seriously ill patients prefer comfort-oriented care, the default option that was checked on their advance directive dramatically influenced their choice. Halpern comments that this finding makes sense because patients can't be expected to have deep-seated preferences about choices that are rarely encountered and difficult to contemplate.