Our research team has conducted a number of impactful studies that have been translated into practice by a range of entities positively influencing health for millions of people. We have designed programs based on our findings that improve both the value and quality of care provided by health plans, employers and health systems.
Electronic Health Record Defaults • Generics
Within Penn Medicine, we changed the default electronic health record (EHR) choice from brand-name prescriptions to generics in a number of practices and found the percentage of generics prescribed increased overnight from about 75% to 98%, saving millions of dollars annually. This study and others like it formed the foundation of the Penn Medicine Nudge Unit, the world’s first health system-based nudge unit, a joint initiative of CHIBE and the Penn Medicine Center for Health Care Innovation.
Other Penn Medicine Nudge Unit highlights include an active choice intervention in the EHR that led to a 37% relative increase in vaccinations; secure text messaging among provider teams leading to a 14% decrease in patient length of stay in the hospital; a change in defaults in radiation oncology leading to a 40% decline in daily CT scan imaging among palliative care patients; and a default change for cardiac rehabilitation that increased referral rates from 15% to 80%.
Implementation Science • Nudges
In partnership with several health systems, CHIBE Associate Director Rinad Beidas, PhD, is using behavioral science principles to increase implementation of a universal safe firearm storage program in pediatric primary care. Working with various stakeholders (e.g. firearm experts, firearm safety instructors, parents/guardians, clinicians, and health system leadership), Dr. Beidas and her team are collaborating on a shared mission to keep kids safe with the best science we have. With funding from the National Institute of Mental Health (NIMH), this team will test what methods can increase universal safe firearm storage in the pediatric primary care setting: either an EHR implementation strategy (nudge) or the EHR implementation strategy plus 1 year of facilitation to target implementation barriers (nudge+). This project demonstrates the ability CHIBE members have to bring together diverse stakeholders to work collaboratively, and it has real impact to save lives.
Joint Replacement Surgery • Episode Management
Working with data from Baptist Health System in Houston, we conducted an observational study following patients who had joint replacement surgery under a bundled payment program offered by CMS, determining that average Medicare expenditures for joint replacement episodes declined 20.8%. Baptist Health was able to drive savings through reductions in internal costs such as artificial joint implants as well as episode management such as reduced institutional post-acute care.
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