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Impact Health Systems

A Simple Change in the EHR Saves Millions Annually 

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Generic medications cost less than brand-name medicines and have the same therapeutic effect. Research has also shown that generics are associated with improved adherence. Still, brand-name medications are often prescribed.


Within Penn Medicine, our researchers discovered that a change in the default electronic health record (EHR) choice from brand-name prescriptions to generics in a number of practices increased the percentage of generics prescribed 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%.

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