Penn Medicine: Keeping ‘Nudges’ On Track

From Penn Medicine News: Mitesh Patel, MD, MBA, MS, an assistant professor of Medicine, is the founding director of Penn Medicine’s Nudge Unit. He’s been implementing nudges for years, starting with the one that increased the rate of generic prescriptions. And while he’s had eye-opening success, he’s just as careful with every new nudge as he was with the first. “We’re nudging clinicians and patients in a healthier direction by making relatively small changes to their environment,” Patel said. “What we’re doing is subtle and often much more effective than a ‘shove,’ but, because of how effective they are, we need to stay just as mindful as if we were shoving.” Here, Patel explains the deliberate — and delicate — planning that goes behind nudging in health care, and what he and his team do to keep everything going in the right direction. Q: How do you decide what problems warrant a nudge versus what might require a more systemic change? A: I think that’s a key question. And it’s usually hard to know right away, but we make it our first priority to find out. We try to understand the problem by understanding the decision pathway. To do that, we consider the stakeholders, work flow, and where the inappropriate outcome seems to stem from. Nudges are a better fit if a specific decision leads to a less than optimal behavior. But nudges are less of a fit if the problem has to do with multiple factors or factors that are completely outside of the decision-making process. Read the full Q&A on Penn Medicine News.