Penn Medicine Nudge Unit

Launched with support from CHIBE and the Penn Medicine Center for Health Care Transformation and Innovation, the Penn Medicine Nudge Unit is the world’s first behavioral design team embedded within the operations of a health system. The team, which is led by CHIBE Associate Director Dr. M. Kit Delgado, leverages insights from behavioral economics and psychology to design and test approaches to steer medical decision-making and daily health behaviors toward higher value and improved patient outcomes. 

Through its annual request for proposals, the Nudge Unit solicits ideas from across the health system and partners with care teams to make behaviorally driven workflow improvements. In the past year, the first cohort of projects has begun to bear fruit. One such projected extended the default prescription for statins from a 30-day supply to a 90-day supply, which led to a jump in 90-day prescriptions, from 71% to 90%. The idea behind this change is to increase medication adherence, and ultimately cardiovascular health, by making it easier for patients to obtain their medications. Given this success, the 90-day default has since been applied to not only statins but also hypertension and diabetes drugs at Penn Medicine. 

In a nationwide trial aimed at reducing distracted driving, the nudge unit team also demonstrated that loss-framed financial incentives paired with feedback could lower handheld phone use among drivers by 21%. In another project, allowing patients to self-schedule mammograms online was linked to a nearly 15% increase in completed mammograms. 

The 2023 Nudges in Health Care Symposium, hosted every year by the Nudge Unit, brought together stakeholders from health systems nationwide to share insights about creating behaviorally enabled organizations. More than 200 people from 50 institutions attended to share research and explore topics including addressing well-being and burnout, using tools like artificial intelligence to create personalized nudges, and operationalizing effective nudge units.