Effect of Introducing a Default Order in the Electronic Medical Record on Unnecessary Daily Imaging During Palliative Radiotherapy for Adults With Cancer: A Stepped-Wedge Cluster Randomized Clinical Trial

Sonam Sharma; David Guttmann; Dylan S Small; Charles A L Rareshide; Joshua Jones; Mitesh S Patel; Justin E Bekelman

doi:10.1001/jamaoncol.2019.1432

Effect of Introducing a Default Order in the Electronic Medical Record on Unnecessary Daily Imaging During Palliative Radiotherapy for Adults With Cancer: A Stepped-Wedge Cluster Randomized Clinical Trial

JAMA Oncol. 2019 Aug 1;5(8):1220-1222. doi: 10.1001/jamaoncol.2019.1432.

Authors

Sonam Sharma^{1

2}, David Guttmann³, Dylan S Small^{2

4

5}, Charles A L Rareshide⁴, Joshua Jones⁶, Mitesh S Patel^{2

4

7

8}, Justin E Bekelman^{2

6

9}

Affiliations

¹ Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
² Penn Center for Cancer Care Innovation at the Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
³ Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
⁴ Penn Medicine Nudge Unit, Penn Medicine Center for Innovation, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
⁵ Department of Statistics, The Wharton School, University of Pennsylvania, Philadelphia.
⁶ Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
⁷ Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
⁸ Department of Health Care Management, The Wharton School, University of Pennsylvania, Philadelphia.
⁹ Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia.

Abstract

This randomized clinical trial examines the effect of implementing a default order option in the electronic medical record on daily imaging utilization for patients with cancer undergoing radiotherapy during palliative care.