Effect of a behavioral nudge on adoption of an electronic health record-agnostic pulmonary embolism risk prediction tool: a pilot cluster nonrandomized controlled trial

JAMIA Open. 2024 Aug 1;7(3):ooae064. doi: 10.1093/jamiaopen/ooae064. eCollection 2024 Oct.

Abstract

Objective: Our objective was to determine the feasibility and preliminary efficacy of a behavioral nudge on adoption of a clinical decision support (CDS) tool.

Materials and methods: We conducted a pilot cluster nonrandomized controlled trial in 2 Emergency Departments (EDs) at a large academic healthcare system in the New York metropolitan area. We tested 2 versions of a CDS tool for pulmonary embolism (PE) risk assessment developed on a web-based electronic health record-agnostic platform. One version included behavioral nudges incorporated into the user interface.

Results: A total of 1527 patient encounters were included in the trial. The CDS tool adoption rate was 31.67%. Adoption was significantly higher for the tool that included behavioral nudges (39.11% vs 20.66%; P < .001).

Discussion: We demonstrated feasibility and preliminary efficacy of a PE risk prediction CDS tool developed using insights from behavioral science. The tool is well-positioned to be tested in a large randomized clinical trial.

Trial registration: Clinicaltrials.gov (NCT05203185).

Keywords: behavioral economics; clinical decision support; computed tomography; pulmonary angiogram; pulmonary embolism.

Associated data

  • ClinicalTrials.gov/NCT05203185