Penn Medicine

November 2020

Month in Review November 2020

Each month, we round up news stories and publications about work happening at the Acceleration Lab, Center for Digital Health, Nudge Unit, and Way to Health. Want to stay in the know? Subscribe to have the Month in Review sent directly to your inbox.

Top Stories

A nudge helps doctors bring up end of life issues with their dying patients

Mitesh Patel, Ravi Parikh, and Chris Manz wrote about their study leveraging a machine-learning algorithm and nudges to increase the rate of serious illness conversations (SICs) between providers and oncology patients. SICs are structured conversations about prognosis, treatment goals, and end-of-life preferences. Patients who have SICs with their providers experience better quality of life and decrease their chances of dying on a ventilator or in an intensive care unit. In the clinical trial published in JAMA Oncology, doctors from nine practices were split into two groups. One group received a nudge via text messages to have SICs with patients at high-risk for mortality, while the control group received nothing. Fifteen percent of doctors who received the nudge had conversations compared to 4 percent of doctors in the control. Read the opinion piece below to learn more about the study design and outcomes.

Digital health tools offer new opportunities for personalized care

Digital health interventions often fail to create sustained behavior change for patients. A key reason for this is that many programs offer a one-size-fits-all approach to diverse populations with different motivations and values. In an article for Harvard Business Review, Mitesh Patel and Shirley Chen explain how behavioral phenotyping could be applied to make digital health solutions more personalized and effective. The piece references several Nudge Unit studies as examples.

Uniting against an invisible foe

Since March, we have partnered with clinical and executive partners from across the health system on numerous efforts to combat the pandemic. Two of our interventions designed to manage the spread of COVID-19 on campus were recently highlighted in an article by PennToday. COVID SAFE is a saliva-based surveillance program that uses a test developed by Penn Medicine scientists. The Nudge Unit is currently conducting an observational clinical trial on COVID SAFE along with a randomized trial that leverages insights from behavioral economics to test different recruitment strategies. PennOpen Pass, another program highlighted in the article, is a daily symptom tracker that enables clinical staff and contact tracers to act quickly if COVID-19 is detected. Since launching over the summer, the program has enrolled over 60,000 users and completed more than one million symptom and exposure checks.

From 84 days to 5 hours: Telemedicine reduces dermatology consult time

A new study, led by researchers at the Perelman School of Medicine and Independence Blue Cross, demonstrated that allowing primary care doctors to take photos and send them to dermatologists improved access to specialty care. In fact, wait times for consultations decreased from approximately 84 days to less than five days; during the pilot, with no undue increases in utilization or cost that would prohibit widespread implementation. With the onset of the COVID-19 pandemic, telemedicine programs like this are even more crucial, as they accommodate social distancing and reduce patient exposure risk by negating the need for multiple appointments. Learn more about the Teledermatology project here.

Opportunities

Don't miss your opportunity to apply for a two-year advanced fellowship in health services research with the Nudge Unit and the Center for Health Equity Research and Promotion (CHERP) at the VA. Use the link below to access more information about the program and application requirements. The deadline to apply is December 1, 2020.

Additional Coverage

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