Small Change in Electronic Health Record Can Reduce Unnecessary Imaging for Advanced Cancer Patients
A small change in an advanced cancer patient’s electronic health record can cut the use of unnecessary daily imaging during palliative radiation therapy by more than half, according to a JAMA Oncology study published in June.
Daily imaging is common before radiation treatments. National guidelines recommend that patients with advanced cancer who are receiving palliative radiotherapy only undergo imaging once a week, though many practices continue daily imaging, which can prolong appointments for patients who are often in pain due to their cancer.
Applying principles from behavioral economics, this trial of more than 1,000 patients introduced a default prescription order into the electronic health record that specified no daily imaging for palliative cases. Providers retained the ability to opt out of the default when clinically necessary.
“This small nudge meaningfully reduced unnecessary, low-value care for patients with advanced cancer,” said the study’s senior author, Sonam Sharma, MD, an assistant professor of radiation oncology at the Icahn School of Medicine at Mount Sinai. “These patients benefit from shorter appointments to reduce their discomfort and pain from metastatic cancer.”
This study was conducted while Dr. Sharma was at the Perelman School of Medicine at the University of Pennsylvania. It was funded in part by grants from the National Cancer Institute (K07-CA163616) and by the University of Pennsylvania Health System through the Penn Medicine Nudge Unit and the Department of Radiation Oncology.
About the Mount Sinai Health System
Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, nearly 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it.
Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,300 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties.
For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Twitter and YouTube.
Diabetes May Accelerate Blood Cancer Growth, Yet Survival Outcomes Differ by Race
Sep 29, 2023 View All Press Releases
Scientists Create Most Powerful, Accurate Tool Yet to Research Deadliest Blood Cancer
Apr 18, 2023 View All Press Releases
Study Identifies New Gene That Drives Colon Cancer
Oct 14, 2022 View All Press Releases