More "Nudging" In The EHR

If you change the defaults in order sets, clinicians mostly bumble along obliviously.

It’s all clicks these days for clinicians, and so – where a click can be avoided, clinicians are happy to acquiesce.

This is an example of passive decision-support, precisely the sort of low-hanging fruit simple to implement and non-confrontational to clinicians. Where an order in the electronic health record has default settings, any tweak with clinical acceptability will be either unnoticed or met with a shrug.

Here, we see a change in preference list defaults for prescriptions to a 90-day supply of statin therapy – and, as this is a grossly inoffensive change, uptake is instant:

In this modern age of AI-driven innovation, it’s easy to overlook so many simple, battlefield interventions of potentially greater impact.

Now, did increasing the frequency of 90-day supply directly translate into improved medication-days, and subsequent patient-oriented outcomes? That’s the hope, but obviously beyond the scope of this study. Regardless, simple, passive changes to defaults, checked options in order sets, or to the order sets themselves can have outsized influence.