Physician Practice

EHR menu design may influence provider decision-making

Physician Practice Insider, March 24, 2015

As electronic health records (EHR) become more prominent, healthcare organizations should search for the best ways to leverage the functionality offered by this technology.

A study published in the November 2014 Journal of General Internal Medicine revealed that grouping menu choices in EHRs can influence decisions made by primary care providers. The study was aimed at determining whether EHR menu choices could help reduce inappropriate antibiotic use among physicians, says David Tannenbaum, PhD, a post-doctoral researcher at the University of Chicago and one of the authors of the study. “There’s been a lot of work in psychology showing that how you partition or group a set of options can have a dramatic impact on how people make decisions,” Tannenbaum says.

Researchers sent a questionnaire featuring seven clinical vignettes describing signs and symptoms of acute respiratory infections to primary care providers in Chicago. The treatment menu for antibiotic-inappropriate vignettes listed either over-the-counter medication individually while grouping prescriptions together or showed the reverse grouping. The menu for antibiotic-appropriate vignettes listed either narrow-spectrum antibiotics individually while grouping broad-spectrum antibiotics or the reverse.

“You’re not changing any of the information that you provided these experts, you’re just changing how these options are grouped,” Tannenbaum says.

Overall, there was an 11.5% reduction in the selection of aggressive treatment options when aggressive options were grouped rather than listed individually. The researchers concluded that the grouping of menu options and layout of EHR order sets can influence provider decisions, according to the study, “Nudging Physician Prescription Decisions by Partitioning the Order Set: Results of a Vignette-Based Study.”

“This was an early demonstration for us that one subtle facet of EHR design could influence the choice the physicians make,” says Craig R. Fox, PhD, another author of the study and professor of management, psychology, and medicine at the University of California, Los Angeles. “One limitation, of course, is that it was a hypothetical choice. It wasn’t in a real EHR, but it was a first step in showing a proof of concept.”

Read more via Medical Records Briefing.

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