The Penn Medicine Nudge Unit leverages insights from behavioral economics and psychology to design, implement, evaluate, and disseminate approaches to steer medical decision-making toward higher value and improved patient outcomes.
A nudge is a change in the way choices are presented, or information is framed that alters people's behavior predictably without restricting choice. Nudges should be transparent and never misleading, easy to opt out of if needed, and aligned with the person's welfare being nudged.
At the Nudge Unit, we move projects through the following phases:
- Design: We co-design nudge interventions in partnership with frontline clinicians, health system leadership, and patients.
- Implementation: We implement approaches in a pragmatic and measurable manner to inform larger-scale deployment.
- Evaluation: We conduct rigorous evaluations of the intended and unintended impact of interventions.
- Dissemination: We share findings across multiple channels, including peer-reviewed publications, social media, conferences, and our annual symposium.
Human behavior is the final common pathway for most advances in medicine. No matter how effective a medication, protective a vaccine, or beneficial a lifestyle modification, clinicians must recommend them, and patients must engage with them to achieve improvements in health. Our decisions and behaviors are heavily influenced by the environment in which they occur. For example, minor changes to the way choices are presented, and information is framed within the electronic health record can lead to significant differences in the way clinicians order tests and treatments. In addition, social networks and norms influence how individuals eat and exercise. Yet, in many cases, these influences go unnoticed or are not given much thought. Nudge units can help develop systematic approaches to designing interventions that better align decisions and behaviors with long-term goals.
The history of the Nudge Unit
The Penn Medicine Nudge Unit is the world's first behavioral design team embedded within a health system. It was launched in 2016 by Founding Director Dr. Mitesh Patel, with support from the Penn Medicine Center for Health Care Innovation and the Penn Center for Health Incentives and Behavioral Economics. The team began with two people and within three years grew to more than 20. From 2016 to 2021, the Penn Medicine Nudge Unit worked on more than 100 projects, including more than 25 randomized trials resulting in over 75 publications in leading medical journals such as NEJM, JAMA, Nature, and PNAS. In 2018, the team launched an inaugural Nudges in Health Care Symposium to bring together health systems interested in using nudges or developing nudge units to improve health care. The first two symposiums were hosted on Penn's campus and brought together leaders from 30 health systems. In 2021, the symposium took place virtually, and we broadened the audience to include health plans and any other organizations working on using nudges to improve health care. More than 400 people representing over 200 organizations from around the world attended.
In June 2021, Dr. Patel left Penn Medicine to pursue an executive leadership role at the national level for Ascension Health, one of the largest health systems in the US. At Ascension Health, Dr. Patel is National Lead for Behavioral Insights and Vice President for Clinical Transformation. Penn Medicine has committed to continuing its Nudge Unit and is currently searching internally for new leadership.
Nudges in Health Care Symposium
Visit our Nudges in Health Care Symposium page to learn about this annual event.