health economics

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In this article, authors discuss the concept of nudges and the opportunities they present in improving the provision of healthcare. They describe nudges as a way of presenting information and choices as to influence, remind, or motivate a certain behavior. Just as these are used in something as basic as online shopping for clothes, they can also be applied in electronic health record systems, for example, by listing generic medications first so the physician is more likely to prescribe one of those instead of a brand name. By making the incorrect or non preferred option one that is seemingly more difficult or time-consuming, nudges can even direct providers to provide more comprehensive care in the office or set up proper follow up care after an acute incident.

Nudging can also be applied at the public health level to influence healthy behaviors among different populations. Although most public health interventions are created to educate or persuade people to change their behavior, nudges are different in that they influence individuals mindless way of making choices that relate to health behavior (Evers, et.al, 2018). Although this can be very very effective, this brings up somewhat of an ethical issue by potentially harming autonomous decision making. Additionally, consumers often note that they do not trust these nudges as much when coming from policymakers, but do place more trust in nudges from experts in their respective fields (Evers, et.al, 2018).

Although they do require some research into what works, nudges offer great opportunities in healthcare because they are low cost and do not require ongoing resources to keep going. In our current healthcare landscape, the transition from paper-based records to electronic health records provides the perfect opportunity to embed priming, salience, and default nudges into EHR systems through reminders, feedback, and audits. This will ultimately help our pursuit of our high value and quality care, an incentive that patients, providers, administrators, insurers, and other stakeholders can get behind. A major challenge will be concerning healthcare providers. They might feel as if the nudges manipulate them negatively and challenge their ability to properly care for their patients (Yoong, et al., 2020). They will also have to be easily changed in case new research shows a current nudge being used no longer supports an evidence-based practice.

Evers, C., et al. Citizen Approval of Nudging Interventions Promoting Healthy Eating: the Role of Intrusiveness and Trustworthiness. BMC Public Health, vol. 18, no. 1, 2018, doi:10.1186/s12889-018-6097-y.

Yoong, Sze Lin, et al. Nudge Strategies to Improve Healthcare Providers Implementation of Evidence-Based Guidelines, Policies and Practices: a Systematic Review of Trials Included within Cochrane Systematic Reviews. Implementation Science, vol. 15, no. 1, 2020, doi:10.1186/s13012-020-01011-0.

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