{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T05:38:29Z","timestamp":1775108309308,"version":"3.50.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,16]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Electronic health records (EHRs) offer decision support in the form of alerts, which are often though not always interruptive. These alerts, though sometimes effective, can come at the cost of high cognitive burden and workflow disruption. Less well studied is the design of the EHR itself\u2014the ordering provider\u2019s \u201cchoice architecture\u201d\u2014which \u201cnudges\u201d users toward alternatives, sometimes unintentionally toward waste and misuse, but ideally intentionally toward better practice. We studied 3 different workflows at our institution where the existing choice architecture was potentially nudging providers toward erroneous decisions, waste, and misuse in the form of inappropriate laboratory work, incorrectly specified computerized tomographic imaging, and excessive benzodiazepine dosing for imaging-related sedation. We changed the architecture to nudge providers toward better practice and found that the 3 nudges were successful to varying degrees in reducing erroneous decision-making and mitigating waste and misuse.<\/jats:p>","DOI":"10.1093\/jamia\/ocac238","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T22:20:34Z","timestamp":1671142834000},"page":"545-550","source":"Crossref","is-referenced-by-count":9,"title":["Behavioral \u201cnudges\u201d in the electronic health record to reduce waste and misuse: 3 interventions"],"prefix":"10.1093","volume":"30","author":[{"given":"Carrie K","family":"Grouse","sequence":"first","affiliation":[{"name":"Department of Neurology, UCSF , San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maggie W","family":"Waung","sequence":"additional","affiliation":[{"name":"Department of Neurology, UCSF , San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A Jay","family":"Holmgren","sequence":"additional","affiliation":[{"name":"Center for Clinical Informatics and Improvement Research, UCSF , San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2765-7451","authenticated-orcid":false,"given":"John","family":"Mongan","sequence":"additional","affiliation":[{"name":"Department of Radiology, UCSF , San Francisco, California, USA"},{"name":"Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, UCSF , San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9774-7180","authenticated-orcid":false,"given":"Aaron","family":"Neinstein","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, UCSF , San Francisco, California, USA"},{"name":"UCSF Center for Digital Health Innovation, UCSF , San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S Andrew","family":"Josephson","sequence":"additional","affiliation":[{"name":"Department of Neurology, UCSF , San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raman R","family":"Khanna","sequence":"additional","affiliation":[{"name":"Division of Hospital Medicine, Department of Medicine, UCSF , San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"issue":"1\u201310","key":"2023021611060751200_","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41746-020-0221-y","article-title":"An overview of clinical decision support systems: benefits, risks, and strategies for success","volume":"3","author":"Sutton","year":"2020","journal-title":"NPJ Digit Med."},{"key":"2023021611060751200_","volume-title":"Nudge: 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