"In a new study published in JAMA Network Open involving 402 U.S.-based primary care physicians, investigators from Northwestern University and the University of Sydney identified a "sweet spot" in clinical decision-making. By presenting just the right number of treatment alternatives in the electronic health record (EHR) system, physicians were more likely to choose a high-quality alternative rather than defaulting to the status quo."
"Adding more than two options didn't further improve decision-making, which suggests more isn't always better. "We have this unrealistic notion that doctors are rational all the time about the decisions we're making for our patients, but we're human, too," said study author Jeffrey Linder, MD, MPH, chief of General Internal Medicine in the Department of Medicine and a Northwestern Medicine physician who played a key role in designing the study. "We're trying to make it easier for physicians to do the right thing.""
A trial of 402 U.S. primary care physicians found that offering two or more appropriate treatment options in the electronic health record increased selection of high-quality alternatives to 62 percent versus 44 percent when only one option was offered. Offering exactly two options produced the observed improvement; adding more than two options did not further increase selection of alternatives. Thoughtfully designed EHR prompts that curate and present a small number of evidence-based alternatives can nudge physicians away from defaulting to the status quo. Excessive alerts based on outdated evidence risk alert fatigue and reduced effectiveness.
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