Innovative Environments in Health Care: Where and How New Approaches Are Succeeding – PRC Researcher David Asch

In the March issue of Health Affairs, UPenn PRC Researcher David Asch, MD, MBA, David W. Bates, MD, MSc, Brigham and Women’s, and Aziz Sheikh, MD, University of Edinburgh,  examine innovation practices at five large academic medical centers: the Cleveland and Mayo Clinics, the University of Pennsylvania and University of Pittsburgh Medical Centers, and Geisinger Health System.  Noting that “nearly every big health care organization today wants to innovate, and, indeed, the ability to innovate will likely represent one of the key determinants of success in value-based care,” Asch and his co-authors “suggest the following strategies for organizations that want to innovate successfully: Do fewer projects, but do them better; allow the important to triumph over the urgent; and use a “slow trigger, fast bullet” approach—that is, find the root cause of a problem before deciding on a solution.”

Does Competition Positively Impact Physical Activity? : PRC Researchers Kevin Volpp and David Asch

PRC Director Kevin Volpp, MD, PhD, and PRC Researcher David Asch, MD, MBA, compare the effectiveness of different combinations of social comparison feedback and financial incentives to increase physical activity in a study in the July/August issue of the American Journal of Health Promotion.

In one of the first randomized trials to test different combinations of social comparison feedback and financial incentives, the researchers found that social comparison to the median with financial incentives was more effective than social comparison to the top quartile without incentives.  In the social comparison condition, participants, grouped by team,  were provided with feedback on their performance and the performance of other teams.  “By focusing social comparison feedback on performance relative to other teams,” the researchers suggest, “we leverage individuals’ competitive drive to motivate behavior change.” These findings may help to guide larger evaluations of interventions to increase physical activity using social comparison feedback and financial incentives.

 

Read more about this study at LiveScience.

AcademyHealth Article-of-the-Year Award: PRC Director Kevin Volpp and PRC Researcher David Asch

PRC Director Kevin Volpp, MD, PhD, and PRC Researcher David Asch, MD, MBA, were recognized for their significant contribution to the fields of health services research and health policy with the AcademyHealth Article-of-the-Year Award.

Volpp, MD, PhD, is the founding Director of LDI’s Center for Health Incentives and Behavioral Economics (CHIBE), a Professor of Medicine and Vice Chairman for Health Policy of the Department of Medical Ethics and Health Policy at Penn’s Perelman School of Medicine, and a Professor of Health Care Management at the Wharton School.

Asch, MD, MBA, is Executive Director of the Penn Medicine Center for Health Care Innovation, a Co-Director of the National Clinical Scholars Program, and a Professor of both Medicine at Penn’s Perelman School of Medicine and Health Care Management at the Wharton School.

Originally published in the Journal of the American Medical Association (JAMA) in November of 2015, the winning paper and its study were the latest to address the issue of how best to improve patient outcomes via financial incentives. The project’s different tack was to test pay-for-performance incentives on just doctors, just patients and then on doctors AND patients together.

The award, which recognizes the year’s “best scientific work in the fields of health services research and health policy” was presented at AcademyHealth’s Annual Research Meeting in Boston on June 28 .

 

 

 

 

 

 

 

 

 

 

One Year After Disneyland: Buttenheim & Asch on Leveraging Behavioral Insights to Promote Vaccine Acceptance

In a JAMA Pediatrics Viewpoint, UPenn PRC Researchers Alison Buttenheim, PhD, and David Asch, MD, look at the 2014 Disney measles outbreak and what it showed about the effect of vaccination refusal on disease risk. Since the outbreak, parents continue to skip vaccinating their children, affecting “everyone by weakening the herd immunity conferred by widespread vaccination,” according to the authors.

Buttenheim and Asch identify interventions which might make the reasons for vaccinating more salient to parents and health behavior theories which recognize the complex ways people make decisions about their children’s well-being. “There is so much more known today than 2 decades ago about not just the errors in people’s judgment, but how predictable those errors are and therefore how well they can be anticipated. This knowledge should be used to promote health for individuals and populations.”

 

Preliminary Data Show that Electronic Pill Bottles Help People Remember to Take Their Medication

David Asch, MD, MBA, UPenn PRC investigator

An ongoing project headed up by the PRC’s Kevin Volpp and David Asch was cited in a Washington Post article. The study focuses on how behavioral economics can be an effective strategy for increasing medication adherence.  Researchers at Penn gave 1,000 patients with heart disease “electronic pill bottles” that would light up and beep and notified a designated friend or relative (as well as their doctor) to remind the patient if they didn’t comply within a few days.  Those who took their medications became eligible for a lottery to win a cash prize.  Preliminary data suggest a big improvement in adherence compared with a control group.

Read the article in the Washington Post, by Lenny Bernstein, here.