{"id":"https://openalex.org/W4311580226","doi":"https://doi.org/10.1093/jamia/ocac238","title":"Behavioral \u201cnudges\u201d in the electronic health record to reduce waste and misuse: 3 interventions","display_name":"Behavioral \u201cnudges\u201d in the electronic health record to reduce waste and misuse: 3 interventions","publication_year":2022,"publication_date":"2022-12-15","ids":{"openalex":"https://openalex.org/W4311580226","doi":"https://doi.org/10.1093/jamia/ocac238","pmid":"https://pubmed.ncbi.nlm.nih.gov/36519951"},"language":"en","primary_location":{"id":"doi:10.1093/jamia/ocac238","is_oa":true,"landing_page_url":"https://doi.org/10.1093/jamia/ocac238","pdf_url":"https://academic.oup.com/jamia/article-pdf/30/3/545/49198791/ocac238.pdf","source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"bronze","oa_url":"https://academic.oup.com/jamia/article-pdf/30/3/545/49198791/ocac238.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5029579880","display_name":"Carrie K. Grouse","orcid":"https://orcid.org/0009-0000-8875-535X"},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Carrie K Grouse","raw_affiliation_strings":["Department of Neurology, UCSF , San Francisco, California, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Neurology, UCSF , San Francisco, California, USA","institution_ids":["https://openalex.org/I180670191"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5052408475","display_name":"Maggie W. Waung","orcid":"https://orcid.org/0009-0005-7383-0771"},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Maggie W Waung","raw_affiliation_strings":["Department of Neurology, UCSF , San Francisco, California, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Neurology, UCSF , San Francisco, California, USA","institution_ids":["https://openalex.org/I180670191"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027068804","display_name":"A Jay Holmgren","orcid":"https://orcid.org/0000-0002-7939-6831"},"institutions":[{"id":"https://openalex.org/I4210152177","display_name":"Center for Clinical Research (United States)","ror":"https://ror.org/05fnzzk18","country_code":"US","type":"company","lineage":["https://openalex.org/I4210152177"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"A Jay Holmgren","raw_affiliation_strings":["Center for Clinical Informatics and Improvement Research, UCSF , San Francisco, California, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Center for Clinical Informatics and Improvement Research, UCSF , San Francisco, California, USA","institution_ids":["https://openalex.org/I4210152177"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5053343994","display_name":"John Mongan","orcid":"https://orcid.org/0000-0003-2765-7451"},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]},{"id":"https://openalex.org/I4210110664","display_name":"University of California San Francisco Medical Center","ror":"https://ror.org/01t8svj65","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210110664"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"John Mongan","raw_affiliation_strings":["Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, UCSF , San Francisco, California, USA","Department of Radiology, UCSF , San Francisco, California, USA","Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA"],"raw_orcid":"https://orcid.org/0000-0003-2765-7451","affiliations":[{"raw_affiliation_string":"Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, UCSF , San Francisco, California, USA","institution_ids":[]},{"raw_affiliation_string":"Department of Radiology, UCSF , San Francisco, California, USA","institution_ids":["https://openalex.org/I180670191","https://openalex.org/I4210110664"]},{"raw_affiliation_string":"Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, UCSF, San Francisco, California, USA","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5004321742","display_name":"Aaron Neinstein","orcid":"https://orcid.org/0000-0002-9774-7180"},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]},{"id":"https://openalex.org/I4210110459","display_name":"City of Hope","ror":"https://ror.org/01z1vct10","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1301076528","https://openalex.org/I4210110459"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Aaron Neinstein","raw_affiliation_strings":["Division of Endocrinology, Department of Medicine, UCSF , San Francisco, California, USA","UCSF Center for Digital Health Innovation, UCSF , San Francisco, California, USA"],"raw_orcid":"https://orcid.org/0000-0002-9774-7180","affiliations":[{"raw_affiliation_string":"Division of Endocrinology, Department of Medicine, UCSF , San Francisco, California, USA","institution_ids":["https://openalex.org/I180670191"]},{"raw_affiliation_string":"UCSF Center for Digital Health Innovation, UCSF , San Francisco, California, USA","institution_ids":["https://openalex.org/I4210110459"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027938519","display_name":"S. Andrew Josephson","orcid":"https://orcid.org/0000-0001-7502-550X"},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"S Andrew Josephson","raw_affiliation_strings":["Department of Neurology, UCSF , San Francisco, California, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Neurology, UCSF , San Francisco, California, USA","institution_ids":["https://openalex.org/I180670191"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5019034270","display_name":"Raman Khanna","orcid":"https://orcid.org/0000-0003-0117-075X"},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Raman R Khanna","raw_affiliation_strings":["Division of Hospital Medicine, Department of Medicine, UCSF , San Francisco, California, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Hospital Medicine, Department of Medicine, UCSF , San Francisco, California, USA","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":7,"corresponding_author_ids":["https://openalex.org/A5019034270"],"corresponding_institution_ids":[],"apc_list":{"value":3967,"currency":"USD","value_usd":3967},"apc_paid":null,"fwci":2.0523,"has_fulltext":true,"cited_by_count":9,"citation_normalized_percentile":{"value":0.90206569,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":90,"max":98},"biblio":{"volume":"30","issue":"3","first_page":"545","last_page":"550"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.9977999925613403,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10350","display_name":"Electronic Health Records Systems","score":0.9977999925613403,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13248","display_name":"Healthcare Technology and Patient Monitoring","score":0.9879000186920166,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12918","display_name":"Healthcare Systems and Technology","score":0.979200005531311,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/nudge-theory","display_name":"Nudge theory","score":0.9701443910598755},{"id":"https://openalex.org/keywords/choice-architecture","display_name":"Choice architecture","score":0.8664007782936096},{"id":"https://openalex.org/keywords/workflow","display_name":"Workflow","score":0.6979789733886719},{"id":"https://openalex.org/keywords/architecture","display_name":"Architecture","score":0.536532998085022},{"id":"https://openalex.org/keywords/psychological-intervention","display_name":"Psychological intervention","score":0.5335617065429688},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.42432859539985657},{"id":"https://openalex.org/keywords/internet-privacy","display_name":"Internet privacy","score":0.37523528933525085},{"id":"https://openalex.org/keywords/business","display_name":"Business","score":0.36912208795547485},{"id":"https://openalex.org/keywords/risk-analysis","display_name":"Risk analysis (engineering)","score":0.3369233310222626},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.3013351559638977},{"id":"https://openalex.org/keywords/psychology","display_name":"Psychology","score":0.25903230905532837},{"id":"https://openalex.org/keywords/nursing","display_name":"Nursing","score":0.18990471959114075},{"id":"https://openalex.org/keywords/database","display_name":"Database","score":0.13365772366523743},{"id":"https://openalex.org/keywords/social-psychology","display_name":"Social psychology","score":0.09078291058540344}],"concepts":[{"id":"https://openalex.org/C8858961","wikidata":"https://www.wikidata.org/wiki/Q7068367","display_name":"Nudge theory","level":2,"score":0.9701443910598755},{"id":"https://openalex.org/C2776031354","wikidata":"https://www.wikidata.org/wiki/Q5104029","display_name":"Choice architecture","level":2,"score":0.8664007782936096},{"id":"https://openalex.org/C177212765","wikidata":"https://www.wikidata.org/wiki/Q627335","display_name":"Workflow","level":2,"score":0.6979789733886719},{"id":"https://openalex.org/C123657996","wikidata":"https://www.wikidata.org/wiki/Q12271","display_name":"Architecture","level":2,"score":0.536532998085022},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.5335617065429688},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.42432859539985657},{"id":"https://openalex.org/C108827166","wikidata":"https://www.wikidata.org/wiki/Q175975","display_name":"Internet privacy","level":1,"score":0.37523528933525085},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.36912208795547485},{"id":"https://openalex.org/C112930515","wikidata":"https://www.wikidata.org/wiki/Q4389547","display_name":"Risk analysis (engineering)","level":1,"score":0.3369233310222626},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3013351559638977},{"id":"https://openalex.org/C15744967","wikidata":"https://www.wikidata.org/wiki/Q9418","display_name":"Psychology","level":0,"score":0.25903230905532837},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.18990471959114075},{"id":"https://openalex.org/C77088390","wikidata":"https://www.wikidata.org/wiki/Q8513","display_name":"Database","level":1,"score":0.13365772366523743},{"id":"https://openalex.org/C77805123","wikidata":"https://www.wikidata.org/wiki/Q161272","display_name":"Social psychology","level":1,"score":0.09078291058540344},{"id":"https://openalex.org/C142362112","wikidata":"https://www.wikidata.org/wiki/Q735","display_name":"Art","level":0,"score":0.0},{"id":"https://openalex.org/C153349607","wikidata":"https://www.wikidata.org/wiki/Q36649","display_name":"Visual arts","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D057188","descriptor_name":"Workflow","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057188","descriptor_name":"Workflow","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057188","descriptor_name":"Workflow","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057188","descriptor_name":"Workflow","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D057286","descriptor_name":"Electronic Health Records","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":4,"locations":[{"id":"doi:10.1093/jamia/ocac238","is_oa":true,"landing_page_url":"https://doi.org/10.1093/jamia/ocac238","pdf_url":"https://academic.oup.com/jamia/article-pdf/30/3/545/49198791/ocac238.pdf","source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},{"id":"pmid:36519951","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/36519951","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association : JAMIA","raw_type":null},{"id":"pmh:oai:escholarship.org:ark:/13030/qt7659807n","is_oa":true,"landing_page_url":"https://escholarship.org/uc/item/7659807n","pdf_url":"https://escholarship.org/content/qt7659807n/qt7659807n.pdf","source":{"id":"https://openalex.org/S4306400115","display_name":"eScholarship (California Digital Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I2801248553","host_organization_name":"California Digital Library","host_organization_lineage":["https://openalex.org/I2801248553"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"A Scholarly Journal of Informatics in Health and Biomedicine, vol 30, iss 3","raw_type":"article"},{"id":"pmh:oai:pubmedcentral.nih.gov:9933068","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/9933068","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"J Am Med Inform Assoc","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1093/jamia/ocac238","is_oa":true,"landing_page_url":"https://doi.org/10.1093/jamia/ocac238","pdf_url":"https://academic.oup.com/jamia/article-pdf/30/3/545/49198791/ocac238.pdf","source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4311580226.pdf","grobid_xml":"https://content.openalex.org/works/W4311580226.grobid-xml"},"referenced_works_count":12,"referenced_works":["https://openalex.org/W2010718399","https://openalex.org/W2346814295","https://openalex.org/W2388450580","https://openalex.org/W2599946081","https://openalex.org/W2786925997","https://openalex.org/W2793047146","https://openalex.org/W2884110172","https://openalex.org/W2893419480","https://openalex.org/W3003063751","https://openalex.org/W3004612364","https://openalex.org/W3154616243","https://openalex.org/W3154939553"],"related_works":["https://openalex.org/W4376870533","https://openalex.org/W2982424490","https://openalex.org/W3158446864","https://openalex.org/W3173277169","https://openalex.org/W2941211423","https://openalex.org/W3122903754","https://openalex.org/W2801041533","https://openalex.org/W3112032814","https://openalex.org/W3132050044","https://openalex.org/W3215950497"],"abstract_inverted_index":{"Electronic":[0],"health":[1],"records":[2],"(EHRs)":[3],"offer":[4],"decision":[5],"support":[6],"in":[7,89,129],"the":[8,27,40,43,75,90,110,121],"form":[9,91],"of":[10,29,42,92],"alerts,":[11,20],"which":[12],"are":[13],"often":[14],"though":[15,21],"not":[16],"always":[17],"interruptive.":[18],"These":[19],"sometimes":[22,54],"effective,":[23],"can":[24],"come":[25],"at":[26,71],"cost":[28],"high":[30],"cognitive":[31],"burden":[32],"and":[33,58,87,101,118,133,136],"workflow":[34],"disruption.":[35],"Less":[36],"well":[37],"studied":[38,67],"is":[39],"design":[41],"EHR":[44],"itself-the":[45],"ordering":[46],"provider's":[47],"\"choice":[48],"architecture\"-which":[49],"\"nudges\"":[50],"users":[51],"toward":[52,56,63,83,115],"alternatives,":[53],"unintentionally":[55],"waste":[57,135],"misuse,":[59],"but":[60],"ideally":[61],"intentionally":[62],"better":[64,116],"practice.":[65],"We":[66,108],"3":[68,122],"different":[69],"workflows":[70],"our":[72],"institution":[73],"where":[74],"existing":[76],"choice":[77],"architecture":[78,111],"was":[79],"potentially":[80],"nudging":[81],"providers":[82,114],"erroneous":[84,131],"decisions,":[85],"waste,":[86],"misuse":[88],"inappropriate":[93],"laboratory":[94],"work,":[95],"incorrectly":[96],"specified":[97],"computerized":[98],"tomographic":[99],"imaging,":[100],"excessive":[102],"benzodiazepine":[103],"dosing":[104],"for":[105],"imaging-related":[106],"sedation.":[107],"changed":[109],"to":[112,126],"nudge":[113],"practice":[117],"found":[119],"that":[120],"nudges":[123],"were":[124],"successful":[125],"varying":[127],"degrees":[128],"reducing":[130],"decision-making":[132],"mitigating":[134],"misuse.":[137]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":5},{"year":2024,"cited_by_count":2},{"year":2023,"cited_by_count":1}],"updated_date":"2026-05-21T06:26:12.895304","created_date":"2025-10-10T00:00:00"}