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The 34Th Annual Meeting of the Society for Medical Decision Making Oral & Poster Abstract Sessions

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The 34Th Annual Meeting of the Society for Medical Decision Making Oral & Poster Abstract Sessions The 34th Annual Meeting of the Society for Medical Decision Making Oral & Poster Abstract Sessions Wednesday, October 17, 2012 INF. INFORMS / SMDM JOINT PRESENTATIONS Next Session » 1:30 PM - 5:45 PM: Wed. Oct 17, 2012 Phoenix Convention Center Abstracts: INF-1. INFORMS/SMDM APPLICATIONS JOINT CLUSTER 1:30 PM - 5:40 PM: Wed. Oct 17, 2012 Phoenix Convention Center Part of Session: INFORMS / SMDM JOINT PRESENTATIONS Steven M. Shechter, PhD, University of British Columbia, Vancouver, BC, Canada Click here to link to the INFORMS website for presentation details. https://informs.emeetingsonline.com/emeetings/formbuilder/clustersessionlist.asp?cln no=2903&mmnno=220 Cluster Information Title: INFORMS/SMDM Applications Joint Cluster Chair: Elisa Long,Assistant Professor, Yale School of Management, New Haven CT 06520, United States of America, [email protected] Co-Steven Shechter,Assistant Professor, University of British Columbia, Chair: Vancouver BC V6T 1Z2, Canada, [email protected] Wednesday Oct 17, 13:30 - 15:00 : Implementing OR/IE/MDM in Practice Chair: Sheldon Jacobson,Professor, University of Illinois, 201 N. Goodwin Avenue (MC258), Urbana IL 61801, United States of America, [email protected] Co-Dominick Frosch,[email protected] Chair: Wednesday Oct 17, 13:30 - 15:00 : Operations Research for Public Health Chair: Margaret Brandeau,Stanford University, Huang Engineering Center, Stanford CA 94305, United States of America, [email protected] James Stahl,[email protected] Wednesday Oct 17, 15:20 - 16:50 : Decision Analytic and Patient-Centered Modeling in Medicine Chair: Jagpreet Chhatwal,Assistant Professor, University of Pittsburgh, 130 De Soto St, Pittsburgh PA, United States of America, [email protected] Jeremy Goldhaber-Fiebert,Assistant Professor of Medicine, Stanford University School of Medicine, 117 Encina Commons, Room 217, Stanford CA 94305-6019, United States of America, [email protected] Wednesday Oct 17, 15:20 - 16:50 : Healthcare Operations Management Chair: Pinar Keskinocak,Professor, Georgia Institute of Technology, School of Industrial and Systems Eng., 765 Ferst Drive, Atlanta GA 30332, United States of America, [email protected] Joel Tsevat,[email protected] Wednesday, October 17, 5:00pm-5:50pm - Plenary E Block - Plenary Symposium What Pilots and the Airline Industry Can Teach Clinicians and Hospitals About Patient Safety The airline industry has made tremendous advanced in the safety of aviation over the past 30 years, and has successfully ingrained a culture of safety into operations. As reported by the Robert Wood Johnson Foundation, the formation of the Commercial Aviation Safety Team in the mid 1990’s has reduced several types of airline fatalities to near zero. Unfortunately, after the landmark To Err Is Human report by the Institute of Medicine noted huge numbers of patients are harmed and die as a result of errors, no similar improvement has been witnessed in health care patient safety. This panel will explore how the successes of safety improvement in aviation can be translated into health care. Mark S. Roberts, MD, MPP, Professor and Chair of Health Policy and Management and the Graduate School of Public Health, University of Pittsburgh; Arnold Barnett, PhD, is the George Eastman Professor of Management Science and a Professor of Statistics at the MIT Sloan School of Management; Brent James, MD, MStat, Chief Quality Officer, and Executive Director, Institute for Health Care Delivery Research at Intermountain Healthcare, Salt Lake City, Utah. Thursday, October 18, 2012 KEY. KEYNOTE PRESENTATION - NIRAV R. SHAH, MD, MPH, NEW YORK STATE HEALTH DEPARTMENT « Previous Session | Next Session » 9:00 AM - 10:00 AM: Thu. Oct 18, 2012 Regency Ballroom A/B (Hyatt Regency) Abstracts: KEY-1. BUILDING A HEALTHCARE ECOSYSTEM 9:00 AM - 10:00 AM: Thu. Oct 18, 2012 Regency Ballroom A/B (Hyatt Regency) Part of Session: KEYNOTE PRESENTATION - NIRAV R. SHAH, MD, MPH, NEW YORK STATE HEALTH DEPARTMENT Nirav R. Shah, MD, MPH, New York State Health Department, Albany, NY The healthcare delivery "system" largely exists as a series of distinct niches. Yet there is a convergence of forces that promote organization around outcomes and value, which will radically transform our approach to health and wellness. This ecosystem will ensure the smooth operation, resiliency, and survival of a healthcare system that is patient-centered, cost effective, and integrates data and evidence into practice. TRA1. TOP-RANKED ABSTRACTS, CONCURRENT PRESENTATION 1 « Previous Session | Next Session » 10:30 AM - 12:00 PM: Thu. Oct 18, 2012 Regency Ballroom A/B (Hyatt Regency) Session Chairs: Ellen A. Lipstein, MD, MPH A. Scott LaJoie, PhD, MSPH Session Summary: 10:30 AM - 10:48 AM TRA1-1. IMPROVING PHYSICIAN PRESCRIBING DECISIONS THROUGH USER INTERFACE REDESIGN 10:48 AM - 11:06 AM TRA1-2. WHAT'S IN A NAME? THE INFLUENCE OF A DISEASE LABEL ON A PARENT'S DECISION TO MEDICATE A FUSSY BABY 11:06 AM - 11:24 AM TRA1-3. THE EFFECT OF EMOTION AND PHYSICIAN COMMUNICATION BEHAVIORS ON SURROGATES' LIFE-SUSTAINING TREATMENT DECISIONS: A RANDOMIZED TRIAL 11:24 AM - 11:42 AM TRA1-4. MODELING PERSONALIZED RANK ORDER OF PREVENTIVE CARE GUIDELINES 11:42 AM - 12:00 PM TRA1-5. AN INFUENZA VACCINATION POLICY BASED ON A PREVIOUS YEAR'S ILLNESS Abstracts: TRA1-1. IMPROVING PHYSICIAN PRESCRIBING DECISIONS THROUGH USER INTERFACE REDESIGN 10:30 AM - 10:48 AM: Thu. Oct 18, 2012 Regency Ballroom A/B (Hyatt Regency) Part of Session: TOP-RANKED ABSTRACTS, CONCURRENT PRESENTATION 1 Sameer Malhotra, MD, MA1, Jessica Ancker, MPH, PhD1, Curtis L. Cole, MD2, J. Travis Gossey, MD, MPH1, Rainu Kaushal, MD, MPH1 and Adam D. Cheriff, MD1, (1)Weill Cornell Medical College, New York, NY, (2)Weill Cornell. Medical College, New York, NY Purpose: Prescription medication costs represent more than 10% of American healthcare costs and are continuing to increase (CMS 2010). Substituting generic drugs in place of brand-name ones would result in considerable cost savings. Generics also have lower out-of-pocket expenses for patients and are associated with better adherence. Point-of-care electronic decision support in electronic health records (EHR) could affect clinician prescribing patterns. This study, however, is designed to evaluate a much simpler health information technology intervention, i.e., a user interface redesign. Method: At our institution, the electronic prescribing interface was redesigned so that all medication searches defaulted to a generic equivalent if available, even if the provider had searched using a brand name. However, providers still had the option of selecting the brand medication through one extra mouse-click. In many domains, setting one option as the default markedly increases the chance it will be chosen (Johnson and Goldstein, Science2003). To determine whether this default setting would have as strong an effect among physicians in a practice setting, we conducted a retrospective before-after study of new outpatient prescriptions written during the year before and the year after the redesign. Result: 886 clinicians wrote nearly 1 million new prescriptions during the two years. Generics made up 28.2% of newly prescribed medications before the change, more than doubling (65.2%) after the redesign. Only 2.1% of medications with generic equivalents were still prescribed as brands. The large increase in generic prescribing remained in regression models of the pre-post change that controlled for patient characteristics. Conclusion: A relatively simple interface change led to a dramatic change in physician decision-making about generic drugs. Generic names are generally difficult to recall compared to strategically named, marketed and memorable brand-name drugs.The simple user interface redesign removed the onus of memorizing tedious generic names and offered a seamless workflow, steering clinicians towards generic equivalents. Further refinements are needed to ensure that physicians are not directed toward the generic option when it is less than appropriate, for example, when the generic has a narrower therapeutic index than the brand option. Such well-designed “choice environments” (Thaler and Sunstein 2008) can facilitate optimal choices without adding the cognitive burden or distractions that are typically associated with electronic decision support alerts. TRA1-2. WHAT'S IN A NAME? THE INFLUENCE OF A DISEASE LABEL ON A PARENT'S DECISION TO MEDICATE A FUSSY BABY 10:48 AM - 11:06 AM: Thu. Oct 18, 2012 Regency Ballroom A/B (Hyatt Regency) Part of Session: TOP-RANKED ABSTRACTS, CONCURRENT PRESENTATION 1 Laura Scherer, PhD1, Brian J. Zikmund-Fisher, PhD2, Angela Fagerlin, PhD3 and Beth A. Tarini, MD2, (1)VA HSR&D and University of Michigan, Ann Arbor, MI, (2)University of Michigan, Ann Arbor, MI, (3)VA Ann Arbor Healthcare System & University of Michigan, Ann Arbor, MI Purpose: Reducing the prevalence of overdiagnosis and overtreatment has become a priority in light of rising healthcare costs. As one clinical example, otherwise healthy infants with excessive regurgitation and crying are often treated for Gastroesophageal Reflex Disease (GERD), even though symptoms usually resolve spontaneously and medications are no more effective than placebo. In light of these facts, it is unclear why the treatment of GERD persists. In the present research, we examined whether overtreatment persists in part because the physician’s assessment of the symptoms— in particular, use of the diagnostic label “GERD”— increases parents’ perceived need for medical
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