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Table 1 Behavioral economic strategies and associated module opportunity examples

From: Designing for implementation: user-centered development and pilot testing of a behavioral economic-inspired electronic health record clinical decision support module

BE strategy Module opportunity Utilization measure
Suggest alternatives [48] Alert suggests metformin when trying to prescribe other diabetes medication in CW eligible patient Percentage of eligible alerts where alternative is selected
Accountable justification [48] Subcomponent of alert asking for justification if prescribing diabetes medication other than metformin Percentage of eligible alerts where justification is provided (vs. only “clicked through”)
Defaults [30, 49] Default all diabetes management order sets to suggest metformin in eligible patients Percentage of order sets where clinician changes the default option
Anchoring [50] Update HbA1c lab reports for CW eligible patients to show less aggressive treatment goals Qualitative feedback and percentage of CW compliant patients pre- and post implementation update
Peer comparisons/norming [48, 51] Modify clinician quality and safety dashboard to visualize diabetes management peer comparisons with color codes to indicate relative performance Number of views of the peer comparison dashboard
Availability bias [30] Medication preference list prioritizes metformin Number of prescriptions for metformin initiated from preference list