# Nudging Provider Adoption of Clinical Decision Support

> **NIH NIH K23** · FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH · 2020 · $173,665

## Abstract

ABSTRACT
 With the long term career goal of becoming a leading independent researcher transforming health
information technology, Safiya I. Richardson, MD, MPH, proposes a mentored research project and specific
career development plan which will prepare her to use behavioral science to develop effective clinical decision
support (CDS). The disparity between usual and evidenced based clinical practice is responsible for a third of
hospital deaths and waste estimated at 380 billon dollars each year. Computerized CDS has the potential to
narrow this gap by bringing meaningful and relevant evidence to health care providers at the point of decision
making. However, moderate improvements in care seen with CDS are significantly limited by consistently low
provider adoption, estimated at 10%. This project uses behavioral theory and key principles of behavioral
economics to illuminate and address barriers to provider adoption of CDS.
 Using the Capability Opportunity Motivation Behavior (COM-B) framework Dr. Richardson will examine
barriers to provider adoption of a pulmonary embolism risk prediction CDS tool. The use of CDS to assess pre-
test probability before computed tomography pulmonary angiography reduces testing by 25% without any
missed pulmonary emboli. Routine use by providers would result in 600,000 fewer scans, 84,000 fewer cases
of contrast induced nephropathy and prevent 3,000 malignancies as well as 2,000 cancer deaths in the United
States every year. The overall objective of this training application is to develop and evaluate the
feasibility and preliminary efficacy on provider adoption of a new tool that incorporates nudges
designed to address barriers to tool use. Nudges are applications of behavioral science used by behavioral
economists, defined as positive reinforcement and indirect suggestions which have a non-forced effect on
decision making.
 The proposal aims to: 1) develop nudges designed to address identified behavioral barriers to adoption,
2) build and conduct iterative usability testing on prototypes of the new tool, 3) evaluate the feasibility and
preliminary efficacy on provider adoption of the new tool compared to the current tool, in a pilot trial. This
project uses a multistage mixed methods framework. It is the first to evaluate the impact of nudges on provider
adoption of CDS. This research is complemented by career development activities, including formal training in
health informatics, behavioral science, mixed methods and clinical trial design. With the guidance of an
experienced mentoring team, the proposed research and training activities will lead to the development a
competitive R01 grant application to assess the effectiveness of the new tool to improve health outcomes.

## Key facts

- **NIH application ID:** 9838802
- **Project number:** 5K23HL145114-02
- **Recipient organization:** FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH
- **Principal Investigator:** Safiya Richardson
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $173,665
- **Award type:** 5
- **Project period:** 2018-12-15 → 2023-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9838802

## Citation

> US National Institutes of Health, RePORTER application 9838802, Nudging Provider Adoption of Clinical Decision Support (5K23HL145114-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9838802. Licensed CC0.

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