An EHR-based nudge intervention was used to reduce unnecessary sentinel lymph node biopsies (SLNB) in older women with early-stage breast cancer. The intervention added a reminder system to the surgeons’ workflow without requiring extra clicks or actions during patient visits. This effort stemmed from the Choosing Wisely campaign’s recommendation against axillary staging in certain demographics. The nudge system involved flagging eligible patients on the schedule view and reminding surgeons to consider omitting SLNB based on detailed pathology review. The intervention successfully reduced the SLNB rate by almost 50%, with lasting effects beyond the intervention period. Dr. Anne Wallace highlighted challenges and potential risks associated with implementing such systems in practice and stressed the importance of ongoing communication among healthcare providers.
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Could an EHR Nudge Reduce Unnecessary Biopsies?
