Doctors are more likely to try a new therapy when they are persuaded to do so by an influential colleague, according to new Northwestern Medicine research published in Physical Review X.
By analyzing physician social networks, the authors examined how doctors are professionally connected and pass information to each other and how that leads to increasing adoption. The authors have used the new finding to simulate a technology intervention that acts like an influential colleagueopinionated but not too bossythat they plan to design for the real world. The goal is to accelerate physicians adoption of new treatments and tests.
The traditional model is a study is published in a journal and discussed at medical conferences, and then doctors in that field were supposed to integrate that into their clinical practice, said lead author Curtis Weiss, M.D. The problem with that is doctors are busy and dont always read the journals or go to those conferences. But the bigger issue is even if you read the article and go to the conference, if you dont see a patient with that condition for six months you may have forgotten the therapy. And theres no follow up or reinforcement after the conference about how to use it.
The authors analyzed the social networks of critical care physicians in the medical intensive care unit at Northwestern Memorial Hospital. The test case was a new high-impact serum assay that measures an enzyme shown to be a marker of life-threatening bacterial infections and sepsis in critically ill patients. The assay has been reported in medical literature as an effective marker but is not yet a part of the guidelines for care. The current way to diagnose infection is a culture but those results take 48 to 72 hours. A quicker diagnosis may improve patient treatment.
Prior to the study, Northwestern didnt have the assay available in its lab. Weiss learned the assay was going to become available and convinced the lab director not to tell anyone before the experiment. Weiss and senior author Luis Amaral then seeded information about the new serum to two other ICU physicians chosen at random. The authors tracked the adoption of the assay over the next nine months, during which time 20 out of 36 doctors adopted the assay.
We discovered the persuasion model was more accurate in explaining the number and pattern of physicians who started to use the assay, Weiss said.
A computer simulation based on the experimental data aimed at optimizing adoption showed a reminder every five to seven days delivered as a strong suggestion, but not an order, would have had the greatest impact in accelerating adoption of the new test.
Optimized interventions could help increase adoption of best practices in hospitals around the country and increase quality of care, commented Weiss.
Next, the authors plan to design real-world interventions that deliver the knowledge to physicians and emphasize using the new therapy or best practice closer to the point at which they would actually use it.
Weiss and Amaral are considering verbal face-to-face reminders, messages sent to pagers or by email, or automated reminders generated by the electronic health record.
Interventions also can regularly audit doctors adoption. It could say Hey, you only used this 30 percent of the time when you should have used it 100 percent of the time, Weiss said.
The study is available here.
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