JUNE 2019
The Healthy Nudge
Welcome to The Healthy Nudge . Each month, we'll get you up to speed on the latest developments in policy-relevant health behavioral economics research at CHIBE. Want more frequent updates? Follow us on Twitter @PennCHIBE and visit our website .
Sugary Drink Sales Fall Following "Soda Tax"
CHIBE-affiliated faculty member Christina Roberto, PhD, and staff member Michael T. LeVasseur, PhD, MPH, published their findings on the Philadelphia beverage tax one year after its implementation in JAMA. They found that sweetened drink sales dropped by 38%, suggesting sugary drink taxes could improve long-term health of city residents. The goal of the 1.5 cent per ounce tax was to generate revenue to support universal pre-K, community schools, and improvements to parks and recreation centers, with the potential side benefit of curbing consumption of unhealthy drinks. Their findings were reported on locally, nationally, and globally from The Philadelphia Inquirer, to TIME, the AP, Forbes, and Agence France-Presse. Read more in this LDI article.
Doctor's Appointment? Time of Day Matters
In JAMA Network Open, CHIBE-affiliated faculty members Shivan J. Mehta, MD, MBA; Dylan S. Small, PhD; and Mitesh S. Patel, MD, MBA, MS, investigated primary care doctors’ orders for screening tests over the course of a day. The question they posed was: “Are breast and colorectal cancer screening rates associated with the time of day a patient visits the primary care clinician?” They found that patients with later appointment times were less likely to be ordered for and receive guideline-recommended cancer screening.
Improving Health Care by Gamifying It
CHIBE’s Kevin Volpp, MD, PhD, and Mitesh Patel, MD, MBA, MS, published an article in Harvard Business Review on combining behavioral economics and gamification to drive behavior change in health care. They argue that engaging participation, setting appropriate goals, providing a “fresh start” to patients, offering social incentives, and harnessing the concept of loss-aversion can all be used to improve health and wellbeing. Drs. Volpp and Patel also led a HBR webinar that delved into successful examples of studies and interventions that use gamification, as well as some health and fitness apps that do not effectively use game elements.
 CHIBE Profile
ThaiBinh Luong, PhD, is a data scientist on the Penn Medicine Predictive Healthcare team, specializing in machine learning methods and natural language processing. She works with CHIBE Associate Director Amol Navathe, MD, PhD, to improve patient health outcomes.

What are some areas in which predictive analytics can transform our health care delivery system?

My CHIBE projects primarily focus on physician decision-making in the hospital, so our main source of data is electronic health records (EHR). We’ve built numerous machine learning-based models, two of which help clinicians decide whether or not to order particular lab tests. One model predicts if a patient has a high risk of sepsis and would therefore benefit from a lab order. Another model from a separate project predicts if a patient has an extremely low risk of a heart attack — in which case ordering a lab would not add value.

Do you have advice for people who want to apply machine learning to their projects?

My first question is always, "Have you tried logistic regression?" It's been shown — and we've seen similar results in our work — that the performance of logistic regression is usually comparable to machine learning methods. Machine learning algorithms are beneficial because they can handle a wider variety of data. But the trade-off is that their increased complexity make it more difficult to interpret results. Every method is a tool in your toolbox; you want to use the most appropriate tool to solve your problem.
If you've determined that you absolutely need machine learning, it doesn't need to be complicated. There are open source software packages that make it easy to get started with a few lines of code on your laptop. Currently, the first go-to models are tree-based methods because they perform well while still being relatively interpretable.

What’s the most rewarding part of your job?
I love working with a diverse group of people who bring different skills and experiences to the table. Sometimes, thinking about the magnitude of what we're doing can seem overwhelming. "We're trying to SAVE LIVES!" That's amazing and scary at the same time. I definitely can't solve any of these big problems on my own. It's humbling to be able to learn so much from everyone around me.
Blog Spotlight
SGIM Honors Our Faculty
At the Society of General Internal Medicine's (SGIM) annual meeting, Kevin Volpp, MD, PhD, Director of CHIBE and Health Policy Division Chief in the Department of Medical Ethics and Health Policy, won the SGIM John M. Eisenberg National Award for Career Achievement in Research. This honor recognizes a senior scientist "whose innovative research has changed the way we care for patients and conduct research." In addition, Atheendar Venkataramani, MD, PhD, MPhil, CHIBE-affiliated faculty member and an Assistant Professor of Medical Ethics and Health Policy, was honored for the SGIM Best Published Research Paper of the Year, " Police Killings and Their Spillover Effects on the Mental Health of Black Americans: A Population-Based, Quasi-experimental Study." This study published in The Lancet explored how police killings of more than 300 black Americans each year may affect the mental health of the communities in which those events occur.
CHIBE Associate Director Appointed to MedPAC
CHIBE Associate Director Am ol Navathe, MD, PhD, has been appointed by the Government Accountability Office as a new member of the Medicare Payment Advisory Commission (MedPAC). “It is a great honor to serve as a new Commissioner on MedPAC,” Dr. Navathe said. “I’m thrilled to re-engage in public service to continue improving health care for Americans. This will build on our team’s work with innovative organizations like Hawaii Medical Services Association, the Blue Cross Blue Shield of Hawaii, and Advocate Health Care.”
Funding for Dissertation Research in Behavioral Science Deadline:
LOI: 6/3, Application: 7/2

The Office of Planning, Research, and Evaluation in the Administration for Children and Families, U.S. Department of Health and Human Services, has published a  funding opportunity announcement  for grants to support dissertation research by doctoral students using behavioral economics/behavioral science approaches to study questions related to social services programs and policies. The maximum grant award is $25,000 per year, and applicants may choose whether to apply for one or two years. Questions? Email: behavioralscholars@icfi.com .
Executive Education Program in Behavioral Economics Offered This Summer

Carnegie Mellon University is offering a weeklong executive education program this summer in behavioral economics. The program will be taught by several CHIBE-affiliated members, such as Silvia Saccardo, PhD; Gretchen Chapman, PhD; Saurabh Bhargava, PhD; and George Loewenstein, PhD. The program is designed to help executives and senior management leverage insights from the field of behavioral economics to strengthen their brand, engage consumers, improve employee well-being, and institutionalize an evidence-based approach to organizational decision-making and change management. The courses will use research to explore evolving employer-employee relationships as well as digital interactions between businesses and consumers. Dates: July 29 - August 2, 2019. Location: Carnegie Mellon University. Fee: $7,500.
Work-in-Progress Seminar:
Shu Wen Ng, PhD
Associate (Research) Professor of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
June 13 @ Noon
253 Biomedical Research Building
Work-in-Progress Seminar:
S. Ryan Greysen, MD, MHS, MA, FHM
Section Chief of Hospital Medicine, Perelman School of Medicine
June 27 @ Noon
253 Biomedical Research Building
In The News
Why we can’t stop using our phones while driving

Major Payment Reform Program for Cancer Drugs Falls Short

University of Pennsylvania professor named to key Medicare commission

How to Overcome Clinicians' Resistance to Nudges

Is There a Best Time of Day to See Your Doctor?

Philadelphia Soda Tax Cut Consumption By 1.3 Billion Ounces

EHR Alerts Help to Increase Prescriptions of Preventive Therapy

How Bots Will Change the Doctor-Patient Relationship

Can 'Nudge' Letters Cut Overprescribing of Psych Meds?

Making it easier for patients & providers to do the right things
What's New?
Tell us about a behavioral economics-related project or article that a colleague is working on that you find fascinating and deserves more attention. Email chibe@pennmedicine.upenn.edu.
New Publications

The Center for Health Incentives and Behavioral Economics (CHIBE) at the University of Pennsylvania conducts behavioral economics research aimed at reducing the disease burden from major U.S. public health problems. Originally founded within the Leonard Davis Institute of Health Economics , our mission is to inform health policy, improve healthcare delivery and increase healthy behavior.