Today I’m sending you notes on my conversation with Dr. Mitesh Patel. He’s the Director of the Penn Medicine Nudge Unit, which is the world’s first behavioral design team embedded within a health system. He is the Ralph Muller Presidential Assistant Professor of Medicine and Health Care Management at the Perelman School of Medicine and The Wharton School at the University of Pennsylvania.

What does he do?

Also, Dr. Patel is on faculty at the Penn Medicine Center for Health Care innovation and the Center for Health Incentives and behavioral economics, and a Staff Physician at the Crescenz VA Medical Center in Philadelphia, and a Senior Fellow at the Leonard Davis Institute of Health Economics. His research focuses on combining insights from behavioral economics with scalable technology platforms to improve health and health care.

Furthermore, He has led more than 25 clinical trials in partnership with health systems, insurers, employers, and community organizations that tested ways to design nudges, incentives, and gamification to change clinician and patient behavior. This work includes digital health interventions using wearable devices and smartphones, and health system interventions using the electronic health record.

His other accomplishments, aside from his research

In addition, Dr. Patel is Director of the VA Advanced Fellowship Program in Health Services Research and Development in Philadelphia and Co-Director of the Wharton MBA Course on E-Health. He has received several national research awards including the 2018 Outstanding Junior Investigator of the Year from SGIM, the 2018 Alice Hersh Emerging Leader Award from AcademyHealth, and the 2019 Young Physician-Scientist Award from ASCI.

Dr. Patel’s work has been published in leading medical journals including the New England Journal of Medicine, JAMA, Annals of Internal Medicine, and Health Affairs. His work has been featured in numerous media outlets including the New York Times, NBC Today Show, Wall Street Journal, Harvard Business Review, The Economist, Forbes, Time, NPR and CNN.

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Podcast Episode Summary

  • 1:13 – Why he decided to ditch medical school for two years and get an MBA to learn more about health care management (hint: it had to do with liver transplant pricing)
  • 8:13 – How doctors can aid in human-focused design and implement outcomes which the system actually needs. How we can get metrics which actually matter.
  • 15:00 – The path to medical school, why medicine is in need of a change in business tactics, and how his work at Penn impacts this particular interface of human-facing technology
  • 20:15 – How medical graduates should evaluate careers in business and how they can merge their two interests to impact academic health systems
  • 22:16 – Being clear with expectations is paramount when you are trying to gain projects and mentors
  • 27:27 – How wearables impact the data that clinical trials can collect; how we can screen continuously for chronic disease and pitfalls of wearable tech
  • 34:13 – How clinicians can get work with economists in order to make workflows more efficient in clinical medicine and patient-centered
  • 36:09 – How to run a behavioral study when the system is always changing
  • and more!

Resources

Dr. Patel’s Mentors – Kevin Volpp, David Asch

Robert Wood Johnson National Clinician Scholars Program

Studies talked about during the podcast

Generic Prescribing

Dr. Mitesh Patel’s website

Quotes

“If you really know what you want to work on, you can really dive into it, if you don’t, you need to do that broad exploration upfront. And so, and there’s typically an evolution between or in the beginning, are really exploring. And during that stage, you want to do a lot of things, but not expose yourself to a lot of time to all those things.”

“So I think these technologies as they get more passive and embedded can can be very useful. I think one of the challenges is a lot of people have wearables stopped using them after a time.”

“We’re in a dynamic health system, and things will change halfway through a study. If we can get a randomized trial, then the unexpected thing should be happening evenly. And that’s ideal. If not, if we can measure or capture that, then we have to see…what was the impact of that unexpected change?”

Not a quote, but an important take-away

Three things that make up a good nudge: it is for simple and specific processes, it can leverage technology (EHR or mobile devices) to test at a small and large scale quickly, and it is impactful (~4X change).

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