DexCare Blog

How Nudge Theory and Choice Architecture Fuel Patient Choice

By David McKanna, Director of Product Marketing,
and Kory Booher, Southeast Director of Partnerships

What do free chips and salsa have to do with patient access? If you’re a health system leader, it might be time to find out.

At your favorite Tex-Mex restaurant, servers bring out chips and salsa with a purpose. They’re not just breaking the ice. They also know you’re more likely to order a cool drink to wash down those salty snacks. Maybe you’ll even ask for a side of guacamole or queso. This approach benefits everyone. You leave with a belly full of delicious food, while the restaurant generates extra revenue from your visit.

This concept of “nudging” consumers to take a desired action isn’t just for food. Well-known brands in entertainment (Netflix), e-commerce (Amazon), and fitness (Orangetheory) use nudge theory to encourage action and delight their customers. 

And now, leading health systems are leveraging nudge theory to balance their patient loads, increase appointment bookings, and deliver an enhanced patient experience.

What is Nudge Theory?

Best-selling authors Richard Thaler, a Nobel laureate, and Cass Sunstein, a legal scholar, popularized the concept of nudge theory in their 2009 book Nudge. Their theory suggests that people can be influenced—or nudged—toward making choices that benefit them, even if they don’t realize it at that moment.

Nudge theory is often used alongside choice architecture, another concept rooted in behavioral economics. Choice architecture emphasizes designing decision-making environments in ways that influence a person’s choices without restricting their freedom to decide.

To understand how nudge theory and choice architecture work together, imagine you’ve decided to adopt healthier eating habits. Now think about the refrigerator inside your home. Using the concepts of choice architecture, you might redesign your refrigerator shelves, stocking fresh fruits and vegetables at eye level and moving sugary snacks and processed food toward the back. This simple rearrangement will subtly nudge you toward healthier choices, while still giving you the freedom to enjoy a pint of ice cream.


Hungry Yet? So Are Your Health System’s Patients

One of the fundamental aspects of choice architecture is the reality of human tendencies. We’re inherently prone to procrastination, forgetfulness, and decision fatigue. In the healthcare context, all of these human behaviors impact a patient’s ability—or inability—to schedule and attend appointments. 

By incorporating elements of nudge theory and choice architecture into your online and mobile experiences, your health system can give patients a sense of ownership over their health. Plus, you can encourage proactive patient behaviors and foster deeper engagement in preventive care.

But health systems also shouldn’t give their patients too much choice. After all, humans get overwhelmed when confronted with too many choices. In health care, that means patients may choose the wrong venue for their care. This can lead to higher out-of-pocket costs, lower patient satisfaction, higher operational costs for your health system, and in many cases, suboptimal outcomes.


Isn’t My Health System Already Using Choice Architecture?

Some health systems think they’re using choice architecture because they incorporate decision trees in their web and mobile experiences. But decision trees are actually the opposite of choice architecture. They really leave you with very few decisions at all.

From a patient perspective, using a decision tree is like someone putting you on a diet. You end up with strict rules that irritate you, particularly when they render zero results. 

Ever reach the end of a long digital decision tree and been told to call the office to book an appointment? It’s maddening—like dieting for a month and still seeing the same weight on the scale!


Serving Up Nudge Theory Through Patient Self-Scheduling

Unlike decision trees, modern patient self-scheduling solutions empower health systems to nudge patients toward scheduling appointments that meet their immediate needs and align with your health system’s goals.

With self-scheduling, patients gain greater flexibility and control over their healthcare journey. Your patients can book appointments at their convenience without having to navigate complex phone systems or wait for callbacks.

From an organizational perspective, health systems can incorporate subtle nudges and choice architecture principles into patient self-scheduling to guide patients toward optimal decision-making. The data analytics and machine learning algorithms within DexCare, for example, enable health systems to identify appointment patterns and patient preferences. 

With this detailed information, health systems can identify trends, forecast demand, anticipate resource needs, allocate staffing efficiently, and minimize wait times for patients. This enables health systems to unlock all of their available capacity, provide the type of human-centered care patients want, and free up providers to practice at the top of their license.


Nudge Theory in Action: Real Results From a Leading Health System

While nudge theory is a “theory,” it’s already proven in its ability to enhance health system operations and improve the patient experience.

Using DexCare, a major regional health system in Georgia deployed nudge theory and choice architecture by surfacing its virtual care services as options toward the top of its online Find Care solution. This approach nudged low-acuity patients to the most appropriate care, effectively removing low-acuity patients from specialists’ schedules. As a result, the system quadrupled its virtual visits and created additional capacity by reducing the time-to-care for all providers by five days. 

The same health system then used DexCare to offer patients alternative providers with greater availability during their provider searches. This step nudged patients toward the provider the health system wanted them to see. The result: a 3x increase in online specialist bookings, with 20% coming from those other suggested providers or locations.


A Better Patient Experience is Within Your Health System’s Grasp

By taking cues from what works in other industries, health systems can find powerful new ways to help their patients take a more active role in their health. Patient self-scheduling is a shining example of how small, subtle changes can significantly improve the patient experience, boost patient satisfaction, and enhance operational efficiency.


If you want to see how nudge theory and choice architecture empower amazing self-scheduling journeys, request a demo of DexCare today.