Ascension, one of the nation’s largest nonprofit Catholic health systems, is featured in a recently published article in NEJM Evidence, a publication of NEJM Group, publisher of the New England Journal of Medicine, for innovative use of digital nudge technology to improve preventive care delivery in primary care settings.
The article highlights how Ascension is using text message nudges to better prepare patients for upcoming primary care visits — preparing them to address overdue screenings, vaccinations and other preventive needs. By reaching out in advance of appointments, Ascension is helping patients engage more fully in their care and supporting more effective conversations with clinicians.
“Even when services are available, many patients delay or miss preventive care,” said Mitesh Patel, MD, MBA, Ascension Vice President and Chief Clinical Transformation Officer. “Our digital nudge approach helps change that by making it easier for patients to take action and for clinicians to provide timely and proactive care. It not only encourages patients to come through the door but also helps streamline the appointment process and make each visit more meaningful.”
Primary care visits are key opportunities to close preventive care gaps, but patients often arrive focused on immediate concerns. Introducing new topics during the visit can delay decision-making as patients process the information. Preparing patients in advance helps them engage more fully and receive timely care.
“Healthcare is rapidly evolving as new technology helps us to address patient needs more efficiently—yet persistent gaps in access remind us there is still important work to be done,” said Thomas Aloia, MD, MHCM, FACS, FACHE, Ascension Executive Vice President and Chief Clinical Officer. “Digital nudges are one more tool to facilitate preventive care, like wellness visits and cancer screenings, in ways that feel simple, supportive, and effective.”
In a cluster randomized trial of more than 29,000 patient visits, individuals who received a text message nudge before their appointment were more likely to address preventive care needs during the visit — 23.5% compared to 20.3% among those who received usual care. The findings suggest that a simple, timely prompt can make a measurable difference in closing care gaps.
The nudge technology was also linked to better follow-through over time, with more total care gaps closed within 90 days. It improved appointment engagement as well — increasing completion rates while reducing no-shows and cancellations. Patients provided consent for these electronic communications and could opt out at any time.
“This work really shows that innovation at Ascension is about doing better for patients, families and communities,” said Richard Fogel, MD, FACC, FHRS, Ascension Chief Health Outcomes Officer. “We are investing in solutions that create a better care experience and help patients live healthier, more fulfilling lives.”
