3 A/B testing in healthcare: how you can apply tech industry methods to improve quality in your system

BackgroundRandomized trials are the gold standard of evidence in healthcare. But their use in QI remains limited, held back by a perception that they do not suit the fast-paced, adaptable world of QI. It doesn’t have to be this way. At NYU Langone we draw on lessons from tech company A/B testing to build a learning healthcare system through RCTs. Now you can too.ObjectivesExplain how NYU Langone’s RapidRCT lab designs, implements, and iterates rapid RCTs in our healthcare system – and how other systems can do this too.MethodsRapidly-iterated RCTs, of different operational changes within NYU. Presentation of two examples; an iterative RCT of pediatric vaccination reminders and a more complex RCT to identify who we should target with reminder phone calls for screening appointments.ResultsA cleanliness/safety focused text, and a one-off text did not improve pediatric vaccination rates. But, two reminder texts 48hrs apart were effective (0.4 vaccines per child in intervention, compared to 0.3 in the control arm (p=0.02)). Reminder phone calls were effective for all groups (6.9% of gaps in care closed for intervention vs 0.5% for controls (p