The Rapid RCT Lab has worked with 16 departments across NYU Langone and completed 47 trials, and we are currently involved in 4 ongoing trials, with 21 additional trials in the planning stage.

Because of our lab, we now know that:

• shortening our mammogram reminder messages and including a link directly to a booking page can increase the appointment rate from 35 percent to 50 percent
• changing just a few sentences in telephone outreach scripts can both shorten telephone calls and increase rates of appointments for annual examinations
• our 19,000 post-discharge phone calls did nothing to reduce risk of readmission
• targeting telephone screening reminders at patients least likely to attend on their own is more effective than targeting those who were more likely to attend (and perhaps just needed a little nudge)
• real-time prescription benefit alerts, which prompt prescribers to offer “cheaper” medications to patients, reduce patient out-of-pocket costs by an average of 11 percent, and by nearly 40 percent in high-cost drug classes.

Some recent results from our studies include the following:

• Scheduling Reminders: Best aimed at those patients who are least likely to attend
• Shortened Scheduling Messaging: Patients who receive a shorter reminder message schedule more appointments
• Florida Call Center: Small changes to a call script can significantly increase appointment scheduling
• Patient Experience: Sending patients thank you cards does not improve survey response rates
• COVID-19 Predictive Model: Displaying patient risk scores to clinicians was safe but did not reduce length of stay
• Prescriptions: Real-time recommendations can reduce patient out-of-pocket costs
• Flu Vaccine Alerts: Optimizing the inpatient influenza alert increases the vaccination rate, reduces alert fatigue, and simplifies workflow
• Pediatric Vaccines: Text reminders improve routine pediatric vaccination rates
• BETTER CARE-Heart Failure: Best practice alert (BPA) and in-basket message both increased MRA prescribing
• MyChart Messages: Personalized messages doubled patient response rate for preventative care appointments
• BPA Optimization: Program to safely reduce VTE prophylaxis best practice alert firings
• Flu Vaccine Alerts, Fall 2023 Round: Daily firings reduced significantly with slightly lower vaccination rate?

Selected Publications

• Mukhopadhyay A … Blecker S. Cluster-Randomized Trial Comparing Ambulatory Decision Support Tools to Improve Heart Failure Care. JACC. 2023. JACC.
• Rosen K … Horwitz L. Effect of text message reminders to improve paediatric immunisation rates: a randomised controlled quality improvement project. BMJ Qual Saf. 2025. DOI.
• Matulewicz R … Blecker S. Efficacy of a Clinical Decision Support Tool to Promote Guideline-Concordant Evaluations in Patients With High-Risk Microscopic Hematuria: A Cluster Randomized Quality Improvement Project. Journal of Urology. DOI.
• Horwitz LI … Jones SA. Creating a learning health system through rapid-cycle, randomized testing. N Engl J Med. 2019. Opens in a new tab.
• Using Rapid Randomized Trials to Improve Health Care Systems | Annual Reviews
• Austrian J … Mann, D. Applying A/B testing to clinical decision support: Rapid randomized controlled trials. J Med Internet Res. 2021. Opens in a new tab.
• Blecker S … Katz SD. Interrupting providers with clinical decision support to improve care for heart failure. J. Med. Inform. 2019. DOI.
• Desai SM … Horwitz LI. Effects of real-time prescription benefit recommendations on patient out-of-pocket costs: A cluster randomized clinical trial. JAMA Intern. Med. 2022. Opens in a new tab.
• Major VJ … Aphinyanaphongs Y. Evaluating the effect of a COVID-19 predictive model to facilitate discharge: A randomized controlled trial. Appl Clin Inform. 2022. Opens in a new tab.