EFFECTIVENESS: Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning by Hospitalists

Advance Care Planning Clinical Trial

Official title:

Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning Conversations by Hospitalists With Older Adults

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT04881968
• Other study ID #: STUDY00031186 - B
• Secondary ID: P01AG019783
• Status: Terminated
• Phase: N/A
• Start date: July 15, 2021
• Est. completion date: August 13, 2021

Study information

• Verified date: February 2022
• Source: Dartmouth-Hitchcock Medical Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Hopewell Hospitalist is a theory-based adventure video game designed to increase the likelihood that a physician will engage in an advance care planning (ACP) conversation with a patient over the age of 65. Drawing on the theory of narrative engagement, players assume the persona of a hospitalist physician and navigate a series of clinical encounters with seriously-ill patients over the age of 65. Players experience the consequences of having (or not having) ACP conversations in a timely fashion. The planned study is a crossover phase III trial testing the effectiveness of providing physicians with a link to a free version of Hopewell Hospitalist as a means for increasing ACP rates measured by ACP billing frequency.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 1261
• Est. completion date: August 13, 2021
• Est. primary completion date: August 13, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: N/A and older

Eligibility

Hospitalist Inclusion Criteria:

• Employed by Sound

• Not previously included in the Efficacy Trial Arm of the study.

Hospitalist Exclusion Criteria:

• Not employed by Sound

• Does not provide informed consent

• Previously included in the Efficacy Trial Arm of the study.

Related Conditions & MeSH terms

• Advance Care Planning

Intervention

Behavioral:
• Hopewell Hospitalist Video Game
Hopewell Hospitalist is a customized theory-based adventure video game that uses narrative engagement to educate physician players on advance care planning to increase physicians' likelihood of engaging in and billing for ACP conversations.

Locations

Country	Name	City	State
United States	Dartmouth Hitchcock Medical Center	Lebanon	New Hampshire

Sponsors (3)

Lead Sponsor	Collaborator
Dartmouth-Hitchcock Medical Center	National Institute on Aging (NIA), Sound Physicians

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Hopewell Hospitalist - Apple App Store and Google Analytics	Number of unique downloads for the HH game will be provided by the Apple App store. Using Google Analytics we will be able to discern time spent playing the game for each individual hospitalist using their unique log-in passphrase.	3 months
Primary	Incidence of Billed Advance Care Planning	Change in physician advance care planning billing for patients over the age of 65 in the three months before and after the roll-out of the video game intervention at their hospital. Advance care planning billing is defined as the presence/absence of ACP charges (Medicare billing codes 99497 or 99498) during a physician's patient's hospitalization.	6 months (3 months pre and 3 months post intervention)
Primary	Merit-based Incentive Payment System Advance Care Planning Quality Score	Change in the Merit-based Incentive Payment System (MIPS) self-report measure of advance care planning by enrolled hospitalists (MiPS-ACP quality score). The MiPS-ACP quality score is the percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan. The quality score ranges from 0-100%, with higher scores indicating that a greater proportion of patients with an advance care plan documented in the medical record.	6 months (3 months pre and 3 months post intervention)
Secondary	Hospitalist-Managed Patient In-Hospital Mortality Rate	In-hospital mortality rate for patients managed by enrolled hospitalists.	6 months (3 months pre and 3 months post intervention)
Secondary	Hospitalist-Managed Patient 90-Day Mortality Rate	90-day mortality rate for patients managed by enrolled hospitalists.	6 months (3 months pre and 3 months post intervention)
Secondary	Sum of Resources Utilized by Hospitalist-Managed Patients	Combined sum of resources utilized by patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention). It is a composite measure including: admission to ICU, receipt of life-sustaining treatment(s) including mechanical ventilation, placement of tracheostomy, insertion of gastric feeding tube, new onset dialysis. This measure ranges from 0 to 5, where higher scores indicate greater utilization of resources during the index hospitalization.	6 months (3 months pre and 3 months post intervention)
Secondary	Incidence of Hospitalist-Managed Patient Admission to ICU	Incidence of admission to ICU for patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).	6 months (3 months pre and 3 months post intervention)
Secondary	Incidence of Hospitalist-Managed Patient Mechanical Ventilation	Incidence of mechanical ventilation of patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).	6 months (3 months pre and 3 months post intervention)
Secondary	Incidence of Hospitalist-Managed Patient Receipt of Life-Sustaining Treatment(s)	Incidence of placement of tracheostomy, insertion of gastric feeding tube, new onset dialysis for patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).	6 months (3 months pre and 3 months post intervention)
Secondary	Hospitalist-Managed Patient Length of Stay	Total days between admission and discharge for patients managed by enrolled hospitalists.	6 months (3 months pre and 3 months post intervention)
Secondary	Hospitalist-Managed Patient Disposition Status Type	Type of status upon discharge of patients managed by enrolled hospitalists (e.g., discharged to home, to skilled nursing, to hospice, deceased, etc.).	6 months (3 months pre and 3 months post intervention)
Secondary	Hospitalist-Managed Patient 90-Day Episode-Based Spending	Amount of total Medicare payments between index admission and 90-days for patients managed by enrolled hospitalists.	6 months (3 months pre and 3 months post intervention)