Decreasing ED Utilization by Nudging Patients to Call Their Providers

Emergency Treatment Clinical Trial

Official title:

Decreasing ED Utilization by Nudging Patients to Call Their Provider or Triage Nurse After Women's Health Procedures

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04567849
• Other study ID #: 2020-0849
• Status: Completed
• Phase: N/A
• Start date: November 16, 2021
• Est. completion date: June 15, 2023

Study information

• Verified date: July 2023
• Source: Geisinger Clinic
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

In the present study, patients will be sent a message shortly after completing a medical procedure that informs or reminds them that they can reach out to Geisinger, and how to do it, if they have any medical issues or concerns. Researchers will assess if such messages make patients more likely to contact Geisinger with post-procedure medical concerns and decrease emergency department utilization.

Description:

Decreasing emergency department (ED) over-utilization is a priority for healthcare systems across the country. Patients uncertain about a medical issue routinely end up in the ED when less costly and time-consuming alternatives could have addressed their concern. If patients reach out to healthcare facilities rather than heading directly to the ED, they can often be directed toward resources better suited to their concerns than the ED.

Geisinger is thus working to encourage patients to contact healthcare providers if any concerns arise and patients are uncertain about where to go for care. Patients who have recently had a medical procedure may be particularly valuable to encourage, as they routinely have concerns related to the procedure and discharge can serve as a useful touch-point to remind the patient where they can go for questions or concerns.

In the present study, patients will be sent a patient portal message shortly after completing any Women's Health medical procedure. The message will inform or remind patients how they can reach Geisinger if they have any medical issues or concerns. The purpose of this study is to assess if such messages make patients more likely to contact Geisinger with medical concerns and, in turn, decrease unnecessary ED utilization. This study will A/B test 2 messages, encouraging patients to either call their recent provider directly or to call a tele-nurse hotline, and will assess if these messages perform better than a control group that will not be sent any such message.

Generalized linear models will examine the primary study outcomes as a function of the study arms (between-subjects).

Recruitment information / eligibility

• Status: Completed
• Enrollment: 11546
• Est. completion date: June 15, 2023
• Est. primary completion date: June 15, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Patient had a procedure in Women's Health within the study period (including both surgical and in-office procedures as well as baby delivery)

• Patient is enrolled in myGeisinger, Geisinger's patient portal

Exclusion Criteria:

• If procedure was labor that resulted in fetal demise or stillborn.

Related Conditions & MeSH terms

• Emergencies
• Emergency Treatment
• Telephone Hotlines

Intervention

Behavioral:
• message
patient portal message
• provider
nudging calling the patient's provider
• tele-nurse
nudging calling the tele-nurse

Locations

Country	Name	City	State
United States	Geisinger	Danville	Pennsylvania

Sponsors (1)

Lead Sponsor	Collaborator
Geisinger Clinic

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Phone calls	Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment	18 months or as long as it takes to reach N=17,300, whichever occurs first
Primary	ED utilization	Proportion of patients who visit the ED within 30 days of their appointment	18 months or as long as it takes to reach N=17,300, whichever occurs first
Secondary	Phone calls	Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment	12 months
Secondary	ED utilization	Proportion of patients who visit the ED within 30 days of their appointment	12 months
Secondary	Phone calls - surgical patients only	Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment	18 months or as long as it takes to reach N=17,300, whichever occurs first
Secondary	ED utilization - surgical patients only	Proportion of patients who visit the ED within 30 days of their appointment	18 months or as long as it takes to reach N=17,300, whichever occurs first
Secondary	Phone calls - surgical patients only	Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment	12 months
Secondary	ED utilization - surgical patients only	Proportion of patients who visit the ED within 30 days of their appointment	12 months