Impact of Social Risk Decision Support

Health Social Determinant Clinical Trial

Official title:

Improving Population and Clinical Health With Integrated Services and Advanced Analytics

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT03973346
• Other study ID #: VEST-RWJF-PHASE2
• Status: Withdrawn
• Phase: N/A
• Start date: June 1, 2019
• Est. completion date: December 31, 2020

Study information

• Verified date: February 2021
• Source: Indiana University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine the impact of embedding a risk-stratification tool, designed to identify patient needs for services that address social determinant of health related needs, in a commercial electronic health record system (EHR).

Description:

Social determinant of health related needs and social risk factors complicate care delivery and drive health and well-being. Social needs are common among undeserved patient populations, but health care providers are often not equipped to routinely identify and address patients in need.

Using a combination of health information exchange, electronic health record, and aggregate datasets the investigators developed predictive algorithms to identify patients a highest risk for a need for a referral to a social worker, dietitian, behavioral health, or other wraparound service provider. Risk scores are available to primary care providers in two ways within the electronic health record system (EHR): 1) a graphical summary of individual risk or 2) a line listing of all scheduled patients.

The investigators are introducing the risk-stratification tool in an urban safety-net primary care provider on a voluntary usage basis.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: December 31, 2020
• Est. primary completion date: December 31, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Encounters among patients seeking primary care service at any of the 9 Eskenazi Health FQHC clinics in Indianapolis, IN from January 2017 to May 2020.

• The propensity score matched primary care encounters from non-Eskenazi facilities.

Exclusion Criteria:

• Emergency encounters or hospitalizations

Related Conditions & MeSH terms

• Health Social Determinant

Intervention

Other:
• Risk screening tool exposure
Risk screening tool is available to providers

Locations

Country	Name	City	State
United States	Eskenazi Health	Indianapolis	Indiana

Sponsors (2)

Lead Sponsor	Collaborator
Indiana University	Robert Wood Johnson Foundation

Country where clinical trial is conducted

United States, 

References & Publications (3)

Kasthurirathne SN, Vest JR, Menachemi N, Halverson PK, Grannis SJ. Assessing the capacity of social determinants of health data to augment predictive models identifying patients in need of wraparound social services. J Am Med Inform Assoc. 2018 Jan 1;25(1):47-53. doi: 10.1093/jamia/ocx130. — View Citation

Vest JR, Grannis SJ, Haut DP, Halverson PK, Menachemi N. Using structured and unstructured data to identify patients' need for services that address the social determinants of health. Int J Med Inform. 2017 Nov;107:101-106. doi: 10.1016/j.ijmedinf.2017.09.008. Epub 2017 Sep 20. — View Citation

Vest JR, Menachemi N, Grannis SJ, Ferrell JL, Kasthurirathne SN, Zhang Y, Tong Y, Halverson PK. Impact of Risk Stratification on Referrals and Uptake of Wraparound Services That Address Social Determinants: A Stepped Wedged Trial. Am J Prev Med. 2019 Apr;56(4):e125-e133. doi: 10.1016/j.amepre.2018.11.009. Epub 2019 Feb 14. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	ED utilization rate	Rate of potentially avoidable emergency department utilization as determined by encounters recorded in health information exchange data and categorized using the NYU ED Algorithm.	6 months
Primary	Missed primary care appointments rate	Rate of no show / cancelled appointments at the intervention site primary care clinics as recorded in the intervention site's electronic health record system	6 months
Secondary	Hospitalization rate	Rate of all cause and potentially preventable hospitalization as determined by encounters recorded in health information exchange data and categorized using AHRQ's prevention quality indicator definitions	6 months