Multimorbidity Clinical Trial
Official title:
Evaluating the Impact of an Integrated Risk Assessment System (Philips Lifeline Personal Emergency Response Service) on Healthcare Utilization
This study is being done to evaluate the impact of a system called CareSage. The CareSage system is a technology that uses clinical data to monitor, identify and target care to patients at risk of being transported to the hospital. The investigators want to see whether the CareSage system is effective in helping to identify hospital admissions which can be prevented.
The growing elderly population and rising rates of costly chronic disease have led to the
development of preventative homecare management opportunities to improve health outcomes and
reduce the number of patients who enter costly inpatient care. Partners HealthCare at Home
(PHH) is a preventative homecare management system which offers general care as well as
specialized services to help patients and their loved ones manage chronic conditions at home.
Such continuity of care is achieved through a multidisciplinary clinical team and the
integration of telemonitoring into the patient's care plan.
The Philips Lifeline Personal Emergency Response Service (PERS), a wearable button device
worn on the wrist or as a pendant, is a telemonitoring device available to patients receiving
care through PHH. When the patient presses the button, the patient is immediately connected
with a Lifeline response agent. Philips Lifeline (PLL) has developed CareSage, a predictive
analytics engine that combines continuous monitoring with predictive analytics. The clinical
interface (CareSage platform) helps care teams monitor the patient's calculated risk scores
for emergency transport. The algorithm used by this integrated risk assessment system was
originally developed after studying a large cohort of the PERS subscribers (N = ~600,000). In
Phase 1 of this study the algorithm was validated among a cohort (N = 3,335) of PHH patients
to predict emergency transports in this population (AUC = .76).
In Phase 2 of this study, the investigators will conduct a prospective, randomized trial of
370 patients to assess the effect of the risk assessment CareSage platform and PHH tailored
interventions on the rate of readmissions, quality of life, and the overall cost of medical
care. The investigators hypothesize that a multidisciplinary intervention approach could
significantly reduce the healthcare resource utilization in patient at high risk for
hospitalization. The intervention will flag those patients at the highest risk for hospital
transport, alert the patient's care team that an intervention may be needed, thereby
targeting care at high risk patients who are most likely to get readmitted. By predicting
which patients are at high risk of hospital transport which may lead to hospitalization,
targeting interventions at those patients and engaging patients with their care team, the
investigators hope to reduce readmissions, hospital days, and rates of mortality in high risk
patients.
The goal of this 2-arm randomized controlled study is to assess the impact of the CareSage
risk assessment platform on 90- and 180-day Emergency Department (ED) visits in a cohort of
PHH patients. All patients will receive the PERS device and be followed for a total of 9
months, including an initial 3-month observation period and followed by a 6-month
intervention period. At the beginning of the observation period (baseline), enrolled patients
will be randomized into 2 groups: the Intervention Group or the Control Group. During the
observation period the CareSage algorithm will calibrate using patient data (both groups)
collected during this interval from the PERS device. Then, during the intervention period,
patients in the intervention group will be actively monitored by the CareSage algorithm and
will receive tailored PHH interventions if flagged as being at high risk for emergency
transport. Patients in the control group will receive care as usual during the intervention
period. All data collected during the study will be used to further strengthen the CareSage
algorithm developed in the Phase I of this study.
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT05421143 -
Co-design of a Seamless Person-centered Intervention to Optimize Medication Use Across Healthcare Levels
|
||
Completed |
NCT04942613 -
Engaging Medically Complex Veterans in Tele-Rehabilitation Using a Biobehavioral Approach
|
N/A | |
Completed |
NCT02928939 -
Therapeutic Conflicts and Multimorbidity
|
||
Recruiting |
NCT05560451 -
Telehealth-delivered Peer Support to Improve Quality of Life Among Veterans With Multimorbidity
|
N/A | |
Completed |
NCT03697772 -
Continuity of Care and Use of Urgent Healthcare in Multimorbid Patients
|
||
Recruiting |
NCT03439410 -
Clinical Complexity in Internal Medicine Wards. San MAtteo Complexity Study
|
||
Active, not recruiting |
NCT05985044 -
Living With Multimorbidity: CO-ORDINATE Program
|
N/A | |
Completed |
NCT02866799 -
Multi-PAP: Improving Prescription in Primary Care Patients With Multimorbidity and Polypharmacy
|
N/A | |
Recruiting |
NCT05406193 -
A New Care Model for Patients With Complicated Multimorbidity
|
N/A | |
Completed |
NCT02962687 -
Video-Enhanced Care Management for Medically Complex Veterans
|
N/A | |
Completed |
NCT02664454 -
Compared Efficacy of Nurse-led and GP-led Geriatric Assessment in PrImary Care
|
N/A | |
Not yet recruiting |
NCT04391218 -
A Multidisciplinary Intervention Including a Clinical Decision Support System and an App for Drug Therapy Management in Older Patients
|
N/A | |
Recruiting |
NCT04856202 -
ACP in Older Patients With Multimorbidity: a Randomized Pilot
|
N/A | |
Completed |
NCT03912103 -
Interdisciplinary Medication Review Interventions in an Integrated Outpatient Department.
|
N/A | |
Completed |
NCT04955600 -
Digital Technology in the Home of Elderly Patients With Multimorbidity
|
||
Completed |
NCT05893212 -
Nature Walks or Exercise as a Group Activity, the Effect Well-being, Sleep and Activity.
|
N/A | |
Recruiting |
NCT06123546 -
Effectiveness of a Patient-oriented Discharge Summary
|
N/A | |
Completed |
NCT03528005 -
Effectiveness of Integrated Care Network
|
N/A | |
Completed |
NCT03088982 -
Preventing Decompensation Among Multimorbid Outpatients in Residential Care. A Cohort Study With a Six-month Follow-up.
|
N/A | |
Not yet recruiting |
NCT06458218 -
Impact of Multi-component Interventions on Populations With Mental Health Symptoms and High-risk COPD
|
N/A |