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Nurse Based Care Management clinical trials

View clinical trials related to Nurse Based Care Management.

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NCT ID: NCT02106221 Completed - Clinical trials for Health Information Technology

Transforming Outcomes for Patients Through Medical Home Evaluation & reDesign

TOPMED
Start date: July 2011
Phase: Phase 3
Study type: Interventional

The purpose of this study is to support enhancement, implementation, and evaluation of an improved model for delivering improved primary care to high-risk older adults through the use of health IT tools, focusing on issues related to the patient-centered primary care home (PCPCH) and other similar high-value elements that are proposed to improve patient outcomes. During this study, participating clinics will utilize the already-implemented Integrated Care Coordination Information System (ICCIS). Clinic staff will meet with a practice facilitator (monthly and as needed), and will track study activities and submit invoices via ICCIS reporting. These invoices will be used to simulate a shared savings model where clinics will be reimbursed based on their progress and effort towards their goals. Clinics will set and work towards goals that they have chosen. Goals for the control arm are self-selected by the clinics themselves; goals for the invention arm are related to high-value elements (HVE) that have been identified as areas that can improve patient outcomes. These HVE are: 1. Evidence-based Care Management Based on Need 2. Identification of At-Risk Populations 3. Patient Engagement and Alerts Based on Goals 4. Integrated Information for Care Management, especially around Utilization 5. Population Management Tools

NCT ID: NCT01890603 Completed - Clinical trials for Health Information Technology

Enhancing Complex Care Through an Integrated Care Coordination Information System

Start date: September 2008
Phase: Phase 3
Study type: Interventional

Cluster randomized controlled trial comparing care coordination incentives to pay for performance (quality measure) incentives in clinics on utilization, cost, quality, and patient experience.