Point-of-Care Follow-Up With Primary Care After Emergency Department Discharge

Conditions Influencing Health Status Clinical Trial

Official title:

Point-of-Care Follow-Up With Primary Care After Emergency Department Discharge

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02740348
• Other study ID #: 091554
• Status: Completed
• Phase: N/A
• First received: April 13, 2016
• Last updated: August 4, 2017
• Start date: November 2015
• Est. completion date: July 31, 2017

Study information

• Verified date: August 2017
• Source: George Washington University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this trial is to determine whether setting up a follow-up appointment for patients who received treatment and were discharged from the emergency department increases their compliance with the follow-up appointment. We are enrolling patients who need a follow-up visit, have health insurance but report do not have a primary care doctor. Patients are randomized to one of three treatment groups: (1) assistance setting up a follow-up appointment by a research assistant using ZocDoc; (2) ZocDoc information given to the subject to set up follow-up appointment by him/herself; or (3) usual discharge instructions by ED staff. Subjects are phoned approximately 2 weeks after the ED visit and asked whether they completed a follow-up visit, satisfaction with their ED visit, satisfaction with their follow-up visit, and additional ED treatment and recovery.

Description:

This is a randomized controlled trial involving adult emergency department (ED) patients who need a follow-up visit as defined by the ED provider (importance of follow-up rated as 5 or greater on a 0 to 10 scale). There is software available called ZocDoc that provides a user the ability to identify primary care providers who have open appointments and will take the person's health insurance (in network and outside of network) and list the doctors based on their proximity to the person in need. We are testing whether booking appointments for ED patients using ZocDoc vs. giving patients the information to use ZocDoc themselves vs. standard discharge instructions given by ED staff (i.e. you should follow-up with a primary care doctor) affects compliance with self-reported follow-up visits. We are enrolling patients while they are in the ED, completed a short baseline interview and then another interview with them over the telephone approximately two weeks after the index ED visit. The follow-up interview asks subjects whether they have completed a follow-up visit, satisfaction with the ED visit and the primary care visit, any other additional ED treatment and extent of recovery from the problem that brought them to the ED the first time.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 220
• Est. completion date: July 31, 2017
• Est. primary completion date: June 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 100 Years

Eligibility

Inclusion Criteria: Patients with health insurance but report not having a primary care provider and are rated by the ED provider as needing a follow-up visit with a primary care provider (rated as moderate to high need by ED provider).

Exclusion Criteria: Patients doesn't want a primary care provider or patient doesn't want a follow-up visit. Patient is unable to understand consent, is a prisoner, or does not have access to email (because ZocDoc sends appointment information to email).

Related Conditions & MeSH terms

• Conditions Influencing Health Status
• Emergencies

Intervention

Behavioral:
• ZocDoc Assistance
Research assistant sets up a follow-up appointment for a subject with a primary care doctor using ZocDoc
• ZocDoc Information
Providing ZocDoc information to subjects so that they can make a follow-up appointment with a primary care doctor themselves

Locations

Country	Name	City	State
United States	George Washington University Hospital	Washington, D.C.	District of Columbia

Sponsors (1)

Lead Sponsor	Collaborator
George Washington University

Country where clinical trial is conducted

United States, 

References & Publications (2)

Chan TC, Killeen JP, Castillo EM, Vilke GM, Guss DA, Feinberg R, Friedman L. Impact of an internet-based emergency department appointment system to access primary care at safety net community clinics. Ann Emerg Med. 2009 Aug;54(2):279-84. doi: 10.1016/j.annemergmed.2008.10.030. Epub 2008 Dec 13. — View Citation

Doran KM, Colucci AC, Hessler RA, Ngai CK, Williams ND, Wallach AB, Tanner M, Allen MH, Goldfrank LR, Wall SP. An intervention connecting low-acuity emergency department patients with primary care: effect on future primary care linkage. Ann Emerg Med. 2013 Mar;61(3):312-321.e7. doi: 10.1016/j.annemergmed.2012.10.021. Epub 2012 Dec 20. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Self-reported follow-up visit	patient-reported follow-up visit with a primary care doctor	2-4 weeks after the index ED visit
Secondary	Satisfaction with the ED visit	patient-reported satisfaction rating	Measured 2 weeks after the index ED visit
Secondary	Satisfaction with the primary care visit	patient-reported satisfaction rating	2-4 weeks after the index ED visit
Secondary	Recovery from health problem	patient-reported resolution of problem that they reported during index ED visit	2-4 weeks after the index ED visit
Secondary	Additional ED visit(s)	Did patient receive additional ED treatment for same problem as index ED visit	2-4 weeks after the index ED visit