IT to Support Integration of Social Determinant of Health Services to Reduce Avoidable Emergency Department Visits

Substance Use Disorders Clinical Trial

Official title:

Use of Information Technology to Support Integration of Social Determinant of Health Services to Reduce Avoidable Emergency Department Visits

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT04125433
• Other study ID #: NCBHNPIC
• Status: Not yet recruiting
• Phase: N/A
• Start date: August 1, 2020
• Est. completion date: August 30, 2022

Study information

• Verified date: October 2019
• Source: Northern New York Rural Behavioral Health Institute
• Contact: Barry Brogan, MAPP
• Phone: 518-891-9460
• Email: barry[@]behaviorhealthnet.orh
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Working through regional Accountable Care Organizations (ACO) the sponsor will establish a 2-year pilot project to demonstrate that early recognition and intervention in the various Social Determinant of Health (SDoH) domains can reduce avoidable Emergency Department (ED) visits by high utilizers. The regional ACO's will contract with Medicaid Managed Care Plans to assign traditional high ED utilizing members to the pilot project. Members will be offered enhanced peer facilitated care management services connecting members with available SDoH community based services. Members fitting our eligibility criteria will self-select by way of completing a pilot project consent form.

Description:

The project employs a two level intervention to include Peer Support Specialist (PSS) and Community Health Advocate (CHA). Contact and engagement with participating members will be through both direct intervention in the emergency department by Peer Support Specialist (the peer) as well as in the community for prevention visits and follow up by both the peer and Community Health Advocate. These well-positioned Peers and Community Health Advocates will address Behavioral and Social Determinants of Health (SDoH) concerns through a highly coordinated intervention supported by a common IT Medicaid member tracking platform. This research project will determine the feasibility of deploying a single shared IT platform that will include referral, appointment completion, and intervention outcome data. Project staff will develop a trusting relationship with the members and will improve member access and engagement with community-based services. The project will also seek to determine the impact on total cost of care through redirecting study participants to community resources that are more appropriate, and less expensive than return visits to the emergency department.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 400
• Est. completion date: August 30, 2022
• Est. primary completion date: June 30, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• Adults age 18 to 65

• New York State Medicaid Managed Care Members

• Have utilized emergency department services 6 or more times in a 12-month period

• Have been assigned to the Pilot Project by their Medicaid Managed Care Plan

Exclusion Criteria:

• Individuals not assigned by a Managed Care Organization meeting the above criteria

Related Conditions & MeSH terms

• Emergencies
• Mental Health Issue
• Substance Use Disorders
• Substance-Related Disorders

Intervention

Behavioral:
• Peer Integrated Care Services
The project employs a two level intervention to include Peer Support Specialist (PSS) and Community Health Advocate (CHA). Contact and engagement with participating members will be through both direct intervention in the emergency department as well as in the community for prevention visits and follow up. Peers and Community Health Advocates will address Behavioral and Social Determinants of Health (SDoH) concerns through a coordinated intervention supported by a common IT Medicaid member tracking platform. This research project will determine the feasibility of deploying a single shared IT platform that will include referral, appointment completion, and intervention outcome data. Project staff will develop a relationship with the members improving member access and engagement with community-based services. The project will determine the impact on total cost of care through redirecting study participants to community resources rather than return visits to the emergency department.

Locations

Country	Name	City	State
United States	Northern New York Rural Behavioral Health Institute	Saranac Lake	New York

Sponsors (1)

Lead Sponsor	Collaborator
Northern New York Rural Behavioral Health Institute

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in Adoption and Use of IT Platform	Change in Number of Participating Agencies That Contribute Data to the IT System	Months 6, 12, 18, 24
Primary	Change in Engagement of Medicaid Member Participants with Peer Integration Care Services	The change in acceptance by Medicaid Members of Peer Integrated Care Services	Months 0, 3, 6, 9, 12, 15, 18, 21, 24
Primary	Change in Total Cost of Care for Participating Members	Change in cost trend for participating members. Pre-study vs. study period.	Month 0, Month 24
Secondary	Change in Emergency Room Visits by Participating Members	Change in rate of Emergency Department utilization by participating members.	Month 0, 6, 12,18,24