NCT03784950

Brief Summary

Using behavioral economics, the study objective is to increase the efficiency, quality, and timeliness of care for Los Angeles County (LAC) Department of Health Services (DHS) patients by nudging specialists toward more effective use of eConsult, a web-based consultation and communication portal for Primary Care Providers (PCPs) and specialists, improving access for patients in greatest need of specialty care.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
220

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Mar 2017

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

March 1, 2017

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 31, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 31, 2018

Completed
3 months until next milestone

First Submitted

Initial submission to the registry

December 5, 2018

Completed
19 days until next milestone

First Posted

Study publicly available on registry

December 24, 2018

Completed
Last Updated

December 24, 2018

Status Verified

December 1, 2018

Enrollment Period

1.5 years

First QC Date

December 5, 2018

Last Update Submit

December 20, 2018

Conditions

Quality of Health Care

Outcome Measures

Primary Outcomes (5)

  • Rating - Medical Decision Making

    Peers' ratings of Medical Decision Making in Specialists' responses to PCPs

    Baseline to Post-Intervention, up to 12 months

  • Rating - Application of Expected Practices

    Peers' ratings of Expected Practices in Specialists' responses to PCPs

    Baseline to Post-Intervention, up to 12 months

  • Rating - Relationship Building

    Peers' ratings Relationship Building in Specialists' responses to PCPs

    Baseline to Post-Intervention, up to 12 months

  • Rating - Expert Elicitation

    Peers' ratings of Specialists' skill in elicitation of information from PCPs

    Baseline to Post-Intervention, up to 12 months

  • Rating - Educational Value

    Peers' ratings of Educational Value of eConsults

    Baseline to Post-Intervention, up to 12 months

Study Arms (3)

Rating tool only

EXPERIMENTAL

Rating eConsults from peer specialists in first phase

Behavioral: Rating tool

Feedback only

EXPERIMENTAL

Receiving feedback from peer specialists in first phase

Behavioral: Feedback

Rating Tool plus Feedback

EXPERIMENTAL

Both rating and feedback in second phase.

Behavioral: Rating toolBehavioral: Feedback

Interventions

Rating toolBEHAVIORAL

eConsult Specialty Reviewers are asked to rate the quality of other specialists' recently completed eConsult exchanges on the following four dimensions: 1) efforts to elicit additional information from PCPs, when needed; 2) medical decision making; 3) inclusion of educational content for PCPs, when appropriate; 4) perceived effect on the PCP-specialist relationship (i.e., overall tone of the eConsult exchange)

Rating Tool plus FeedbackRating tool only
FeedbackBEHAVIORAL

eConsult Specialty Reviewers receive confidential feedback via email on their performance (top performer vs not a top performer) as compared to colleagues in their specialty. Feedback is based on other reviewers ratings of their eConsult exchanges on the following four dimensions: 1) efforts to elicit additional information from PCPs, when needed; 2) medical decision making; 3) inclusion of educational content for PCPs, when appropriate; 4) perceived effect on the PCP-specialist relationship (i.e., overall tone of the eConsult exchange)

Feedback onlyRating Tool plus Feedback

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • LACDHS providers who are eConsult system users

You may not qualify if:

  • None

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Los Angeles County Department of Health Services

Los Angeles, California, 90012, United States

Location

Related Publications (3)

  • Barnett ML, Yee HF Jr, Mehrotra A, Giboney P. Los Angeles Safety-Net Program eConsult System Was Rapidly Adopted And Decreased Wait Times To See Specialists. Health Aff (Millwood). 2017 Mar 1;36(3):492-499. doi: 10.1377/hlthaff.2016.1283.

    PMID: 28264951BACKGROUND

  • Lee MS, Ray KN, Mehrotra A, Giboney P, Yee HF Jr, Barnett ML. Primary Care Practitioners' Perceptions of Electronic Consult Systems: A Qualitative Analysis. JAMA Intern Med. 2018 Jun 1;178(6):782-789. doi: 10.1001/jamainternmed.2018.0738.

    PMID: 29801079BACKGROUND

  • Behavioral Economics and eConsult Steering Committee; Meeker D, Friedberg MW, Knight TK, Doctor JN, Zein D, Cayasso-McIntosh N, Goldstein NJ, Fox CR, Linder JA, Persell SD, Dea S, Giboney P, Yee HF. Effect of Peer Benchmarking on Specialist Electronic Consult Performance in a Los Angeles Safety-Net: a Cluster Randomized Trial. J Gen Intern Med. 2022 May;37(6):1400-1407. doi: 10.1007/s11606-021-07002-1. Epub 2021 Sep 9.

    PMID: 34505234DERIVED

Study Officials

  • Daniella Meeker, PhD

    University of Southern California

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
SEQUENTIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Assistant Professor

Study Record Dates

First Submitted

December 5, 2018

First Posted

December 24, 2018

Study Start

March 1, 2017

Primary Completion

August 31, 2018

Study Completion

August 31, 2018

Last Updated

December 24, 2018

Record last verified: 2018-12

Data Sharing

IPD Sharing
Will not share

Locations

US(1)