Quality IQ Patient Simulation Physician Practice Measurement and Engagement

NCT03800901 | Completed

• 1 other identifier: 01-QIQ-K-2018
• Study Type: interventional
• Target: 187
• Locations: 1 country
• Sites: 1

Brief Summary

This study will test the quality of physician care decisions using a patient-simulation based measurement and feedback approach that combines multiple-choice care decisions with real-time, personalized scoring and feedback. The study will also measure the impact of gaming-inspired competition and motivation, including a weekly leaderboard, to improve evidence-based care decisions. In addition, the study the test the impact of CME and MOC credits on participant engagement in the process.

Conditions

Diabetes; Hypertension; Depression; Osteoarthritis; Asthma; Pain; Heart Failure

Outcome Measures

Primary Outcomes (1)

• Change in the percentage of evidence-based diagnostic and treatment decisions made in the simulations.

  In each case, participants will answer multiple-choice questions about their preferred course of action to work-up, diagnose and treat patients in the primary care setting. Each question has specific evidence-based scoring criteria identifying necessary and unnecessary care decisions. Each provider will get a score for each case, ranging from 0 to 100 percentage based on the care decisions they make in the case. Over the course of the project, the investigators will track the percentage of correct, evidence-based care decisions made by participants, with the hypothesis that serial measurement and feedback on evidence-based care decisions will lead to increases in appropriate decisions over time. Higher scores represent a better outcome.

  3 months

Secondary Outcomes (6)

• Change in MIPS-relevant care decisions made in the patient simulations

  3 months

• Change in ordering of unneeded work-up tests made in the patient simulations

  3 months

• Participant case completion rate

  3 months

• Participant Satisfaction

  3 months

• Impact of available CME and ABIM MOC on recruitment rate

  3 months

Study Arms (2)

Control

ACTIVE COMPARATOR

The Control arm will be asked to care for online, Quality IQ patient simulations and will receive feedback based on their care decisions made in each case. The feedback will identify correct care, unneeded care, or gaps in care and recommend or reinforce evidence-based care decisions and includes references. This arm will not be offered Continuing Medical Education (CME) or American Board of Internal Medicine (ABIM) Part II Maintenance of Certification (MOC) credits for their participation.

Other: Quality IQ Patient Simulations

CME

EXPERIMENTAL

The CME arm will be asked to care for online, Quality IQ patient simulations and will receive feedback based on their care decisions made in each case. The feedback will identify correct care, unneeded care, or gaps in care and recommend or reinforce evidence-based care decisions and includes references. This arm will be offered Continuing Medical Education (CME) and American Board of Internal Medicine (ABIM) Part II Maintenance of Certification (MOC) credits for their participation.

Other: Continuing Medical Education; Other: Quality IQ Patient Simulations

Interventions

Continuing Medical Education OTHER

CME or ABIM MOC credits

Also known as: CME

CME

Quality IQ Patient Simulations OTHER

Online patient cases designed to simulate typical patients seen in a primary care practice. In each case, providers will answer multiple-choice questions about their preferred course of action to work-up, diagnose and treat patients in the primary care setting. After each question, providers will receive evidence-based feedback, including references, on the appropriateness of each of their care decisions. Feedback will be supported with relevant reference to evidence-based guidelines, including national MIPS quality measures. Cases will cover clinical conditions aligned with MIPS measures that are commonly seen in the primary care setting including: diabetes, hypertension, depression, osteoarthritis, asthma and pain control.

Also known as: Clinical Performance and Value vignettes, CPVs

CME; Control

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Board-certified in internal medicine or family medicine
• Minimum patient panel size of 1,500 patients
• English-speaking
• Access to the internet
• Informed, signed and voluntarily consented to be in the study

You may not qualify if:

• Not board certified in either internal medicine or family medicine
• Patient panel size less than 1,500 patients
• Non-English speaking
• Unable to access the internet
• Does not voluntarily consent to be in the study

Sponsors & Collaborators

• Qure Healthcare, LLC: lead
• CE Outcomes: collaborator

Study Sites (1)

QURE Healthcare

San Francisco, California, 94109, United States

Location

Related Publications (5)

• Burgon TB, Cox-Chapman J, Czarnecki C, Kropp R, Guerriere R, Paculdo D, Peabody JW. Engaging Primary Care Providers to Reduce Unwanted Clinical Variation and Support ACO Cost and Quality Goals: A Unique Provider-Payer Collaboration. Popul Health Manag. 2019 Aug;22(4):321-329. doi: 10.1089/pop.2018.0111. Epub 2018 Oct 17.

  PMID: 30328782 BACKGROUND

• Weigel PA, Ullrich F, Shane DM, Mueller KJ. Variation in Primary Care Service Patterns by Rural-Urban Location. J Rural Health. 2016 Spring;32(2):196-203. doi: 10.1111/jrh.12146. Epub 2015 Sep 16.

  PMID: 26376210 BACKGROUND

• Peabody JW, Luck J, Glassman P, Dresselhaus TR, Lee M. Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. JAMA. 2000 Apr 5;283(13):1715-22. doi: 10.1001/jama.283.13.1715.

  PMID: 10755498 BACKGROUND

• Peabody JW, Luck J, Glassman P, Jain S, Hansen J, Spell M, Lee M. Measuring the quality of physician practice by using clinical vignettes: a prospective validation study. Ann Intern Med. 2004 Nov 16;141(10):771-80. doi: 10.7326/0003-4819-141-10-200411160-00008.

  PMID: 15545677 BACKGROUND

• Burgon T, Casebeer L, Aasen H, Valdenor C, Tamondong-Lachica D, de Belen E, Paculdo D, Peabody J. Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial. J Med Internet Res. 2021 Dec 23;23(12):e31042. doi: 10.2196/31042.

  PMID: 34941547 DERIVED

MeSH Terms

Conditions

Diabetes Mellitus; Hypertension; Depression; Osteoarthritis; Asthma; Pain; Heart Failure

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Vascular Diseases; Cardiovascular Diseases; Behavioral Symptoms; Behavior; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Bronchial Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Heart Diseases

Study Officials

• John Peabody, MD, PhD

  QURE Healthcare

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: The Control arm, who are not offered CME or ABIM MOC credits for their participation, will be unaware of the interventional CME arm. The CME arm will also be unaware of the Control arm. Per recommendations from the IRB, all participants at the end of the study will receive a study debrief letter informing them of the other study arms.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Model Details: The study will enroll practicing PCPs in the US. Once eligibility is determined and providers are enrolled in the study, they will be randomized into one of two arms: * Control: will not be offered CME or ABIM MOC credits for their participation. * CME Arm: will be offered CME or ABIM MOC credits for their participation. Between the two arms, all other aspects of the study will remain constant. All providers will then care for 1 Quality IQ patient simulation each week over the course of 6-8 weeks.

Study Record Dates

• First Submitted: January 4, 2019
• First Posted: January 11, 2019
• Study Start: January 11, 2019
• Primary Completion: March 11, 2019
• Study Completion: April 15, 2019
• Last Updated: March 3, 2020

Record last verified: 2020-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)