EFFECTIVENESS: Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning by Hospitalists

NCT04881968 | Terminated Results DMC

• 2 other identifiers: STUDY00031186 - BP01AG019783
• Study Type: interventional
• Target: 1,261
• Locations: 1 country
• Sites: 1

Brief Summary

Hopewell Hospitalist is a theory-based adventure video game designed to increase the likelihood that a physician will engage in an advance care planning (ACP) conversation with a patient over the age of 65. Drawing on the theory of narrative engagement, players assume the persona of a hospitalist physician and navigate a series of clinical encounters with seriously-ill patients over the age of 65. Players experience the consequences of having (or not having) ACP conversations in a timely fashion. The planned study is a crossover phase III trial testing the effectiveness of providing physicians with a link to a free version of Hopewell Hospitalist as a means for increasing ACP rates measured by ACP billing frequency.

Conditions

Advance Care Planning

Keywords

advance care planning; physician performance; serious games; narrative engagement

Outcome Measures

Primary Outcomes (2)

• Incidence of Billed Advance Care Planning

  Change in physician advance care planning billing for patients over the age of 65 in the three months before and after the roll-out of the video game intervention at their hospital. Advance care planning billing is defined as the presence/absence of ACP charges (Medicare billing codes 99497 or 99498) during a physician's patient's hospitalization.

  6 months (3 months pre and 3 months post intervention)

• Merit-based Incentive Payment System Advance Care Planning Quality Score

  Change in the Merit-based Incentive Payment System (MIPS) self-report measure of advance care planning by enrolled hospitalists (MiPS-ACP quality score). The MiPS-ACP quality score is the percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan. The quality score ranges from 0-100%, with higher scores indicating that a greater proportion of patients with an advance care plan documented in the medical record.

  6 months (3 months pre and 3 months post intervention)

Secondary Outcomes (9)

• Hospitalist-Managed Patient In-Hospital Mortality Rate

  6 months (3 months pre and 3 months post intervention)

• Hospitalist-Managed Patient 90-Day Mortality Rate

  6 months (3 months pre and 3 months post intervention)

• Sum of Resources Utilized by Hospitalist-Managed Patients

  6 months (3 months pre and 3 months post intervention)

• Incidence of Hospitalist-Managed Patient Admission to ICU

  6 months (3 months pre and 3 months post intervention)

• Incidence of Hospitalist-Managed Patient Mechanical Ventilation

  6 months (3 months pre and 3 months post intervention)

Other Outcomes (1)

• Hopewell Hospitalist - Apple App Store and Google Analytics

  3 months

Study Arms (2)

Control: Usual Care

NO INTERVENTION

The control arm occurs prior to receipt of the video game intervention and reflects usual care. Each hospitalist 'crosses over' from control to intervention at a single time point.

Video Game Intervention

EXPERIMENTAL

Each hospitalist 'crosses over' from control to intervention at a single time point by receiving a link to the Hopewell Hospitalist game via email and logging in to play the video game.

Behavioral: Hopewell Hospitalist Video Game

Interventions

Hopewell Hospitalist Video Game BEHAVIORAL

Hopewell Hospitalist is a customized theory-based adventure video game that uses narrative engagement to educate physician players on advance care planning to increase physicians' likelihood of engaging in and billing for ACP conversations.

Video Game Intervention

Eligibility Criteria

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

You may qualify if:

• Employed by Sound
• Not previously included in the Efficacy Trial Arm of the study.

You may not qualify if:

• Not employed by Sound
• Does not provide informed consent
• Previously included in the Efficacy Trial Arm of the study.

Sponsors & Collaborators

• Dartmouth-Hitchcock Medical Center: lead
• Sound Physicians: collaborator
• National Institute on Aging (NIA): collaborator

Study Sites (1)

Dartmouth Hitchcock Medical Center

Lebanon, New Hampshire, 03766, United States

Location

Results Point of Contact

• Title: Dr. Amber Barnato
• Organization: The Dartmouth Institute

amber.barnato@dartmouth.edu

603-646-5237

Study Officials

• Amber Barnato, MD, MPH, MS

  Dartmouth-Hitchcock Medical Center and Geisel School of Medicine�

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: A physician's treatment assignment will be masked during analysis.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Susan J. and Richard M. Levy 1960 Distinguished Professor in Health Care Delivery

Model Details: We will email the Uniform Resource Locator (URL) to download the App with encouragement to play the game, including positive feedback from participants in the efficacy study. Receipt of the email will be our measure of intervention delivery. Each hospitalist 'crosses over' from control to intervention at a single time point.

Study Record Dates

• First Submitted: May 6, 2021
• First Posted: May 11, 2021
• Study Start: July 15, 2021
• Primary Completion: August 13, 2021
• Study Completion: August 13, 2021
• Last Updated: February 25, 2022
• Results First Posted: February 2, 2022

Record last verified: 2022-02

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF, CSR, ANALYTIC CODE
• Time Frame: Upon publication of the planned manuscripts. Data will be retained through February 2028.
• Access Criteria: Data will require completion of a data use agreement with Dartmouth.

Locations

US (1)