Feasibility and Efficacy Study for a Pre-visit Lab Protocol for Adult Medicine Physicals

NCT05707364 | Enrolling By Invitation

• 1 other identifier: EH22-450
• Study Type: observational
• Target: 301,000
• Locations: 1 country
• Sites: 1

Brief Summary

This is a research study evaluating the implementation of a clinic workflow to encourage pre-visit laboratory testing, such as blood work. The purpose of this research is to understand provider and patient satisfaction with clinic workflows to support pre-visit laboratory tests (blood work) for annual physical and wellness visits. Providers and staff at participating sites will be approached to fill out an anonymous survey regarding experiences with implementation of the pre-visit laboratory testing workflow. Additional data from NorthShore's Enterprise Data Warehouse (EDW) will be collected to assess the pre-lab test rate before implementation, at 6 months, and 12 months, in addition to provider and staff time efficiencies and patient satisfaction as assessed by surveys.

Conditions

Physical Examination; Diagnostic Tests, Routine; Burnout, Professional

Keywords

Feasibility

Outcome Measures

Primary Outcomes (1)

• Change from baseline pre-lab test rate

  Count of pre-lab tests completed out of the total number of annual physical/wellness visits to participating providers to participating providers

  3 months prior to study implementation and then ongoing to month 24 to calculate monthly proportions

Secondary Outcomes (4)

• Change from baseline clinician time spent resulting labs

  baseline (prior to study implementation), at 6-months of implementation, and at 1-year of implementation

• Change from baseline provider satisfaction

  baseline (prior to study implementation), at 6-months of implementation, and at 1-year of implementation

• Change from baseline patient satisfaction

  baseline, 1 year, and 2 year (i.e. annually at every wellness/ annual physical visit)

• Change from baseline frequency of patient encounters post visit

  3 months prior to study implementation and then ongoing to month 24 to calculate monthly proportions

Study Arms (1)

Practices Engaged for Pre-Visit Lab Clinic Workflow

Providers and patients/ at the designated practice sites

Behavioral: Pre-visit Lab Workflow

Interventions

Pre-visit Lab Workflow BEHAVIORAL

1. Based on buy-in from the providers/staff one or both of the practices below will be introduced into the clinic workflow to order pre-visit labs. 1. All procedures are within the standard of care, only the order of operations is being changed. After sharing lab results with patient from the most recent routine physical, physician records labs for the next calendar year in EMR. 2. Prior to appointment, Medical Assistant (MA) will review notes and orders to setup pre-visit labs. 2. Patient contacted to complete labs prior to the scheduled routine physical. 3. Resulted labs are triaged based on urgency. 4. After Visit Summary used to communicate about labs and surveys.

Practices Engaged for Pre-Visit Lab Clinic Workflow

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

4 NorthShore Medical Group Primary Care (Family Medicine/ Internal Medicine/ non-specialty) sites will be asked to implement the study workflow for all prospective patients (approximately 30,000 total) seen between 11/1/2022- 11/1/2024 at the designated offices.

You may qualify if:

• Aged 18 or older.
• Patients must have had an annual physical/ wellness visit within 30 days of completing the survey.
• Patient/ providers willing to complete the survey.

You may not qualify if:

• Participants younger than 18 years of age.

Sponsors & Collaborators

• Endeavor Health: lead
• American Medical Association: collaborator

Study Sites (1)

NorthShore University HealthSystem

Evanston, Illinois, 60201, United States

Location

Related Publications (2)

• Sinsky CA, Sinsky TA, Rajcevich E. Putting Pre-Visit Planning Into Practice. Fam Pract Manag. 2015 Nov-Dec;22(6):34-8. No abstract available.

  PMID: 26761083 BACKGROUND

• American Medical Association. 10 steps to pre-visit planning that can produce big savings. Sept 4, 2015. https://www.ama-assn.org/practice-management/sustainability/10-steps-pre-visit-planning-can-producebig-savings

  BACKGROUND

MeSH Terms

Conditions

Burnout, Professional

Condition Hierarchy (Ancestors)

Occupational Stress; Occupational Diseases; Burnout, Psychological; Stress, Psychological; Behavioral Symptoms; Behavior

Study Officials

• Nadim Ilbawi, MD

  Endeavor Health

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Clinical Assistant Professor

Study Record Dates

• First Submitted: January 6, 2023
• First Posted: January 31, 2023
• Study Start: February 8, 2023
• Primary Completion: May 1, 2025
• Study Completion: May 1, 2025
• Last Updated: April 1, 2024

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)