Reducing Emergency Department Utilization With an After Visit Summary Nudge Toward Alternative Care Options
1 other identifier
interventional
239,841
1 country
1
Brief Summary
Decreasing utilization of the Emergency Department (ED) is a priority for the system. Often, ED visits can be avoided if patients contact Geisinger first to get appropriate direction for their concern or are otherwise better informed about reasons to visit the ED vs. urgent care or primary care facilities. The study team is working to reduce ED utilization by including additional information in adult outpatient After Visit Summaries (AVSs). The study will involve will involve A/B testing different AVS versions, including 1) a version that encourages patients to contact Geisinger via different contact methods, 2) a version that includes a map to the patient's closest ConvenientCare location and accompanying information about ConvenientCare, and 3) a version that includes a self-triage guide. A control group will receive the current standard AVS. Analysis results will be assessed to determine which version is most effective at reducing ED use.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Apr 2023
Shorter than P25 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
March 8, 2023
CompletedFirst Posted
Study publicly available on registry
March 28, 2023
CompletedStudy Start
First participant enrolled
April 3, 2023
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 11, 2023
CompletedStudy Completion
Last participant's last visit for all outcomes
December 11, 2023
CompletedFebruary 26, 2024
February 1, 2024
8 months
March 8, 2023
February 22, 2024
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Inappropriate ED visits
Visited the ED inappropriately (y/n) We will apply the NYU algorithm (Ballard et al., 2010) to determine whether an ED visit is inappropriate.
In the 30 days following the appointment
Other Outcomes (3)
Urgent care visits
In the 30 days following the appointment
Calls
In the 30 days following the appointment
Patient portal messages
In the 30 days following the appointment
Study Arms (4)
Standard practice
NO INTERVENTIONPatients in this arm will receive the current standard practice AVS.
Contact us first
EXPERIMENTALPatients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention.
Contact us first + urgent care map
EXPERIMENTALPatients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care.
Contact us first + urgent care map + self-triage
EXPERIMENTALPatients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate.
Interventions
Information on how to contact Geisinger if the patient needs care
A map of the patient's nearest Geisinger urgent care location, with information about urgent care
A chart demonstrating what to do in response to several common conditions where the patient might be compelled to visit the ED
Eligibility Criteria
You may qualify if:
- Age 18+
- Has a Geisinger Primary Care Physician assigned
- Completes an outpatient office visit or telemedicine appointment at Geisinger
You may not qualify if:
- The AVS was not printed according to the EHR, and the patient does not have an active MyGeisinger patient portal account, so they do not have a way to view the AVS
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Geisinger Cliniclead
Study Sites (1)
Geisinger Clinic
Danville, Pennsylvania, 17822, United States
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Amir Goren, PhD
Geisinger Clinic
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- PREVENTION
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Program Director, Behavioral Insights Team
Study Record Dates
First Submitted
March 8, 2023
First Posted
March 28, 2023
Study Start
April 3, 2023
Primary Completion
December 11, 2023
Study Completion
December 11, 2023
Last Updated
February 26, 2024
Record last verified: 2024-02
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, ANALYTIC CODE
- Time Frame
- By the paper's online publication date. Data will remain available for as long as the Open Science Framework hosts it.
- Access Criteria
- The data on the Open Science Framework will be open to anyone requesting that information.
Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency. This will include the essential data and code needed to replicate the analysis that yielded reported findings.