Nudging High-acuity Emergency Department Patients to Schedule a Follow-up Visit

NCT06535347 | Completed

• 1 other identifier: 2024-0412
• Study Type: interventional
• Target: 6,814
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this campaign is to reduce unnecessary emergency department (ED) visits by encouraging patients with high acuity visits to follow up with an appropriate primary care provider (PCP) or specialist and therefore obtain appropriate care outside of the ED. In this campaign, patients will be assigned to receive or not receive outreach following ED discharge that is aligned with the goal. Outreach will occur via a text message and information added to the patient's after visit summary, and will include a contact number to schedule and hyperlink to allow self-scheduling. The study will assess whether ED use differs across patients in different outreach conditions. It will also examine whether patients followed through on the calls to action in the messages differently across conditions.

Conditions

Emergency Service, Hospital

Outcome Measures

Primary Outcomes (1)

• Return to ED

  ED visit (yes/no)

  within 120 days following day of discharge

Other Outcomes (8)

• PCP/specialist appointment made

  within 7 days following day of discharge

• PCP/specialist appointment made

  within 14 days following day of discharge

• PCP/specialist appointment made

  within 30 days following day of discharge

Study Arms (3)

Control

NO INTERVENTION

This arm will receive no intervention outside of usual care.

Experimental: Schedule Follow-Up Visit - 1 message

EXPERIMENTAL

This arm will receive a text message (at 1 day post-ED discharge) and information added to the patient's after visit summary providing a number and patient portal hyperlink via which to schedule an ED follow-up appointment.

Behavioral: Information about scheduling a follow-up appointment

Experimental: Schedule Follow-Up Visit - 2 messages

EXPERIMENTAL

This arm will receive text messages (at 1 day and 8 days post-ED discharge) and information added to the patient's after visit summary providing a number and patient portal hyperlink via which to schedule an ED follow-up appointment.

Behavioral: Information about scheduling a follow-up appointment

Interventions

Information about scheduling a follow-up appointment BEHAVIORAL

Text message(s) will be sent following discharge from the emergency department, along with an after visit summary.

Also known as: Text messages, Information

Experimental: Schedule Follow-Up Visit - 1 message; Experimental: Schedule Follow-Up Visit - 2 messages

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• \>= 18 years of age
• ED visit rated as high acuity (level L2 or L3)
• Discharged from ED in past 24 hours
• Attributed to a Geisinger PCP in Community Medicine Service Line

You may not qualify if:

• Have an appointment scheduled within 7 days following discharge with a primary care provider or specialist
• Institutionalized
• Cannot be contacted via the communication modality being used in the study (i.e., SMS), due to insufficient/missing contact information in the electronic health record or because the patient opted out
• Admitted to hospital
• Eloped from ED
• Left ED without being seen
• Deceased prior to messaging

Sponsors & Collaborators

• Geisinger Clinic: lead

Study Sites (1)

Geisinger Health System

Danville, Pennsylvania, 17822, United States

Location

MeSH Terms

Conditions

Emergencies

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Amir Goren, PhD

  Geisinger Clinic

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Masking Details: Patients will be aware of their own messages but will not be aware of other messages.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: ‪Program Director, Behavioral Insights Team

Study Record Dates

• First Submitted: July 8, 2024
• First Posted: August 2, 2024
• Study Start: August 9, 2024
• Primary Completion: April 6, 2025
• Study Completion: April 6, 2025
• Last Updated: June 5, 2025

Record last verified: 2025-06

Locations

US (1)