Predictive Modeling for Social Needs in Emergency Department Settings

NCT06655974 | Completed

• 1 other identifier: 2011558232
• Study Type: interventional
• Target: 518,512
• Locations: 1 country
• Sites: 1

Brief Summary

The overall objective of this study is to support emergency department management of patients' health-related social needs. This study will measure the impact of a decision support system that informs clinicians about which patients are likely to screen positive for a health-related social need. The system uses statistical models to create a health-related social need risk score for each patient. The main questions, the study aims to answer are:

• Does providing emergency department clinicians with risk scores on health-related social needs increase screening and referral activities?
• Does providing emergency department clinicians with risk scores on health-related social needs change patients' use of healthcare services? The decision support system with health-related social needs risk scores will be introduced for all adult patients at one emergency department. Screening rates, referrals, and subsequent healthcare encounters will be compared with emergency departments that did not have access to the decision support system.

Conditions

Emergency Service, Hospital; Social Determinants of Health

Keywords

informatics

Outcome Measures

Primary Outcomes (2)

• Percent of emergency department encounters screened for health-related social needs (HRSNs)

  The numerator will be an emergency department encounter with any indication of HRSN screening using any tool or questionnaire, regardless of patient completion or results. The denominator will be all eligible ED encounters.

  At time of emergency department encounter (or within 24 hours)

• Percent of emergency department encounters that were referred for health-related social needs (HRSNs) services

  The numerator will be emergency department encounters with a referral to social worker, case management, community health workers, or related services within 24 hours of the ED encounter. The denominator will be all eligible ED encounters

  At time of emergency department encounter (or within 24 hours)

Secondary Outcomes (4)

• Percent of encounters with an emergency department revisit measured at 3 days

  within 3 days of emergency department encounter

• Percent of encounters with an emergency department revisit measured at 7 days

  within 7 days of emergency department encounter

• Percent of encounters with an emergency department revisit measured at 30 days

  within 30 days of emergency department encounter

• Percent of emergency department encounters with primary care visit within 7 days of an ED encounter

  within 7 days of emergency department visit

Other Outcomes (2)

• Percent of emergency department encounters where the health-related social needs (HRSN) decision support system intervention was accessed.

  At time of emergency department encounter (or within 24 hours)

• Percent of emergency department encounters where the clinical decision support platform was accessed

  At time of emergency department encounter(or within 24 hours)

Study Arms (2)

Decision support intervention group

EXPERIMENTAL

Adult ED patients seeking care the ED site with the health-related social needs decision support system live.

Other: Health-related social needs decision support system

Comparison group

NO INTERVENTION

Adult ED patients created using statistical matching from ED sites in the same metropolitan area.

Interventions

Health-related social needs decision support system OTHER

The clinical decision support intervention will present emergency department clinicians at an Indianapolis, IN ED with a likelihood score for an adult patient screening positive for the following health-related social needs (HRSNs): housing instability, food insecurity, transportation barriers, financial strain, and history of legal involvement. For each HRSN, the likelihood of screening positive is reported as "high", "medium", or "low". These categorizations are the product of logistic regression models. The clinical decision support intervention will be delivered through an existing FHIR (Fast Healthcare Interoperability Resources) standards-based clinical decision support platform.

Decision support intervention group

Eligibility Criteria

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

You may qualify if:

• Adults (\>18 years old)
• Seeking care at Indianapolis, Indiana area emergency departments (EDs).

You may not qualify if:

• Children
• Encounters by patients that present with a critical illness/injury (e.g. severe trauma patients or those with Emergency Severity Index (ESI) classification level 1)
• Encounters by patients who have been transferred from another inpatient facility
• Patients that die during the ED encounter
• Encounters among patients who were ultimately admitted during their ED visits from our analysis

Sponsors & Collaborators

• Indiana University: lead

Study Sites (1)

Indiana University Health

Indianapolis, Indiana, 46202, United States

Location

Related Publications (2)

• Mazurenko O, Hirsh AT, Harle CA, McNamee C, Vest JR. Acceptance of Automated Social Risk Scoring in the Emergency Department: Clinician, Staff, and Patient Perspectives. West J Emerg Med. 2024 Jul;25(4):614-623. doi: 10.5811/westjem.18577.

  PMID: 39028248 BACKGROUND

• Mazurenko O, Harle CA, Blackburn J, Menachemi N, Hirsh A, Grannis S, Boustani M, Musey PI Jr, Schleyer TK, Sanner LM, Vest JR. Effectiveness of a clinical decision support system with prediction modeling to identify patients with health-related social needs in the emergency department: Study protocol. PLoS One. 2025 May 12;20(5):e0323094. doi: 10.1371/journal.pone.0323094. eCollection 2025.

  PMID: 40354398 DERIVED

MeSH Terms

Conditions

Emergencies

Condition Hierarchy (Ancestors)

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

Study Officials

• Joshua R Vest, PhD,MPH

  Indiana University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: The intervention will be at the ED level using a pre-post design with a matched comparison group.

Study Record Dates

• First Submitted: August 23, 2024
• First Posted: October 24, 2024
• Study Start: March 10, 2025
• Primary Completion: December 1, 2025
• Study Completion: December 1, 2025
• Last Updated: March 31, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)