CMSL Ambulatory Sensitive Condition Nudge Study 2

NCT07028398 | Recruiting

• 1 other identifier: 2023-1716-2
• Study Type: interventional
• Target: 12,990
• Locations: 1 country
• Sites: 1

Brief Summary

The project aims to evaluate a nurse-led intervention to reduce inappropriate emergency department (ED) use among adult patients seen at Geisinger's Community Medicine Service Line (CMSL) clinics. The intervention occurs immediately following an appointment where a patient receives a diagnosis of an ambulatory sensitive condition (ASC; i.e., a condition considered to be a risk factor for near-term ED use). The evaluation will compare eligible patients with an ASC who were randomly assigned to receive follow-up outreach (patient portal message and/or call) from a nurse (who was automatically prompted via the Epic electronic health record system to initiate outreach) with those who were randomly assigned to receive standard care. Analyses will be intent-to-treat. The primary outcome is ED use in the week (i.e., 7 days) following the appointment. We ran an earlier version of this intervention (NCT06798389). The current study is modified based on results and clinical guidance. Specifically, more conditions will be included as qualifying ASCs for enrollment. Patients under 30 will be excluded. And rather than calling all patients as in the original study, patient portal users may be contacted via the portal instead of or in addition to a phone call. Finally, in the first study, the intervention was differentially effective by age group (\<45, 45-64, 65+). Our primary analysis will be conducted separately by age group, though we will also conduct an analysis combining across age groups. We will run the study until we reach at least 4,330 patients in each of the following age groups: patients aged 30-45, patients aged 45-64, patients aged 65+. Therefore, our estimated sample size is at least 4,330x3 = 12,990. We may be required to do an interim data pull and/or stop the study early at the direction of clinical or operational leaders.

Conditions

Behavioral Intervention; Emergency Department Visits; Nurse Care Coordination

Keywords

Nudge

Outcome Measures

Primary Outcomes (1)

• ED Visit (yes/no)

  Visited the ED (y/n)

  within 7 days post-appointment

Other Outcomes (3)

• Nurse call to patient

  Within 7 days post-appointment

• Nurse message to patient

  Within 7 days post-appointment

• Nurse calls or sends message to patient

  Within 7 days post-appointment

Study Arms (2)

Nurse Nudge

EXPERIMENTAL

Nurses in CMSL clinics will receive a notification to provide follow-up outreach (calls and/or patient portal messages) to patients after the patient receives an ambulatory sensitive diagnosis.

Behavioral: Nurse Nudge

Control

NO INTERVENTION

Nurses in CMSL clinics will receive standard follow- up notifications, which may mean no notifications, after a patient has received an ambulatory sensitive diagnosis.

Interventions

Nurse Nudge BEHAVIORAL

Nurses will be nudged to contact patients, which may increase the likelihood that the patient receives a post- appointment follow-up call and/or portal message.

Nurse Nudge

Eligibility Criteria

• Age: 30 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age 30 years +
• Has a qualifying visit in CMSL with an ambulatory sensitive condition (ASC) encounter diagnosis

Sponsors & Collaborators

• Geisinger Clinic: lead

Study Sites (1)

Geisinger

Danville, Pennsylvania, 17821, United States

RECRUITING

Central Study Contacts

Amir Goren, PhD

CONTACT

570-214-3495; agoren@geisinger.edu

Study Design

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

Study Record Dates

• First Submitted: June 11, 2025
• First Posted: June 19, 2025
• Study Start: May 29, 2025
• Primary Completion (Estimated): July 31, 2026
• Study Completion (Estimated): July 31, 2026
• Last Updated: February 11, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)