The Role of Framing and Choice Architecture in Patients' Reactions and EHR Error Discovery and Reporting

NCT07206550 | Enrolling By Invitation

• 1 other identifier: IRB-26-19
• Study Type: interventional
• Target: 3,000
• Locations: 1 country
• Sites: 1

Brief Summary

The first goal of our research is to understand the effects of different wordings of certain messages on patients' engagement in reviewing their electronic health records (EHRs). These messages will be about EHR errors and their potential consequences, as well as the benefits that might accrue from reviewing EHRs. The second goal is to understand the effects of different wordings of certain messages on patients' discovery and reporting of potential errors in their electronic health records (EHRs). The main questions it aims to answer are:

1. 1.Does focusing on the negative OR positive consequences of EHR errors in the investigator's messages to people, increase their likelihood of reviewing their EHRs?
2. 2.Does focusing on the negative OR positive consequences of EHR errors in the investigators' messages to people, increase their likelihood of discovery and reporting of potential errors in their EHRs?

Conditions

Electronic Health Records

Keywords

Electronic Health Records; EHR error; error discovery; error reporting; patient portal

Outcome Measures

Primary Outcomes (1)

• Reviewing EHRs

  Whether or not a subject reviews their EHR

  From starting the initial survey through study completion, an average of 20 minutes

Secondary Outcomes (2)

• EHR error discovery

  From starting the initial survey through study completion, an average of 20 minutes

• EHR error reporting

  From starting the initial survey through study completion, an average of 20 minutes

Study Arms (13)

Control group

NO INTERVENTION

The participants in this arm will not receive any message, encouraging them to review their EHRs and report any potential errors.

Gain Framing x Egocentric x "Errors"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "errors", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an error in your EHR. This is a great opportunity to act as your own best advocate, check your EHRs to identify any potential errors, and improve your health outcomes."

Behavioral: Framing

Loss Framing x Egocentric x "Errors"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "errors", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an error in your EHR. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save yourself from experiencing the preventable negative consequences of having a potential error in your EHR."

Behavioral: Framing

Gain Framing x Allocentric x "Errors"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "errors", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an error in your EHR. Such errors can also affect those close to us not just ourselves. This is a great opportunity to act in the interest of your loved ones by improving your health outcomes via checking your EHRs to identify any potential errors. Your loved ones will thank you for prioritizing your safety."

Behavioral: Framing

Loss Framing x Allocentric x "Errors"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "errors", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an error in your EHR. Such errors can also affect those close to us not just ourselves. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save your loved ones from experiencing the preventable negative consequences of having a potential error in your EHR. Your loved ones will thank you for prioritizing your safety."

Behavioral: Framing

Gain Framing x Egocentric x "Unintended Mistakes"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "unintended mistakes", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an unintended mistake in your EHR. This is a great opportunity to act as your own best advocate, check your EHRs to identify any potential unintended mistakes, and improve your health outcomes."

Behavioral: Framing

Loss Framing x Egocentric x "Unintended Mistakes"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "unintended mistakes", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an unintended mistake in your EHR. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save yourself from experiencing the preventable negative consequences of having a potential unintended mistake in your EHR."

Behavioral: Framing

Gain Framing x Allocentric x "Unintended Mistakes"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "unintended mistakes", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an unintended mistake in your EHR. Such unintended mistakes can also affect those close to us not just ourselves. This is a great opportunity to act in the interest of your loved ones by improving your health outcomes via checking your EHRs to identify any potential unintended mistakes. Your loved ones will thank you for prioritizing your safety."

Behavioral: Framing

Loss Framing x Allocentric x "Unintended Mistakes"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "unintended mistakes", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an unintended mistake in your EHR. Such unintended mistakes can also affect those close to us not just ourselves. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save your loved ones from experiencing the preventable negative consequences of having a potential unintended mistake in your EHR. Your loved ones will thank you for prioritizing your safety."

Behavioral: Framing

Gain Framing x Egocentric x "Inaccuracies"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "inaccuracies", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an inaccuracy in your EHR. This is a great opportunity to act as your own best advocate, check your EHRs to identify any potential inaccuracies, and improve your health outcomes."

Behavioral: Framing

Loss Framing x Egocentric x "Inaccuracies"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "inaccuracies", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an e inaccuracy in your EHR. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save yourself from experiencing the preventable negative consequences of having a potential inaccuracy in your EHR."

Behavioral: Framing

Gain Framing x Allocentric x "Inaccuracies"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "inaccuracies", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an inaccuracy in your EHR. Such inaccuracies can also affect those close to us not just ourselves. This is a great opportunity to act in the interest of your loved ones by improving your health outcomes via checking your EHRs to identify any potential inaccuracies. Your loved ones will thank you for prioritizing your safety."

Behavioral: Framing

Loss Framing x Allocentric x "Inaccuracies"

ACTIVE COMPARATOR

The participants in this arm will receive the following message using the term "inaccuracies", encouraging them to review their EHRs and report any potential errors: "If you review your medical record, there is a 20% risk of having an inaccuracy in your EHR. Such inaccuracies can also affect those close to us not just ourselves. Taking no action could lead to severe health-related consequences and occasionally be deadly. Act now and save your loved ones from experiencing the preventable negative consequences of having a potential inaccuracy in your EHR. Your loved ones will thank you for prioritizing your safety."

Behavioral: Framing

Interventions

Framing BEHAVIORAL

The participants will receive different messages using different terms and behavioral framings, encouraging them to review their EHRs and report any potential errors. These wording variations are expected to induce variance in subjects' behaviors with regard to the likelihood of reviewing EHRs, as well as discovering and reporting potential errors in them.

Gain Framing x Allocentric x "Errors"; Gain Framing x Allocentric x "Inaccuracies"; Gain Framing x Allocentric x "Unintended Mistakes"; Gain Framing x Egocentric x "Errors"; Gain Framing x Egocentric x "Inaccuracies"; Gain Framing x Egocentric x "Unintended Mistakes"; Loss Framing x Allocentric x "Errors"; Loss Framing x Allocentric x "Inaccuracies"; Loss Framing x Allocentric x "Unintended Mistakes"; Loss Framing x Egocentric x "Errors"; Loss Framing x Egocentric x "Inaccuracies"; Loss Framing x Egocentric x "Unintended Mistakes"

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Subjects should have access to their patient portal
• Subjects should have checked their EHR in the past 12 months

You may not qualify if:

• Not having access to their patient portal
• Not having checked their EHR in the past 12 months

Sponsors & Collaborators

• The University of Texas at Dallas: lead
• University of Pennsylvania: collaborator
• Virginia Polytechnic Institute and State University: collaborator

Study Sites (1)

Naveen Jindal School of Management, The University of Texas at Dallas

Richardson, Texas, 75080, United States

Location

Study Officials

• Ryan Raimi, PhD

  The University of Texas at Dallas

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: OTHER
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Information Systems

Study Record Dates

• First Submitted: September 18, 2025
• First Posted: October 3, 2025
• Study Start: November 26, 2025
• Primary Completion: April 30, 2026
• Study Completion (Estimated): May 10, 2026
• Last Updated: March 13, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF, ANALYTIC CODE
• Time Frame: Start Date: 6 months after publication of the primary results End Date: 2 years after publication
• Access Criteria: Qualified researchers affiliated with academic institutions, nonprofit organizations, or government agencies will be eligible to request access to the de-identified individual participant data (IPD) and supporting documentation (including the study protocol, statistical analysis plan, informed consent form, and analytic code). Access will be granted to researchers who submit a methodologically sound proposal outlining the intended use of the data. Proposals will be reviewed by the study's principal investigators to assess scientific merit, alignment with ethical standards, and feasibility. Approved researchers will be required to sign a data use agreement to ensure responsible handling of the data and protection of participant confidentiality. Upon approval, data and supporting materials will be shared via a secure online repository or encrypted file transfer.

Locations

US (1)