Electronic Health Record Sharing System (eHRSS) Encounter Notification Service Pilot Project

Study Overview
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Brief Summary
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This study evaluates the value of the automated notification service that allows more timely information access and sharing. A 12-month RCT will be conducted to determine the efficacy of the provision of the service to an elderly care and service provider in improving care and health outcomes of the elderly. Researchers will also examine whether the notification service will better support the carers for the coordination and prioritization of care and service delivery.

Detailed Description
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A research team at the University of Hong Kong is commissioned to conduct a study of the efficacy of providing an automated notification service, i.e., the Encounter Notification Service, via the Electronic Health Record Sharing System (eHRSS) to an elderly caring and service provider that aims to facilitate more timely provision and coordination of healthcare services for home-dwelling elderly. With the access to the automated notification service containing up-to-date encounter information of the elderly in the eHRSS (e.g. discharge date from the public hospital, outpatient appointments), it is expected that the elderly caring and service provider can improve its allocation of resources and prioritize the provision of service to elderly patients who are in need, i.e., during the transition of care. As a result, the caring support and services provided by the elderly caring and service provider to the elderly can be more timely and effective, and an improvement in patient health outcomes can be expected. To obtain evidence to determine the value of the automated notification service, a systematic study of the efficacy is suggested. Thus, researchers set out to conduct a 12-month randomized controlled trial (RCT) to examine whether the provision of the automated notification service to the caring and service provider will result in improvements in care and health outcomes of the elderly. Also, researchers will assess whether the notification service will better support the carers for the coordination and prioritization of care and service provision and improve workflow and administrative procedures amongst different sectors. In this pilot study, the Senior Citizen Home Safety Association (SCHSA) is the participated elderly caring and service provider.

Official Title
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Efficacy of Providing an Automated Notification Service, the Encounter Notification Service Via the eHRSS for Home-based Care and Services Provided by Community Healthcare Providers for the Elderly: A 12-month Randomized Controlled Trial

Conditions
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Home-dwelling Elderly, Health Care Recipient

Intervention / Treatment
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* Behavioral: Encounter notification service


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: are aged 18 years or older have registered in eHRSS as healthcare recipients and given consent for sharing their records in the eHRSS with the SCHSA are able to understand spoken Cantonese Exclusion Criteria: with mental incapacity with hearing difficulties

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Encounter notification service<br>For participants randomized to the intervention group, their encounter information stored in the eHRSS will be provided to the SCHSA via the automated notification service. Healthcare professionals of the SCHSA would access the electronic health record and provide caring support and services via telephone calls during the 12-month study period. | Behavioral: Encounter notification service<br>* The caring support and services provided by SCHSA will consist of multiple components, including standard call & care center support, medical appointment reminder, assistance to reschedule appointment, follow-up calls with either nurse or health workers to monitor health situation of service recipients, assessing needs of service recipient for elderly home care and/or rehabilitation services, providing elderly home care and/or rehabilitation services based on assessment, assessing needs of service recipient for emotional and community support, providing additional emotional support via either social calls by volunteers or counseling by social workers, and making referrals for community support services.<br>|
| No Intervention: Usual care service<br>For participants randomized in the control group, no notification will be sent to the SCHSA. Usual care service will be provided during the 12-month study period. In addition, each control participant will receive placebo phone calls at least once every three months (e.g., the calls could be about greeting and general checking). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| changes in the number of Accident and Emergency (A&E) visits |  | from baseline to 6 and 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| changes in the number of non-attendance to outpatient appointments |  | from baseline to 6 and 12 months | 
| changes in the number of unplanned hospitalizations |  | from baseline to 6 and 12 months | 
| changes in the number of 30-day unplanned readmissions |  | from baseline to 6 and 12 months | 
| changes in the stability of health condition | measured by a questionnaire with items on a 5-point Likert scale ranging from 1 (worse outcome) to 5 (better outcome) | from baseline to 6 and 12 months | 
| changes in the understanding of the arrangement of outpatient appointments | measured by a questionnaire with items on a 5-point Likert scale ranging from 1 (worse outcome) to 5 (better outcome) | from baseline to 6 and 12 months | 
| changes in the elderly's perceptions of the services | measured by a questionnaire with items on a 5-point Likert scale ranging from 1 (worse outcome) to 5 (better outcome) | from baseline to 6 and 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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automated notification service, community healthcare providers, randomized controlled trial