Clinical trial NCT04604457: Impact of Predictive Modeling on Time to Palliative Care in an Outpatient Primary Care Population
Official title: Impact of Predictive Modeling on Time to Palliative Care in an Outpatient Primary Care Population
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Palliative Care
Keywords: machine learning
predictive model
palliative care
Lead sponsor: Mayo Clinic
Sponsor class: OTHER
First posted: 2020-10-27
Enrollment: 127070
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Intervention model description: Step-wedge design with 7 wedges: the first wedge has all primary care teams in the standard of care arm; every six weeks one or two care teams switch to the intervention arm.
Primary purpose: SCREENING

Brief summary: A machine learning algorithm will be used to accurately identify patients in certain primary care units who may benefit from palliative care consults.

Detailed description: A machine learning algorithm will be used to accurately identify patients in certain primary care units who may benefit from palliative care consults. These patients will be presented weekly to a palliative care specialist in a custom user interface. The palliative care specialist will reach out to primary care teams if she determines that the patient would benefit from palliative care. If the primary care provider agrees, he/she would write a palliative care consult order for the patient. The goal is to reduce the time to palliative care for these patients, who may not have been identified as quickly without the algorithm.

Eligibility criteria: Inclusion Criteria:

* Adult patient assigned to a primary care unit from July 2020 to June 2021.
* Weekly the palliative care specialists will select patients by looking at patients in sorted order starting with the highest score and proceeding down the list and evaluating each patient for exclusion criteria.

Exclusion Criteria:

* Patients that have been seen by Palliative care will be excluded for 75 days
* Patients under the age of 18 years.
* Patients currently enrolled with hospice

Primary outcomes:
measure: Timely identification for need of palliative care
timeFrame: Through study completion, an average of 1 year
Secondary outcomes:
measure: Number of palliative care consults
timeFrame: Through study completion, an average of 1 year
measure: Number of advanced care planning notes documented in the EHR
timeFrame: Through study completion, an average of 1 year
measure: Number of billing codes for palliative care
timeFrame: Through study completion, an average of 1 year
measure: Positive predictive value of screened patients
timeFrame: Through study completion, an average of 1 year
measure: Percent of patients who are eligible for ECH based palliative care
timeFrame: Through study completion, an average of 1 year
measure: Percent agreement between Palliative Care and Primary Care and average time between Primary Care Contact and Response
timeFrame: Through study completion, an average of 1 year
Other outcomes:
Locations:
city: Rochester
country: United States
facility: Mayo Clinic in Rochester
state: Minnesota
Study officials:
affiliation: Mayo Clinic
name: Rachel Havyer, MD
role: PRINCIPAL_INVESTIGATOR
References: