Clinical trial NCT06655974: Predictive Modeling for Social Needs in Emergency Department Settings
Official title: Protocol for Evaluating the Effectiveness of a Clinical Decision Support System With Prediction Modeling to Identify Patients With Health-related Social Needs in the Emergency Department
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Emergency Service, Hospital
Social Determinants of Health
Keywords: informatics
Lead sponsor: Indiana University
Sponsor class: OTHER
First posted: 2024-10-24
Enrollment: 48000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The intervention will be at the ED level using a pre-post design with a matched comparison group.
Primary purpose: HEALTH_SERVICES_RESEARCH

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.


Eligibility criteria: Inclusion Criteria:

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

Exclusion Criteria:

* 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

Primary outcomes:
measure: Percent of emergency department encounters screened for health-related social needs (HRSNs)
timeFrame: At time of emergency department encounter (or within 24 hours)
measure: Percent of emergency department encounters that were referred for health-related social needs (HRSNs) services
timeFrame: At time of emergency department encounter (or within 24 hours)
Secondary outcomes:
measure: Percent of encounters with an emergency department revisit measured at 3 days
timeFrame: within 3 days of emergency department encounter
measure: Percent of encounters with an emergency department revisit measured at 7 days
timeFrame: within 7 days of emergency department encounter
measure: Percent of encounters with an emergency department revisit measured at 30 days
timeFrame: within 30 days of emergency department encounter
measure: Percent of emergency department encounters with primary care visit within 7 days of an ED encounter
timeFrame: within 7 days of emergency department visit
Other outcomes:
measure: Percent of emergency department encounters where the health-related social needs (HRSN) decision support system intervention was accessed.
timeFrame: At time of emergency department encounter (or within 24 hours)
measure: Percent of emergency department encounters where the clinical decision support platform was accessed
timeFrame: At time of emergency department encounter(or within 24 hours)
Locations:
city: Indianapolis
country: United States
facility: Indiana University Health
state: Indiana
Study officials:
affiliation: Indiana University
name: Joshua R Vest, PhD,MPH
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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.