Clinical trial NCT04567849: Decreasing ED Utilization by Nudging Patients to Call Their Providers
Official title: Decreasing ED Utilization by Nudging Patients to Call Their Provider or Triage Nurse After Women's Health Procedures
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Emergency Treatment
Telephone Hotlines
Keywords: Behavioral Economics
Patient Portal
Lead sponsor: Geisinger Clinic
Sponsor class: OTHER
First posted: 2020-09-29
Enrollment: 11546
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Throughout the study, patients will be randomized equally across all three arms.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: In the present study, patients will be sent a message shortly after completing a medical procedure that informs or reminds them that they can reach out to Geisinger, and how to do it, if they have any medical issues or concerns. Researchers will assess if such messages make patients more likely to contact Geisinger with post-procedure medical concerns and decrease emergency department utilization.

Detailed description: Decreasing emergency department (ED) over-utilization is a priority for healthcare systems across the country. Patients uncertain about a medical issue routinely end up in the ED when less costly and time-consuming alternatives could have addressed their concern. If patients reach out to healthcare facilities rather than heading directly to the ED, they can often be directed toward resources better suited to their concerns than the ED.

Geisinger is thus working to encourage patients to contact healthcare providers if any concerns arise and patients are uncertain about where to go for care. Patients who have recently had a medical procedure may be particularly valuable to encourage, as they routinely have concerns related to the procedure and discharge can serve as a useful touch-point to remind the patient where they can go for questions or concerns.

In the present study, patients will be sent a patient portal message shortly after completing any Women's Health medical procedure. The message will inform or remind patients how they can reach Geisinger if they have any medical issues or concerns. The purpose of this study is to assess if such messages make patients more likely to contact Geisinger with medical concerns and, in turn, decrease unnecessary ED utilization. This study will A/B test 2 messages, encouraging patients to either call their recent provider directly or to call a tele-nurse hotline, and will assess if these messages perform better than a control group that will not be sent any such message.

Generalized linear models will examine the primary study outcomes as a function of the study arms (between-subjects).

Eligibility criteria: Inclusion Criteria:

* Patient had a procedure in Women's Health within the study period (including both surgical and in-office procedures as well as baby delivery)
* Patient is enrolled in myGeisinger, Geisinger's patient portal

Exclusion Criteria:

* If procedure was labor that resulted in fetal demise or stillborn.

Primary outcomes:
measure: Phone calls
timeFrame: 18 months or as long as it takes to reach N=17,300, whichever occurs first
measure: ED utilization
timeFrame: 18 months or as long as it takes to reach N=17,300, whichever occurs first
Secondary outcomes:
measure: Phone calls
timeFrame: 12 months
measure: ED utilization
timeFrame: 12 months
measure: Phone calls - surgical patients only
timeFrame: 18 months or as long as it takes to reach N=17,300, whichever occurs first
measure: ED utilization - surgical patients only
timeFrame: 18 months or as long as it takes to reach N=17,300, whichever occurs first
measure: Phone calls - surgical patients only
timeFrame: 12 months
measure: ED utilization - surgical patients only
timeFrame: 12 months
Other outcomes:
Locations:
city: Danville
country: United States
facility: Geisinger
state: Pennsylvania
Study officials:
affiliation: Geisinger Clinic
name: Amir Goren, PhD
role: PRINCIPAL_INVESTIGATOR
References: