Decreasing ED Utilization by Nudging Patients to Call Their Providers

Sponsor
Geisinger Clinic (Other)
Overall Status
Enrolling by invitation
CT.gov ID
NCT04567849
Collaborator
(none)
17,300
1
3
17.4
991.7

Study Details

Study Description

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.

Condition or Disease Intervention/Treatment Phase
  • Behavioral: message
  • Behavioral: provider
  • Behavioral: tele-nurse
N/A

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).

Study Design

Study Type:
Interventional
Anticipated Enrollment :
17300 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Intervention Model Description:
Throughout the study, patients will be randomized equally across all three arms.Throughout the study, patients will be randomized equally across all three arms.
Masking:
Double (Participant, Care Provider)
Masking Description:
Participants (i.e., patients) will not be informed specifically of their assignment to different arms throughout the study. Providers will not be randomized to study arms or informed of patient assignment.
Primary Purpose:
Health Services Research
Official Title:
Decreasing ED Utilization by Nudging Patients to Call Their Provider or Triage Nurse After Women's Health Procedures
Actual Study Start Date :
Nov 16, 2021
Anticipated Primary Completion Date :
May 1, 2023
Anticipated Study Completion Date :
May 1, 2023

Arms and Interventions

Arm Intervention/Treatment
No Intervention: Control

No intervention control group

Experimental: Nudge: call provider

This group will receive a patient portal message the morning after completing their procedure. The message will encourage patients to call their recent Women's Health provider (with appropriate phone number listed) if any questions or concerns arise about their healthcare.

Behavioral: message
patient portal message

Behavioral: provider
nudging calling the patient's provider

Experimental: Nudge: call tele-nurse

This group will receive a patient portal message the morning after completing their procedure. The message will encourage patients to call Geisinger's nurse triage hotline (with appropriate phone number listed) if any questions or concerns arise about their healthcare.

Behavioral: message
patient portal message

Behavioral: tele-nurse
nudging calling the tele-nurse

Outcome Measures

Primary Outcome Measures

  1. Phone calls [18 months or as long as it takes to reach N=17,300, whichever occurs first]

    Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment

  2. ED utilization [18 months or as long as it takes to reach N=17,300, whichever occurs first]

    Proportion of patients who visit the ED within 30 days of their appointment

Secondary Outcome Measures

  1. Phone calls [12 months]

    Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment

  2. ED utilization [12 months]

    Proportion of patients who visit the ED within 30 days of their appointment

  3. Phone calls - surgical patients only [18 months or as long as it takes to reach N=17,300, whichever occurs first]

    Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment

  4. ED utilization - surgical patients only [18 months or as long as it takes to reach N=17,300, whichever occurs first]

    Proportion of patients who visit the ED within 30 days of their appointment

  5. Phone calls - surgical patients only [12 months]

    Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment

  6. ED utilization - surgical patients only [12 months]

    Proportion of patients who visit the ED within 30 days of their appointment

Eligibility Criteria

Criteria

Ages Eligible for Study:
N/A and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
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.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Geisinger Danville Pennsylvania United States 17822

Sponsors and Collaborators

  • Geisinger Clinic

Investigators

  • Principal Investigator: Amir Goren, PhD, Geisinger Clinic

Study Documents (Full-Text)

More Information

Publications

None provided.
Responsible Party:
Amir Goren, Program Director, Behavioral Insights Team, Geisinger Clinic
ClinicalTrials.gov Identifier:
NCT04567849
Other Study ID Numbers:
  • 2020-0849
First Posted:
Sep 29, 2020
Last Update Posted:
Apr 5, 2022
Last Verified:
Mar 1, 2022
Individual Participant Data (IPD) Sharing Statement:
Yes
Plan to Share IPD:
Yes
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Amir Goren, Program Director, Behavioral Insights Team, Geisinger Clinic
Additional relevant MeSH terms:

Study Results

No Results Posted as of Apr 5, 2022