Impact of Social Risk Decision Support

Sponsor

Indiana University (Other)

Overall Status

Withdrawn

CT.gov ID

NCT03973346

Collaborator

Robert Wood Johnson Foundation (Other)

Enrollment

Location

Arms

Actual Duration (Months)

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of this study is to determine the impact of embedding a risk-stratification tool, designed to identify patient needs for services that address social determinant of health related needs, in a commercial electronic health record system (EHR).

Condition or Disease	Intervention/Treatment	Phase
Health Social Determinant	Other: Risk screening tool exposure	N/A

Detailed Description

Social determinant of health related needs and social risk factors complicate care delivery and drive health and well-being. Social needs are common among undeserved patient populations, but health care providers are often not equipped to routinely identify and address patients in need.

Using a combination of health information exchange, electronic health record, and aggregate datasets the investigators developed predictive algorithms to identify patients a highest risk for a need for a referral to a social worker, dietitian, behavioral health, or other wraparound service provider. Risk scores are available to primary care providers in two ways within the electronic health record system (EHR): 1) a graphical summary of individual risk or 2) a line listing of all scheduled patients.

The investigators are introducing the risk-stratification tool in an urban safety-net primary care provider on a voluntary usage basis.

Study Design

Study Type:

Interventional

Actual Enrollment :

0 participants

Allocation:

Non-Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

Multiple observation, pre-post with a secondary data source comparison group design, and a difference-in-difference modeling approach.Multiple observation, pre-post with a secondary data source comparison group design, and a difference-in-difference modeling approach.

Masking:

None (Open Label)

Primary Purpose:

Screening

Official Title:

Improving Population and Clinical Health With Integrated Services and Advanced Analytics

Actual Study Start Date :

Jun 1, 2019

Actual Primary Completion Date :

Dec 31, 2020

Actual Study Completion Date :

Dec 31, 2020

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Intervention group Encounters at primary care clinics with the risk screening tool	Other: Risk screening tool exposure Risk screening tool is available to providers
No Intervention: Comparison group Propensity score matched comparison encounters

Arm

Intervention/Treatment

Experimental: Intervention group

Encounters at primary care clinics with the risk screening tool

Other: Risk screening tool exposure

Risk screening tool is available to providers

No Intervention: Comparison group

Propensity score matched comparison encounters

Outcome Measures

Primary Outcome Measures

ED utilization rate [6 months]
Rate of potentially avoidable emergency department utilization as determined by encounters recorded in health information exchange data and categorized using the NYU ED Algorithm.
Missed primary care appointments rate [6 months]
Rate of no show / cancelled appointments at the intervention site primary care clinics as recorded in the intervention site's electronic health record system

Secondary Outcome Measures

Hospitalization rate [6 months]
Rate of all cause and potentially preventable hospitalization as determined by encounters recorded in health information exchange data and categorized using AHRQ's prevention quality indicator definitions

Eligibility Criteria

Criteria

Ages Eligible for Study:

N/A and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

Encounters among patients seeking primary care service at any of the 9 Eskenazi Health FQHC clinics in Indianapolis, IN from January 2017 to May 2020.
The propensity score matched primary care encounters from non-Eskenazi facilities.

Exclusion Criteria:

Emergency encounters or hospitalizations

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Eskenazi Health	Indianapolis	Indiana	United States	46202

Sponsors and Collaborators

Indiana University
Robert Wood Johnson Foundation

Investigators

Principal Investigator: Joshua R Vest, PhD, Associte Professor

Study Documents (Full-Text)

None provided.

More Information

Publications

Responsible Party:

Joshua R. Vest, PhD, Associate Professor & Center Director, Indiana University

ClinicalTrials.gov Identifier:

NCT03973346

Other Study ID Numbers:

VEST-RWJF-PHASE2

First Posted:

Jun 4, 2019

Last Update Posted:

Feb 10, 2021

Last Verified:

Feb 1, 2021

Individual Participant Data (IPD) Sharing Statement:

Plan to Share IPD:

Studies a U.S. FDA-regulated Drug Product:

Studies a U.S. FDA-regulated Device Product:

Keywords provided by Joshua R. Vest, PhD, Associate Professor & Center Director, Indiana University

risk prediction

Study Results

No Results Posted as of Feb 10, 2021