Decreasing ED Utilization by Nudging Patients to Call Their Providers

Not Applicable

Completed

• Conditions: Telephone Hotlines; Emergency Treatment
• Interventions: Behavioral: message; Behavioral: tele-nurse; Behavioral: provider

• Registration Number: NCT04567849
• Lead Sponsor: Geisinger Clinic

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).

Study Timeline

• Study First Submitted: 2020-09-23
• Study First Submitted QC: 2020-09-23
• Study First Posted: 2020-09-29
• Study Start: 2021-11-16
• Primary Completion: 2023-06-15
• Study Completion: 2023-06-15
• Status Verified: 2023-07
• Last Update Submitted: 2023-07-14
• Last Update Posted: 2023-07-18

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 11546

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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Nudge: call tele-nurse	message	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.
Nudge: call tele-nurse	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.
Nudge: call provider	message	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.
Nudge: call provider	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.

Primary Outcome Measures

Name	Time	Method
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
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

Name	Time	Method
Phone calls	12 months	Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment
ED utilization	12 months	Proportion of patients who visit the ED within 30 days of their appointment
Phone calls - surgical patients only	12 months	Proportion of patients who call the tele-nurse or their provider within 30 days of their appointment
ED utilization - surgical patients only	12 months	Proportion of patients who visit the ED within 30 days of their appointment

Trial Locations

Locations (1)

Geisinger; 🇺🇸 Danville, Pennsylvania, United States