Application of Behavioral Economics to Improve the Quality and Value of eConsult Specialty Reviews
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 220
- Locations
- 2
- Primary Endpoint
- Rating - Medical Decision Making
Study Overview
Brief Summary
Using behavioral economics, the study objective is to increase the efficiency, quality, and timeliness of care for Los Angeles County (LAC) Department of Health Services (DHS) patients by nudging specialists toward more effective use of eConsult, a web-based consultation and communication portal for Primary Care Providers (PCPs) and specialists, improving access for patients in greatest need of specialty care.
Detailed Description
Historically, the Los Angeles County (LAC) Department of Health Services (DHS) Safety Net system has faced challenges in delivering specialty services that are timely, geographically equitable, and coordinated in a patient centered manner. Recently, LACDHS improved infrastructure through implementation of eConsult, a web-based consultation and communication portal for Primary Care Providers (PCPs) and specialists, improving access for patients in greatest need of specialty care. The study investigators will conduct a pragmatic randomized trial with the goal of increasing the efficiency, quality, and timeliness of care for LACDHS patients by nudging specialists toward more effective use of eConsult. If successful, these nudges may reduce the number and increase the value of face-to-face consults.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Health Services Research
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •LACDHS providers who are eConsult system users
Exclusion Criteria
- Not provided
Arms & Interventions
Rating tool only
Rating eConsults from peer specialists in first phase
Intervention: Rating tool (Behavioral)
Feedback only
Receiving feedback from peer specialists in first phase
Intervention: Feedback (Behavioral)
Rating Tool plus Feedback
Both rating and feedback in second phase.
Intervention: Rating tool (Behavioral)
Rating Tool plus Feedback
Both rating and feedback in second phase.
Intervention: Feedback (Behavioral)
Outcomes
Primary Outcomes
Rating - Medical Decision Making
Time Frame: Baseline to Post-Intervention, up to 12 months
Peers' ratings of Medical Decision Making in Specialists' responses to PCPs
Rating - Relationship Building
Time Frame: Baseline to Post-Intervention, up to 12 months
Peers' ratings Relationship Building in Specialists' responses to PCPs
Rating - Application of Expected Practices
Time Frame: Baseline to Post-Intervention, up to 12 months
Peers' ratings of Expected Practices in Specialists' responses to PCPs
Rating - Expert Elicitation
Time Frame: Baseline to Post-Intervention, up to 12 months
Peers' ratings of Specialists' skill in elicitation of information from PCPs
Rating - Educational Value
Time Frame: Baseline to Post-Intervention, up to 12 months
Peers' ratings of Educational Value of eConsults
Secondary Outcomes
No secondary outcomes reported
Investigators
Daniella Meeker
Assistant Professor
University of Southern California