Application of Behavioral Economics to Improve eConsult

Not Applicable

Completed

• Conditions: Quality of Health Care
• Interventions: Behavioral: Rating tool; Behavioral: Feedback

• Registration Number: NCT03784950
• Lead Sponsor: University of Southern California

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.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study Start: 2017-03-01
• Primary Completion: 2018-08-31
• Study Completion: 2018-08-31
• Status Verified: 2018-12
• Study First Submitted: 2018-12-05
• Study First Submitted QC: 2018-12-20
• Last Update Submitted: 2018-12-20
• Study First Posted: 2018-12-24
• Last Update Posted: 2018-12-24

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 220

Inclusion Criteria

• LACDHS providers who are eConsult system users

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Exclusion Criteria

• None

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
Rating tool only	Rating tool	Rating eConsults from peer specialists in first phase
Feedback only	Feedback	Receiving feedback from peer specialists in first phase
Rating Tool plus Feedback	Rating tool	Both rating and feedback in second phase.
Rating Tool plus Feedback	Feedback	Both rating and feedback in second phase.

Primary Outcome Measures

Name	Time	Method
Rating - Medical Decision Making	Baseline to Post-Intervention, up to 12 months	Peers' ratings of Medical Decision Making in Specialists' responses to PCPs
Rating - Relationship Building	Baseline to Post-Intervention, up to 12 months	Peers' ratings Relationship Building in Specialists' responses to PCPs
Rating - Application of Expected Practices	Baseline to Post-Intervention, up to 12 months	Peers' ratings of Expected Practices in Specialists' responses to PCPs
Rating - Expert Elicitation	Baseline to Post-Intervention, up to 12 months	Peers' ratings of Specialists' skill in elicitation of information from PCPs
Rating - Educational Value	Baseline to Post-Intervention, up to 12 months	Peers' ratings of Educational Value of eConsults

Trial Locations

Locations (1)

Los Angeles County Department of Health Services; 🇺🇸 Los Angeles, California, United States