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Clinical Trials/NCT03784950
NCT03784950CompletedNot Applicable

Application of Behavioral Economics to Improve the Quality and Value of eConsult Specialty Reviews

University of Southern California2 sites in 1 country220 target enrollmentStarted: March 1, 2017Last updated:
Conditions
Interventions

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

Experimental

Rating eConsults from peer specialists in first phase

Intervention: Rating tool (Behavioral)

Feedback only

Experimental

Receiving feedback from peer specialists in first phase

Intervention: Feedback (Behavioral)

Rating Tool plus Feedback

Experimental

Both rating and feedback in second phase.

Intervention: Rating tool (Behavioral)

Rating Tool plus Feedback

Experimental

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

Sponsor Class
Other
Responsible Party
Principal Investigator
Principal Investigator

Daniella Meeker

Assistant Professor

University of Southern California

Study Sites (2)

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