Discontinuation of Automated Engagement Support
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 488
- 试验地点
- 2
- 主要终点
- Claims paid in past 12 months for covered services
研究概览
简要总结
The Chronic Kidney Disease Engagement System is currently in place for 1700 adults receiving care from Empire Physicians Medical Group (EPMG), an Independent Practice Association located in Palm Desert, California. The system monitors routine clinical laboratory test results and send messages to patients and providers when action is indicated, such as when tests are overdue or results require extra clinical attention. This study will assess what happens to laboratory results, utilization of laboratory tests, and costs of care when ther system is discontinued.
详细描述
The Chronic Kidney Disease Engagement System is currently in place for 1700 adults receiving care from Empire Physicians Medical Group (EPMG), an Independent Practice Association located in Palm Desert, California. The system monitors routine clinical laboratory test results and send messages to patients and providers when action is indicated, such as when tests are overdue or results require extra clinical attention. Patients receive first class letters directing them to call their provider. Providers receive fax or electronic messages directing them to reach out to the patient to arrange follow-up care. It has been used for over three years and appears to have improved adherence to Chronic Kidney Disease (CKD) treatment guidelines by influencing both patient and provider actions. EPMG wishes to restrict the service to those patients with advanced CKD and discontinue it for CKD stages 1-3. The investigators propose implementing this new policy in a randomized fashion with one half of the current early stage patients continuing to receive the service while the other half will no longer receive messages. The investigators will monitor laboratory results and health care utilization for both groups to determine what effect, if any, discontinuation has on quality of care.
Human subjects will either continue to receive letters from the service when their tests are overdue or require additional clinical attention, or will no longer receive the service. All subjects will continue to receive care from their providers. The main outcomes include the frequency of recommended tests for CKD, the level of those tests, and utilization of health care services as indicated by claims data provided by EPMG. No additional data collection will occur beyond that which has been routinely done for clinical care. The study will continue for 36 months.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Receiving services from Patient Engagement Services at randomization. CKD Stages 1, 2 or
- •Under the care of Empire Physicians Medical Group of Palm Desert, California.
排除标准
- •Patient refusal.
研究组 & 干预措施
Active
These subjects will continue to receive Patient Engagement services.
干预措施: Patient Engagement (Other)
Control
These patients will have all Patient Engagement services discontinued.
结局指标
主要结局
Claims paid in past 12 months for covered services
时间窗: 3 years
Total and breakdown by categories
次要结局
- Hemoglobin test completed within time allotted per disease stage(3 years)
- Serum electrolytes test completed within time allotted per disease stage(3 years)
- Serum calcium test completed within time allotted per disease stage(3 years)
- Serum albumin test completed within time allotted per disease stage(3 years)
- Lipid test completed within time allotted per disease stage(3 years)
- Serum parathyroid hormone test completed within time allotted per disease stage(3 years)
- Serum phosphorus test completed within time allotted per disease stage(3 years)
- Urine albumin-to-creatinine ratio test completed within time allotted per disease stage(3 years)
- Latest LDL <100 mg/dl AND completed within time allotted per disease stage(3 years)
- Estimated glomerular filtration(3 years)
研究者
Benjamin Littenberg
Professor of Medicine
University of Vermont