Protocol for Evaluating the Effectiveness of a Clinical Decision Support System With Prediction Modeling to Identify Patients With Health-related Social Needs in the Emergency Department
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Emergency Service, Hospital
- Sponsor
- Indiana University
- Enrollment
- 518512
- Locations
- 1
- Primary Endpoint
- Percent of emergency department encounters screened for health-related social needs (HRSNs)
- Status
- Completed
- Last Updated
- last month
Overview
Brief Summary
The overall objective of this study is to support emergency department management of patients' health-related social needs. This study will measure the impact of a decision support system that informs clinicians about which patients are likely to screen positive for a health-related social need. The system uses statistical models to create a health-related social need risk score for each patient. The main questions, the study aims to answer are:
- Does providing emergency department clinicians with risk scores on health-related social needs increase screening and referral activities?
- Does providing emergency department clinicians with risk scores on health-related social needs change patients' use of healthcare services?
The decision support system with health-related social needs risk scores will be introduced for all adult patients at one emergency department. Screening rates, referrals, and subsequent healthcare encounters will be compared with emergency departments that did not have access to the decision support system.
Investigators
Joshua R. Vest, PhD
Professor
Indiana University
Eligibility Criteria
Inclusion Criteria
- •Adults (\>18 years old)
- •Seeking care at Indianapolis, Indiana area emergency departments (EDs).
Exclusion Criteria
- •Encounters by patients that present with a critical illness/injury (e.g. severe trauma patients or those with Emergency Severity Index (ESI) classification level 1)
- •Encounters by patients who have been transferred from another inpatient facility
- •Patients that die during the ED encounter
- •Encounters among patients who were ultimately admitted during their ED visits from our analysis
Outcomes
Primary Outcomes
Percent of emergency department encounters screened for health-related social needs (HRSNs)
Time Frame: At time of emergency department encounter (or within 24 hours)
The numerator will be an emergency department encounter with any indication of HRSN screening using any tool or questionnaire, regardless of patient completion or results. The denominator will be all eligible ED encounters.
Percent of emergency department encounters that were referred for health-related social needs (HRSNs) services
Time Frame: At time of emergency department encounter (or within 24 hours)
The numerator will be emergency department encounters with a referral to social worker, case management, community health workers, or related services within 24 hours of the ED encounter. The denominator will be all eligible ED encounters
Secondary Outcomes
- Percent of encounters with an emergency department revisit measured at 3 days(within 3 days of emergency department encounter)
- Percent of encounters with an emergency department revisit measured at 7 days(within 7 days of emergency department encounter)
- Percent of encounters with an emergency department revisit measured at 30 days(within 30 days of emergency department encounter)
- Percent of emergency department encounters with primary care visit within 7 days of an ED encounter(within 7 days of emergency department visit)