Predictive Modeling for Social Needs in Emergency Department Settings

Not Applicable

Recruiting

• Conditions: Emergency Service, Hospital; Social Determinants of Health

• Registration Number: NCT06655974
• Lead Sponsor: Indiana University

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.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2024-08-23
• Study First Submitted QC: 2024-10-22
• Study First Posted: 2024-10-24
• Status Verified: 2025-03
• Study Start: 2025-03-10
• Last Update Submitted: 2025-03-26
• Last Update Posted: 2025-04-01
• Primary Completion: 2025-12-01
• Study Completion: 2025-12-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 48000

Inclusion Criteria

• Adults (>18 years old)
• Seeking care at Indianapolis, Indiana area emergency departments (EDs).

Exclusion Criteria

• Children
• 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

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Percent of emergency department encounters screened for health-related social needs (HRSNs)	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	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 Outcome Measures

Name	Time	Method
Percent of encounters with an emergency department revisit measured at 3 days	within 3 days of emergency department encounter	The numerator will be an emergency department encounter at any facility included in the Indiana for Network Care database within 3 days of an ED encounter at an intervention or comparator site. ED revisits may serve as the index visit for subsequent revisits. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator.
Percent of encounters with an emergency department revisit measured at 7 days	within 7 days of emergency department encounter	The numerator will be an emergency department encounter at any facility included in the Indiana for Network Care database within 7 days of an ED encounter at an intervention or comparator site. ED revisits may serve as the index visit for subsequent revisits. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator.
Percent of encounters with an emergency department revisit measured at 30 days	within 30 days of emergency department encounter	The numerator will be an emergency department encounter at any facility included in the Indiana for Network Care database within 30 days of an ED encounter at an intervention or comparator site. ED revisits may serve as the index visit for subsequent revisits. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator
Percent of emergency department encounters with primary care visit within 7 days of an ED encounter	within 7 days of emergency department visit	The numerator will include all emergency department encounters with a completed family medicine, internal medicine, OBGYN, or geriatrician visit64 within 7 days of the ED visit. The denominator will be all eligible ED encounters. Encounters resulting in an inpatient admission will be excluded from the numerator and denominator.

Trial Locations

Locations (1)

Indiana University Health; 🇺🇸 Indianapolis, Indiana, United States