An Integrated, Virtual and On-Demand Solution to Avoid ED Utilization
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,484
- 试验地点
- 2
- 主要终点
- Emergency Department Visits
研究概览
简要总结
This project will evaluate a virtual, on-demand telemedicine program for High emergency department (ED) utilizers with comorbid physical health conditions and behavioral health correlates. Researchers will randomize patients to have either full access to the full intervention (treatment group) or to receive only standard care (control group). Analyses will be intent-to-treat. The primary outcome is the number of ED visits 120 days after the first Best Practice Alert (BPA) firing.
The research team plans to enroll 3200 patients in this study. However, randomization may end due to system constraints on December 31, 2025 before reaching that target. This sample provides 80% power to detect a 35% relative reduction in ED utilization using a two-tailed test with an alpha of .15, assuming 40% compliance with the program.
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
- None
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
- •Patient presents to the ED and meets the following criteria:
- •Inclusion Criteria:
- •18+ years old
- •4+ Geisinger ED visits in the last 6 months
- •Geisinger Health Plan (GHP) insurance member
- •Has a Geisinger PCP
- •Patient is being seen at one of the following facilities: Geisinger Lewistown Hospital, Geisinger Medical Center, Geisinger Bloomsburg Hospital, Geisinger Jersey Shore Hospital, Geisinger Community Medical Hospital, Geisinger Wyoming Valley, Geisinger Medical Center Muncy, Geisinger Shamokin Ach Hospital, Geisinger South Wilkes Barre
排除标准
- •Patient being seen in departments determined ineligible by the study team
- •Patient is diagnosed with alcohol and substance-related disorders
- •Patient is going to receive inpatient care
- •Patient is coded in the ED as Level 1 (i.e., seeking life-saving measures)
- •Patient has an Intellectual Disability or Traumatic Brain Injury
- •Patient is actively seeing a BH provider
研究组 & 干预措施
Integrated Telemedicine Program
Patients will be invited to participate in the integrated telemedicine program through text, email, and/or phone calls.
干预措施: Integrated Telemedicine Program (Behavioral)
Control
Patients will receive only standard care and will receive no invitation to participate in the integrated telemedicine program.
结局指标
主要结局
Emergency Department Visits
时间窗: within 120 days of the initial BPA firing
Number of emergency department visits
次要结局
未报告次要终点
研究者
Amir Goren
Principal Investigator
Geisinger Clinic