Asthma, Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder, Depression, Epilepsy
Conditions
Keywords
chronic disease, patient portal, health information technology, patient provider communication, quality improvement
Brief summary
TriVox Health is an online system designed to make it easy for healthcare providers to monitor patients' disease symptoms and functioning over time and in between in-person visits (http://www.youtube.com/watch?v=VR1vcbx0Ef4). Using combined quality improvement and randomized clinical trial methods, we will evaluate the impact of TriVox on the health outcomes, patient/family experience of care, and healthcare utilization for children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD), asthma, autism, depression, and epilepsy.
Detailed description
TriVox Health is a web-based patient management and monitoring system designed to track patients' disease symptoms and response to therapy over time. TriVox Health enables clinics to use electronic surveys to gather data remotely from multiple responders, including patients, parents/guardians, school personnel and ancillary providers, and view the responses in a timely manner via graphical, tabular, and narrative summary formats. This quality improvement (QI) initiative will implement TriVox as the standard of care for all patients who receive care for ADHD, asthma, autism, depression, and epilepsy within seven ambulatory specialties at Boston Children's Hospital. Patients and families will use TriVox to report on patient health status and will complete clinically-reTriVoxlevant questionnaires at routine intervals. Providers will use the information collected through TriVox to inform their clinical care of the patient/family. To evaluate the effectiveness of TriVox, we will conduct a 24-month phased, cluster randomized controlled trial (RCT) where we randomize providers to active vs. delayed-start to TriVox use, with patients clustered by provider (within specialties) for analytic purposes. Delayed-start providers will crossover to active TriVox use after 12 months. Patients/families will complete additional surveys in order to assess the system's actual or potential effects on patient/family-provider interactions, healthcare utilization and costs.
Interventions
OTHERTriVox for clinical care
Use TriVox disease modules to manage patients
Sponsors
Boston Children's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Pediatric patients with clinical diagnosis of ADHD, asthma, autism, depression, and/or epilepsy * Patient receives care for these diagnoses from providers in participating ambulatory clinics (Primary Care, Adolescent Medicine, Developmental Medicine, Neurology, Psychiatry) * Patient's primary caregiver enrolled in TriVox
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in caregiver-rated disease-specific symptoms | Baseline to 12 months | Caregiver-reported ratings on disease-specific symptom rating scale. For example, Vanderbilt ADHD Parent Rating Scale for ADHD; Asthma Control Test for asthma |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients with red flag alerts | 1 month | Number of patients whose responses to clinical questionnaires trigger a red flag alert in ICISS |
| Change in caregiver-rated global functioning | Baseline to 12 months | Caregiver ratings on modified Clinical Global Assessment Scale |
| Experience of care | Baseline and after every ambulatory visit for up to 84 months | Participant ratings on Post-Visit Experience of Care Survey |
Other
| Measure | Time frame | Description |
|---|---|---|
| Healthcare utilization | 12 months | inpatient and ambulatory visits within healthcare system directly related to patient's medical or mental health condition |
| Direct out of pocket expenditures | 12 months | Out of pocket expenditures directly related to care for child's medical or mental health condition, e.g. co-pays, prescription costs |
Countries
United States
Outcome results
None listed