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Decreasing ED Utilization by Nudging Patients to Call Their Providers

Decreasing ED Utilization by Nudging Patients to Call Their Provider or Triage Nurse After Women's Health Procedures

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04567849
Enrollment
11546
Registered
2020-09-29
Start date
2021-11-16
Completion date
2023-06-15
Last updated
2023-07-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Emergency Treatment, Telephone Hotlines

Keywords

Behavioral Economics, Patient Portal

Brief summary

In the present study, patients will be sent a message shortly after completing a medical procedure that informs or reminds them that they can reach out to Geisinger, and how to do it, if they have any medical issues or concerns. Researchers will assess if such messages make patients more likely to contact Geisinger with post-procedure medical concerns and decrease emergency department utilization.

Detailed description

Decreasing emergency department (ED) over-utilization is a priority for healthcare systems across the country. Patients uncertain about a medical issue routinely end up in the ED when less costly and time-consuming alternatives could have addressed their concern. If patients reach out to healthcare facilities rather than heading directly to the ED, they can often be directed toward resources better suited to their concerns than the ED. Geisinger is thus working to encourage patients to contact healthcare providers if any concerns arise and patients are uncertain about where to go for care. Patients who have recently had a medical procedure may be particularly valuable to encourage, as they routinely have concerns related to the procedure and discharge can serve as a useful touch-point to remind the patient where they can go for questions or concerns. In the present study, patients will be sent a patient portal message shortly after completing any Women's Health medical procedure. The message will inform or remind patients how they can reach Geisinger if they have any medical issues or concerns. The purpose of this study is to assess if such messages make patients more likely to contact Geisinger with medical concerns and, in turn, decrease unnecessary ED utilization. This study will A/B test 2 messages, encouraging patients to either call their recent provider directly or to call a tele-nurse hotline, and will assess if these messages perform better than a control group that will not be sent any such message. Generalized linear models will examine the primary study outcomes as a function of the study arms (between-subjects).

Interventions

BEHAVIORALmessage

patient portal message

BEHAVIORALprovider

nudging calling the patient's provider

BEHAVIORALtele-nurse

nudging calling the tele-nurse

Sponsors

Geisinger Clinic
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Caregiver)

Masking description

Participants (i.e., patients) will not be informed specifically of their assignment to different arms throughout the study. Providers will not be randomized to study arms or informed of patient assignment.

Intervention model description

Throughout the study, patients will be randomized equally across all three arms.

Eligibility

Sex/Gender
ALL
Healthy volunteers
No

Inclusion criteria

* Patient had a procedure in Women's Health within the study period (including both surgical and in-office procedures as well as baby delivery) * Patient is enrolled in myGeisinger, Geisinger's patient portal

Exclusion criteria

* If procedure was labor that resulted in fetal demise or stillborn.

Design outcomes

Primary

MeasureTime frameDescription
Phone calls18 months or as long as it takes to reach N=17,300, whichever occurs firstProportion of patients who call the tele-nurse or their provider within 30 days of their appointment
ED utilization18 months or as long as it takes to reach N=17,300, whichever occurs firstProportion of patients who visit the ED within 30 days of their appointment

Secondary

MeasureTime frameDescription
Phone calls12 monthsProportion of patients who call the tele-nurse or their provider within 30 days of their appointment
ED utilization12 monthsProportion of patients who visit the ED within 30 days of their appointment
Phone calls - surgical patients only18 months or as long as it takes to reach N=17,300, whichever occurs firstProportion of patients who call the tele-nurse or their provider within 30 days of their appointment
ED utilization - surgical patients only18 months or as long as it takes to reach N=17,300, whichever occurs firstProportion of patients who visit the ED within 30 days of their appointment

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026