Behavioral Intervention, Emergency Department Visits, Telemedicine
Conditions
Brief summary
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.
Interventions
BEHAVIORALIntegrated Telemedicine Program
The integrated telemedicine program is short-term bridge support provided by a virtually accessible team, including a behavioral health provider (Health Psychologist or Licensed Clinical Social Worker \[LCSW\]) and Community Health Worker (CHW). Once stabilized, members transition from bridge support to ongoing care with a Geisinger Health System Primary Care Provider and Behavioral Health Provider.
Sponsors
Geisinger Clinic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
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
Exclusion criteria
* 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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Emergency Department Visits | within 120 days of the initial BPA firing | Number of emergency department visits |
Countries
United States
Outcome results
None listed