Aligning Patients and Their Primary Care Providers (APP)

Kaiser Permanente

Status: Completed

Conditions: Quality of Health Care; Communication; Primary Health Care; Medical Informatics Applications; Comorbidity

Treatments: Device: iPad; Behavioral: Visit Planner; Other: Attention Control Pamphlet

Study type: Interventional

Funder types: Other

Identifiers

NCT02707146

CN-14-2070-H

Details and patient eligibility

About

This project focuses on improving the patient-provider primary care visit interaction by addressing the need to align patient and provider priorities in a way that incorporates patients' goals and preferences while supporting the clinical work of their providers.

Full description

The aim of this clinical trial is to enroll new and/or complex patients and their physicians in a 12-month randomized study. At each scheduled primary care visit during the trial period, Intervention Patients will be provided with a waiting room Tablet loaded with the "Visit Planner" intervention tool designed to support prioritization and discussion of top health care concerns. Control Patients will be given a written educational handout to review. Patient-centered outcomes will be obtained at baseline and after visits using validated survey instruments. Clinical outcomes focus on differences in quality of care. If successful, this approach to aligning patient and provider visit priorities can potentially be disseminated and adapted to a wide variety of different care settings.

Enrollment: 750 patients

Sex: All

Ages: 30+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Kaiser Permanente member with an assigned primary care provider, with at least one quality care gap at baseline (overdue screening tests, elevated risk factor levels, sub-optimal adherence to chronically prescribed medicines, current smoker)

• Patients must be either:

  • 1. relatively new to their provider (0-3 visits in past 18 months) or if associated with their provider for > 18 months,
  • 2. have evidence for medical complexity (4 or more prescribed medicines, in a chronic disease management program, or recently admitted to hospital or emergency department)

Exclusion criteria

• Excluded by their primary care provider

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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750 participants in 2 patient groups

Tablet in the waiting room

Experimental group

Description:

Patients in the intervention arm will be met in the waiting room prior to their primary care visit and will use the "Visit Planner" tool application on the tablet

Treatment:

Device: iPad

Behavioral: Visit Planner

Health Education Handout

Active Comparator group

Description:

Patients in the control arm will be met in the waiting room prior to their primary care visit and will be given an educational pamphlet on health lifestyle to review

Treatment:

Other: Attention Control Pamphlet