Decreasing ED Utilization by Nudging Patients to Call Their Providers

Geisinger Health

Status: Completed

Conditions: Telephone Hotlines; Emergency Treatment

Treatments: Behavioral: message; Behavioral: provider; Behavioral: tele-nurse

Study type: Interventional

Funder types: Other

Identifiers

NCT04567849

2020-0849

Details and patient eligibility

About

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.

Full 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).

Enrollment: 11,546 patients

Sex: All

Volunteers: No Healthy Volunteers

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.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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11,546 participants in 3 patient groups

Control

No Intervention group

Description:

No intervention control group

Nudge: call provider

Experimental group

Description:

This group will receive a patient portal message the morning after completing their procedure. The message will encourage patients to call their recent Women's Health provider (with appropriate phone number listed) if any questions or concerns arise about their healthcare.

Treatment:

Behavioral: provider

Behavioral: message

Nudge: call tele-nurse

Experimental group

Description:

This group will receive a patient portal message the morning after completing their procedure. The message will encourage patients to call Geisinger's nurse triage hotline (with appropriate phone number listed) if any questions or concerns arise about their healthcare.

Treatment:

Behavioral: tele-nurse

Behavioral: message