Nudging High-acuity Emergency Department Patients to Schedule a Follow-up Visit

Geisinger Health

Status: Completed

Conditions: Emergency Service, Hospital

Treatments: Behavioral: Information about scheduling a follow-up appointment

Study type: Interventional

Funder types: Other

Identifiers

NCT06535347

2024-0412

Details and patient eligibility

About

The goal of this campaign is to reduce unnecessary emergency department (ED) visits by encouraging patients with high acuity visits to follow up with an appropriate primary care provider (PCP) or specialist and therefore obtain appropriate care outside of the ED. In this campaign, patients will be assigned to receive or not receive outreach following ED discharge that is aligned with the goal. Outreach will occur via a text message and information added to the patient's after visit summary, and will include a contact number to schedule and hyperlink to allow self-scheduling. The study will assess whether ED use differs across patients in different outreach conditions. It will also examine whether patients followed through on the calls to action in the messages differently across conditions.

Full description

Enrollment will conclude when either 7500 participants have been enrolled or after 120 days, whichever occurs first.

Enrollment: 6,814 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• >= 18 years of age
• ED visit rated as high acuity (level L2 or L3)
• Discharged from ED in past 24 hours
• Attributed to a Geisinger PCP in Community Medicine Service Line

Exclusion criteria

• Have an appointment scheduled within 7 days following discharge with a primary care provider or specialist
• Institutionalized
• Cannot be contacted via the communication modality being used in the study (i.e., SMS), due to insufficient/missing contact information in the electronic health record or because the patient opted out
• Admitted to hospital
• Eloped from ED
• Left ED without being seen
• Deceased prior to messaging

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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6,814 participants in 3 patient groups

Control

No Intervention group

Description:

This arm will receive no intervention outside of usual care.

Experimental: Schedule Follow-Up Visit - 1 message

Experimental group

Description:

This arm will receive a text message (at 1 day post-ED discharge) and information added to the patient's after visit summary providing a number and patient portal hyperlink via which to schedule an ED follow-up appointment.

Treatment:

Behavioral: Information about scheduling a follow-up appointment

Experimental: Schedule Follow-Up Visit - 2 messages

Experimental group

Description:

This arm will receive text messages (at 1 day and 8 days post-ED discharge) and information added to the patient's after visit summary providing a number and patient portal hyperlink via which to schedule an ED follow-up appointment.

Treatment:

Behavioral: Information about scheduling a follow-up appointment