Reducing Emergency Department Utilization With an After Visit Summary Nudge Toward Alternative Care Options

Geisinger Health

Status: Completed

Conditions: Behavior, Health

Treatments: Behavioral: Contact information; Behavioral: Self-triage chart; Behavioral: Urgent care map

Study type: Interventional

Funder types: Other

Identifiers

NCT05787548

2022-0340

Details and patient eligibility

About

Decreasing utilization of the Emergency Department (ED) is a priority for the system. Often, ED visits can be avoided if patients contact Geisinger first to get appropriate direction for their concern or are otherwise better informed about reasons to visit the ED vs. urgent care or primary care facilities. The study team is working to reduce ED utilization by including additional information in adult outpatient After Visit Summaries (AVSs). The study will involve will involve A/B testing different AVS versions, including 1) a version that encourages patients to contact Geisinger via different contact methods, 2) a version that includes a map to the patient's closest ConvenientCare location and accompanying information about ConvenientCare, and 3) a version that includes a self-triage guide. A control group will receive the current standard AVS. Analysis results will be assessed to determine which version is most effective at reducing ED use.

Enrollment: 239,841 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18+
• Has a Geisinger Primary Care Physician assigned
• Completes an outpatient office visit or telemedicine appointment at Geisinger

Exclusion criteria

• The AVS was not printed according to the EHR, and the patient does not have an active MyGeisinger patient portal account, so they do not have a way to view the AVS

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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239,841 participants in 4 patient groups

Standard practice

No Intervention group

Description:

Patients in this arm will receive the current standard practice AVS.

Contact us first

Experimental group

Description:

Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention.

Treatment:

Behavioral: Contact information

Contact us first + urgent care map

Experimental group

Description:

Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care.

Treatment:

Behavioral: Urgent care map

Behavioral: Contact information

Contact us first + urgent care map + self-triage

Experimental group

Description:

Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate.

Treatment:

Behavioral: Urgent care map

Behavioral: Contact information

Behavioral: Self-triage chart