|
|
Home
Search
Study Topics
Glossary
|
 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||||||||||||||||||||||||||||||||
| Sponsored by: |
Duke University |
|---|---|
| Information provided by: | Duke University |
| ClinicalTrials.gov Identifier: | NCT00365885 |
Purpose
The purpose of this study is to determine the value of shared health information on care quality and costs when this information is used to notify care providers about concerning health events for patients cared for by a community-based network of providers.
| Condition | Intervention |
|---|---|
|
Clinical Decision Support Medical Informatics Interventions Population Health Management Quality of Healthcare |
Other: Computer-based clinical decision support. |
| Study Type: | Interventional |
| Study Design: | Treatment, Randomized, Single Blind (Subject), Active Control, Factorial Assignment, Efficacy Study |
| Official Title: | Showing Health Information Value in a Community Network |
| Estimated Enrollment: | 18000 |
| Study Start Date: | August 2006 |
| Estimated Study Completion Date: | June 2008 |
| Arms | Assigned Interventions |
|---|---|
|
1: Experimental
electronic mail notifications to care managers about sentinel health events
|
Other: Computer-based clinical decision support.
computer decision support system that generates notifications about sentinel health events and communicates this information via electronic mail to care managers, feedback reports to clinical managers, and letters to patients
|
|
2: Experimental
feedback reports with notifications to clinic managers about sentinel health events
|
Other: Computer-based clinical decision support.
computer decision support system that generates notifications about sentinel health events and communicates this information via electronic mail to care managers, feedback reports to clinical managers, and letters to patients
|
|
3: Experimental
letters to patients with notifications about sentinel health events
|
Other: Computer-based clinical decision support.
computer decision support system that generates notifications about sentinel health events and communicates this information via electronic mail to care managers, feedback reports to clinical managers, and letters to patients
|
|
4: No Intervention
electronic mail notifications to care managers about sentinel health events -- generated but withheld
|
|
|
5: No Intervention
feedback reports with notifications to clinic managers about sentinel health events -- generated but withheld
|
|
|
6: No Intervention
letters to patients with notifications about sentinel health events -- generated but withheld
|
Project Abstract This three-year project will assess the costs and benefits of health information technology (HIT) in an established community-wide network of academic, private and public healthcare facilities created to share clinical information for the purpose of population-based care management of over 16,000 Medicaid beneficiaries in Durham County, North Carolina. The area of interest for this project is the impact of information-driven interventions on care quality, patient safety and healthcare costs across the diverse stakeholders participating in this collaborative partnership. In order to asses HIT value rigorously in the context of a production information system that is under continual development, we propose to conduct a randomized controlled trial. Specifically, we will randomly assign patients by family unit to either a control group or to an intervention group in which they will initially receive one of 3 information-driven interventions. The interventions include clinical alerts sent to care providers, performance feedback reports presented to clinic managers, and care reminders sent directly to patients. The content of the interventions will address "concerning" events (e.g., an emergency room encounter for asthma) and care deficiencies (e.g., delinquency on biannual mammogram) identified from the composite set of clinical data in our information system. To assess the benefits and burdens of the interventions, combinations of the 3 interventions will be sequentially introduced into the study groups over the course of the project. The analysis will compare groups receiving various combinations of interventions as well as those receiving no interventions. At baseline and at six-month intervals throughout the course of the study, we will measure emergency department encounter rates, hospitalization rates, HEDIS scores, missed appointment rates, glycated hemoglobin levels in diabetics, and patient satisfaction. Our assessment will look at the societal value of HIT as well as the value for individual stakeholders including patients, providers, payers, purchasers and policy makers. From these measures, we will assess the costs and benefits of this community-wide effort to promote interoperability of clinical data exchange in order to increase the understanding of HIT value in a community setting. In our preliminary studies, we have observed a statistically significant 3-fold reduction in repeat ED encounter rates using email alerts alone. The approach used in this project is able to be generalized across geographic areas and healthcare settings and can, therefore, serve to promote the dissemination of HIT to other communities.
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
-
Contacts and Locations| United States, North Carolina | |
| Duke University Medical Center | |
| Durham, North Carolina, United States, 27710 | |
| Principal Investigator: | David F Lobach, MD, PhD | Duke University |
More Information
| Study ID Numbers: | R01-HS015057, R01-HS015057 |
| Study First Received: | August 16, 2006 |
| Last Updated: | November 4, 2007 |
| ClinicalTrials.gov Identifier: | NCT00365885 |
| Health Authority: | United States: Institutional Review Board |
|
Medical Informatics Decision Support Systems, Clinical Community Health Services Costs and Cost analysis |
