Trial Outcomes & Findings for Evaluation of VLER-Indiana Health Information Exchange Demonstration Project (NCT NCT01446705)
NCT ID: NCT01446705
Last Updated: 2019-05-16
Results Overview
Determining rates of usage of healthcare by veterans by source of data. This will clue us into any differences in utilization patterns between groups.
COMPLETED
57073 participants
2 years
2019-05-16
Participant Flow
Participant milestones
| Measure |
Controls in Study (Not Enrolled in Health Care Exchange)
Patients in this arm will represent Veterans seen at the Indianapolis VA Medical Center (VAMC) for whom information exchange has not been activated.
|
Patients Enrolled in HIE
Patients in this arm will represent Veterans seen at the Indianapolis VAMC for whom information exchange has been activated by the patient choosing to "opt-in."
|
|---|---|---|
|
Overall Study
STARTED
|
50446
|
6627
|
|
Overall Study
COMPLETED
|
50446
|
6627
|
|
Overall Study
NOT COMPLETED
|
0
|
0
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Evaluation of VLER-Indiana Health Information Exchange Demonstration Project
Baseline characteristics by cohort
| Measure |
Controls in Study (Not Enrolled in Health Care Exchange)
n=50446 Participants
Patients in this arm will represent Veterans seen at the Indianapolis VAMC for whom information exchange has not been activated.
|
Enrolled in HIE
n=6627 Participants
Patients in this arm will represent Veterans seen at the Indianapolis VAMC for whom information exchange has been activated by the patient choosing to "opt-in."
|
Total
n=57073 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
60.74 years
STANDARD_DEVIATION 15.77 • n=5 Participants
|
62.17 years
STANDARD_DEVIATION 13.98 • n=7 Participants
|
60.91 years
STANDARD_DEVIATION 15.58 • n=5 Participants
|
|
Sex: Female, Male
Female
|
3607 Participants
n=5 Participants
|
514 Participants
n=7 Participants
|
4121 Participants
n=5 Participants
|
|
Sex: Female, Male
Male
|
46839 Participants
n=5 Participants
|
6113 Participants
n=7 Participants
|
52952 Participants
n=5 Participants
|
|
Region of Enrollment
United States
|
50446 Participants
n=5 Participants
|
6627 Participants
n=7 Participants
|
57073 Participants
n=5 Participants
|
|
Charlson Score
|
.66 units on a scale
STANDARD_DEVIATION 1.42 • n=5 Participants
|
1.25 units on a scale
STANDARD_DEVIATION 1.92 • n=7 Participants
|
.73 units on a scale
STANDARD_DEVIATION 1.5 • n=5 Participants
|
PRIMARY outcome
Timeframe: 2 yearsPopulation: Veterans divided into enrolled and non-enrolled in HIE groups
Determining rates of usage of healthcare by veterans by source of data. This will clue us into any differences in utilization patterns between groups.
Outcome measures
| Measure |
Controls in Study (Not Enrolled in Health Care Exchange)
n=50446 Participants
Patients in this group were not enrolled in Health Information Exchange.
|
Enrolled in HIE
n=6627 Participants
This group represents veterans were enrolled in Health Information Exchange via VLER
|
Controls Post Intervention
Not enrolled in HIE post intervention
|
Enrolled Post Intervention
Those participating in HIE post intervention
|
|---|---|---|---|---|
|
Understanding Utilization of Healthcare Procedures by Veterans According to Source of Data
VA Data Only
|
41982 participants
|
5073 participants
|
—
|
—
|
|
Understanding Utilization of Healthcare Procedures by Veterans According to Source of Data
Data in Both Sources
|
8358 participants
|
1497 participants
|
—
|
—
|
|
Understanding Utilization of Healthcare Procedures by Veterans According to Source of Data
Data only in Outside Source
|
20 participants
|
37 participants
|
—
|
—
|
|
Understanding Utilization of Healthcare Procedures by Veterans According to Source of Data
No Data
|
86 participants
|
20 participants
|
—
|
—
|
PRIMARY outcome
Timeframe: 2 YearsPopulation: 5269 individuals were excluded due to lacking cost information.
Before after analysis of the presence of health information exchange on costs within the VA healthcare system; Measure is cost, unadjusted, in dollars for the year post enrollment in the health information exchange
Outcome measures
| Measure |
Controls in Study (Not Enrolled in Health Care Exchange)
n=45700 Participants
Patients in this group were not enrolled in Health Information Exchange.
|
Enrolled in HIE
n=6104 Participants
This group represents veterans were enrolled in Health Information Exchange via VLER
|
Controls Post Intervention
Not enrolled in HIE post intervention
|
Enrolled Post Intervention
Those participating in HIE post intervention
|
|---|---|---|---|---|
|
Effect of Health Information Exchange on Cost
|
6,529 $ per year unadjusted total VA cost
Standard Deviation 9,153
|
9,915 $ per year unadjusted total VA cost
Standard Deviation 12,386
|
—
|
—
|
PRIMARY outcome
Timeframe: 3 yearsPopulation: These are diabetics within the cohort defined as being diagnosed, alive, and being aged 18-75. Specifically looking at LDL
This study will measure the impact of HIE upon health care quality the underuse of ambulatory care services for diabetics. Measurements of underuse before and after implementation will detect improvements in the quality of care. To measure underuse, the study employs a measurement set that is sensitive to the potential effects and feasible for electronic data capture. In this specific instance, we expect the LDL levels to reflect lower numbers among diabetics due to greater health management via information sharing.
Outcome measures
| Measure |
Controls in Study (Not Enrolled in Health Care Exchange)
n=1445 Participants
Patients in this group were not enrolled in Health Information Exchange.
|
Enrolled in HIE
n=338 Participants
This group represents veterans were enrolled in Health Information Exchange via VLER
|
Controls Post Intervention
n=1445 Participants
Not enrolled in HIE post intervention
|
Enrolled Post Intervention
n=338 Participants
Those participating in HIE post intervention
|
|---|---|---|---|---|
|
Health Care Quality: Affect of HIE on LDL Levels of Participants.
|
86.308 mg/dL of LDL
Interval 85.677 to 86.938
|
85.263 mg/dL of LDL
Interval 83.762 to 86.763
|
83.957 mg/dL of LDL
Interval 83.321 to 84.592
|
82.640 mg/dL of LDL
Interval 81.12 to 84.155
|
SECONDARY outcome
Timeframe: 3 yearsPopulation: This analysis looked specifically at hospitalizations within a cohort of diabetes patients (a subset of the whole).
This study will use the Agency for Healthcare Research and Quality's (AHRQ) Prevention Quality Indicators (PQI) to calculate the outcome measure. The PQIs are a set of measures used with hospital inpatient data to identify ambulatory care sensitive conditions. The PQIs consist of 14 conditions. The study will adopt 12 that are commonly used for adult patients: angina, asthma, bacterial pneumonia, chronic obstructive pulmonary disease, congestive heart failure, dehydration, diabetes long-term complications, diabetes short-term complications, diabetes uncontrolled, hypertension, lower-limb amputation among diabetes patients, and urinary infection.
Outcome measures
| Measure |
Controls in Study (Not Enrolled in Health Care Exchange)
n=11176 Participants
Patients in this group were not enrolled in Health Information Exchange.
|
Enrolled in HIE
n=2149 Participants
This group represents veterans were enrolled in Health Information Exchange via VLER
|
Controls Post Intervention
n=11176 Participants
Not enrolled in HIE post intervention
|
Enrolled Post Intervention
n=2149 Participants
Those participating in HIE post intervention
|
|---|---|---|---|---|
|
Health Care Quality: Care Sensitive Admissions
|
2083 ACS Hospitalizations per 100k patients
|
3229 ACS Hospitalizations per 100k patients
|
2194 ACS Hospitalizations per 100k patients
|
3350 ACS Hospitalizations per 100k patients
|
Adverse Events
Controls in Study (Not Enrolled in Health Care Exchange)
Patients Enrolled in HIE
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Dr. David A. Haggstrom
Center for Health Information and Communication, Roudebush VA Medical Center
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place