Impact of Social Risk Decision Support

NCT ID: NCT03973346

Last Updated: 2021-02-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2019-06-01

Study Completion Date

2020-12-31

Brief Summary

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The purpose of this study is to determine the impact of embedding a risk-stratification tool, designed to identify patient needs for services that address social determinant of health related needs, in a commercial electronic health record system (EHR).

Detailed Description

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Social determinant of health related needs and social risk factors complicate care delivery and drive health and well-being. Social needs are common among undeserved patient populations, but health care providers are often not equipped to routinely identify and address patients in need.

Using a combination of health information exchange, electronic health record, and aggregate datasets the investigators developed predictive algorithms to identify patients a highest risk for a need for a referral to a social worker, dietitian, behavioral health, or other wraparound service provider. Risk scores are available to primary care providers in two ways within the electronic health record system (EHR): 1) a graphical summary of individual risk or 2) a line listing of all scheduled patients.

The investigators are introducing the risk-stratification tool in an urban safety-net primary care provider on a voluntary usage basis.

Conditions

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Health Social Determinant

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Multiple observation, pre-post with a secondary data source comparison group design, and a difference-in-difference modeling approach.
Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Intervention group

Encounters at primary care clinics with the risk screening tool

Group Type EXPERIMENTAL

Risk screening tool exposure

Intervention Type OTHER

Risk screening tool is available to providers

Comparison group

Propensity score matched comparison encounters

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Risk screening tool exposure

Risk screening tool is available to providers

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Encounters among patients seeking primary care service at any of the 9 Eskenazi Health FQHC clinics in Indianapolis, IN from January 2017 to May 2020.
* The propensity score matched primary care encounters from non-Eskenazi facilities.

Exclusion Criteria

* Emergency encounters or hospitalizations
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Robert Wood Johnson Foundation

OTHER

Sponsor Role collaborator

Indiana University

OTHER

Sponsor Role lead

Responsible Party

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Joshua R. Vest, PhD

Associate Professor & Center Director

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Joshua R Vest, PhD

Role: PRINCIPAL_INVESTIGATOR

Associte Professor

Locations

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Eskenazi Health

Indianapolis, Indiana, United States

Site Status

Countries

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United States

References

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Kasthurirathne SN, Vest JR, Menachemi N, Halverson PK, Grannis SJ. Assessing the capacity of social determinants of health data to augment predictive models identifying patients in need of wraparound social services. J Am Med Inform Assoc. 2018 Jan 1;25(1):47-53. doi: 10.1093/jamia/ocx130.

Reference Type BACKGROUND
PMID: 29177457 (View on PubMed)

Vest JR, Grannis SJ, Haut DP, Halverson PK, Menachemi N. Using structured and unstructured data to identify patients' need for services that address the social determinants of health. Int J Med Inform. 2017 Nov;107:101-106. doi: 10.1016/j.ijmedinf.2017.09.008. Epub 2017 Sep 20.

Reference Type BACKGROUND
PMID: 29029685 (View on PubMed)

Vest JR, Menachemi N, Grannis SJ, Ferrell JL, Kasthurirathne SN, Zhang Y, Tong Y, Halverson PK. Impact of Risk Stratification on Referrals and Uptake of Wraparound Services That Address Social Determinants: A Stepped Wedged Trial. Am J Prev Med. 2019 Apr;56(4):e125-e133. doi: 10.1016/j.amepre.2018.11.009. Epub 2019 Feb 14.

Reference Type BACKGROUND
PMID: 30772150 (View on PubMed)

Other Identifiers

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VEST-RWJF-PHASE2

Identifier Type: -

Identifier Source: org_study_id

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