Trial Outcomes & Findings for EFFECTIVENESS: Hopewell Hospitalist: A Video Game Intervention to Increase Advance Care Planning by Hospitalists (NCT NCT04881968)

NCT ID: NCT04881968

Last Updated: 2022-02-25

Results Overview

Change in physician advance care planning billing for patients over the age of 65 in the three months before and after the roll-out of the video game intervention at their hospital. Advance care planning billing is defined as the presence/absence of ACP charges (Medicare billing codes 99497 or 99498) during a physician's patient's hospitalization.

Recruitment status

TERMINATED

Study phase

NA

Target enrollment

1261 participants

Primary outcome timeframe

6 months (3 months pre and 3 months post intervention)

Results posted on

2022-02-25

Participant Flow

Individuals who received an invitation via an email from the Chief Experience Officer at Sound Physicians were considered enrolled. In this pre/post study design, each participant would be assigned to both the Control Arm, in which we would analyze ACP billing 90 days prior to the intervention, and the Video Game Intervention Arm, in which we would analyze ACP billing 90 days post intervention.

Participant milestones

Participant milestones
Measure
Entire Study Population
Each hospitalist in our study population 'crosses over' from control to intervention at a single time point by receiving a link to the Hopewell Hospitalist game via email and logging in to play the video game. Hopewell Hospitalist Video Game: Hopewell Hospitalist is a customized theory-based adventure video game that uses narrative engagement to educate physician players on advance care planning to increase physicians' likelihood of engaging in and billing for ACP conversations.
Overall Study
STARTED
1261
Overall Study
COMPLETED
1261
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

We did not collect information regarding age from study participants.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Entire Study Population
n=1261 Participants
Each hospitalist in our study population 'crosses over' from control to intervention at a single time point by receiving a link to the Hopewell Hospitalist game via email and logging in to play the video game. Hopewell Hospitalist Video Game: Hopewell Hospitalist is a customized theory-based adventure video game that uses narrative engagement to educate physician players on advance care planning to increase physicians' likelihood of engaging in and billing for ACP conversations.
Region of Enrollment
United States
1261 participants
n=1261 Participants

PRIMARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Primary Outcome: Incidence of Billed Advance Care Planning.

Change in physician advance care planning billing for patients over the age of 65 in the three months before and after the roll-out of the video game intervention at their hospital. Advance care planning billing is defined as the presence/absence of ACP charges (Medicare billing codes 99497 or 99498) during a physician's patient's hospitalization.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Primary Outcome: Merit-based Incentive Payment System Advance Care Planning Quality Score.

Change in the Merit-based Incentive Payment System (MIPS) self-report measure of advance care planning by enrolled hospitalists (MiPS-ACP quality score). The MiPS-ACP quality score is the percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record or documentation in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker or provide an advance care plan. The quality score ranges from 0-100%, with higher scores indicating that a greater proportion of patients with an advance care plan documented in the medical record.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Hospitalist-Managed Patient In-Hospital Mortality Rate.

In-hospital mortality rate for patients managed by enrolled hospitalists.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Hospitalist-Managed Patient 90-Day Mortality Rate.

90-day mortality rate for patients managed by enrolled hospitalists.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Sum of Resources Utilized by Hospitalist-Managed Patients.

Combined sum of resources utilized by patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention). It is a composite measure including: admission to ICU, receipt of life-sustaining treatment(s) including mechanical ventilation, placement of tracheostomy, insertion of gastric feeding tube, new onset dialysis. This measure ranges from 0 to 5, where higher scores indicate greater utilization of resources during the index hospitalization.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Incidence of Hospitalist-Managed Patient Admission to ICU.

Incidence of admission to ICU for patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Incidence of Hospitalist-Managed Patient Mechanical Ventilation.

Incidence of mechanical ventilation of patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Incidence of Hospitalist-Managed Patient Receipt of Life-Sustaining Treatment(s).

Incidence of placement of tracheostomy, insertion of gastric feeding tube, new onset dialysis for patients managed by enrolled hospitalists during their index hospitalization (first hospitalization in the relevant period: control or intervention).

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Hospitalist-Managed Patient Length of Stay

Total days between admission and discharge for patients managed by enrolled hospitalists.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Hospitalist-Managed Patient Disposition Status Type

Type of status upon discharge of patients managed by enrolled hospitalists (e.g., discharged to home, to skilled nursing, to hospice, deceased, etc.).

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: 6 months (3 months pre and 3 months post intervention)

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Hospitalist-Managed Patient 90-Day Episode-Based Spending

Amount of total Medicare payments between index admission and 90-days for patients managed by enrolled hospitalists.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 3 months

Population: We are reporting on all study participants in this section. No data was collected for the Secondary Outcome: Hopewell Hospitalist - Apple App Store and Google Analytics

Number of unique downloads for the HH game will be provided by the Apple App store. Using Google Analytics we will be able to discern time spent playing the game for each individual hospitalist using their unique log-in passphrase.

Outcome measures

Outcome data not reported

Adverse Events

Entire Study Population

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Amber Barnato

The Dartmouth Institute

Phone: 603-646-5237

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place