Predictive Modeling for Social Needs in Emergency Department Settings

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

RECRUITING

Clinical Phase

NA

Total Enrollment

48000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-03-10

Study Completion Date

2025-12-31

Brief Summary

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The overall objective of this study is to support emergency department management of patients' health-related social needs. This study will measure the impact of a decision support system that informs clinicians about which patients are likely to screen positive for a health-related social need. The system uses statistical models to create a health-related social need risk score for each patient. The main questions, the study aims to answer are:

* Does providing emergency department clinicians with risk scores on health-related social needs increase screening and referral activities?
* Does providing emergency department clinicians with risk scores on health-related social needs change patients' use of healthcare services?

The decision support system with health-related social needs risk scores will be introduced for all adult patients at one emergency department. Screening rates, referrals, and subsequent healthcare encounters will be compared with emergency departments that did not have access to the decision support system.

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Detailed Description

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Conditions

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Emergency Service, Hospital Social Determinants of Health

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

The intervention will be at the ED level using a pre-post design with a matched comparison group.

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Decision support intervention group

Adult ED patients seeking care the ED site with the health-related social needs decision support system live.

Group Type EXPERIMENTAL

Health-related social needs decision support system

Intervention Type OTHER

The clinical decision support intervention will present emergency department clinicians at an Indianapolis, IN ED with a likelihood score for an adult patient screening positive for the following health-related social needs (HRSNs): housing instability, food insecurity, transportation barriers, financial strain, and history of legal involvement. For each HRSN, the likelihood of screening positive is reported as "high", "medium", or "low". These categorizations are the product of logistic regression models. The clinical decision support intervention will be delivered through an existing FHIR (Fast Healthcare Interoperability Resources) standards-based clinical decision support platform.

Comparison group

Adult ED patients created using statistical matching from ED sites in the same metropolitan area.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Health-related social needs decision support system

The clinical decision support intervention will present emergency department clinicians at an Indianapolis, IN ED with a likelihood score for an adult patient screening positive for the following health-related social needs (HRSNs): housing instability, food insecurity, transportation barriers, financial strain, and history of legal involvement. For each HRSN, the likelihood of screening positive is reported as "high", "medium", or "low". These categorizations are the product of logistic regression models. The clinical decision support intervention will be delivered through an existing FHIR (Fast Healthcare Interoperability Resources) standards-based clinical decision support platform.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adults (\>18 years old)
* Seeking care at Indianapolis, Indiana area emergency departments (EDs).

Exclusion Criteria

* Children
* Encounters by patients that present with a critical illness/injury (e.g. severe trauma patients or those with Emergency Severity Index (ESI) classification level 1)
* Encounters by patients who have been transferred from another inpatient facility
* Patients that die during the ED encounter
* Encounters among patients who were ultimately admitted during their ED visits from our analysis

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes