Nudging High Emergency Department Utilizers to Consider Non-emergent Healthcare Resources

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

1553 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-03

Study Completion Date

2025-10-31

Brief Summary

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The goal of this campaign is to reduce unnecessary ED visits by providing patients who are high ED utilizers (with a visit of any acuity) with alternative resources to manage their health outside of the ED. In this campaign, patients will be randomized to receive one of two types of outreach following discharge aligned with the goal. Outreach may occur via (1) a phone call from a Geisinger Community Health Worker (CHW) or Community Medical Assistant (CMA); current standard practice or (2) an interactive chatbot message providing similar information and questions to those provided by the CHW/CMA. The study team will measure whether ED use differs across patients in different outreach conditions. The study team will also examine whether patients followed through on the message-specific calls to action in the messages differently across conditions.

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Detailed Description

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Conditions

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Emergency Service, Hospital

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Patients will be aware of their own messages but will not be aware of other messages.

Study Groups

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Community Health Worker/Community Medical Assistant Outreach

Patients will receive outreach from a community health worker or a community medical assistant, as is current standard practice, including guidance about ED-alternative resources to encourage care outside of the ED when appropriate.

Group Type ACTIVE_COMPARATOR

Live outreach

Intervention Type BEHAVIORAL

High ED utilizers will be called (and possibly visited) by a CHW/CMA guiding them through ED-alternative resources.

SMS Chatbot Messages

Patients will be sent interactive SMS chatbot messages, including guidance about ED-alternative resources to encourage care outside of the ED when appropriate; patients will not receive outreach from a community health worker or community medical assistant.

Group Type EXPERIMENTAL

Automated interactive messages

Intervention Type BEHAVIORAL

High ED utilizers will be sent SMS text messages guiding them through ED-alternative resources, with different guidance (including a follow-up phone call from a healthcare worker) depending on patient responses.

Interventions

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Automated interactive messages

High ED utilizers will be sent SMS text messages guiding them through ED-alternative resources, with different guidance (including a follow-up phone call from a healthcare worker) depending on patient responses.

Intervention Type BEHAVIORAL

Live outreach

High ED utilizers will be called (and possibly visited) by a CHW/CMA guiding them through ED-alternative resources.

Intervention Type BEHAVIORAL

Other Intervention Names

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Text Call

Eligibility Criteria

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Inclusion Criteria

* Geisinger Health Plan insurance or KACO membership
* Any PCP or no PCP
* Visit of any acuity
* 4 or more ED visits in the past 6 months

Exclusion Criteria

* Institutionalized
* Cannot be contacted via the communication modality being used in the study (i.e., SMS), due to insufficient/missing contact information in the electronic health record or because the patient opted out
* Admitted to hospital
* Eloped from ED
* Left ED without being seen
* Deceased prior to messaging
* Qualifies for more intensive care management due to higher-level category of complexity

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No