Using Point-of-Care Video Prescriptions to Improve Aftercare Following Discharge From a Pediatric Emergency Department

Optimizing Emergency Aftercare With Mobile Video Prescriptions

The goal of this project is to develop the content and delivery platform that electronically distributes mobile video discharge education for underserved populations and to demonstrate utilization, satisfaction, and improved health outcomes.

Study Overview

• Status: Unknown
• Conditions: Compliance; Emergency Department Aftercare; Emergency Department Utilization
• Intervention / Treatment: Other: Video Prescription (additional education)

Detailed Description

Emergency department (ED) visits have increased by 25% over the past decade. 85% of these patients are discharged, and the standard of care is to provide each patient/caregiver with written instructions that highlight how to care for a particular illness at home and signs to return to the hospital. Compliance with such ED discharge instructions is limited, leading to suboptimal medical care and unnecessary return visits to the ED. Inadequate health literacy, language disparities, and poor comprehension of written discharge information contribute to this problem. This health gap is more prevalent in children of young parents, low-income families, and minority populations where a disproportionate number of patients visit the ED for non-emergent care, often because of a lack of health education. The ED environment is chaotic and distracting and suboptimal to educate patients. Such education is best accomplished where aftercare occurs-in the home, but many patients lack direction and motivation to seek reliable sources of focused health education.

healthEworks LLC has developed Video Prescriptions™ - concise 3-5 minute video modules specific to the most common discharge diagnoses that patients receive in the ED. Further work is needed to develop a professional, diagnosis-specific product. These videos will feature Dr. Christina Johns, an emergency physician who specializes in delivering health information on camera. Each video will be interactive, high definition, designed for small screen size, such as for a smartphone or laptop computer. Each video prescription™ will highlight the transition from hospital to home and focuses on what the diagnosis means, how to treat it at home, and which signs should prompt the patient to return to the ED or seek urgent care. A HIPAA-compliant tablet-based platform will link ED patients with their personalized video education, establishing an innovative system of post-discharge information sharing.

The use of video prescriptions™ will improve patient health education for the 100 million patients who are discharged from U.S. ED's annually. This technology is particularly applicable for hospitals that face increasing pressures to provide performance measures for hospital discharge.

Video prescriptions™ will be utilized by ED patients, regardless of socioeconomic status, will improve patient satisfaction and reduce unnecessary ED return visits.

• Specific Aim 1: Demonstrate patient utilization of video prescriptions Criteria for acceptance: a hyperlink click rate of greater than 70%
• Specific Aim 2: Demonstrate improved health outcomes. Criteria for acceptance: a reduction in return visits by 10%
• Specific Aim 3: Demonstrate quality of video content by showing improved patient satisfaction scores. Criteria for acceptance: improvement in patient satisfaction scores by 20%

• Study Type: Interventional
• Enrollment (Anticipated): 5000
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • District of Columbia
    • Washington, District of Columbia, United States, 20010
      • Recruiting
      • Children's National Medical Center (UMC and SZ campuses)
      • Contact: David J Mathison, MD MBA; Email: dmathiso@childrensnational.org
      • Principal Investigator: David J Mathison, MD MBA

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: No older than 18 years (Child, Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• fits one of diagnostic criteria
• not previously enrolled in past week

Exclusion Criteria:

• primary language other than english or spanish
• does not consent to receive email communication

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; current standard of care
Experimental: Intervention Group; receives video prescription	Other: Video Prescription (additional education); receives video prescriptions

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Video Prescription Utilization Rate	measured with hyperlink click rate and successful streaming verification	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ED Return Visit Rate	ED return visits within 72 hrs and one week. Will also be stratified into 'unnecessary' return visits by assessing resource use and billing data.	6 months

Collaborators and Investigators

• Sponsor: healthEworks LLC
• Collaborators: National Institutes of Health (NIH)

Study record dates

Study Major Dates

• Study Start: January 1, 2012
• Primary Completion (Anticipated): June 1, 2013
• Study Completion (Anticipated): December 1, 2013

Study Registration Dates

• First Submitted: February 22, 2012
• First Submitted That Met QC Criteria: March 2, 2012
• First Posted (Estimate): March 5, 2012

Study Record Updates

• Last Update Posted (Estimate): January 4, 2013
• Last Update Submitted That Met QC Criteria: January 2, 2013
• Last Verified: January 1, 2013

More Information

Terms related to this study

• Keywords: mobile health; underserved populations; video education; ED utilization; streaming media
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: R41MD006695-01 (U.S. NIH Grant/Contract)