Impact of the CommunityRx Program on Health, Service Utilization and Costs

The CommunityRx system generates patient-centered e-prescriptions for community services (HealtheRx) via an interface between the electronic health records (EHR) and a comprehensive community resource database. Based on a patient's diagnoses, a HealtheRx will be printed automatically at the end of the ambulatory care visit and will provide patients with a customized map and/or list of places in their community that provide health and social services as well as contact information for a local community health worker who can provide limited case management support. The CommunityRx program aims to promote: 1) better healthcare, 2) better health, and 3) lower cost. The purpose of this research is to systematically evaluate the impact of CommunityRx on health outcomes as well as health care service utilization and total cost of care for Medicaid, Medicare and other beneficiaries. The investigators hypothesize that beneficiaries who participate in the CommunityRx intervention will experience better healthcare, better health and lower total cost of care.

Study Overview

• Status: Completed
• Conditions: Connecting Patients to Self-care Resources
• Intervention / Treatment: Behavioral: HealtheRx

• Study Type: Interventional
• Enrollment (Actual): 113295
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Illinois
    • Chicago, Illinois, United States, 60637
      • University of Chicago

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Intervention group eligibility: Patients receiving ambulatory care at a clinical site connected to CommunityRx who live in the CommunityRx geography. Control group eligibility: Patients receiving care at a clinical site connected to CommunityRx who live outside the CommunityRx geography.

Exclusion Criteria:

• Patients receiving care at a clinical site not connected to CommunityRx.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention group; This group of patients receives the HealtheRx.	Behavioral: HealtheRx; The HealtheRx is a prescription for community self-care resources. It includes a printed list of self-care resources provided to the patient at an ambulatory visit and tailored based on data from the electronic medical record.
No Intervention: Control group; This group of patients does not receive the HealtheRx

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in cost per beneficiary per year	Cost per beneficiary per year	Annual, up to 6 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in emergency department visit rate	Hospital emergency department visit rate, overall and for patients diagnosed with a) diabetes, b) hypertension, and c) asthma	Every 3 months, up to 72 months
Change in HbA1c control	Percentage of patients 18-75 years of age with diabetes (type 1 or type 2) who had hemoglobin A1c > 9.0 %.	Every 3 months, up to 72 months
Change in controlling high blood pressure	% of patients >=18 years old with hypertension diagnosis and a most recent BP measure <140/90mg	Every 3 months, up to 72 months
Change in body mass index	Percentage of patients overweight or obese (BMI >=25.0 and <30, BMI >=30)	Every 3 months, up to 72 months
Change in inpatient admission rate	Average number of in patient admissions per person	Every 3 months, up to 72 months
Change in participant satisfaction (percentage of participants reporting they are satisfied with the HealtheRx)	Program participant satisfaction survey, percentage of participants reporting they are satisfied with the HealtheRx	Every 3 months, up to 60 months
Change in provider satisfaction ( percent of providers reporting they are satisfied with the HealtheRx system)	Provider satisfaction survey, percent of providers reporting they are satisfied with the HealtheRx system	Every 6 months, up to 60 months
Change in rate of participant use of community-based service providers listed on HealtheRx	Program participant survey, percent of participants who report using at least 1 service listed on their HealtheRx	Every 3 months, up to 60 months
Change in HealtheRx reach (proportion of the population in the geography who receive at least 1 HealtheRx)	The proportion of the population in the geography who receive at least 1 HealtheRx	Every 3 months, up to 60 months
Change in HealtheRx delivery (providers communicate to patients about the HealtheRx)	providers communicate to patients about the HealtheRx	Every 3 months, up to 60 months
Change in HealtheRx usefulness (participant survey, the percent of program participants who report that their HealtheRx is useful)	Program participant survey, the percent of program participants who report that their HealtheRx is useful	Every 3 months, up to 60 months
Change in HealtheRx Understandability (participant survey, the percent of program participants who report that their HealtheRx is easy to understand)	Program participant survey, the percent of program participants who report that their HealtheRx is easy to understand	Every 3 months, up to 60 months
Change in information sharing (participant survey, the percent of program participants who report that they shared information about the HealtheRx with someone else)	Program participant survey, the percent of program participants who report that they shared information about the HealtheRx with someone else	Every 3 months, up to 60 months
Change in knowledge about resources (participant survey, the percent of program participants who report that they did not know about some of the places listed on their HealtheRx)	Program participant survey, the percent of program participants who report that they did not know about some of the places listed on their HealtheRx	Every 3 months, up to 60 months
Change in provider confidence in serving social needs (Provider satisfaction survey,)	Provider satisfaction survey, the proportion of providers reporting they are confident in their ability to serve their patients social needs	Every 6 months, up to 60 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in technical problems with the CommunityRx system (e.g., number of times system does not work properly)	The number of technical problems experienced with the CommunityRx system (e.g., number of times system does not work properly)	Every 3 months, up to 60 months
Change in % of eligible patients receiving a HealtheRx	CommunityRx database and electronic medical records, the proportion of eligible patients who receive a HealtheRx	Every 3 months, up to 60 months
Change in number of places mapped (community organizations, identified in the geographic region)	Number of places, or community organizations, identified in the geographic region	Every year, up to 6 years
Change in number of CommunityRx reports delivered (Number of CommunityRx reports created and given to community organizations)	Number of CommunityRx reports created and given to community organizations	Every 3 months, up to 60 months
Change in number of times a community health information specialist is contacted (CHIS call tracker)	CHIS call tracker, number of times a program participant contacted a CHIS	Every 3 months, up to 60 months
Change in referrals by service type (number of referrals, or number of times a service was listed on a HealtheRx)	CommunityRx database, number of referrals, or number of times a service was listed on a HealtheRx	Every 3 months, up to 60 months
Change in services identified (number of services identified as available at community organizations0	Service level survey, count of number of services identified as available at community organizations	Every 3 months, up to 60 months

Collaborators and Investigators

• Sponsor: University of Chicago
• Investigators: Principal Investigator: Stacy Lindau, MD, MAPP, University of Chicago

Publications and helpful links

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2013
• Primary Completion (Actual): December 1, 2016
• Study Completion (Actual): December 1, 2023

Study Registration Dates

• First Submitted: July 25, 2014
• First Submitted That Met QC Criteria: April 7, 2015
• First Posted (Estimated): April 8, 2015

Study Record Updates

• Last Update Posted (Actual): May 9, 2024
• Last Update Submitted That Met QC Criteria: May 7, 2024
• Last Verified: May 1, 2024

More Information

Terms related to this study

• Keywords: Health Information Technology (HIT); self-care
• Other Study ID Numbers: IRB13-0771