Electronic Health Record Sharing System (eHRSS) Encounter Notification Service Pilot Project

Efficacy of Providing an Automated Notification Service, the "Encounter Notification Service" Via the eHRSS for Home-based Care and Services Provided by Community Healthcare Providers for the Elderly: A 12-month Randomized Controlled Trial

This study evaluates the value of the automated notification service that allows more timely information access and sharing. A 12-month RCT will be conducted to determine the efficacy of the provision of the service to an elderly care and service provider in improving care and health outcomes of the elderly. Researchers will also examine whether the notification service will better support the carers for the coordination and prioritization of care and service delivery.

Study Overview

• Status: Unknown
• Conditions: Home-dwelling Elderly; Health Care Recipient
• Intervention / Treatment: Behavioral: Encounter notification service

Detailed Description

A research team at the University of Hong Kong is commissioned to conduct a study of the efficacy of providing an automated notification service, i.e., the "Encounter Notification Service," via the Electronic Health Record Sharing System (eHRSS) to an elderly caring and service provider that aims to facilitate more timely provision and coordination of healthcare services for home-dwelling elderly. With the access to the automated notification service containing up-to-date encounter information of the elderly in the eHRSS (e.g. discharge date from the public hospital, outpatient appointments), it is expected that the elderly caring and service provider can improve its allocation of resources and prioritize the provision of service to elderly patients who are in need, i.e., during the transition of care. As a result, the caring support and services provided by the elderly caring and service provider to the elderly can be more timely and effective, and an improvement in patient health outcomes can be expected.

To obtain evidence to determine the value of the automated notification service, a systematic study of the efficacy is suggested. Thus, researchers set out to conduct a 12-month randomized controlled trial (RCT) to examine whether the provision of the automated notification service to the caring and service provider will result in improvements in care and health outcomes of the elderly. Also, researchers will assess whether the notification service will better support the carers for the coordination and prioritization of care and service provision and improve workflow and administrative procedures amongst different sectors.

In this pilot study, the Senior Citizen Home Safety Association (SCHSA) is the participated elderly caring and service provider.

• Study Type: Interventional
• Enrollment (Anticipated): 864
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • Recruiting
    • Senior Citizen Home Safety Association
    • Contact: Cheryl Fung

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• are aged 18 years or older
• have registered in eHRSS as healthcare recipients and given consent for sharing their records in the eHRSS with the SCHSA
• are able to understand spoken Cantonese

Exclusion Criteria:

• with mental incapacity
• with hearing difficulties

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Encounter notification service; For participants randomized to the intervention group, their encounter information stored in the eHRSS will be provided to the SCHSA via the automated notification service. Healthcare professionals of the SCHSA would access the electronic health record and provide caring support and services via telephone calls during the 12-month study period.	Behavioral: Encounter notification service; The caring support and services provided by SCHSA will consist of multiple components, including standard call & care center support, medical appointment reminder, assistance to reschedule appointment, follow-up calls with either nurse or health workers to monitor health situation of service recipients, assessing needs of service recipient for elderly home care and/or rehabilitation services, providing elderly home care and/or rehabilitation services based on assessment, assessing needs of service recipient for emotional and community support, providing additional emotional support via either social calls by volunteers or counseling by social workers, and making referrals for community support services.
No Intervention: Usual care service; For participants randomized in the control group, no notification will be sent to the SCHSA. Usual care service will be provided during the 12-month study period. In addition, each control participant will receive placebo phone calls at least once every three months (e.g., the calls could be about greeting and general checking).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
changes in the number of Accident and Emergency (A&E) visits	from baseline to 6 and 12 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
changes in the number of non-attendance to outpatient appointments		from baseline to 6 and 12 months
changes in the number of unplanned hospitalizations		from baseline to 6 and 12 months
changes in the number of 30-day unplanned readmissions		from baseline to 6 and 12 months
changes in the stability of health condition	measured by a questionnaire with items on a 5-point Likert scale ranging from 1 (worse outcome) to 5 (better outcome)	from baseline to 6 and 12 months
changes in the understanding of the arrangement of outpatient appointments	measured by a questionnaire with items on a 5-point Likert scale ranging from 1 (worse outcome) to 5 (better outcome)	from baseline to 6 and 12 months
changes in the elderly's perceptions of the services	measured by a questionnaire with items on a 5-point Likert scale ranging from 1 (worse outcome) to 5 (better outcome)	from baseline to 6 and 12 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
changes in the carers' perceptions of the impacts of the notification service	A questionnaire survey will be conducted to assess carers' perceptions of the automated notification service on care coordination and prioritization, workflow, and administrative procedures.	from baseline to 6 and 12 months

Collaborators and Investigators

• Sponsor: The University of Hong Kong
• Collaborators: Hospital Authority, Hong Kong
• Investigators: Principal Investigator: Kalun Or, PhD, The University of Hong Kong

Publications and helpful links

General Publications

• Doig GS, Simpson F. Randomization and allocation concealment: a practical guide for researchers. J Crit Care. 2005 Jun;20(2):187-91; discussion 191-3. doi: 10.1016/j.jcrc.2005.04.005.
• Beck A, Scott J, Williams P, Robertson B, Jackson D, Gade G, Cowan P. A randomized trial of group outpatient visits for chronically ill older HMO members: the Cooperative Health Care Clinic. J Am Geriatr Soc. 1997 May;45(5):543-9. doi: 10.1111/j.1532-5415.1997.tb03085.x.
• Sommers LS, Marton KI, Barbaccia JC, Randolph J. Physician, nurse, and social worker collaboration in primary care for chronically ill seniors. Arch Intern Med. 2000 Jun 26;160(12):1825-33. doi: 10.1001/archinte.160.12.1825.
• Mizrahi T, Abramson JS. Collaboration between social workers and physicians: perspectives on a shared case. Soc Work Health Care. 2000;31(3):1-24. doi: 10.1300/J010v31n03_01.

Study record dates

Study Major Dates

• Study Start (Actual): June 20, 2020
• Primary Completion (Anticipated): December 14, 2020
• Study Completion (Anticipated): December 31, 2021

Study Registration Dates

• First Submitted: November 25, 2019
• First Submitted That Met QC Criteria: December 2, 2019
• First Posted (Actual): December 4, 2019

Study Record Updates

• Last Update Posted (Actual): November 6, 2020
• Last Update Submitted That Met QC Criteria: November 5, 2020
• Last Verified: November 1, 2020

More Information

Terms related to this study

• Keywords: randomized controlled trial; automated notification service; community healthcare providers
• Other Study ID Numbers: MYCARER 20191108

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No