Informing Low-acuity Emergency Department Patients of Non-emergent Resources

Informing Low-acuity Emergency Department Patients of Non-emergent Healthcare Resources Following Discharge to Decrease Emergency Department Utilization

The goal of this campaign is to reduce unnecessary visits to a Geisinger emergency department (ED)/encourage patients with high acuity visits to follow up with an appropriate Geisinger provider. In this campaign, patients will be assigned to receive or not receive outreach following ED discharge that is aligned with the goal. Outreach will occur via a text message, as well as information added to the patient's after visit summary, and will includecalls to action to see their Geisinger CMSL PCP either in person or virtually. The study will assess whether ED use differs across patients in different outreach conditions. It will also examine whether patients follow through on the message-specific calls to action in the messages differently across conditions.

Study Overview

• Status: Completed
• Conditions: Emergency Service, Hospital
• Intervention / Treatment: Behavioral: Information about healthcare resources

• Study Type: Interventional
• Enrollment (Actual): 6242
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Danville, Pennsylvania, United States, 17822
      • Geisinger Health System

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• >= 18 years of age
• Geisinger ED visit rated as low acuity (L4 or L5)
• Discharged from Geisinger ED in past 24 hours

Exclusion Criteria:

• Cannot be contacted via the communication modality being used in the study (i.e., SMS), due to insufficient/missing contact information in the EHR or because the patient opted out
• Admitted to hospital
• Already included in intervention in past 365 days

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control; This arm will receive no intervention outside of usual care.
Experimental: Other Healthcare Resources; This arm will receive text messages suggesting alternatives to seeking care at a Geisinger emergency department such as seeing their Geisinger CMSL primary care provider in person or virtually (telehealth). Text suggesting these alternatives may also be included in a modified discharge paperwork packet.	Behavioral: Information about healthcare resources; Text messages will be sent following discharge from the emergency department; text may also be modified in the (online and/or printed) discharge summary packet.; Other Names: Text messages; Information; Discharge summary text

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Return to Geisinger ED	ED visit (yes/no)	within 120 days following day of discharge

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
PCP visit	PCP appointment attended (yes/no)	within 60 days following day of discharge
Telehealth appointment attended	Telehealth appointment attended (yes/no)	within 60 days following day of discharge
Urgent care visit	Urgent care appointment attended (yes/no)	within 60 days following day of discharge
Call made to PCP	Record of patient call to PCP (yes/no)	within 60 days following day of discharge
PCP appointment made	PCP appointment made (yes/no)	within 60 days following day of discharge
Telehealth appointment made	Telehealth appointment made (yes/no)	within 60 days following day of discharge
Any of the suggested actions taken	PCP called or visited, telehealth appointment attended, or PCP or telehealth appointment made (yes/no)	within 60 days following day of discharge

Collaborators and Investigators

• Sponsor: Geisinger Clinic
• Investigators: Principal Investigator: Amir Goren, PhD, Geisinger Clinic

Study record dates

Study Major Dates

• Study Start (Actual): April 25, 2024
• Primary Completion (Actual): December 27, 2024
• Study Completion (Actual): December 27, 2024

Study Registration Dates

• First Submitted: April 1, 2024
• First Submitted That Met QC Criteria: April 1, 2024
• First Posted (Actual): April 5, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 8, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: 2024-0183

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