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Decreasing utilization of the Emergency Department (ED) is a priority for the system. Often, ED visits can be avoided if patients contact Geisinger first to get appropriate direction for their concern or are otherwise better informed about reasons to visit the ED vs. urgent care or primary care facilities. The study team is working to reduce ED utilization by including additional information in adult outpatient After Visit Summaries (AVSs). The study will involve will involve A/B testing different AVS versions, including 1) a version that encourages patients to contact Geisinger via different contact methods, 2) a version that includes a map to the patient's closest ConvenientCare location and accompanying information about ConvenientCare, and 3) a version that includes a self-triage guide. A control group will receive the current standard AVS. Analysis results will be assessed to determine which version is most effective at reducing ED use.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard practice | No Intervention | Patients in this arm will receive the current standard practice AVS. | |
| Contact us first | Experimental | Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention. |
|
| Contact us first + urgent care map | Experimental | Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. |
|
| Contact us first + urgent care map + self-triage | Experimental | Patients in this arm will receive the standard AVS, plus information on how to contact Geisinger if they need medical attention, plus a map to their nearest Geisinger urgent care location and additional information about urgent care. This arm will also receive a self-triage chart, with common reasons patients go to the ED and situations where seeking alternative care might be appropriate. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Contact information | Behavioral | Information on how to contact Geisinger if the patient needs care |
|
| Measure | Description | Time Frame |
|---|---|---|
| Inappropriate ED visits | Visited the ED inappropriately (y/n) We will apply the NYU algorithm (Ballard et al., 2010) to determine whether an ED visit is inappropriate. | In the 30 days following the appointment |
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| Measure | Description | Time Frame |
|---|---|---|
| Urgent care visits | Visited urgent care (y/n) | In the 30 days following the appointment |
| Calls | Called Geisinger (y/n) | In the 30 days following the appointment |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Amir Goren, PhD | Geisinger Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Geisinger Clinic | Danville | Pennsylvania | 17822 | United States |
Data with no personally identifiable information will be made available to other researchers on the Open Science Framework for transparency. This will include the essential data and code needed to replicate the analysis that yielded reported findings.
By the paper's online publication date. Data will remain available for as long as the Open Science Framework hosts it.
The data on the Open Science Framework will be open to anyone requesting that information.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Feb 22, 2024 | Feb 22, 2024 | Prot_SAP_001.pdf |
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| ID | Term |
|---|---|
| D015438 | Health Behavior |
| ID | Term |
|---|---|
| D001519 | Behavior |
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| Urgent care map | Behavioral | A map of the patient's nearest Geisinger urgent care location, with information about urgent care |
|
| Self-triage chart | Behavioral | A chart demonstrating what to do in response to several common conditions where the patient might be compelled to visit the ED |
|
| Patient portal messages | Sent a patient portal message (y/n) | In the 30 days following the appointment |