Ignite Creation Date:
2024-05-05 @ 11:23 AM
Last Modification Date:
2024-10-26 @ 9:06 AM
Study NCT ID:
NCT00013117
Status:
COMPLETED
Last Update Posted:
2015-04-07
First Post:
2001-03-14
Brief Title:
Computer-Assisted Access to Specialist Expertise
Sponsor:
US Department of Veterans Affairs
Organization:
VA Office of Research and Development
Study Overview
Official Title:
Computer-Assisted Access to Specialist Expertise
Status:
COMPLETED
Status Verified Date:
2007-11
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The goal of this research was to determine if providing specialist input to primary care providers PCPs by means of informal consultation could improve the process and outcomes of care for diabetes Several studies support the role for specialists and their specific knowledge and expertise in a variety of disorders including diabetes A variety of methods have been designed to optimize the use of specialty expertise including practice guidelines and disease management approaches as well as the consultationreferral process The referral-consultation process is an important mechanism for obtaining clinically useful information At one end of the spectrum of this process informal consultation involves discussion about a patient with a colleague without the consultant seeing the patient at the other end of the spectrum care of the patient is transferred to another physician and the process is formalized Because much specialist expertise resides in the specialists themselves the expansion of primary care sites to include community-based outpatient clinics has implications for access to the specialists located elsewhere This study was designed to evaluate a computer-assisted voice mail system which is relatively inexpensive and more convenient than video-telemedicine systems making it more practical and more easily exportable Diabetes care delivery was chosen as the model in which to assess informal consultation based on its frequency among veterans management challenges and the emphasis on improvement in diabetes care in VA A secondary goal of the project was to better characterize the consultation process
Detailed Description:
Background
The goal of this research was to determine if providing specialist input to primary care providers PCPs by means of informal consultation could improve the process and outcomes of care for diabetes Several studies support the role for specialists and their specific knowledge and expertise in a variety of disorders including diabetes A variety of methods have been designed to optimize the use of specialty expertise including practice guidelines and disease management approaches as well as the consultationreferral process The referral-consultation process is an important mechanism for obtaining clinically useful information At one end of the spectrum of this process informal consultation involves discussion about a patient with a colleague without the consultant seeing the patient at the other end of the spectrum care of the patient is transferred to another physician and the process is formalized Because much specialist expertise resides in the specialists themselves the expansion of primary care sites to include community-based outpatient clinics has implications for access to the specialists located elsewhere This study was designed to evaluate a computer-assisted voice mail system which is relatively inexpensive and more convenient than video-telemedicine systems making it more practical and more easily exportable Diabetes care delivery was chosen as the model in which to assess informal consultation based on its frequency among veterans management challenges and the emphasis on improvement in diabetes care in VA A secondary goal of the project was to better characterize the consultation process
Objectives
Patients with diabetes mellitus are complex and may benefit from the input of multiple specialists and PCPs must determine the need for and coordinate the input from those multiple specialists With that in mind the three objectives of the study are 1 To assess the impact of computer-assisted access to specialist expertise CASE on process of care for patients with diabetes mellitus 2 To assess the impact of CASE on outcomes of care at the patient level clinical outcomes and satisfaction provider level satisfaction and the system level health services utilization and costs and 3 To characterize the consultation-referral process in community-based outpatient clinics CBOCs
Methods
Randomized controlled trial with access to the CASE system constituting the intervention and a descriptive study of the consultation process The major outcome variables will be the consultation type adherence to diabetes practice guidelines clinical outcome of diabetes care glycemic control patient and provider satisfaction
Status
Project work has been completed The final report has been submitted
The goal of this research was to determine if providing specialist input to primary care providers PCPs by means of informal consultation could improve the process and outcomes of care for diabetes Several studies support the role for specialists and their specific knowledge and expertise in a variety of disorders including diabetes A variety of methods have been designed to optimize the use of specialty expertise including practice guidelines and disease management approaches as well as the consultationreferral process The referral-consultation process is an important mechanism for obtaining clinically useful information At one end of the spectrum of this process informal consultation involves discussion about a patient with a colleague without the consultant seeing the patient at the other end of the spectrum care of the patient is transferred to another physician and the process is formalized Because much specialist expertise resides in the specialists themselves the expansion of primary care sites to include community-based outpatient clinics has implications for access to the specialists located elsewhere This study was designed to evaluate a computer-assisted voice mail system which is relatively inexpensive and more convenient than video-telemedicine systems making it more practical and more easily exportable Diabetes care delivery was chosen as the model in which to assess informal consultation based on its frequency among veterans management challenges and the emphasis on improvement in diabetes care in VA A secondary goal of the project was to better characterize the consultation process
Objectives
Patients with diabetes mellitus are complex and may benefit from the input of multiple specialists and PCPs must determine the need for and coordinate the input from those multiple specialists With that in mind the three objectives of the study are 1 To assess the impact of computer-assisted access to specialist expertise CASE on process of care for patients with diabetes mellitus 2 To assess the impact of CASE on outcomes of care at the patient level clinical outcomes and satisfaction provider level satisfaction and the system level health services utilization and costs and 3 To characterize the consultation-referral process in community-based outpatient clinics CBOCs
Methods
Randomized controlled trial with access to the CASE system constituting the intervention and a descriptive study of the consultation process The major outcome variables will be the consultation type adherence to diabetes practice guidelines clinical outcome of diabetes care glycemic control patient and provider satisfaction
Status
Project work has been completed The final report has been submitted
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None