Ignite Creation Date:
2025-12-24 @ 4:55 PM
Ignite Modification Date:
2025-12-24 @ 4:55 PM
Study NCT ID:
NCT03784950
Status:
COMPLETED
Last Update Posted:
2018-12-24
First Post:
2018-12-05
Is Possible Gene Therapy:
False
Has Adverse Events:
False
Brief Title:
Application of Behavioral Economics to Improve eConsult
Sponsor:
Organization:
Raw JSON
{'hasResults': False, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}}, 'protocolSection': {'designModule': {'phases': ['NA'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'NONE'}, 'primaryPurpose': 'HEALTH_SERVICES_RESEARCH', 'interventionModel': 'SEQUENTIAL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 220}}, 'statusModule': {'overallStatus': 'COMPLETED', 'startDateStruct': {'date': '2017-03-01', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2018-12', 'completionDateStruct': {'date': '2018-08-31', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2018-12-20', 'studyFirstSubmitDate': '2018-12-05', 'studyFirstSubmitQcDate': '2018-12-20', 'lastUpdatePostDateStruct': {'date': '2018-12-24', 'type': 'ACTUAL'}, 'studyFirstPostDateStruct': {'date': '2018-12-24', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2018-08-31', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Rating - Medical Decision Making', 'timeFrame': 'Baseline to Post-Intervention, up to 12 months', 'description': "Peers' ratings of Medical Decision Making in Specialists' responses to PCPs"}, {'measure': 'Rating - Application of Expected Practices', 'timeFrame': 'Baseline to Post-Intervention, up to 12 months', 'description': "Peers' ratings of Expected Practices in Specialists' responses to PCPs"}, {'measure': 'Rating - Relationship Building', 'timeFrame': 'Baseline to Post-Intervention, up to 12 months', 'description': "Peers' ratings Relationship Building in Specialists' responses to PCPs"}, {'measure': 'Rating - Expert Elicitation', 'timeFrame': 'Baseline to Post-Intervention, up to 12 months', 'description': "Peers' ratings of Specialists' skill in elicitation of information from PCPs"}, {'measure': 'Rating - Educational Value', 'timeFrame': 'Baseline to Post-Intervention, up to 12 months', 'description': "Peers' ratings of Educational Value of eConsults"}]}, 'oversightModule': {'oversightHasDmc': False, 'isFdaRegulatedDrug': False, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'conditions': ['Quality of Health Care']}, 'referencesModule': {'references': [{'pmid': '28264951', 'type': 'BACKGROUND', 'citation': 'Barnett ML, Yee HF Jr, Mehrotra A, Giboney P. Los Angeles Safety-Net Program eConsult System Was Rapidly Adopted And Decreased Wait Times To See Specialists. Health Aff (Millwood). 2017 Mar 1;36(3):492-499. doi: 10.1377/hlthaff.2016.1283.'}, {'pmid': '29801079', 'type': 'BACKGROUND', 'citation': "Lee MS, Ray KN, Mehrotra A, Giboney P, Yee HF Jr, Barnett ML. Primary Care Practitioners' Perceptions of Electronic Consult Systems: A Qualitative Analysis. JAMA Intern Med. 2018 Jun 1;178(6):782-789. doi: 10.1001/jamainternmed.2018.0738."}, {'pmid': '34505234', 'type': 'DERIVED', 'citation': 'Behavioral Economics and eConsult Steering Committee; Meeker D, Friedberg MW, Knight TK, Doctor JN, Zein D, Cayasso-McIntosh N, Goldstein NJ, Fox CR, Linder JA, Persell SD, Dea S, Giboney P, Yee HF. Effect of Peer Benchmarking on Specialist Electronic Consult Performance in a Los Angeles Safety-Net: a Cluster Randomized Trial. J Gen Intern Med. 2022 May;37(6):1400-1407. doi: 10.1007/s11606-021-07002-1. Epub 2021 Sep 9.'}]}, 'descriptionModule': {'briefSummary': 'Using behavioral economics, the study objective is to increase the efficiency, quality, and timeliness of care for Los Angeles County (LAC) Department of Health Services (DHS) patients by nudging specialists toward more effective use of eConsult, a web-based consultation and communication portal for Primary Care Providers (PCPs) and specialists, improving access for patients in greatest need of specialty care.', 'detailedDescription': 'Historically, the Los Angeles County (LAC) Department of Health Services (DHS) Safety Net system has faced challenges in delivering specialty services that are timely, geographically equitable, and coordinated in a patient centered manner. Recently, LACDHS improved infrastructure through implementation of eConsult, a web-based consultation and communication portal for Primary Care Providers (PCPs) and specialists, improving access for patients in greatest need of specialty care. The study investigators will conduct a pragmatic randomized trial with the goal of increasing the efficiency, quality, and timeliness of care for LACDHS patients by nudging specialists toward more effective use of eConsult. If successful, these nudges may reduce the number and increase the value of face-to-face consults.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* LACDHS providers who are eConsult system users\n\nExclusion Criteria:\n\n* None'}, 'identificationModule': {'nctId': 'NCT03784950', 'briefTitle': 'Application of Behavioral Economics to Improve eConsult', 'organization': {'class': 'OTHER', 'fullName': 'University of Southern California'}, 'officialTitle': 'Application of Behavioral Economics to Improve the Quality and Value of eConsult Specialty Reviews', 'orgStudyIdInfo': {'id': 'HS-17-00077'}}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Rating tool only', 'description': 'Rating eConsults from peer specialists in first phase', 'interventionNames': ['Behavioral: Rating tool']}, {'type': 'EXPERIMENTAL', 'label': 'Feedback only', 'description': 'Receiving feedback from peer specialists in first phase', 'interventionNames': ['Behavioral: Feedback']}, {'type': 'EXPERIMENTAL', 'label': 'Rating Tool plus Feedback', 'description': 'Both rating and feedback in second phase.', 'interventionNames': ['Behavioral: Rating tool', 'Behavioral: Feedback']}], 'interventions': [{'name': 'Rating tool', 'type': 'BEHAVIORAL', 'description': "eConsult Specialty Reviewers are asked to rate the quality of other specialists' recently completed eConsult exchanges on the following four dimensions: 1) efforts to elicit additional information from PCPs, when needed; 2) medical decision making; 3) inclusion of educational content for PCPs, when appropriate; 4) perceived effect on the PCP-specialist relationship (i.e., overall tone of the eConsult exchange)", 'armGroupLabels': ['Rating Tool plus Feedback', 'Rating tool only']}, {'name': 'Feedback', 'type': 'BEHAVIORAL', 'description': 'eConsult Specialty Reviewers receive confidential feedback via email on their performance (top performer vs not a top performer) as compared to colleagues in their specialty. Feedback is based on other reviewers ratings of their eConsult exchanges on the following four dimensions: 1) efforts to elicit additional information from PCPs, when needed; 2) medical decision making; 3) inclusion of educational content for PCPs, when appropriate; 4) perceived effect on the PCP-specialist relationship (i.e., overall tone of the eConsult exchange)', 'armGroupLabels': ['Feedback only', 'Rating Tool plus Feedback']}]}, 'contactsLocationsModule': {'locations': [{'zip': '90012', 'city': 'Los Angeles', 'state': 'California', 'country': 'United States', 'facility': 'Los Angeles County Department of Health Services', 'geoPoint': {'lat': 34.05223, 'lon': -118.24368}}], 'overallOfficials': [{'name': 'Daniella Meeker, PhD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'University of Southern California'}]}, 'ipdSharingStatementModule': {'ipdSharing': 'NO'}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'University of Southern California', 'class': 'OTHER'}, 'collaborators': [{'name': 'Los Angeles County Department of Public Health', 'class': 'OTHER_GOV'}], 'responsibleParty': {'type': 'PRINCIPAL_INVESTIGATOR', 'investigatorTitle': 'Assistant Professor', 'investigatorFullName': 'Daniella Meeker', 'investigatorAffiliation': 'University of Southern California'}}}}