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OpenTrials
Completed

NCT Number: NCT03784950

Application of Behavioral Economics to Improve eConsult

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.

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Key information

Conditions

Quality of Health Care

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Los Angeles County Department of Health Services

Los Angeles, California, 90012, United States

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • LACDHS providers who are eConsult system users

Exclusion criteria

  • None

Treatment and study plan

Rating tool

Behavioral

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)

Feedback

Behavioral

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)

Primary outcomes

  1. Rating - Medical Decision Making

    Time frame: Baseline to Post-Intervention, up to 12 months

    Peers' ratings of Medical Decision Making in Specialists' responses to PCPs

  2. Rating - Application of Expected Practices

    Time frame: Baseline to Post-Intervention, up to 12 months

    Peers' ratings of Expected Practices in Specialists' responses to PCPs

  3. Rating - Relationship Building

    Time frame: Baseline to Post-Intervention, up to 12 months

    Peers' ratings Relationship Building in Specialists' responses to PCPs

  4. Rating - Expert Elicitation

    Time frame: Baseline to Post-Intervention, up to 12 months

    Peers' ratings of Specialists' skill in elicitation of information from PCPs

  5. Rating - Educational Value

    Time frame: Baseline to Post-Intervention, up to 12 months

    Peers' ratings of Educational Value of eConsults

Sponsors and collaborators

Lead sponsor

University of Southern California

Other

Collaborators

  • Los Angeles County Department of Public Health

Registry information

Official study title

Application of Behavioral Economics to Improve the Quality and Value of eConsult Specialty Reviews

Important dates

Study start
2017
Primary completion
2018
Study completion
2018
First posted
Dec 24, 2018
Registry last updated
Dec 24, 2018

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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